Collecting Data to Prevent Drownings

By Stidham, Shelli Stephens | Parks & Recreation, February 1994 | Go to article overview

Collecting Data to Prevent Drownings


Stidham, Shelli Stephens, Parks & Recreation


The teenager sat in a wheelchair in the middle of a stage and looked out at the hundreds of high school students that had come to hear her talk. The students listened intently as the teenager talked about the car crash that left her without the use of her legs. They listened when she said that her life may have been different if she had thought to buckle her seat belt before she got into the car that night. When the teenager had finished talking, the students left the auditorium and got into their cars and pickups to go home. As they left the school parking lot that day, more had their seat belts buckled than when they had arrived that morning.

Why was the teenager at the high school talking to the students about her spinal cord injury? The answer is simple. She was part of a program run by the Oklahoma State Department of Health's Injury Prevention Service to help prevent similar injuries. Department staff had collected data on injuries in the state and found that motor vehicle injuries are the leading cause of death and disability among Oklahoma teenagers. Consequently, they developed a prevention program using the information they had learned, implemented it at selected high schools across the state and evaluated the results.

"The first step in injury prevention is determining what the problem is," says Sue Mallonee, R.N.M.P.H., chief of the Injury Prevention Service. "We must identify high-risk groups and activities by determining the chain of events leading to the injury." The authors of Injury in America: A Continuing Public Health Problem echo Mallonee's statements. The authors note that "high-quality, epidemiologic data are essential for the planning, development and evaluation of efforts to prevent injuries."

Injury mortality data is relatively easy to obtain because death records are maintained in every state, usually in the vital records division of the state health department. These records include the date, place and cause of death as well as the victim's age, sex, race and residence. Medical examiner's and coroners reports are also completed for all people who died as a result of an injury or an unexpected natural death.

During the mid 1980s, the Oklahoma State Department of Health began studying the impact of injuries in Oklahoma by reviewing death certificate data. Staff used the data to calculate for premature death. Because the burden of injury falls disproportionately on the young, comparing the total number of injury deaths with deaths from other causes can be misleading. Researchers say it is also important to consider how the deaths of many young people may affect the future of the society; therefore, it is important to consider the impact of premature death. Deaths occurring prior to age of life expectancy, most often 65 years of age, are called premature. The number of years of life that would have remained are considered years of potential life lost. In Oklahoma in 1983 and 1984, there were more years of potential life lost from injuries than any other cause, says Mallonee. "In fact, the proportion of total years of potential life lost due to unintentional injuries in Oklahoma was substantially higher than for the U.S. as a whole," she says.

Tip of the Iceberg

However, injuries resulting in deaths are only the tip of the iceberg. One study of childhood injuries found that for every death due to injuries among children zero-to-nineteen years old, there are 45 hospitalizations and 1,300 visits to emergency rooms. The researchers estimated that the number of injuries treated at home and in physicians' offices may be double those treated in emergency facilities.

With this information in mind, the state health department applied for and received a federal grant from the Centers for Disease Control in Atlanta in 1987 to establish a surveillance system for submersion injuries, hospitalized and fatal burn injuries and hospitalized traumatic spinal cord injuries. …

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