U.S Healthcare final- Intentional and Unintentional Injuries

Question 1

Why Injuries are a Focus of Public Health

where does it rank amongst the leading causes of death?

who does it mostly affect?

from people ages 1 to 44, where does it rank among the leading causes of death?

what is YPLL and how do injuries affect it

Answer 1

Injuries are the 5th leading cause of death in the United States

Injuries disproportionately affect young people

Injuries are the number one cause of death in people ages 1 to 44

Injuries cause many years of potential life lost (YPLL)

Question 2

Why Injuries are a Focus of Public Health

what do injuries cause and how do they affect the healthcare system

what are injuries caused by

Answer 2

Injuries are a major cause of disability, resulting in huge costs to the healthcare system

Injuries are preventable
- Caused by behaviors
- Influenced by physical and social environments

Question 3

Epidemiology of Injuries

what does it look at to determine what

what are the two types of fatal injuries

Answer 3

Looks at patterns that suggest where the greatest need for prevention and intervention exist

Fatal injuries
- Unintentional or accidental
- Intentional (homicide or suicide)

Question 4

Socioeconomic Status and Injury Rates

are injuries higher or lower for lower SES

do low-income areas have a higher or lower unintentional injury rate

Answer 4

Rates higher in lower SES

The death rate from unintentional injury twice as high in low-income areas

House fires, pedestrian fatalities, and homicides more common in lower SES

The poor tend to have higher-risk jobs, lower-quality housing, older defective cars, hazardous products like space heaters

Question 5

Race and Gender Affect Injury Rates

which gender is most likely to sustain injury: males are 2x as likely as females

do whites or African Americans have a higher rate of injury mortality, why

Answer 5

Males are more likely to sustain injuries than females, fatality rate 2.1 times higher for all age groups

African Americans have higher rates of injury mortality than whites. Why?
- High rates of homicide among young black males, eight times the rate for white youths

Question 6

Leading Categories of Injury Deaths in the United States

Answer 6

Poisoning - opioid overdose
Motor Vehicle
Firearms
Falls
Suffocation
Drowning
Fire/burns
Cut/Pierce

do not have to know the order/list
understand what is on the list

Question 7

What are the Trends for the Top 3 Categories

are MVA increasing> But what is still the case?

has the rate for Injury deaths from firearms increased or decreased

has the rate for injury deaths from poisoning increased or decreased

Answer 7

From 1980 to present

Motor vehicle accidents have decreased but remain the second leading cause of injury death

Injury deaths from firearms has decreased from number two to number three and remains the third leading cause

Injury deaths from poisoning has increased from third to being the number one cause

Question 8

Injury Pyramid

do all injuries result in death and what kind of injury is most likely reliably reported

what can non-fatal injuries result in

Answer 8

All injuries do not result in death but fatal injuries are most reliably reported

Data on non-fatal injuries is less complete though
- Non-fatal injuries can have serious and devastating effects
- Non-fatal injuries result in long-term disability

the data is often incomplete

Question 9

Alcohol and Injuries

what is a significant factor or injury?

what % of traffic accidents involved alcohol

where does alcohol rank in the leading cause of death

Answer 9

Alcohol is a significant factor in many injuries

31% of traffic fatalities in 2018 involved alcohol

We learned that alcohol is the third actual cause of death

Question 10

Analyzing Injuries

injuries are an interaction between what 3 things

what is a host

what is an agent

what is an environment

Answer 10

Chain of causation (host, agent and environment)
- Injuries are an interaction over time between a host, an agent, and the environment

Host = person who suffers the injury
Agent = car, firearms, swimming pool, power tools
Environment = road conditions, weather, involvement of other people

Question 11

Analyzing Injuries

Three levels of prevention

what is primary prevention?

what is secondary prevention?

what is tertiary prevention, what does it determine

Answer 11

Three levels of prevention
Primary = prevents injury-causing events from occurring (host, agent, environment)

Secondary or during = affects the outcome of the event

Tertiary or after = depends on conditions after the event or injury, determines whether the injured survives and the extent of resulting disability, treatment

on exam

Question 12

Analyzing Injuries

what are the 3 E’s

there is the law about chains around fences, what is the type of prevention and which injury control is it

Answer 12

The 3 E’s of Modern Injury Control:

Education:

Enforcement - laws
Examples
Fires - Smoke detectors
Flammable fabrics - Laws on children’s sleepwear
Drowning – fences around pools
Poisoning – childproof caps
law!

Engineering
Examples
Changes to automobiles to improve safety
Changes to motorcycle helmets to decrease the impact of head injuries

there is a law about chains around fences: primary prevention. enforcement

Question 13

PH Approach to Injury Prevention and Control

Problem: A large number of children die from drowning in swimming pools

Prevention intervention: A law was passed requiring fences around all pools

In the chain of causation – which link?-
In the 3 levels of prevention – which level?-
Modern injury control – which E?-

Answer 13

In the chain of causation – which link?- agent
In the 3 levels of prevention – which level?- primary
Modern injury control – which E?- enforcement

GOOD JOOOOBBBBBB THANK YOU JESUS I WILL ACE ALL OF MY FINALS IN THE NAME OF JESUS AMEN

Question 14

Motor Vehicle Accidents

where does it rank in causes of death

Answer 14

The number two cause of injury deaths
The leading cause of death for people ages 1 to 34

Question 15

National Highway Traffic Safety Administration (NHTSA)

what is it under

what does it carry out

what is it responsible for

Answer 15

Under the U.S. Dept of Transportation

Established by the Highway Safety Act of 1970

Carries out safety programs

Responsible for reducing deaths, injuries and economic loss resulting from MVA

Question 16

National Highway Traffic Safety Administration (NHTSA)

what does it set and enforce

what does it provide to the state and local government?

what does it conduct research on

Answer 16

Sets and enforces safety performance standards for motor vehicles

Provides grants to state and local government for conducting local highway safety programs
- Reducing drunk driving
- Promotion of seat belts
- Promotion of child safety seats
- Investigate odometer fraud

Conducts research on driver behavior and traffic safety

Question 17

Contributing Factors in Fatal and Non-Fatal Car Crashes

why can’t youth drink alcohol (besides brain anatomy reason)

Answer 17

Alcohol
- Prevention: What is in place?

Youth:
Inexperience
Risky behaviors
Poor judgment
Prevention: What is in place?

Question 18

Contributing Factors in Fatal and Non-Fatal Car Crashes

Prevention: What is in place?-

Non-use of seat belts and child safety seats
Prevention: What is in place?-

Distractions (cell phones, hand-held devices)
Prevention: What is in place?

Answer 18

Speed
Prevention: What is in place?- speed limits

Non-use of seat belts and child safety seats
Prevention: What is in place?- regulations that require that we use this

Distractions (cell phones, hand-held devices)
Prevention: What is in place?- laws

Question 19

Motor Vehicle AccidentsPrevention and Control

which link does each address

Primary: requiring people with impaired sites to wear glasses (___), yearly break inspections (____), Sanding and salting slippery roads (_____), the vehicle has safety features to prevent fire (_____),

Secondary: requiring people to wear seat belts (_____), airbags (______), ambulance services available in all towns (______)

Tertiary: injured are truthful about drug and alcohol consumption (_____), properly trained emergency response (______)

Answer 19

Prevention
Primary: requiring people with impaired sight to wear glasses (Host), yearly break inspections (Agent), Sanding and salting slippery roads (Environment), vehicle has safety features to prevent fire (Agent),

Secondary: requiring people to wear seat belts (Host), airbags (Agent), ambulance services available in all towns (Environment)

Tertiary: injured are truthful about drug and alcohol consumption (Host), properly trained emergency response (Environment)

Question 20

Pedestrian Injury: Who is at the Most Risk?

older adults

children

who is alcohol-impaired

what kind of areas

Answer 20

Older adults: Pedestrians ages 65 and older accounted for 19% of all pedestrian deaths and an estimated 10% of all pedestrians injured in 2008.

Children: In 2018, one in every five children between the ages of 5 and 9 who were killed in traffic crashes was a pedestrian.

Drivers and pedestrians who are alcohol-impaired

Urban areas

Question 21

Pedestrian Injury: a Public Health Intervention
example

In Queens Boulevard in NY:

Answer 21

In Queens Boulevard in NY:

Walk/don’t walk signs: Added more signs, including in median strips, increased visibility

Allowed more time for crossing

Strict enforcement of speed limits

Fences and barriers in the median strip to prevent jaywalking

Restrict vehicles from making u-turns and left turns

Posted pedestrian signage about the danger

Question 22

Bicyclists and Motorcyclists deaths

is this rate increasing or decreasing

what aged children are victims too

what kind of injuries account for this kind of death

what are the preventions that could be put into place

Answer 22

Every year an increasing number of motorcyclists and bicyclists are killed in crashed

Children under 16 account for 11% of bicycle-related fatalities

Head injuries account for more than 60% of bicycle-related deaths and are the leading cause of death in motorcycle accidents

Prevention:
Helmets
Education
Regulation

Question 23

Poisoning

where does this rank in the causes of death

what does it surpass

is there an increase in unintentional poisoning

Answer 23

The leading cause of injury death

Surpassed firearms in 2004
- Every day, 87 people die as a result of unintentional poisoning; another 2,277 are treated in emergency departments.

• Unintentional poisoning deaths in the United States increased by 160% from 1999 to 2009.

Question 24

Poisoning

what is a poison?

what are the two types and are examples of each

Answer 24

Poison: any substance, including medications, that is harmful to your body if too much is ingested, inhaled, injected, or absorbed through the skin. Any substance can be a poison if too much is taken.

Intentional poisoning = suicide, homicide

Unintentional poisoning (a majority) = no harm intended
- Overdoses of medications (often recreational drugs)
- Ingestion of household products

Question 25

Poisoning

Answer 25

In 2009 drug poisoning became the leading cause of injury death in the United States

Question 26

Groups at Risk for Poisoning

which gender is likely to die from this

which demographic has the highest death rate

which age group had the highest mortality rate

which age group had the lowest mortality rate

Answer 26

Among those who die from unintentional poisoning, Men were nearly twice as likely as women to die;

American Indians/Alaska Natives had the highest death rate, followed by Whites and then Blacks

The highest mortality rates were among people 45-49 years of age

The lowest mortality rates were among children less than 15 years old because they do not abuse drugs as frequently as older people.

Question 27

Poisoning

what are the most common types of poison

is drug overdose on the rise or decline?

in which age groups does unintentional poisoning causes more deaths than MVA

Answer 27

Most common poisons:
Opioid pain relievers
Cocaine
Heroine

Drug overdose death rates continue to rise dramatically in the United States.

Among people 35 to 54 years old, unintentional poisoning causes more deaths than MVA

As pharmacists, what do you think of these trends?

Question 28

Poisoning

what are the preventions in place

Answer 28

Prevention:
Child safety caps
Education
Regulation

Is enough being done to prevent poisoning with these 3 most common agents?

Question 29

Firearms Injuries

where does this rank on the causes of death?

what are prevention in place for this issue

Answer 29

The third leading cause of injury deaths

The number of deaths from firearms shifts from year to year:
Tougher gun control laws
Community policing
Demographic changes
Current trend not known

Question 30

Rates of Firearms Injuries

about 50% of firearm fatalities are what

40% are what

the remainder is what

how does the U.S homicide rate compare with other developed countries

what about suicide rates

Answer 30

About 50% of firearm fatalities are suicides

About 40% are homicides

The remainder are unintentional shootings

Homicide rates in the U.S. are 2 to 4 times higher than those in other developed countries

Suicide rates in the U.S. are comparable though a high percentage are committed with firearms

Question 31

Firearms Injuries

Who is at the greatest risk?:

Answer 31

Teenagers and young adults
Males
African Americans more than whites

Question 32

Interventions to prevent and reduce firearm deaths and violence

is this an easy or controversial topic

Answer 32

Gun control – controversial

Brady Gun Control Act in 1994 – assault weapon ban

Community programs – education and youth development programs

The 3 E’s:
Education
Enforcement
Engineering

Safety features – trigger catches

Question 33

Occupational Injuries

are workplaces becoming safer or more dangerous

what is OSHA
- what is their mission
- what do they set
- what do they inspect

what s NIOSH
- what do they impose
- what do they conduct
- what is the NIOSH liist

Answer 33

In general, workplaces are becoming increasingly safer

The Occupational Safety and Health Act of 1970 (OSHA)
- Mission to prevent occupational injuries and deaths and make sure the workplace is safe
- Sets standards
- Inspects workplaces

The National Institute for Occupational Safety and Health (NIOSH)
- Imposes penalties for workplace hazards
- Conducts research
- Conducts hazard evaluations
- NIOSH list: list of meds that are hazardous

Question 34

Occupational Injuries

what are the Leading occupational causes of death:

Answer 34

Motor vehicle accidents
Falls
Workplace homicides

Question 35

Occupational Injuries

what Occupations that have higher risks of occupational fatality and injury include:

Answer 35

Fishing
Logging
Construction
Agriculture
Police officers
Firemen

Question 36

Nonfatal Traumatic Brain Injury

is it a threat

how many are treated in the ED

Answer 36

A serious public health threat in the United States

CDC estimates that 2.2 million persons with TBIs are treated in U.S. hospital emergency departments (EDs) each year

Question 37

Nonfatal Traumatic Brain Injury

what do they range from

what do they lead to

Answer 37

Range from mild concussions to debilitating injuries:

Lead to:
Changes in thinking
Changes in sensation
Changes in language
Increased risk of Alzheimer’s and Parkinson’s Disease

sometimes does not lead to any debilitating/long term lasting injuries

Question 38

Nonfatal Traumatic Brain Injury

which gender is 2x as likely to suffer from this

what are the leading causes:

Answer 38

Males twice as likely as females to suffer TBI

High risk in the elderly

Leading causes:
MVA - motor vehicle accidents
Falls
Bicycle accidents
Sports injuries

Question 39

Tertiary Prevention

Answer 39

Promptness and quality of emergency care plays a significant role in mortality from injuries

Greatly affects degree of disability from injury