1. N orthwest P ortland A rea I ndian H ealth B oard Indian Leadership for Indian Health Injury Prevention in Indian Country Bridget Canniff Project Director Injury Prevention Program

2. 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

3. Injuries are NOT accidents !  They are NOT random, unavoidable events  They occur in predictable patterns  They are associated with risk factors  Most are preventable

4. 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

5. 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

6. Motor Vehicle Safety Seat Belts and Child Safety Seats Buckle up those you love and for those who love you

8. Motor Vehicle Safety  What things can help improve safety on the road?  What can we do to prevent crashes and reduce injury from crashes?

9. 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

10. “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.”

11. 5 Ways Seat Belts and Child Safety Seats Prevent Injury 1. Help the body slow down 2. Contact the strongest parts of the body 3. Spread forces over a wide area of the body 4. Protects the brain, spinal cord, & for kids, abdomen 5. Keep adults and children in the vehicle

12. 4 Steps for Kids 1.Rear-facing 2.Forward-facing 3.Booster seats 4.Adult seat belts

13. Step 1 ■ At minimum: Keep infants rear-facing until 1 year and 20 lbs ■ Recommended: until 2 years Rear-Facing Infant Seats

14. Steps 1 & 2 ■ Reclined for rear- facing and upright for forward-facing Rear-Facing / Forward-Facing Convertibles

15. Step 2 Forward-Facing Child Seats  Follow recommendation for specific seat

16. Step 3 ■ Booster seats are for children from 40 to 80/100 pounds ■ Lap/shoulder belt only ■ Head restraint ■ Use shoulder belt positioners High back booster Belt-positioning backless booster Booster Seats

17. Step 4 ■ 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 Seat Belts

18. 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

19. 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?

20. 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

21. 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

22. Interventions Car seat distribution programs and checks Certified Child Passenger Safety (CPS) technicians Working with car manufacturers and car seat designers on compatibility

23. 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 Motor Vehicle Safety Resources

24. Elder Safety and Falls Prevention

25. 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

26. Comprehensive check-ups Medication management Vision care Make home safe Regular exercise for balance & strength Proven Interventions

27. 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

28. Poisoning Prevention

29. Household chemicals and poisons Lead Carbon monoxide Medications and drugs Poisoning Prevention

30. Interventions Keep cleaning products and chemicals out of children’s reach Test for lead paint Install carbon monoxide detectors Lock up medications

31. 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

32. Community Injury Prevention

33. What injury prevention efforts are priorities for YOUR tribal communities? Who is involved, or could be involved? Needs? Interests? Goals? Resources? Priorities & Partnerships

34. Adapted from National Center for Injury Prevention and Control, CDC Define the Problem -Surveillance Identify Risk Factors -Who, What? Find what Prevents the Problem -What Works? Implement & Evaluate Programs -Prevention Public Health Approach

35. 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 

36. 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?

37. 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

38. 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

39. Questions? Thank you!