Unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation, 2006–2012

2019 ◽  
Vol 25 (6) ◽  
pp. 574-576
Author(s):  
Anne Kenney ◽  
Wendy Shields ◽  
Alexandra Hinton ◽  
Francene Larzelere ◽  
Novalene Goklish ◽  
...  
Keyword(s):  
American Indian ◽  
American Indians ◽  
Age Distribution ◽  
Unintentional Injury ◽  
Public Health Problem ◽  
Targeted Prevention ◽  
Unintentional Injuries ◽  
Indian Reservation ◽  
Injury Death ◽  
Fort Apache Indian Reservation

This study aims to describe the epidemiology of unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation between 2006 and 2012. Unintentional injury death data were obtained from the Arizona Department of Health Services and death rates were calculated per 100 000 people per year and age adjusted using data obtained from Indian Health Service and the age distribution of the 2010 US Census. Rate ratios were calculated using the comparison data obtained through CDC’s Web-based Injury Statistics Query and Reporting System. The overall unintentional injury mortality rate among American Indians residing on the Fort Apache Indian Reservation between 2006 and 2012 was 107.0 per 100 000. When stratified by age, White Mountain Apache Tribe (WMAT) mortality rates for all unintentional injuries exceed the US all races rate except for ages 10–14 for which there were no deaths due to unintentional injury during this period. The leading causes of unintentional injury deaths were MVCs and poisonings. Unintentional injuries are a significant public health problem in the American Indian and Alaska Native communities. Tribal-specific analyses are critical to inform targeted prevention and priority setting.

Prevention of Traumatic Deaths to Children in the United States: How Far Have We Come and Where Do We Need to Go?

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 791-797
Author(s):  
Frederick P. Rivara ◽  
David C. Grossman
Keyword(s):  
Unintentional Injury ◽  
The United States ◽  
Mortality Data ◽  
Review Of The Literature ◽  
Prevention Strategies ◽  
Unintentional Injuries ◽  
Injury Death ◽  
Injury Mortality ◽  
Injury Control ◽  
Made In

Objective. To describe the changes in injury mortality from 1978 to 1991 and determine the number of preventable deaths with currently available intervention strategies. Methods. Comparison of injury mortality data for children and adolescents 0 to 19 years in 1978 and 1991. Review of the literature to determine the effectiveness of currently available prevention strategies and application of these to deaths in 1991. Results. The injury death rate declined by 26% over the 14-year period. Death rates of unintentional injuries decreased by 39%, with declines in all categories of unintentional injuries. Homicides increased by 67% and suicides by 17%; nearly all of this increase was in deaths from firearms. If currently available prevention strategies were fully used, 6640 deaths could have been prevented, a further 31% decrease. Conclusions. Although great strides have been made in preventing deaths from trauma, the application of currently available prevention strategies could save a large number of additional lives. However, the increasing problem of intentional injury will partly counterbalance the success in unintentional injury control.

scholarly journals Area-based socioeconomic disparities in mortality due to unintentional injury and youth suicide in British Columbia, 2009–2013

2019 ◽  
Vol 39 (2) ◽  
pp. 35-44 ◽  
Author(s):  
Moe Zandy ◽  
Li Rita Zhang ◽  
Diana Kao ◽  
Fahra Rajabali ◽  
Kate Turcotte ◽  
...  
Keyword(s):  
Unintentional Injury ◽  
Mortality Rates ◽  
Material Deprivation ◽  
Mortality Data ◽  
Targeted Prevention ◽  
Local Health ◽  
Youth Suicide ◽  
Intentional Injury ◽  
Unintentional Injuries ◽  
Mortality Burden

Introduction The association between health outcomes and socioeconomic status (SES) has been widely documented, and mortality due to unintentional injuries continues to rank among the leading causes of death among British Columbians. This paper quantified the SES-related disparities in the mortality burden of three British Columbia’s provincial injury prevention priority areas: falls among seniors, transport injury, and youth suicide. Methods Mortality data (2009 to 2013) from Vital Statistics and dissemination area or local health area level socioeconomic data from CensusPlus 2011 were linked to examine age-standardized mortality rates (ASMRs) and disparities in ASMRs of unintentional injuries and subtypes including falls among seniors (aged 65+) and transport-related injuries as well as the intentional injury type of youth suicide (aged 15 to 24). Disparities by sex and geography were examined, and relative and absolute disparities were calculated between the least and most privileged areas based on income, education, employment, material deprivation, and social deprivation quintiles. Results Our study highlighted significant sex differences in the mortality burden of falls among seniors, transport injury, and youth suicide with males experiencing significantly higher mortality rates. Notable geographic variations in overall unintentional injury ASMR were also observed across the province. In general, people living in areas with lower income and higher levels of material deprivation had increasingly higher mortality rates compared to their counterparts living in more privileged areas. Conclusion The significant differences in unintentional and intentional injury-related mortality outcomes between the sexes and by SES present opportunities for targeted prevention strategies that address the disparities.

scholarly journals Unintentional Injuries and Sociodemographic Factors among Households in Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hailemichael Mulugeta ◽  
Yifokire Tefera ◽  
Teferi Abegaz ◽  
Steven M. Thygerson
Keyword(s):  
Road Traffic ◽  
Household Head ◽  
Unintentional Injury ◽  
Public Health Problem ◽  
Sociodemographic Factors ◽  
Household Wealth ◽  
P Value ◽  
Unintentional Injuries ◽  
Severe Injuries ◽  
The Past

Background. Unintentional injuries are a public health problem throughout the world including Africa. Most of the injury studies in Ethiopia are from the healthcare facility or workplace that does not reflect the problem at the community level. Therefore, this study aimed to assess the unintentional injuries and sociodemographic factors among households in Ethiopia. Methods. This study was done from the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about unintentional injuries and injury mechanisms in the past 12 months among 16,650 households. The selection of households was from nine regions and two city administrations of Ethiopia using a stratified cluster sampling procedure. Descriptive statistics were used to characterize the data and the chi-square test was applied as a test of significance and a p value of <0.05 was considered statistically significant. Result. Of the 16,650 households that participated in the study, 394 (2.4%) reported that at least one household member suffered from an unintentional injury in the past 12 months. The leading mechanisms of injury were unintentional falls (152 falls, 33.2%) and road traffic incidents (96 incidents, 21.0%). Among household members who were injured, 84.3% survived and 15.7% died because of the injury. Divorce marital status of the household head [AOR: 2.12, 95% CI (1.12–4.41)] and family size of the household ≥ 6 [AOR:1.65, 95% CI (1.21–2.26)] were associated with high likelihood of occurrence of an injury, while lowest household wealth index [AOR: 0.69, 95% CI (0.50–0.95)] was protective against injuries. Conclusion. A low prevalence of unintentional injury was found from the community in this survey, which might be due to the tendency of the community to report severe injuries. Fall and road traffic accidents were the leading mechanisms of selected sociodemographic factors of the households that were associated with unintentional injuries. Injury prevention efforts should focus on falls and transportation injuries with special attention to the sociodemographic context of the communities.

Guns, Alcohol, and Intimate Partner Violence: The Epidemiology of Female Suicide in New Mexico

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 121-126 ◽  
Author(s):  
Lenora Olson ◽  
Frank Huyler ◽  
Arthur W Lynch ◽  
Lynne Fullerton ◽  
Deborah Werenko ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
New Mexico ◽  
American Indians ◽  
Partner Violence ◽  
The United States ◽  
Intimate Partner ◽  
Injury Death ◽  
Female Suicide ◽  
Blood Alcohol Levels ◽  
Associated Risk Factors

Suicide is among the leading causes of death in the United States, and in women the second leading cause of injury death overall. Previous studies have suggested links between intimate partner violence and suicide in women. We examined female suicide deaths to identify and describe associated risk factors. We reviewed all reports from the New Mexico Office of the Medical Investigator for female suicide deaths occurring in New Mexico from 1990 to 1994. Information abstracted included demographics, mechanism of death, presence of alcohol/drugs, clinical depression, intimate partner violence, health problems, and other variables. Annual rates were calculated based on the 1990 census. The New Mexico female suicide death rate was 8.2/100,000 persons per year (n = 313), nearly twice the U. S. rate of 4.5/100,000. Non-Hispanic whites were overrepresented compared to Hispanics and American Indians. Decedents ranged in age from 14 to 93 years (median = 43 years). Firearms accounted for 45.7% of the suicide deaths, followed by ingested poisons (29.1%), hanging (10.5%), other (7.7%), and inhaled poisons (7.0%). Intimate partner violence was documented in 5.1% of female suicide deaths; in an additional 22.1% of cases, a male intimate partner fought with or separated from the decedent immediately preceding the suicide. Nearly two-thirds (65.5%) of the decedents had alcohol or drugs present in their blood at autopsy. Among decedents who had alcohol present (34.5%), blood alcohol levels were far higher among American Indians compared to Hispanics and non-Hispanic Whites (p = .01). Interpersonal conflict was documented in over 25% of cases, indicating that studies of the mortality of intimate partner violence should include victims of both suicide and homicide deaths to fully characterize the mortality patterns of intimate partner violence.

scholarly journals Affordability and Availability of Child Restraints in an Under-Served Population in South Africa

2020 ◽  
Vol 17 (6) ◽  
pp. 1979 ◽  
Author(s):  
Prasanthi Puvanachandra ◽  
Aliasgher Janmohammed ◽  
Pumla Mtambeka ◽  
Megan Prinsloo ◽  
Sebastian Van As ◽  
...  
Keyword(s):  
South Africa ◽  
Road Traffic ◽  
Public Health Problem ◽  
Global Public Health ◽  
Injury Death ◽  
Middle Income ◽  
Suitable Alternative ◽  
Middle Income Countries ◽  
Restraint Use ◽  
Child Restraint

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.

scholarly journals 1428. Lyme Disease Treatment in the United States: Prescribing Patterns from a Nationwide Commercial Insurance Database, 2016-2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S720
Author(s):  
Amy M Beeson ◽  
Grace E Marx ◽  
Amy M Schwartz ◽  
Alison F Hinckley
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Standard Treatment ◽  
Age Distribution ◽  
Public Health Problem ◽  
The United States ◽  
Adverse Outcomes ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Low Incidence

Abstract Background Lyme disease (LD) is the most common vector-borne disease in the United States and is a significant public health problem. The use of non-standard antibiotic treatment regimens for LD has been associated with adverse effects; however, the overall landscape of treatment has not been described previously. We aimed to describe real-world antibiotic prescribing patterns for LD. Methods We performed a retrospective analysis of the MarketScan commercial claims database of outpatient encounters from 2016-2018 in the United States. We identified all individuals with a visit that included an LD diagnosis code and a prescription within 30 days of the visit for one or more of 12 antibiotics that may be prescribed for LD. We then categorized each individual as having received either standard or non-standard treatment during the two-year period. Standard treatment was defined as treatment with a first, second or third-line antibiotic for LD, for no longer than 30 days, and for no more than two episodes during the study period. Descriptive and multivariable analyses were performed to compare characteristics of people who received standard vs non-standard treatment for LD. Results A total of 84,769 prescriptions met criteria for inclusion, written for 45,926 unique patients. The mean duration of prescriptions was 21.4 days (SD 10.8). Most individuals (84.5%) treated for LD received standard treatment during the study period. Female gender (OR 1.5, p&lt; 0.0001) and age 19-45 (p=0.0003) were significantly associated with being prescribed non-standard LD treatment. Treatment in low-incidence states (OR 2.2 compared to high-incidence states, p&lt; 0.0001) and during non-summer months (OR 2.2, p&lt; 0.0001) was more likely to be non-standard. Age distribution of patients receiving treatment for Lyme disease, by gender and age at first prescription Seasonality of standard versus non-standard treatment of Lyme disease Conclusion In this population of employed, young, and insured patients, young and middle-aged women were at the highest risk of receiving non-standard LD treatment. Treatments prescribed in states with low incidence of LD or during non-summer months were also more likely to be non-standard, a trend which likely reflects misdiagnosis or overtreatment of LD. Future studies are needed to further define prescriber and patient factors associated with non-standard LD treatment and related adverse outcomes. Disclosures All Authors: No reported disclosures

Indigenous standpoint theory as a theoretical framework for decolonizing social science health research with American Indian communities

2021 ◽  
pp. 117718012110420
Author(s):  
Genevieve R Cox ◽  
Paula FireMoon ◽  
Michael P Anastario ◽  
Adriann Ricker ◽  
Ramey Escarcega-Growing Thunder ◽  
...  
Keyword(s):  
Social Sciences ◽  
Social Science ◽  
American Indian ◽  
American Indians ◽  
Health Research ◽  
Cultural Context ◽  
Ways Of Knowing ◽  
Standpoint Theory ◽  
Theoretical Frameworks ◽  
The Social

Theoretical frameworks rooted in Western knowledge claims utilized for public health research in the social sciences are not inclusive of American Indian communities. Developed by Indigenous researchers, Indigenous standpoint theory builds from and moves beyond Western theoretical frameworks. We argue that using Indigenous standpoint theory in partnership with American Indian communities works to decolonize research related to American Indian health in the social sciences and combats the effects of colonization in three ways. First, Indigenous standpoint theory aids in interpreting how the intersections unique to American Indians including the effects of colonization, tribal and other identities, and cultural context are linked to structural inequalities for American Indian communities. Second, Indigenous standpoint theory integrates Indigenous ways of knowing with Western research orientations and methodologies in a collaborative process that works to decolonize social science research for American Indians. Third, Indigenous standpoint theory promotes direct application of research benefits to American Indian communities.

Recounting coup as the recirculation of Indigenous vitality: A narrative alternative to historical trauma

2021 ◽  
pp. 136346152110549
Author(s):  
Joseph P. Gone
Keyword(s):  
Mental Health ◽  
American Indian ◽  
American Indians ◽  
Historical Trauma ◽  
Psychological Trauma ◽  
Community Members ◽  
Trauma Narrative ◽  
War Narratives ◽  
Tribal Communities ◽  
The Impact

Contemporary American Indians suffer from disproportionately high degrees of psychiatric distress. Mental health researchers and professionals, as well as American Indian community members, have consistently associated these disproportionate rates of distress with Indigenous historical experiences of European and Euro-American colonization. This emphasis on the impact of colonization and associated historical consciousness within tribal communities has occasioned increasingly widespread professional consideration of historical trauma among Indigenous peoples. In contrast to personal experiences of a traumatic nature, the discourse of Indigenous historical trauma (IHT) weds the concepts of “historical oppression” and “psychological trauma” to explain community-wide risk for adverse mental health outcomes originating from the depredations of past colonial subjugation through intergenerational transmission of vulnerability and risk. Long before the emergence of accounts of IHT, however, many American Indian communities prized a markedly different form of narrative: the coup tale. By way of illustration, I explore various historical functions of this speech genre by focusing on Aaniiih-Gros Ventre war narratives, including their role in conveying vitality or life. By virtue of their recognition and celebration of agency, mastery, and vitality, Aaniiih war stories functioned as the discursive antithesis of IHT. Through comparative consideration of the coup tale and the trauma narrative, I propose an alternative framework for cultivating Indigenous community “survivance” rather than vulnerability based on these divergent discursive practices.

Stepfamily Closeness and Depression Among American Indian Emerging Adults: A Structural Equation Modeling Approach

2018 ◽  
Vol 40 (3) ◽  
pp. 267-292 ◽  
Author(s):  
Kaitlin P. Ward ◽  
Gordon E. Limb ◽  
Sarah Higbee ◽  
Helena Haueter
Keyword(s):  
American Indian ◽  
Emerging Adults ◽  
American Indians ◽  
Structural Equation ◽  
The United States ◽  
Equation Model ◽  
Equation Modeling ◽  
Racial Groups ◽  
Biological Parent ◽  
Parent Child

Stepfamilies are one of the fastest growing family structures among all racial groups in the United States. Stepfamily research among many racial groups, specifically American Indians, is virtually nonexistent. This is unfortunate, as American Indians are more likely to divorce and remarry compared with other populations. From a family systems perspective, this study examined whether retrospectively perceived closeness in three stepfamily relationships, namely child–residential biological parent, child–residential stepparent, and child–stepsibling, were negatively associated with depression scores in 226 American Indian emerging adults. A structural equation model showed that increased child–residential biological parent and child–stepsibling closeness predicted decreased depression scores, whereas child–residential stepparent closeness did not. We also found that depression scores significantly predicted retrospective perceptions of child–residential biological parent, child–residential stepparent, and child–stepsibling closeness. Findings encourage interventions that strengthen American Indian child–residential biological parent and child–stepsibling relationships, and underscore the need for further research that explores American Indian stepfamily relationships.

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