Chapter 13
2. Injury and Violence: A Public Health Issue
Over 5 million global deaths annually due to injury and violence.
8% of global mortality attributed to injuries (WHO, 2021).
3. The Big Picture
Injuries can be intentional or unintentional.
Long-term consequences and increased mortality risk associated with both types.
Unintentional injuries cause approximately 37 million emergency department visits yearly.
4. Unintentional Injury
Definition: Absence of predetermined intent to injure; it is sudden.
Disproportionately affects the young and impoverished.
Examples: Drowning, falls, motor vehicle crashes (MVC), burns.
5. Incidence of Unintentional Injuries
Unintentional injuries are predictable and preventable.
Third leading cause of death in the U.S.
Leading causes of unintentional injury deaths:
Poisoning: 20.0 per 100,000
Falls: 12.0 per 100,000
MVCs: 11.5 per 100,000 (CDC, 2021).
6. Global Incidence of Unintentional Injuries
MVC is 10th leading cause of death in lower-income countries.
8th leading cause of death in upper middle-income countries.
7. Intentional Injury
Definition: Deliberate acts causing harm to self or others.
Violence: Physical force used to violate or damage.
Nonfatal physical assault: 402.5 per 100,000 (CDC).
8. Types of Intentional Violence
Self-Inflicted Violence:
Suicide
Cutting/self-mutilation
Interpersonal Violence:
Family
Community
Acquaintance
Stranger
Collective Violence:
Groups engaging in violence: nations, communities, gangs.
9. Surveillance of Injury and Violence
Reporting mechanisms at local, state, national levels:
Public Health Departments
Motor Vehicle Crash (MVC) reports
Police reports
Death certificates
National Violent Death Reporting System.
10. Risk Factors for Injury and Violence
Risk factors vary by type of injury:
Behavioral factors
Environmental factors
Socioeconomic factors.
11. Haddon’s Matrix
Framework for assessing injury risks based on agent, environment, and host.
Phases: Pre-event, Event, Post-event.
Assess host/human, agent, and environment in each phase.
12. Prevention Strategies
CDC National Center for Injury Prevention:
Conducts surveillance, collects data, provides leadership, and funds research.
Nurses play a critical role in:
Collaborative care
Interventions and policy advocacy.
13. MVC (Motor Vehicle Crashes) Epidemiology
Leading cause of unintentional injury deaths for ages 15 to 24.
Road traffic injury: Collision-related injury.
14. Risk Factors for MVC
Alcohol impairment, distracted driving (visual, manual, cognitive).
15. Global Safety Initiatives
WHO Global Plan for Road Safety includes:
Safe road infrastructure, vehicles, road use, and post-crash response.
16. Burn-Related Injuries
Definition: Injury due to heat/radiation/chemicals.
Prevention includes:
Primary: Environmental measures
Secondary: Fire response techniques
Tertiary: Improved medical treatments.
17. Drowning Epidemiology
236,000 deaths worldwide annually; significant risk in young children and the elderly.
Prevention: Supervision, learning to swim, safe barriers.
18. Falls Epidemiology
Major cause of injuries across age groups; 684,000 deaths globally.
Prevention includes safeguarding home environments and supervision.
19. Unintentional Poisoning
Involves any harmful substance exposure.
The U.S. has a mortality rate of 25.8 per 100,000.
20. Self-Directed Violence (SDV)
Defined as intentional self-harm; rise in suicide rates noted.
Risk factors: Mental health issues, social isolation.
21. Violence Against Women and Children
Family violence (IPV), community violence, child maltreatment.
One in four adults have experienced childhood physical abuse (WHO).
22. Community Violence
Includes crime and weapon use in public spaces.
Increased risk in economically disadvantaged areas.
23. Collective Violence
War inflicts greater health impacts than many diseases, leading to public health system breakdowns.
24. Risk Assessment
Risk factors assessed based on behavioral, environmental, and socioeconomic aspects related to injury.