Susan P. Baker, a pioneering researcher in field of injury prevention, is this year’s recipient of the Frank A. Calderone Prize awarded by the Mailman School of Public Health at Columbia University. The Calderone Prize is the school’s highest honor. Baker, a professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, was recognized for her extraordinary career in bringing the prevention of injuries to the forefront of public health and public policy. Baker, an epidemiologist and licensed pilot, is a founder of the Bloomberg School’s Center for Injury Research and Policy. For more than four decades, she has made the study and reduction of preventable injuries a priority – and a newly defined field of inquiry – in public health research and policy, and has continuously worked to raise the visibility and stress the urgency of injury control. Her research played an integral role in the creation of child passenger protection laws and graduated driver licensing (GDL); as a results of her work, all states now require child safety seats and virtually all states have GDL laws. Her additional areas of focus include, among others, fatalities related to aviation, motorcycles, and heavy trucks; carbon monoxide poisoning; the relationship between alcohol and homicide; the use of drugs in adolescent suicide; drowning; childhood asphyxiation; house fires; falls in the elderly, and fatal occupational injuries. Professor Baker will accept the Calderone Prize on May 6, 2010 and give a major and original address at the Mailman School. She will be joined by Dr. Thomas Farley, New York City Commissioner of Health and Dean Linda Fried in a panel discussion immediately following on the practical applications of Professor Baker’s path-breaking work. The Frank A. Calderone Prize in Public Health is overseen by the Mailman School of Public Health and presented to an individual who has made a transformational contribution in the field of public health. The Prize recognizes an individual who has accomplished extraordinary distinction in public health and/or who has made a specific contribution that has had long-term national or global implications. This is the first time the Calderone Prize has been bestowed upon an injury control researcher. “Sue Baker is a true pioneer,” said Mailman School Dean Fried. “She not only created a new field of academic inquiry in public health; she ensured that her research would have practical application and underpin a transformation in public policy. The Mailman School is proud to bestow the Calderone Prize on Professor Baker.” Dr. Thomas Farley, New York City Health Commissioner, observed, “Sue Baker has had an extraordinary career, using research to illuminate a field of inquiry and connecting it to policy changes that have improved countless lives. That is exactly what the Calderone Prize celebrates: public health leadership that leads to practical improvements in how we live.” “I am truly honored by this extraordinary recognition,” said Professor Baker. “When I started in this field many years ago, injury was hardly considered a public health issue, despite being one of the leading causes of death and disability. I feel very fortunate to have had so many opportunities to build a career in injury prevention, to train so many outstanding injury professionals, and to have been able to influence real policy changes to save lives. While we have collectively come so far, there is more work to be done. That is why I hope this Prize will now draw even more attention to the burden of injury, and encourage more young leaders to enter the field.” The Calderone Prize presentation and panel discussion will take place at 11:00 AM in the Mailman School’s 8th floor auditorium, Allan Rosenfield Building, 722 West 168th Street, NYC.
Significant increases seen in deaths from falls, motorcycle crashes, machinery use and poisoning The risk of dying from injuries is increasing for Americans ages 65 and older according to a new report from the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. The report found significant increases in death rates from falls (42 percent increase), machinery (46 percent increase), motorcycle crashes (145 percent increase) and unintentional poisoning (34 percent increase). The results are published in the February issue of Injury Prevention and are available online at the journal’s website. “Our findings reveal significant increases in death rates from several different injury causes,” said study co-author Susan P. Baker, MPH, a professor with the Bloomberg School’s Center for Injury Research and Policy. “While the overall change in injury mortality among persons 65 and older was small, this study identifies important causes worthy of further investigation.” The overall change in injury mortality for individuals aged 65 years and older during 2002-2006 was three percent. In contrast, the rate of deaths attributed to falls increased by at least 38 percent in all racial/ethnic groups, with the greatest increase seen in whites (45 percent). Significant declines occurred in the rate of deaths attributed to motor vehicle crashes, suffocation and suicide. “We know injuries are taking a toll on older adults. This research helps us to build upon our knowledge and translate science into effective programs and policies that prevent these injuries and minimize the consequences of injuries when they occur,” said Grant Baldwin, PhD, MPH, Director of the Division of Unintentional Injury Prevention at the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention in Atlanta, Ga. The study also looked at changes in emergency department (ED) visits, and found that despite the significant increase in fatal falls, there has been no significant increase in fall-related admissions among the study population. The authors speculate this could be attributed to a trend in recent years to report the underlying cause of death as a fall. In addition, many elderly people are now living longer with conditions that may predispose them to falls. “Alcohol is another contributing risk factor worthy of consideration,” added senior author Guoqing Hu, PhD. “Given the association between alcohol and injury, recent documented increases in alcohol problems among the elderly may be another partial explanation for the increase in severe falls.” Hu and Baker accessed data from the CDC Web-based Injury Statistics Query and Reporting System (WISQARS), which provides data on deaths and hospital emergency department-treated injuries according to cause and intent of injury. WISQARS mortality data are based on annual data from the National Vital Statistics System of the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC). WISQARS non-fatal injury data are based on annual nationally representative nonfatal injury data of the National Electronic Injury Surveillance System-All Injury Program operated by the Consumer Product Safety Commission in collaboration with the National Center for Injury Prevention and Control (CDC). Support for this research was provided by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, through a grant to the Johns Hopkins Center for Injury Research and Policy.
Unintentional suffocation of infants twice as common in rural areas
The death rate from injuries in rural areas of China is higher than in urban areas, according to a new study by researchers from the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. Rural males of all ages were 47 percent more likely to die from injuries than urban males, and the overall rate in rural females was 33 percent higher than in urban females. For babies under one year of age, unintentional suffocation was the most important source of the total urban-rural disparity, whereas drowning was the great contributor to disparity among children ages 1 to 4 years. At the other end of the age spectrum, suicide accounted for the bulk of the disparity for both men and women. The report is published in the winter 2010 issue of The Journal of Rural Health. “As good policy decisions rely on the availability of good data, the objective of this study was to provide information on urban-rural disparities in injury mortality in China, so as to offer a basis for governmental decisions related to injury interventions,” said Susan P. Baker, MPH, professor with the Injury Center. “The findings should be used to set priorities for reducing the high rate of fatal injuries in rural China.” The researchers analyzed 2006 data collected from the Chinese Death Cause Registration, which cover about 10 percent of the total population. This sample has been proven to be a representative sample of the total Chinese population. Analyses were gender- specific because sex has been reported to play a role in explaining urban-rural disparities in injury mortality in China. “While our research did not investigate causes behind the disparities, previous research has shown that rural residents of China have more law violations and high-risk behaviors than urban residents, such as driving after drinking, driving without a license, storing pesticides at home, and using rat poison at home. Studies worldwide have also linked higher injury mortality rates to longer times for response and transport to medical care in rural areas,” said Guoqing Hu, PhD, lead study author and associate professor of epidemiology and health statistics at Central South University in China. “Further research is needed to develop effective interventions for reducing injuries and narrowing the urban-rural gap in injury mortality in China,” said Hu. The research was funded by grants from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy.
One-third of injured patients occupants of noncommercial planes
The first ever published study of aviation-related injuries and deaths in the U.S. finds that on average,1013 patients are admitted to U.S. hospitals with aviation-related injuries annually, and that an average of 753 aviation-deaths occur each year. The study, conducted by researchers from the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy and Columbia University, also reports that the largest categories of patients were occupants of civilian, noncommercial powered aircraft (32 percent) and parachutists (29 percent). For aircraft occupants as well as parachutists, lower limb fractures were the most common injury, encompassing 27 percent of all hospitalized injuries. While burns were seen in only 2.5 percent of patients, they were responsible for 13 percent of deaths. The report is published in the December issue of Aviation, Space, and Environmental Medicine. “Our findings provide valuable information, not previously available, on the number and kinds of injuries sustained in aviation-related events,” said lead author Susan P. Baker, professor with the Injury Center. “Because many injuries can be prevented through changes in the structure of aircraft, these data should be used to recognize needed improvements in aircraft design. For example, the high numbers of lower limb fractures suggest modifications should be considered to the various structures likely to be contacted by the feet and legs when a crash occurs.” The researchers analyzed data from the nationwide inpatient sample (NIS), a data system sponsored by the Agency for Healthcare Research and Quality that contains information for approximately 20 percent of all hospital admissions in the U.S. Using the International Classification of Diseases, 9th edition, codes for air transport accidents were used to identify patients who were hospitalized for aviation-related injuries during 2000-2005. Aviation-related deaths were identified using International Classification of Diseases, 10th edition. The distribution of aviation-injuries was calculated by victim type, discharge status and length of stay. “Unlike the highly effective surveillance system for all aviation crashes and incidents in the military, there is no formal injury reporting structure for civil aviation crashes,” said Dennis F. Shanahan, MD, MPH, an adjunct faculty member with the Bloomberg School’s Department of Health Policy and Management. “Consequently, it is difficult to identify problems in particular aircraft or to estimate the feasibility of proposed improvements. It is our strong recommendation that a group such as the National Transportation Safety Board or FAA establish a program modeled after the military or the reporting system of the National Highway Traffic Safety Administration so we can ultimately reduce the number of aviation-related injuries and deaths.” The research was funded by grants from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy (www.jhsph.edu/InjuryCenter)
First time groups work together to enhance fire safety education
The National Fire Protection Association (NFPA) and the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health (JHSPH) announced a joint project titled Strengthening the Impact of Fire and Life Safety Messages on Children. The goal is to determine the best way to communicate fire safety messages to children ages 3-9. Each year approximately 290 children ages 3-9 die as a result of fire in the U.S. This project is made possible by funding from FEMA’s Grant Programs Directorate, U.S. Department of Homeland Security, AFG Fire Prevention and Safety Grants. “Fire departments and other safety educators reach out to millions of children each year to help them learn how to keep themselves safe from fire and other hazards,” said Judy Comoletti, NFPA’s division manager of public education. “As safety educators, it is vital that we understand and continually review what types of messaging have the greatest impact on children when encouraging them to practice safe behaviors. Resources being developed through this project will guide us and others interested in ways to best reach this young audience and their families with life-saving information.” Through this project, the two organizations are seeking to increase safety behaviors among children. Children will be asked to observe video vignettes that vary how safety content is communicated and how safety messages are framed. Researchers will evaluate what they learn, which types of messages have the most impact on children and how their parents react to the program. “The outcomes of this study will contribute to understanding how children and their parents react to safety messages,” said Andrea Gielen, ScM, ScD, director of the Johns Hopkins Center for Injury Research and Policy. “Despite the fact that injuries are the number one cause of death for children in the U.S., little is currently known about how best to reach them with safety information.” To ensure the outcomes of this study will impact future health education work, a guide for developing educational materials will be developed to help others involved in fire and life safety programs. The guide will be available on NFPA’s Web site for use by any fire department or other fire safety organization. The project is slated to be completed by July 2010.
A group of 18 research universities, professional organizations and advocacy groups have joined together to urge Congress to include injury prevention in health care reform. Each day, 475 Americans die from injuries related to motor vehicle crashes, assaults, fires and other trauma. This results in 170,000 deaths every year, more than twice that from diabetes and more than four times that of breast cancer. To reach policymakers and their staffs with the message that research based injury prevention can save lives and money, the group will run an ad in the September 8th “Health Care Hits the Road” theme issue of Roll Call, the newspaper of Capitol Hill. It is the first time these groups have come together to educate policymakers on the significant burden injuries pose to the health care system. “Injury is one of the most serious and costly health problems in the United States, yet many people are unaware that many injuries can be prevented by applying what we already know works. Right now we have an unprecedented opportunity to reduce costs and save lives,” said Andrea Gielen, ScD, ScM, director of the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy, one of the participating groups. “As two key goals of health care reform are to contain costs and improve outcomes, it’s a logical part of the solution to include injury prevention in health care reform. ” Key facts about injuries: - During the August congressional recess, an estimated 4 million Americans received medical care for injuries, generating 9 billion dollars in lifetime medical expenses.
- Injury is the number one cause of death for people ages 1 to 45.
- Nearly 50 million non-fatal injuries in the U.S. each year require medical care.
- Annually, injuries generate lifetime costs to society of $406 billion, including $80 billion in medical care.
Examples of proven effective prevention measures that can save lives and money are car seats and bike helmets. “These safety products have demonstrated their injury prevention and cost savings benefit time and again. Yet, only a handful of children’s hospitals offer comprehensive safety resource centers that we know can ensure that parents have access to lifesaving education and effective injury prevention devices,” explained Gielen. “At the other end of the age spectrum, older adults who exercise regularly, have their vision checked, undergo medication management, and who have access to a home hazard assessment can reduce their risk of experiencing a life-altering fall. Comprehensive fall prevention services can help reduce the 11.5 million falls treated annually in the health care system and the $14 billion in lifetime medical costs generated as a result.” Partner organizations include: American Academy of Pediatrics, American Trauma Society, Center for Injury Research and Policy of Nationwide Children’s Hospital, Harborview Injury Prevention & Research Center, Home Safety Council, Johns Hopkins Center for Injury Research and Policy, Medical College of Wisconsin Injury Research Center, Mount Sinai Injury Control Research Center, National Association of Children’s Hospitals and Related Institutions, National Fire Protection Association, Research!America, Safe Kids USA, Society for Advancement of Violence and Injury Research, State and Territorial Injury Prevention Directors Association, University of Iowa Injury Prevention Research Center, University of North Carolina Injury Prevention Research Center, Washington University Brown Center for Violence and Injury Prevention, and West Virginia University Injury Control Research Center. The advertisement, links to the partner organizations, and more examples of how to include injury prevention in health care reform are available online at www.jhsph.edu/InjuryCenter/HealthCareReform.
Death Rate from Unintentional Poisoning Triples in Middle-Aged White Women
While the total mortality rate from unintentional injury increased in the U.S. by 11 percent between 1999 and 2005, far larger increases were seen in some subgroups analyzed by age, race, ethnicity and type of injury by researchers at the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. Their analysis found that white women between 45 and 64 years old experienced a 230 percent increase in the rate of poisoning mortality over the study period. White men in this age group experienced an increase of 137 percent. The study is available online at the website of the American Journal of Preventive Medicine in advance of publication in the September print edition of the journal. The study also found mortality rates from falls varied widely across age and gender. The death rate from falls increased 38 percent for white men and 48 percent for white women 65 and older. The mortality rate did not increase significantly for older blacks of either sex. Overall, 89 percent of the total increase in unintentional injury deaths in the U.S. between 1999 and 2005 was due to poisoning among those 15 to 64 years old and falls among those 45 and older, which increased by about 11,200 and 6,600, respectively. “The large increases in the number of deaths attributable to poisoning and falls underscore the need for more research on the specific circumstances involved,” said study co-author Susan P. Baker, MPH, a professor with the Bloomberg School’s Center for Injury Research and Policy. “While we don’t know the cause behind the recent increase in falls mortality, it appears that the increase in poisonings is largely due to prescription drugs.” Baker says national prevention efforts are needed to control the abuse of prescription drugs and limit access. Prescriptions for opioid analgesics to address pain have increased dramatically in the past decade, and data from the Centers for Disease Control and Prevention (CDC) show that prescription drugs have replaced illegal drugs such as cocaine as the most prominent substances in fatal drug overdoses.
Senior author Guoqing Hu, PhD, and Baker analyzed data from the CDC Web-based Injury Statistics Query and Reporting System (WISQARS), which provides data on deaths according to cause and intent of injury. WISQARS mortality data are based on annual data files of the National Center for Health Statistics (NCHS) of CDC. In addition to falls and poisonings, four other leading causes of intentional injury deaths were identified for subsequent analyses: suffocation, drowning, fire/burns and motor vehicle crashes. Suffocation rates generally decreased or had no significant change, but they greatly increased in white children less than one year old. Drowning rates increased among white men 65 and older and among white middle-aged women, but decreased in black males 5 to 24 years old, black females 5 to14 years old, and whites females 15 to 24 years. Mortality from fires and burns decreased the most. The rate of dying due to a motorcycle crash more than doubled in Hispanic males 15 to 24 years and in white males ages 45 to 64 years. “By teasing out the impact of gender, age and race on trends in mortality rates, we are able to better identify changes worthy of attention from clinicians and policymakers,” said Hu. “As injury continues to be a leading cause of death for all age groups, and in fact the leading cause of death for adults 44 and younger, it’s critical we redouble our efforts to prevent unnecessary suffering and save lives.” The research was funded by the Johns Hopkins Center for Injury Research and Policy.
| 
