U.S Healthcare final- Intentional and Unintentional Injuries Flashcards
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
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)
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
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
Epidemiology of Injuries
what does it look at to determine what
what are the two types of fatal injuries
Looks at patterns that suggest where the greatest need for prevention and intervention exist
Fatal injuries
- Unintentional or accidental
- Intentional (homicide or suicide)
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
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
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
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
Leading Categories of Injury Deaths in the United States
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
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
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
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
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
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
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
Analyzing Injuries
injuries are an interaction between what 3 things
what is a host
what is an agent
what is an environment
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
Analyzing Injuries
Three levels of prevention
what is primary prevention?
what is secondary prevention?
what is tertiary prevention, what does it determine
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
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
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
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?-
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
Motor Vehicle Accidents
where does it rank in causes of death
The number two cause of injury deaths
The leading cause of death for people ages 1 to 34
National Highway Traffic Safety Administration (NHTSA)
what is it under
what does it carry out
what is it responsible for
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
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
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
Contributing Factors in Fatal and Non-Fatal Car Crashes
why can’t youth drink alcohol (besides brain anatomy reason)
Alcohol
- Prevention: What is in place?
Youth:
Inexperience
Risky behaviors
Poor judgment
Prevention: What is in place?
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?
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
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 (______)
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)
Pedestrian Injury: Who is at the Most Risk?
older adults
children
who is alcohol-impaired
what kind of areas
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
Pedestrian Injury: a Public Health Intervention
example
In Queens Boulevard in NY:
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
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
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
Poisoning
where does this rank in the causes of death
what does it surpass
is there an increase in unintentional poisoning
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.
Poisoning
what is a poison?
what are the two types and are examples of each
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
Poisoning
In 2009 drug poisoning became the leading cause of injury death in the United States
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
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.
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
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?
Poisoning
what are the preventions in place
Prevention:
Child safety caps
Education
Regulation
Is enough being done to prevent poisoning with these 3 most common agents?
Firearms Injuries
where does this rank on the causes of death?
what are prevention in place for this issue
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
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
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
Firearms Injuries
Who is at the greatest risk?:
Teenagers and young adults
Males
African Americans more than whites
Interventions to prevent and reduce firearm deaths and violence
is this an easy or controversial topic
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
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
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
Occupational Injuries
what are the Leading occupational causes of death:
Motor vehicle accidents
Falls
Workplace homicides
Occupational Injuries
what Occupations that have higher risks of occupational fatality and injury include:
Fishing
Logging
Construction
Agriculture
Police officers
Firemen
Nonfatal Traumatic Brain Injury
is it a threat
how many are treated in the ED
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
Nonfatal Traumatic Brain Injury
what do they range from
what do they lead to
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
Nonfatal Traumatic Brain Injury
which gender is 2x as likely to suffer from this
what are the leading causes:
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
Tertiary Prevention
Promptness and quality of emergency care plays a significant role in mortality from injuries
Greatly affects degree of disability from injury
