Unintentional Injuries Children Adolescents Christina Leinweber Alyxandra Sapienza

Unintentional Injuries: Children & Adolescents Christina Leinweber, Alyxandra Sapienza, Christy Trexler, and Donna Zeigenfuss

Objectives Identify why unintentional child injuries are a global health problem Identify the global disparities related to child injury and associated mortality Discuss the role community and public health nurses can assume in addressing the problem of unintentional child injuries

Unintentional Child Injuries: Identification of the Problem Injury and disability impact millions of children and adolescent across the world on a yearly basis The impact of injuries and associated deaths impact family members for a lifetime There is an unequal burden of injury from a global perspective A plan of action is needed in order to decrease the number of unintentional injuries in countries across the world

Unintentional Child Injuries: Identification of the Problem How is unintentional child injury defined? Injuries are put into two categories Unintentional Leading causes include road traffic crashes, drowning, burns and falls Intentional Deliberate acts of violence or neglect Can be difficult to classify some injuries Example: accidental fall or pushed? Neglect, abuse or accident? Regardless, the large majority of fatal child injuries are unintentional: 90%

Identification of the Problem: Falling Short Globally Proven strategies that work to reduce injury and death among children in highincome countries Prevention programs combining education, environmental modification and legislation Examples reduction of speeding, deterring drunk-driving, appropriate use of child car seats Increased use of smoke alarms Regulations on the use of high risk fire materials for children's’ clothing Controlling hot water temperatures Limiting access to pools, installing covers on wells, teaching children to swim Home citation programs to train parents So, what is the problem? Low and middle-income countries, and socioeconomically challenged families in highincome countries have been neglected! Unintentional injuries and deaths among children are on the rise from a global perspective

Unintentional Injury: A Global Health Problem More than 875, 000 children under the age of 18 die from injury each year This is based on data from WHO Member States Community surveys being conducted indicate an even higher death toll than this Injuries are the LEADING CAUSE of DEATH in children between 1 and 18 Non-fatal injuries impact between 10 and 30 MILLION children and adolescents every year Many of these injuries occur at home MOST INJURIES CAN BE PREVENTED!

A Global Health Problem The burden falls most heavily on children in poorer countries or from poorer families in all societies Injuries are still a major cause of death for children and adolescents in high-income countries Rates of child and adolescent injury and death are growing in low and middle income countries Rate per 100, 00 population as of 2010 High-income countries: 7. 7 Low-income countries: 37. 2 Until recently, little to no attention has been paid to injuries in low and middle income countries Appropriate interventions have not been implemented to the same extent as in high income countries

Geographical Distribution: Injury Mortality

Injury Deaths in Children: Causes Road Traffic: Falls Male: 111, 497 Male: 22, 288 Female: 71, 336 Female: 14, 731 Drowning: Poisoning Male: 89, 898 Male: 19, 844 Female: 55, 028 Female: 15, 785 Burns: Violence Male: 34, 011 Male: 16, 238 Female: 39, 837 Female: 14, 720 Self-inflicted Male: 8, 573 Female: 6, 309

Global Risk Factors Globally, most child and adolescent injury deaths occur in low and middle-income countries Availability of medical care Environmental factors Age and developmental level Within High-income countries, there is a strong socioeconomic gradient Children from poor families are more likely to sustain an injury Poverty is strongly associated with most types of injury Low/middle income countries: Children are more likely to be pedestrians More likely to live in homes with open flames Play in work places or near dangerous machines/chemicals Steep gradient among children of indigenous people Ex: Australia

Economic and Social Costs Injuries in high-income countries create a major contribution to hospital and health-care costs EXAMPLE: Unintentional injuries in US, ages 1 -19 Account for 11% of all hospital admissions 39% of emergency department visits 13% of medical costs Emotional and monetary impacts on family units Missed school Missed work Increased poverty

Challenges to Implementing Change Fatalism Lack of awareness among policy makers Lack of human resources Poor data collection Failure to implement known interventions Lack of political commitment Poor quality emergency care or medical agencies

Nursing Implications: WHO Plan of Action Nursing roles in Data and measurement: Survey and surveillance data Investigation of injury and violence epidemiology Investigation of health-care access Promotion of standardized classification systems Development of standard tools for estimating costs of injury Investigating disability effects of child injuries Promotion of the inclusion of the problem in national demographic health surveys

Nursing Implications: WHO Plan of Action Nursing roles in research: Development of research agenda for injury prevention High priority research questions Potential research projects Holding workshops with experts and partners Promotion of information sharing Promotion of funding for research in injury reduction

Nursing Implications: WHO Plan of Action Nursing role in prevention Legislation, Product regulation and enforcement modification Environmental Supportive Education modification home visiting and skills development Community-based studies

Nursing Implications: WHO Plan of Action Nursing role in services provided for children affected by injury Training programs for trauma care systems Development of national models of care for rehabilitation of injured children Increased services for those affected by injury Support groups Coordination of care and case management

Nursing Implications: WHO Plan of Action Nursing role in advocacy: Develop awareness among policy makers Develop easily understood and evidence based messages related to the problem of child injuries Advocate for inclusion of international forums related to child injury Advocate for resources among donors, foundations, national governments, local agencies and the private sector Foster collaboration among organizations concerned with child health and injury Child welfare agencies Department of Health Law enforcement agencies School Districts

Conclusion Many children are impacted everyday by injury, and many of those children die Low to middle income countries assume a larger share of the problem than high income countries Child injuries and deaths related to injury are preventable Commitment from public health nurses is needed in order to impact change

References http: //www. who. int/mediacentre/factsheets/en/ (Links to an external site. ) http: //www. who. int/violence_injury_prevention/child/organizations/en/ http: //www. who. int/violence_injury_prevention/child/injury/en/