# Presentation: 193323

## IHS Injury Prevention Program

- OEHE Orientation Course
- January 29, 2002
- Tempe, AZ

## Slide 2

## Leading Causes of Death Age-adjusted Rates, AI/AN, 1994-1996

**Source: Trends in Indian Health-1998, DHHS, OPEL, Division of Program Statistics**

**Rates are per 100,000 service population**

## Unintentional Injury Death Rates, American Indians Alaska Natives, 1973-1995

- Rates adjusted for age and race miscoding of Indian race on death certificates. Rate per 100,000 population.  Trends in Indian Health 1998-1999.

## Fatal Injury Rates Per IHS Area1998

**WA**

**Portland**
**115.3**

**Billings**
**143.6**

**Aberdeen**
**159.5**

**Bemidji**
**96.2**

**OR**

**ID**

**MT**

**WY**

**ND**

**SD**

**NE**

**MN**

**IA**

**WI**

**MI**

**IN**

**ME**

**NY**

**PA**

**California**
**57.8**

**CA**

**NV**

**UT**

**AZ**

**AK**

**CO**

**NM**

**KS**

**OK**

**TX**

**LA**

**MS**

**AL**

**FL**

**SC**

**NC**

**TN**

**Tucson**
**194**

**Navajo**
**135.9**

**Albuquerque**
**114.1**

**Oklahoma City**
**51.2**

**Nashville**
**67.5**

**Phoenix**
**140.4**

**Alaska**
**132.1**

- Rates are per 100,000 service population

_**Source**_**: National Center for Health Statistics Vital Statistics System**

**US All Races Rate: 48.26**

## Leading Causes of Unintentional Injury Death Ages 1-44, AI/AN, 1998

_**Source**_**: National Center for Health Statistics Vital Statistics System**

**N = 1,943**

- MV Traffic
- 60.5%

- Poisoning 11.6%

- Drowning 6.3%

- Fire/Burn 3.4%

- Falls 3.1%

- Pedestrian 3.1%

**Notes:**
As you can see, of the causes of unintentional injury death, MVC’s account for over 60% of all unintentional injury deaths for AI/AN’s ages 1-44.

## Leading Causes of Injury Death 

- All ages AI/AN - 1998
- Aberdeen Area

| Cause | Rate | US Rate |
| --- | --- | --- |
| All MVC | 66.3 | 16.15 |
| Suicide | 31.1 | 11.31 |
| Drowning/Suffocation | 11.4 | 1.89 |
| Homicide | 9.3 | 6.62 |
| Falls | 9.3 | 4.66 |
| Fire/Burns | 7.3 | 1.41 |

- N=154

- Rates are per 100,000 service population

- 1998 User Population: 96,524

## Leading Causes of Injury Death 

- Leading Causes of Injury Death
- All ages AI/AN - 1998
- Alaska Area

| Cause | Rate | US Rate |
| --- | --- | --- |
| Suicide | 48.2 | 11.31 |
| Drowning/Suffocation | 19.2 | 1.89 |
| All MVC | 15.4 | 16.15 |
| Homicide | 13.5 | 6.62 |
| Poisoning | 10.6 | 6.8 |
| Unknown | 8.7 | 3.33 |

- N=137

- Rates are per 100,000 service population

- 1998 User Population: 103,688

**AK**

## IHS Injury Prevention Program Mission

- Decrease the incidence of severe injuries and death to the lowest level possible
- Increase the ability of tribes to prevent injuries within their communities.

## IHS Injury Prevention Program Role

- Provide technical assistance
- Evaluate injury prevention projects
- Fund local interventions
- Advocate for tribal injury prevention programs at federal, regional levels
- Provide data for action at community level

## Public Health Approach

- Describe the problem and contributing factors
- Make a change
- Evaluate the program

## Program Progression

- 1970s	Community Education
- 1985	Federal Infrastructure
- 1986-1987	Surveillance systems
- 1987-1989	Coalition building
- 1989-1990	Complete Injury Prevention
- 1990s	Strategic Plan & capacity building
- Present	Building Tribal Infrastructure

## IHS Injury Prevention Program Staff

- Injury Prevention Specialists
- Program Manager
- Area level
- District level
- Tribal
- District/Service Unit Environmental Health staff
- Other IHS/Tribal staff
- Health Educators
- Community Health Representatives
- Public Health Nurses
- EHSC

**Notes:**
1 Program Manager
12 Area Level Positions (9 individuals acting in some capacity as the Area Specialist, with only 6 full time specialists)
6 District level (4 Navajo, 2 Phoenix)
Tribal ?
District/SU EH staff:  

## IHS Injury Prevention Courses

- Area-specific
- Introduction to Injury Prevention
- Data Analysis and Interpretation
- Translating Information into Action
- Injury Prevention Specialist Fellowship
- Injury Prevention Specialist Colloquium
- Topic specific courses

## Injury Prevention Specialist Fellowship Program

- Year long program
- Field course, academics, special study
- Bachelor degree required
- Environmental health specialists, physicians, nurses, social workers, health educators, injury prevention coordinators

## Building Tribal Injury Prevention Capacity: Resources

- 2000 – 2005
- 25 tribal injury prevention programs
- $50,000/year for 5 years
- Build or enhance local injury prevention capacity

## Building Tribal Injury Prevention Capacity: Core Program

- Full-time staff
- Community involvement
- Mission and plan to address injuries
- Basic injury surveillance
- Collaborative partnerships
- Culturally relevant interventions

## Sleep Safe InitiativeIn collaboration with US Fire, Head Start

- Reduce rate of fire, burn injuries in AI/AN children 0 – 5 years of age
- Distribute smoke detectors, provide training curriculum, promote legislation
- Harold Cully, Diana Kuklinski, Chris Allen program coordinators
- 24 + sites

## Tribal Steering Committee

| AB – Peggy Cavanaugh | NS - vacant  |
| --- | --- |
| AK – Helen Andon | NV – Lawrence Garnanez |
| ABQ – Maria Benton | OK – vacant |
| BE – vacant | PH – vacant |
| BI – Elaine Boyd | PO – vacant |
| CA – Norma McAdams | TU – Feliciano Cruz |

## What’s being done in my Area?

## Injury Prevention Coalitions

- AB - UTTC, TISA, Three Affiliated Tribes, Spirit Lake
- AK - KANA, SEARHC
- AQ - Jemez
- BE - Fond du Lac, NNAHA
- BI - Chippewa Creek/Rocky Boy
- CA - CRIHB, Hoopa Valley

- NS -* **Eastern Band of Cherokee, St. Regis Mohawk*
- NV - Navajo Highway Safety, Hardrock Council
- OK - Chickasaw, Caddo, Comanche, Kaw, Ponca
- PH - CRIT, FMCV, Reno-Sparks
- TU - Pascua Yaqui

## Injury Surveillance

- AB – Spirit Lake, Trenton Indian Service Area
- AK – Tanana Chiefs Conference
- BE – Fond du Lac, NNAHA, Sault Ste. Marie, White Earth, Menominee, Intertribal Council of Michigan-Pokagon
- BI - Flathead
- CA – Hoopa Valley, Big Sandy, Pinoleville
- OK – Muscogee (Creek), Cheyenne & Arapho, Osage, Chickasaw, Ponca
- PH – Hopi, White Mountain Apache, Ute,Intertribal Council of Nevada, Colorado River Indian Tribes, First Mesa Consolidated Villages
- PO – Quinault, Coeur d’ Alene

*Sleep Safe & Infrastructure Grantees*

## Fire Safety

- AK - Tanana Chiefs Conference
- AQ - Laguna, Isleta
- BE – Sault Ste. Marie, Fond du Lac, White Earth, Menominee, Intertribal Council of Michigan-Pokagon, Hannahville, St. Croix, Bois Forte
- BI – Flathead
- CA – Big Sandy Pinoleville
- NS – St. Regis Mohawk
- OK – Muscogee (Creek), Cheyenne & Arapaho, Osage, Caddo, Comanche, Ponca
- PH – Hopi, White Mountain Apache, Ute, Intertribal Council of Nevada, First Mesa Consolidated Villages
- PO – Quinault, Coeur d’ Alene

*Sleep Safe & Infrastructure Grantees*

## Injury Prevention Training Courses, Conferences

- AB - United Tribes Technical College
- AK - Kodiak Alaska Native Association
- BE - Fond du Lac, Northern Native American Health Alliance
- OK – Caddo, Comanche
- PH - Colorado River Indian Tribes, First Mesa Consolidated Villages

## Occupant Protection

- AB - Spirit Lake, Trenton Indian Service Area
- BI - Rocky Boy/Chippewa Cree
- NV - Navajo Highway Safety
- OK – Caddo, Comanche, Chickasaw, Kaw
- PH - First Mesa Consolidated Villages, Reno-Sparks