Injury Prevention in Indian Country
Bridget Canniff
Project Director
Injury Prevention Program
Northwest Portland Area
Indian Health Board
Indian Leadership for Indian Health
What is Injury?
Damage or harm caused to the body by
an outside agent or force
Unintentional Injury (aka “Accidents”)
 unplanned/unexpected events (most falls,
motor vehicle crashes, drowning, burns,
etc.)
Intentional Injury
 self-inflicted violence (suicide/attempt)
 assault, domestic violence, homicide
Injuries are NOT accidents!
 They are NOT random,
unavoidable events
 They occur in
predictable patterns
 They are associated
with risk factors
 Most are preventable
What is Injury Prevention?
 Efforts to prevent or reduce the
severity of injuries before they
occur
 Programs which advance the health
of the population by preventing
injuries and improving quality of life
Key Unintentional Injury Topics
 Motor Vehicle Safety
 Seat Belts, Child Safety Seats, Impaired or Distracted
Driving Prevention
 Elder Falls Prevention
 Poisoning Prevention
 Home Safety & Fire Prevention
 Bike Safety & Helmet Use
 Water Safety & Drowning Prevention
 Firearms Safety
Buckle up those you love
and for those who love you
Motor Vehicle Safety
Seat Belts and Child Safety Seats
Motor Vehicle Safety
 What things can help improve safety
on the road?
 What can we do to prevent crashes
and reduce injury from crashes?
Motor Vehicle Safety
• Ensure vehicles are safe and in working
order
• Promote restraint use for all ages
• Discourage aggressive / distracted driving
• Enforcement of laws
• Provide community education
• Change societal attitudes
“We Don’t Buckle Up!”
WHY?
“We don’t get tickets on the Rez.”
“I am only going down the street.”
“I just don’t think about it.”
“He’ll stop crying if I hold him in my lap.”
“She thinks she’s too old.”
5 Ways Seat Belts and Child
Safety Seats Prevent Injury
1.
2.
3.
4.
5.
Help the body slow down
Contact the strongest
parts of the body
Spread forces over a wide
area of the body
Protects the brain, spinal
cord, & for kids, abdomen
Keep adults and children
in the vehicle
4 Steps for Kids
1. Rear-facing
2. Forward-facing
3. Booster seats
4. Adult seat belts
Step 1
Rear-Facing
Infant Seats
■
■
At minimum:
Keep infants
rear-facing
until 1 year and
20 lbs
Recommended:
until 2 years
Steps 1 & 2
Rear-Facing /
Forward-Facing
Convertibles
■
Reclined for rearfacing and upright
for forward-facing
Step 2
Forward-Facing
Child Seats
 Follow
recommendation
for specific seat
Step 3
Booster Seats
■ Booster seats are for
children from 40 to
High back
booster
80/100 pounds
■ Lap/shoulder belt
only
■ Head restraint
■ Use shoulder belt
positioners
Belt-positioning backless booster
Step 4
Seat Belts
■ Vehicle seat belts are made
for adults and older children
4’9” or taller
■ Most children reach this
height at 8 years old and 80+
pounds
■ All children under the age of
13 should still sit in the back
seat
Incorrect Restraint Use
•
Children using adult seat belt face
3.5 times greater risk for serious
injury
•
51-82% of infant car seats and 30% of
booster seats are used incorrectly
•
incorrect installation
•
incompatible with child’s height,
weight, or age
•
straps are too loose
Seat Belts & Child Safety Seats
• Does your tribe have current laws for
on reservation belt/safety seat use,
or follow state law?
• What do the laws mandate?
• What are your impressions of
community compliance with state or
tribal laws?
The Message for Native Communities
■ Wearing a seat belt and
keeping children in safety
seats is the easiest way to
prevent injury or death
■ It only takes a few seconds
– you never know when you
may be in a crash
■ Buckle up for every ride,
even short trips
Interventions
• Community Education
• Enact and enforcement of
restraint laws
• Educating Head Starts, daycares,
schools and health care
providers
• Encouraging Tribal leaders and
elders to spread the message
Interventions
• Car seat distribution programs and
checks
• Certified Child Passenger Safety
(CPS) technicians
• Working with car manufacturers and
car seat designers on compatibility
Motor Vehicle Safety Resources
• NPAIHB IP Program
Luella Azule, IP Coordinator & CPS Technician
lazule@npaihb.org 503-416-3263
• National Highway Traffic Safety Administration
www.nhtsa.gov
• Washington Safety Restraint Coalition
www.800bucklup.org
• Washington State Booster Seat Coalition
www.boosterseat.org
Elder Safety and Falls Prevention
Impact of Elder Falls
• In the Northwest, falls are
responsible for up to 25% of
unintentional injury deaths for
American Indians/Alaska Natives
aged 55 and over
Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based
Injury Statistics Query and Reporting System (WISQARS) [online]. (1999-2007) [cited Feb 18 2009]. Available from
URL: www.cdc.gov/ncipc/wisqars
Proven Interventions
•
•
•
•
•
Comprehensive check-ups
Medication management
Vision care
Make home safe
Regular exercise for
balance & strength
Elder Falls Resources
• NPAIHB IP Website
www.npaihb.org/epicenter/project/
injury_prevention_program
• Fall Prevention Center of Excellence (CA)
www.stopfalls.org
• CDC National Center for Injury Prevention and
Control
www.cdc.gov/homeandrecreationalsafety/falls
Poisoning Prevention
Poisoning Prevention
• Household chemicals
and poisons
• Lead
• Carbon monoxide
• Medications and
drugs
Interventions
• Keep cleaning products
and chemicals out of
children’s reach
• Test for lead paint
• Install carbon
monoxide detectors
• Lock up medications
Poisoning Resources
• Lock Your Meds
www.lockyourmeds.org
• Take Back Your Meds (WA)
www.takebackyourmeds.org
• CDC Healthy Homes – Poisoning Prevention
www.cdc.gov/healthyhomes/bytopic/
poisoning.html
Community Injury Prevention
Priorities & Partnerships
• What injury
prevention efforts
are priorities for
YOUR tribal
communities?
• Who is involved, or
could be involved?
• Needs? Interests?
Goals? Resources?
Public Health Approach
Define the
Problem
-Surveillance
Implement &
Evaluate Programs
-Prevention
Identify
Risk Factors
-Who, What?
Find what Prevents
the Problem
-What Works?
Adapted from National Center for Injury Prevention and Control, CDC
Assess the Need in Your
Community
• Who is being injured? Where? Circumstances?
• How? How many? How serious?
• What time period? Increasing or decreasing in
frequency?
• Which of these injuries is most significant in
terms of:
 personal impact
 economic costs
 social consequences
Assess the Need in Your
Community
• Local injury rates: higher/lower than national/state
rates? How does it compare to other health problems?
• Community issues (cultural, attitudes, beliefs,
behaviors) contributing to injuries?
• How to decreasing injuries? Proven/effective
strategies?
• Community strengths (cultural, attitudes, beliefs,
behaviors) to reduce injuries?
• What’s needed to evaluate an intervention?
Injury Prevention Resources
• NPAIHB Injury Prevention Program
www.npaihb.org/epicenter/project/
injury_prevention_program
• CDC National Center for Injury
Prevention and Control (NCIPC)
www.cdc.gov/injury
Injury Prevention Contacts
Luella Azule (Yakama Nation/Umatilla)
Injury Prevention Coordinator
503-416-3263
lazule@npaihb.org
Bridget Canniff
Project Director, Injury Prevention Program
503-416-3302
bcanniff@npaihb.org
Questions?
Thank you!