Preventing unintentional injuries in Indigenous children and youth in Canada

Question 1

What percentage of all deaths among First Nations people are due to injuries versus in the Canadian population as a whole?

Answer 1

26% versus 6%

Question 2

What are the most common causes of death due to injury in children <10yo?

Answer 2

1. Fires

2. MVC

Question 3

What are the most common causes of death due to injury in children 10-19yo?

Answer 3

1. MVCs

2. Drownings

Question 4

Why is there a discrepancy

Answer 4

1. Lower income
2. Less education
3. Higher unemployment
4. Younger families
5. More likely to live in a rural area
6. More likely to live in unsafe, substandard housing
7. More likely to encounter local shortages in health care personnel and resources
8. Historical inequities
9. Cultural alienation
10. Loss of connectedness with the environment
11. Residential schools
12. Depression
13. Alcohol and substance abuse
14. Increased risk taking behavior
15. Inadequate parenting skills for some

Question 5

What are the six “E”s of injury prevention?

Answer 5

1. Education
2. Empowerment
3. Enabling
4. Engineering
5. Enforcement
6. Employment

Question 6

What are strategies for six Es of injury prevention for MVC?

Answer 6

1. Education:
   a) avoid alcohol and intoxicants
   b) appropriate child restraints and seatbelts
2. Empowerment
   Community plan for safety education and promotion for alcohol reduction, child restraints
3. Enabling
   a) affordable and accessible child restraints
   b) car pooling
   c) designated drivers
4. Engineering:
   a) improved road and lighting conditions
   b) separation of pedestrian and motor vehicles
   c) restraining livestock
5. Enforcement:
   a) speed limits
   b) child restraints
   c) alcohol and drug usage
6. Employment:
   a) local enforcement and education
   b) first response team

Question 7

What are strategies for six Es of injury prevention for ATVs?

Answer 7

1. Education:
   a) helmet use
   b) avoid alcohol and intoxicants
2. Empowerment:
   Community involvement with policies such as helmet use promotion, advocacy for age restriction
3. Enabling
   Accessible and affordable helmets
4. Engineering
   a) Stability improvements to vehicles
   b) limit speed capabilities
5. Enforcement
   a) age restrictions
   b) mandatory helmet use
6. Employment
   a) local educators

Question 8

What are strategies for six Es of injury prevention for fires?

Answer 8

1. Education
   a) never leave children or fires unattended
   b) do not obstruct exits
   c) avoid alcohol and intoxicants around fires
2. Empowerment
   Community involvement in developing, communicating fire plans
3. Enabling:
   a) subsidizing smoke detectors
   b) adequate fire fighting equipment
   c) safe disposal of cigarettes
4. Engineering:
   a) fire plans in place for home and community
   b) improved housing standards
5. Enforcement:
   a) mandatory smoke detectors
   b) removal of fire hazards in the community
6. Employment
   a) train local fire fighters
   b) fire hazard educators
   c) inspectors and maintenance of smoke detectors

Question 9

What are strategies for six Es of injury prevention for drowning?

Answer 9

1. Education
   a) swimming lessons
   b) first aid/CPR training
   c) use of life jackets
   d) active supervision
   e) avoid intoxicants
2. Empowerment
   Community plan for water safety
3. Enabling:
   a) subsidized life jacket purchasing
   b) subsidized or free swimming lessons
   c) lifeguards
4. Engineering:
   a) flotation devices built into winter jackets
5. Enforcement:
   a) alcohol limits on boats
   b) speed limits
   c) supervised swimming areas
6. Employment
   a) swimming instructors
   b) first aid/CPR educators
   c) local lifeguards
   d) signage for unsafe ice and water conditions

Question 10

What are strategies for six Es of injury prevention for falls?

Answer 10

1. Education
   a) supervision of children, esp. around water
   b) barriers around construction or other dangerous sites
   c) first aid/CPR and emergency response
2. Empowerment
   a) community to identify dangerous sites
   b) development of strategies and resources to address danger zones
3. Enabling:
   affordable construction materials and tools for building safer communities
4. Engineering:
   a) reduction of substandard housing
   b) building safer houses
5. Enforcement:
   a) barriers around construction sites
   b) minimum housing standards
6. Employment
   a) First aid and emergency response team
   b) construction of better houses
   c) building inspectors

Question 11

What are strategies for six Es of injury prevention for poisoinings?

Answer 11

1. Education
   a) identification and labeling of toxic and hazardous substances
   b) hazardous substances stored locked and out of reach and sight of children
2. Empowerment
   community input on hazardous materials
3. Enabling
   a) access to child-proof storage
   b) child-proof locks
   d) accessible hazard disposal sites
4. Engineering:
   a) child proof containers
   b) proper disposal sites
5. Enforcement:
   a) proper labeling
   b) child proof containers
   c) proper disposal of toxins
6. Employment
   a) hazards educators

Question 12

What are the CPS recommendations?

Answer 12

1. To focus surveillance: Better data collection and research, using community-based, participatory approaches, are critical to defining the extent and nature of injuries in this population. Data collection should focus on location, age, ethnicity and mechanism of injury. Including Indigenous identifiers in the Canadian Paediatric Surveillance Program for injury studies would help narrow the focus.
2. To improve education: Conferences, public debates, and meetings of coalitions, specialists, community members and leaders are all forums for sharing surveillance data, successful programs and knowledge translation.
3. To strengthen advocacy: The federal government needs to work with provincial/territorial governments and nongovernmental organizations to develop a national injury-prevention (IP) strategy. Indigenous communities need to develop local programs to reduce specific injuries, and to reinforce and evaluate them regularly. ATV and snowmobile safety legislation have special relevance for Indigenous communities, and are being tracked in the Canadian Paediatric Society’s status report, Are We Doing Enough?
4. To reduce barriers: Improving the social determinants of health, such as poverty and substandard housing, enhancing parental support, and increasing access to alcohol and drug rehabilitation programs, will help communities to be more responsive to IP strategies.
5. To evaluate initiatives: The impact of IP programs must be measured, both for success and to identify areas needing improvement.
6. To provide resources: Better funding for IP surveillance, research, building capacity, consultation, disseminating knowledge, monitoring and evaluating IP programs is required.