In 1981, the Indian Health Service (IHS) initiated a program plan for Community Injury Control (CIC). This initiative was a response to the high rate of injury among Native Americans. The programs are the responsibility of the environmental health service officer in each Service Unit of the IHS. The program activities covered areas such as General Safety Training, First Aid Training and CPR, Occupational Safety Training, Motor Vehicle Safety Training, Cultural Identity, and Stress Management. Since this study was conducted too early in the life of the program to assess the long-range impact of community injury control on the injury rates of the Native American population, the primary goal of the study was to measure the correlation of levels of activity directed at specific injuries and any changes in those specific injury rates among Service Units. This study is essentially exploratory in nature. The objective was to present CIC management with some quantifiable results that might assist them in assessing and improving an on-going program. Data used in the study included limited comparative data, taken from literature, for major categories of injuries across Native American, Black American, and White American populations to provide a baseline for incidence and risk factor assumptions inherent to the model. For the actual testing of the model, data was collected from 54 individual Service Units. Detailed questionnaires on types of services offered or strategies employed per individual were distributed to evaluators. Only those units with a population exceeding 2000 were used in the study. Changes in accident levels and CIC activity levels were then regressed by a multiple regression model to try to determine the effect of individual CIC activities. Results of the analysis are presented in summary form in tables and graphs. The study indicates that reductions in hospitalization rates for falls were associated with training in general safety, recreational safety, and first aid. Motor vehicle and assault injuries declined, but could not be attributed to CIC intervention. Some training activities were actually correlated with an increase in hospitalizations. After a series of training activities on poison prevention, for example, there was an increase in poison related suicide attempts.IHS data does not sufficiently isolate specific agents and vehicles for precisely targeted injury control. Supplemental forms should be included with the patient report. Each form should represent an individual cause for patient injury.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-03).
Robertson LS. Epidemiological assessment of the contributing factors of injury mortality and morbidity among Native Americans - final report. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-03). 1985