Priority Area: Unintentional Injuries

The Burden of Unintentional Injuries

Unintentional injuries are a leading cause of death and disability among all age groups in New York State and are the top killer of New Yorkers aged 1-34 years. More than 4,300 New Yorkers die every year as a result of an unintentional injury. During 2000 to 2006, the death rate caused by unintentional injuries increased 10 percent. But injury deaths are only part of the picture. The consequences of non-fatal injuries range from temporary pain and inconvenience, to long-term disability, chronic pain, and a diminished quality of life. Hospitalization and rehabilitation services are often needed. Injuries are consistently among the leading causes of hospitalization for New Yorkers of all age groups. More than 130,000 individuals are injured severely enough to require hospitalization annually. Another 1.3 million unintentionally injured New Yorkers are treated and released from an emergency department each year.

An injury affects more than just the person who was injured and may impact family members who are often called upon to care for the injured person. This can result in stress, time away from work and, sometimes, lost income. The economic impact of injuries includes the costs associated with medical treatment and lost productivity, such as wages and accompanying fringe benefits, or the ability to perform one’s normal household responsibilities. For 2000, the estimated lifetime economic impact of all injuries in the United States exceeded $406 billion.

Objectives

  • By the year 2013, reduce the age-adjusted unintentional injury hospitalization rate and mortality rate in New York so that:
    • Age-adjusted unintentional injury-related hospitalization rate is no more than 44.5 per 10,000. (Baseline: 59.3 per 10,000, SPARCS, 2003-2005)**
    • Age-adjusted unintentional injury-related mortality rate is no more than 17.1 per 100,000. (Baseline: 19.9 per 100,000, Vital Statistics, 2003-2005)*
    • By the year 2013, reduce age-adjusted motor vehicle-related injury mortality in New York to no more than 5.8 per 100,000. (Baseline: 7.7 per 100,000, Vital Statistics, 2003-2005)**
    • By the year 2013, reduce the pedestrian injury hospitalization rate in New York to no more than 1.5 per 10,000. (Baseline: 2.0 per 10,000, SPARCS, 2004-2006)**
    • By the year 2013, reduce the fall related hospitalization rate among persons aged 65 and over in New York to no more than 155 per 10,000. (Baseline: 206.3 per 10,000, SPARCS, 2004-2006)**

    * Healthy People 2010 Objective

    ** Since a Healthy People 2010 Objective is not available, this objective represents a 25% reduction from the 2004-2006 rate.

Indicators for Tracking Public Health Priority Areas

Each community's progress towards reaching these Prevention Agenda Objectives will be tracked so members can see how close each community is to meeting the objectives.

Data and Statistics

  • County Health Assessment Indicator
    • Unintentional injury-related county level indicators are compared to NYS, Rest of State and New York City and, if applicable, Healthy People 2010 objectives.
  • Overview of New York State Injury Statistics
    • Hospitalizations Due to All Injuries, New York State Residents, 1995 through 2006
    • Deaths Due to All Injuries, New York State Residents, 2004 through 2006
    • Deaths and Hospitalizations Due to All Injuries, New York State Residents, 2004 through 2006
    • Initial Emergency Department Visits, Treated and Released, Due to All Injuries, New York State Residents, 2005 through 2006
      • Data are presented in tables and graphs about frequency and rate of ED visits per 100,000 residents in NYS.
  • Governors Traffic Safety Committee
    • Contains tables and reports on New York State traffic crash data and statistical summaries of traffic crash data, traffic tickets, and conviction rates for New York counties.
  • Work Related Fatalities
    • Occupational fatalities are monitored for both the Census for Occupational Injuries (CFOI) program and the Fatality Assessment and Control Evaluation (FACE) program.
  • Bureau of Labor Statistics
    • The Injuries, Illnesses, and Fatalities program provides data on illnesses and injuries in the job and data on worker fatalities.
  • Centers for Disease Control and Prevention
    • Web-based Statistics Query and Reporting System WISQARS TM

      WISQARS is an interactive, online database providing customized injury-related mortality data and nonfatal injury data.

    • Ten Leading Causes Charts

      Charts are a vailable for the leading causes of injury-related deaths and nonfatal injury in multiple file formats.  The charts can be used in slide presentations, Web pages, and print documents.

    • Inventory of National Injury Data Systems

      This inventory describes 44 different federal data systems operated by 16 different agencies and 3 private injury registry systems that provide nationwide injury-related data. Each data system is listed along with the agency or organization and associated websites.

    • Economic Burden of Injury

      The Incidence and Economic Burden of Injuries in the United States examines the lifetime costs associated with the injuries that occur in just one year.

Programs

The NYSDOH coordinates a number of programs to reduce the morbidity and mortality associated with injuries. The Bureau of Injury Prevention develops, implements and evaluates primary prevention programs statewide. The Bureau conducts annual trainings and provides technical assistance to community-based organizations to facilitate the integration of injury prevention strategies into their ongoing activities. Collaborations with over 30 state-level partners increase opportunities to implement injury prevention interventions through a variety of channels and to educate the general public and target populations about injury risks. The Bureau also conducts surveillance of injuries, and their causes and consequences.

State efforts to prevent unintentional injuries focus on improving child passenger safety and occupant restraint, driver safety, bicycle and pedestrian safety, preventing falls in children and older adults, and reducing risk of poisoning, choking, fires and burns. Raising awareness about the causes of these injuries is important to prevent them and reduce the adverse consequences. A public health approach to the prevention of injuries involves collaboration between state and local authorities, community-based organizations, and private sector partners to support services and policies proven to reduce the risk of injury. This depends on identifying community needs and assets, building and sustaining partnerships to implement prevention programs, and measuring their success.

The NYSDOH coordinates a number of occupational programs and monitors various occupationally related illnesses and injuries. A statewide network of occupational health clinics helps prevent occupational disease by providing diagnostic services, medical screening, treatment, referral and educational services for workers exposed to toxic substances and other occupational hazards. The Census for Occupational Injuries (CFOI) program collects verifiable information on occupational fatalities and releases reports periodically. This information is used by health and safety professionals to develop strategies for prevention of both fatalities and serious injuries. The Fatality Assessment and Control Evaluation (FACE) program investigates the factors leading to fatal injuries in the workplace. Recommendations for prevention of future injuries are made and distributed to employers, workers, and other organizations interested in promoting workplace safety. Rapid identification of workplace fatalities will enable NYSDOH investigators to conduct investigations in a timely manner. The Injuries, Illnesses, and Fatalities program provides data on illnesses, injuries and fatalities among employees.

The NYSDOH implements or actively supports the interventions listed below that are recommended in the Community Guide:

  • Promoting proper child safety seat use
    • Support for laws requiring use of child safety seats
    • Community-wide information and enhanced enforcement campaigns
    • Child safety seat distribution and education programs
    • Child safety seat incentive and education programs
  • Use of seat belts
    • Laws requiring use of seat belts by passengers in a motor vehicle
    • Support of enhanced enforcement of seat belt laws
  • Nighttime driving restriction curfew laws
    • Graduated driver’s licensing laws
  • Use of properly worn bicycle helmets
    • Increasing bicycle helmet usage
  • Mandatory helmet use laws
    • Increasing mandatory helmet use law combined with community education
  • Reduce injuries from residential fires
    • Increasing the use of working smoke alarms with adequate coverage for residence
    • Installation of smoke alarms combined with an education and media campaign
    • Support legislation and housing code enforcement to ensure smoke alarms are installed in new and existing homes combined with community-based campaigns and distribution programs
  • School-based education
    • Parental involvement in the safety behavior training of young children;
    • Environmental approaches to reducing pedestrian injuries such as lowering speed limits, and using speed bumps and signs.

Strategies - The Evidence Base for Effective Interventions

Evidence-based, evidence-informed, promising strategies and best practices to prevent or reduce injuries are summarized in the following reports:

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention

  • Preventing Falls: What Works. A CDC Compendium of Effective Community Based Interventions from Around the World

    This CDC guide describes 14 scientifically tested interventions to reduce the risk of falls and fall injuries among adults aged 65 and older. It provides relevant details about these interventions for organizations who want to implement fall prevention programs. The interventions are grouped into three categories: 1) exercise-based, 2) home modification, and 3) multifaceted. Each intervention description includes a short summary of the research study and results, as well as a longer section describing the intervention.

Community-Based Injury Prevention Interventions

This systematic review describes the effectiveness of interventions to reduce or prevent childhood injuries. Results indicate that community-based approaches are effective at increasing some safety practices, such as bicycle helmet use and car seat use among children. The evidence is less compelling that such interventions increase child pedestrian safety, increase adolescent vehicle safety by reducing drinking and driving behaviors, or reduce rates of several categories of childhood injuries.

National Highway Traffic Safety Administration

Evaluations of the effectiveness and lives saved by safety equipment, such as seat belts, air bags, electronic stability control or side impact protection.

County Strategies and Partners Matrix

The County Strategies and Partners Matrix for Unintentional Injuries was compiled from the 2010-2013 community health assessments submitted in 2009 by 5 local health departments. It describes how local health departments collaborate with hospitals and community organizations to plan and address this priority to improve population health outcomes.

Return on Investment

Children's Safety Network - Injury Prevention Counseling

Investing in bicycle helmets, child safety seats, injury prevention counseling by pediatricians, poison control centers, sobriety checkpoints, and enforcement of speed limits save lives, time, money, and medical costs.

Cost-Outcome Analysis in Injury Prevention and Control: Eighty-Four Recent Estimates for the United States, June 2000.

Injury prevention often can reduce medical costs and save lives. In this cost analysis report, a variety of injury prevention interventions were studied to determine the associated benefits and costs, and the cost per year quality-adjusted life year.

Resources

Additional information on selected injury topics is described below:

Traumatic Brain Injury

Driving

Child Passenger Safety

Falls

Smoke Alarms

  • Deaths from fire and burns are the fifth most common cause of unintentional injury-related deaths in the United States. Although a working smoke alarm reduces the risk of death from residential fire by at least 50%, only about three quarters of U.S. households reported having one that functions.

Bicycle Safety

Child passenger safety

Drowning Prevention

  • The NYSDOH is committed to preventing drownings at regulated bathing facilities. Drowning incidents are investigated and data are analyzed to improve prevention strategies. Drowning hazards can be reduced and eliminated through appropriate design of bathing facilities and proper supervision and operation of these facilities by the operators and their staff.

Occupational Fatality Prevention

AARP Public Policy Institute Report: “Planning Complete Streets for an Aging America ”

  • This report addresses the need to create Complete Streets that are safe and convenient for travel by automobile, foot, bicycle and transit regardless of age or ability. The study encourages roadway planners and engineers to approach road design through the lens of Complete Streets and employ design strategies that support older drivers and pedestrians.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control

Partners

CDC National Center for Injury Prevention and Control

General - all injuries

National Consumer Product Safety Committee

Product recalls and safety notices

American Association of Poison Control Centers

General poison prevention information

Safe Kids Worldwide

National Highway Traffic Safety Administration

General traffic safety

NYS Governor’s Traffic Safety Committee

National Fire Protection Association

American Academy of Pediatrics