Violence & Injury Prevention (VIP) Nurah M Alamro, MD. MPH. Lecturer – Community Medicine College...
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Transcript of Violence & Injury Prevention (VIP) Nurah M Alamro, MD. MPH. Lecturer – Community Medicine College...
Violence & Injury Prevention(VIP)
Nurah M Alamro, MD. MPH.Lecturer – Community Medicine
College of MedicineKing Saud University
DefinitionsInjury• “Acute exposure to physical agents such as
mechanical energy, heat, electricity, chemicals, and ionising radiation interacting with the body in amounts or at rates that exceed the threshold of human tolerance. In some cases, injuries result from the sudden lack of essential agents such as oxygen or heat.”
(Source: Gibson, 1961; Haddon, 1963)
20/04/23 2N.ALAMRO - COMM 311
DefinitionsViolence• “The intentional use of physical force or
power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.”
(Source: WHO, 1996)
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The Global Injury Problem
• 5 million deaths worldwide = 9% of all deaths (2000)
• 12% of global burden of disease• Road traffic “incidents” are the leading cause
of injury deaths worldwide• 90% of injury deaths occur in low- and middle-
income countries• Highest number of deaths in S.E. Asia &
Western Pacific regions
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Principles!
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The Epidemiological Model
Vector Agent
Host
Environment
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The Haddon Matrix
Factors
Phase Human Vehicles and Equipment
Environment
Pre-Crash
Crash Prevention Information Attitudes Impairment Enforcement
Road worthiness
Lighting Braking Handling Speed
management
Road design Speed limits Pedestrian
facilities
Crash Injury prevention during the crash
Use of restraints Impairment
Occupant restraints
Other safety devices
Crash protective roadside objects
Post-crash
Life - sustaining First aid skill Access to medics
Ease of access
Fire risk
Rescue facilities
Congestion
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The Ecological Model
IndividualCommunity RelationshipSociety
Complex Linkages
Source: Krug E et al., eds., 2002.20/04/23 8N.ALAMRO - COMM 311
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VIP Public Health Approach
Defining Characteristics
Population-based Multidisciplinary Evidence-based Collective action Prevention
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(1) SurveillanceWhat is the problem?
(2) Risk factoridentification
What are the causes?
(4) Implementation How is it done?
(3) Develop andevaluate
interventionsWhat works?
The Public Health Approach
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Public Health Approach in Action
DESEPAZ in Colombia
(1) SurveillanceHigh rate of violentcrime
(2) Risk factorsAlcoholHandgunsAttitudes/values
(3) InterventionsEducationLegislationCommunity involvement
Reduction in homicides
Public demand for more prevention
(4) ImplementationSpecial budgets for police, judiciary etc. Television advertisingCultural/educational Programmes /Restrictions on alcohol and handguns
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Categorizing Injury
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Data Classification Systems
• International Classification of Disease (ICD)• Occupational Injury and Illness Classification
System (OIICS) • Nordic Medico-Statistical Committee
(NOMESCO)• The International Classification of External
Causes of Injury (ICECI) • The Abbreviated Injury Severity Scale (AIS)
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Injury Pyramid
Deaths
Injuries resulting in hospitalization
Injuries resulting in ambulatory and
emergency treatment
Injuries resulting in treatment inPrimary care settings
Injuries treated by paramedics only(school nurse, physiotherapist, first aid)
Untreated injuries or injuries which werenot reported
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Types of data and potential sources of information
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Source: adapted from Krug et al., eds., 200220/04/23 18N.ALAMRO - COMM 311
Health Statistics and Informatics
Leading Causes of Mortality and Burden of Disease
world, 2004
%
1. Ischaemic heart disease 12.2
2. Cerebrovascular disease 9.7
3. Lower respiratory infections 7.1
4. COPD 5.1
5. Diarrhoeal diseases 3.7
6. HIV/AIDS 3.5
7. Tuberculosis 2.5
8. Trachea, bronchus, lung cancers 2.3
9. Road traffic accidents 2.2
10. Prematurity, low birth weight 2.0
%
1. Lower respiratory infections 6.2
2. Diarrhoeal diseases 4.8
3. Depression 4.3
4. Ischaemic heart disease 4.1
5. HIV/AIDS 3.8
6. Cerebrovascular disease 3.1
7. Prematurity, low birth weight 2.9
8. Birth asphyxia, birth trauma 2.7
9. Road traffic accidents 2.7
10. Neonatal infections and other 2.7
Mortality DALYs
Health Statistics and Informatics
Adult mortality rates by major cause group and region, 2004
0 2 4 6 8 10 12
Africa
Europe
South East Asia
Eastern Mediterranean
Americas
Western Pacific
High income
Death rate per 1000 adults aged 15–59 years
Cardiovascular diseases
Cancers
Other noncommunicable diseases
Injuries
HIVAIDS
Other infectious and parasitic diseases
Maternal and nutritional conditions
Source: WHO, 2004
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Health Statistics and Informatics
Ten leading causes of burden of disease, world, 2004 and 2030
Quiz• In epidemiological
model of road traffic incident, the host is:• Car• Driver• Energy
transferred• Wet road
• Defining VIP according to target group include except:
•Universal•Selective•Indicated•Passive
• Injury can be categorised according:• Severity• Intent• Setting• All of the above
• The apex of the injury pyramid represents:• Relatively small number
of non-fatal injury cases • Relatively small number
of fatal injury cases • More numerous injuries
of lesser severity • More numerous injuries
of greater severity
• According to WHO, RTA as a leading cause of burden of disease in 2030 will rank:• 1st • 3rd • 20th • 9th
““PreventionPrevention is the VaccineVaccine for the DiseaseDisease
of Injury”Injury”
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