Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-30 (of 42 Records) |
Query Trace: Sleet DA [original query] |
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Accelerometer-Measured Daily Steps, Physical Function, and Subsequent Fall Risk in Older Women: The Objective Physical Activity and Cardiovascular Disease in Older Women Study
Schumacher BT , Bellettiere J , LaMonte MJ , Evenson KR , Di C , Lee IM , Sleet DA , Eaton CB , Lewis CE , Margolis KL , Tinker LF , LaCroix AZ . J Aging Phys Act 2021 30 (4) 1-11 Steps per day were measured by accelerometer for 7 days among 5,545 women aged 63-97 years between 2012 and 2014. Incident falls were ascertained from daily fall calendars for 13 months. Median steps per day were 3,216. There were 5,473 falls recorded over 61,564 fall calendar-months. The adjusted incidence rate ratio comparing women in the highest versus lowest step quartiles was 0.71 (95% confidence interval [0.54, 0.95]; ptrend across quartiles = .01). After further adjustment for physical function using the Short Physical Performance Battery, the incidence rate ratio was 0.86 ([0.64, 1.16]; ptrend = .27). Mediation analysis estimated that 63.7% of the association may be mediated by physical function (p = .03). In conclusion, higher steps per day were related to lower incident falls primarily through their beneficial association with physical functioning. Interventions that improve physical function, including those that involve stepping, could reduce falls in older adults. |
Using behavioral science theory to enhance public health nursing
Sleet DA , Dellinger AM . Public Health Nurs 2020 37 (6) 895-899 The application of behavioral science theory is instrumental in advancing nursing research and practice. Nurses can benefit from a thorough understanding of theoretical perspectives related to health behavior change. Behavioral science theory can provide a conceptual context for understanding patient behavior, it can guide research on the determinants of health behavior and health service delivery, and it can offer alternative approaches to nursing practice that may improve the effectiveness of patient care. The aim of this paper is to provide some examples of behavioral theories that can be used in nursing research and practice, and provide an example of how one theory, Stages of Change (Transtheoretical Model), can be applied to older adult fall prevention. Given the critical role behavior plays in premature morbidity and mortality, public health nurses and researchers can benefit by broadening the use of theory in the design and implementation of interventions, using behavioral theory as their guide. |
State-level seat belt use in the United States, 20112016: Comparison of self-reported with observed use and use by fatally injured occupants
Shakya I , Shults RA , Stevens MR , Beck LF , Sleet DA . J Safety Res 2020 73 103-109 Introduction: Despite 49 states and the District of Columbia having seat belt laws that permit either primary or secondary enforcement, nearly half of persons who die in passenger vehicle crashes in the United States are unbelted. Monitoring seat belt use is important for measuring the effectiveness of strategies to increase belt use. Objective: Document self-reported seat belt use by state seat belt enforcement type and compare 2016 self-reported belt use with observed use and use among passenger vehicle occupant (PVO) fatalities. Methods: We analyzed the Behavioral Risk Factor Surveillance System (BRFSS) self-reported seat belt use data during 2011–2016. The Pearson correlation coefficient (r) was used to compare the 2016 BRFSS state estimates with observed seat belt use from state-based surveys and with unrestrained PVO fatalities from the Fatality Analysis Reporting System. Results: During 2011–2016, national self-reported seat belt use ranged from 86–88%. In 2016, national self-reported use (87%) lagged observed use (90%) by 3 percentage points. By state, the 2016 self-reported use ranged from 64% in South Dakota to 93% in California, Hawaii, and Oregon. Seat belt use averaged 7 percentage points higher in primary enforcement states (89%) than in secondary states (82%). Self-reported state estimates were strongly positively correlated with state observational estimates (r = 0.80) and strongly negatively correlated with the proportion of unrestrained PVO fatalities (r = −0.77). Conclusion: National self-reported seat belt use remained essentially stable during 2011–2016 at around 87%, but large variations existed across states. Practical Applications: If seat belt use in secondary enforcement states matched use in primary enforcement states for 2016, an additional 3.98 million adults would have been belted. Renewed attention to increasing seat belt use will be needed to reduce motor-vehicle fatalities. Self-reported and observational seat belt data complement one another and can aid in designing targeted and multifaceted interventions. |
Using behavioral theory to enhance occupational safety and health: Applications to health care workers
Guerin RJ , Sleet DA . Am J Lifestyle Med 2020 15 (3) 269-278 Work-related morbidity and mortality are persistent public health problems across all US industrial sectors, including health care. People employed in health care and social services are at high risk for experiencing injuries and illnesses related to their work. Social and behavioral science theories can be useful tools for designing interventions to prevent workplace injuries and illnesses and can provide a roadmap for investigating the multilevel factors that may hinder or promote worker safety and health. Specifically, individual-level behavioral change theories can be useful in evaluating the proximal, person-related antecedents (such as perceived behavioral control) that influence work safety outcomes. This article (1) provides a brief overview of widely used, individual-level behavior change theories and examples of their application to occupational safety and health (OSH)–related interventions that involve the health care community; (2) introduces an integrated theory of behavior change and its application to promoting the OSH of health care workers; and (3) discusses opportunities for application of individual-level behavior change theory to OSH research and practice activities involving health care workers. The use of behavioral science to consider the role of individual behaviors in promoting health and preventing disease and injury provides a necessary complement to structural approaches to protecting workers in the health care industry. |
The Influence of Older Adults' Beliefs and Attitudes on Adopting Fall Prevention Behaviors
Stevens JA , Sleet DA , Rubenstein LZ . Am J Lifestyle Med 2018 12 (4) 324-330 Among Americans aged 65 years and older, falls are the leading cause of injury death and disability, and finding effective methods to prevent older adult falls has become a public health priority. While research has identified effective interventions delivered in community and clinical settings, persuading older adults to adopt these interventions has been challenging. Older adults often do not acknowledge or recognize their fall risk. Many see falls as an inevitable consequence of aging. Health care providers can play an important role by identifying older adults who are likely to fall and providing clinical interventions to help reduce fall risks. Many older people respect the information and advice they receive from their providers. Health care practitioners can encourage patients to adopt effective fall prevention strategies by helping them understand and acknowledge their fall risk while emphasizing the positive benefits of fall prevention such as remaining independent. To help clinicians integrate fall prevention into their practice, the Centers for Disease Control and Prevention launched the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative. It provides health care providers in primary care settings with resources to help them screen older adult patients, assess their fall risk, and provide effective interventions. |
The global challenge of child injury prevention
Sleet DA . Int J Environ Res Public Health 2018 15 (9) If a disease were killing our children at the rate unintentional injuries are, the public would be outraged and demand that this killer be stopped” | | -C. Everett Koop, MD13th Surgeon General of the United States of America (1982 to 1989). | Go to: | 1. Background | The health of children has changed significantly during the past 50 years. Widespread immunization programs have nearly eliminated the threat of infectious diseases, such as polio, diphtheria, and measles. However, a major public health problem that continues to threaten the health of all children has no vaccine: injury. Child injury represents one of the most immediate public health threats, resulting in the death of nearly 2000 children under age 14 every day around the world. (http://www.who.int/healthinfo/global_burden_disease/estimates/en/). According to Margaret Chan, former Director General of the World Health Organization (WHO), and Ann Veneman, former Executive Director of the United Nations Children’s Fund [1]: | | Once children reach the age of five years, unintentional injuries are the biggest threat to their survival. Unintentional injuries are also a major cause of disabilities, which can have a long-lasting impact on all facets of children’s lives: relationships, learning and play. Among those children who live in poverty, the burden of injury is highest. Child injuries have been neglected for many years and are largely absent from child survival initiatives presently on the global agenda. The World Health Organization, the United Nations Children’s Fund and many partners have set out to elevate child injury to a priority for the global public health and development communities. |
Injury prevention and health promotion: A global perspective
Franklin RC , Sleet DA . Health Promot J Austr 2018 29 (2) 113-116 Since its inception 27 years ago (1990), the Health Promotion Journal of Australia has featured many articles on aspects of injury prevention, particularly noticeable during the past five years. With this issue, it will be only the second time the journal has launched a Special Issue on injury prevention, the first one appearing in Volume 1, issue 2, in 1991.1 As editors of the current issue, we felt the dedicated emphasis on injury prevention and health promotion in the journal is long overdue, given that our careers in injury prevention have changed considerably since the first Special Issue was published (and that a new cadre of health promotion professionals have entered the field). Therefore, we believe it is timely and important to feature some of the recent research focusing on injury prevention and health promotion. |
The epidemiology of unintentional and violence-related injury morbidity and mortality among children and adolescents in the United States
Ballesteros MF , Williams DD , Mack KA , Simon TR , Sleet DA . Int J Environ Res Public Health 2018 15 (4) Injuries and violence among young people have a substantial emotional, physical, and economic toll on society. Understanding the epidemiology of this public health problem can guide prevention efforts, help identify and reduce risk factors, and promote protective factors. We examined fatal and nonfatal unintentional injuries, injuries intentionally inflicted by other (i.e., assaults and homicides) among children ages 0-19, and intentionally self-inflicted injuries (i.e., self-harm and suicides) among children ages 10-19. We accessed deaths (1999-2015) and visits to emergency departments (2001-2015) for these age groups through the Centers for Disease Control and Prevention's (CDC) Web-based Injury Statistics Query and Reporting System (WISQARS), and examined trends and differences by age, sex, race/ethnicity, rural/urban status, and injury mechanism. Almost 13,000 children and adolescents age 0-19 years died in 2015 from injury and violence compared to over 17,000 in 1999. While the overall number of deaths has decreased over time, there were increases in death rates among certain age groups for some categories of unintentional injury and for suicides. The leading causes of injury varied by age group. Our results indicate that efforts to reduce injuries to children and adolescents should consider cause, intent, age, sex, race, and regional factors to assure that prevention resources are directed at those at greatest risk. |
A comprehensive approach to motorcycle-related head injury prevention: Experiences from the field in Vietnam, Cambodia, and Uganda
Craft G , Van Bui T , Sidik M , Moore D , Ederer DJ , Parker EM , Ballesteros MF , Sleet DA . Int J Environ Res Public Health 2017 14 (12) Motorcyclists account for 23% of global road traffic deaths and over half of fatalities in countries where motorcycles are the dominant means of transport. Wearing a helmet can reduce the risk of head injury by as much as 69% and death by 42%; however, both child and adult helmet use are low in many countries where motorcycles are a primary mode of transportation. In response to the need to increase helmet use by all drivers and their passengers, the Global Helmet Vaccine Initiative (GHVI) was established to increase helmet use in three countries where a substantial portion of road users are motorcyclists and where helmet use is low. The GHVI approach includes five strategies to increase helmet use: targeted programs, helmet access, public awareness, institutional policies, and monitoring and evaluation. The application of GHVI to Vietnam, Cambodia, and Uganda resulted in four key lessons learned. First, motorcyclists are more likely to wear helmets when helmet use is mandated and enforced. Second, programs targeted to at-risk motorcyclists, such as child passengers, combined with improved awareness among the broader population, can result in greater public support needed to encourage action by decision-makers. Third, for broad population-level change, using multiple strategies in tandem can be more effective than using a single strategy alone. Lastly, the successful expansion of GHVI into Cambodia and Uganda has been hindered by the lack of helmet accessibility and affordability, a core component contributing to its success in Vietnam. This paper will review the development of the GHVI five-pillar approach in Vietnam, subsequent efforts to implement the model in Cambodia and Uganda, and lessons learned from these applications to protect motorcycle drivers and their adult and child passengers from injury. |
Universal motorcycle helmet laws to reduce injuries: A Community Guide Systematic Review
Peng Y , Vaidya N , Finnie R , Reynolds J , Dumitru C , Njie G , Elder R , Ivers R , Sakashita C , Shults RA , Sleet DA , Compton RP . Am J Prev Med 2017 52 (6) 820-832 CONTEXT: Motorcycle crashes account for a disproportionate number of motor vehicle deaths and injuries in the U.S. Motorcycle helmet use can lead to an estimated 42% reduction in risk for fatal injuries and a 69% reduction in risk for head injuries. However, helmet use in the U.S. has been declining and was at 60% in 2013. The current review examines the effectiveness of motorcycle helmet laws in increasing helmet use and reducing motorcycle-related deaths and injuries. EVIDENCE ACQUISITION: Databases relevant to health or transportation were searched from database inception to August 2012. Reference lists of reviews, reports, and gray literature were also searched. Analysis of the data was completed in 2014. EVIDENCE SYNTHESIS: A total of 60 U.S. studies qualified for inclusion in the review. Implementing universal helmet laws increased helmet use (median, 47 percentage points); reduced total deaths (median, -32%) and deaths per registered motorcycle (median, -29%); and reduced total injuries (median, -32%) and injuries per registered motorcycle (median, -24%). Repealing universal helmet laws decreased helmet use (median, -39 percentage points); increased total deaths (median, 42%) and deaths per registered motorcycle (median, 24%); and increased total injuries (median, 41%) and injuries per registered motorcycle (median, 8%). CONCLUSIONS: Universal helmet laws are effective in increasing motorcycle helmet use and reducing deaths and injuries. These laws are effective for motorcyclists of all ages, including younger operators and passengers who would have already been covered by partial helmet laws. Repealing universal helmet laws decreased helmet use and increased deaths and injuries. |
Building safety into active living initiatives
Pollack K , Bailey M , Gielen A , Wolf S , Auld ME , Sleet DA , Lee KK . Prev Med 2014 69 Suppl 1 S102-5 OBJECTIVE: Efforts to promote environmental designs that facilitate opportunities for physical activity should consider the fact that injuries are the leading cause of death for Americans ages 1 to 44, with transportation-related injuries the most common cause. Drawing on the latest research and best practices in the field of injury prevention, the purpose of this article is to provide those working to promote physical activity with evidence-based recommendations on building in safety while designing active environments. METHOD: A systematic review of the peer-reviewed and gray literature published from 1995 to 2012 was conducted to identify injury prevention strategies applicable to objectives in the Active Design Guidelines (ADG), which present design strategies for active living. Injury prevention strategies were rated according to the strength of the research evidence. RESULTS: We identified 18 urban design strategies and 9 building design strategies that promote safety. Evidence was strong or emerging for 14/18 urban design strategies and 7/9 building design strategies. CONCLUSION: ADG strategies are often wholly compatible with well-accepted injury prevention principles. By partnering with architects and planners, injury prevention and public health professionals can help ensure that new and renovated spaces maximize both active living and safety. |
Can an evidence-based fall prevention program be translated for use in culturally diverse communities?
Sleet DA , Baldwin GT . J Sport Health Sci 2014 3 (1) 32-33 Older adult falls remain a significant public health problem amenable to preventive interventions (CDC, 2009; CDC, 2011). Despite the progress made in identifying risk factors, developing efficacious health-related interventions, and promoting evidence-based programs in the community, much work remains before these strategies are broadly available and effectively used to reduce fall-related injuries (Noonan, Sleet, Stevens, 2011). Newton and Scott-Findlay (2007) point out that the translation of basic scientific knowledge into clinical studies, and from clinical studies to improvements in health services and public health practices, remain major obstacles to widespread adoption. | Donaldson and Finch (2013) showed the feasibility of applying implementation science to sports injury prevention and Li et al (2008) demonstrated how an exercise and balance program (Tai Chi) can successfully be translated into a community program. As important, Li and colleagues maintained program fidelity and adherence to their intervention, at least over the short term, to prevent older adult falls. Manson et al (2013) showed positive results taking a Tai Chi program to low-income older adults, concluding that “non-(Tai chi) culturally related ethnic groups did not experience a barrier to participation in an older low-socioeconomic population sample” (p270). However, the sample consisted of only 56 participants who were recruited into a 16-week program and no attempt was made to translate the findings to the wider multi-ethnic community through the use of existing stakeholders. |
CDC Grand Rounds: evidence-based injury prevention
Degutis LC , Sleet DA , Kohn M , Benjamin G , Cohen N , Iskander J . MMWR Morb Mortal Wkly Rep 2014 62 1048-50 Approximately 5.8 million persons die from injuries each year, accounting for 10% of all deaths worldwide. In the United States, 180,000 persons die each year from injuries, making the category the country's leading cause of death for those aged 1-44 years and the leading cause of years of potential life lost before age 65 years. Injuries also result in 2.8 million hospitalizations and 29 million emergency department visits each year in the United States. Motor vehicle crashes, falls, homicides, suicides, domestic violence, child maltreatment, and other forms of intentional and unintentional injury affect all strata of society, with widespread physical, mental, and reproductive health consequences. Injuries and violence affect not only individuals, but also families and communities, producing substantial economic and societal burdens related to health-care costs, work loss, and disruption of education. The estimated annual U.S. cost in medical expenses and lost productivity resulting from injuries is $355 billion. |
Motor vehicle injury prevention
Sleet DA , Viano DC , Dellinger A . Oxford Bibliographies, Public Health 2013 One hundred years after the first self-propelled vehicle was invented, the world’s first recorded traffic death occurred when Mary Ward was thrown from the passenger seat of her cousin’s steam-powered car and rolled underneath the vehicle traveling 3-4 mph in Ireland on August 31, 1869. The first traffic fatality in the United States reportedly occurred in New York City in 1899 when Henry H. Bliss stepped off a streetcar and was struck by a passing electric-powered taxicab at the corner of Central Park West and 74th Street. By 1900 the yearly traffic death toll in the United States was up to thirty-six, and by 1972 a staggering 54,000 people were killed in traffic, and 2 million maimed. In 2009, traffic injuries were the leading cause of death of Americans aged 10–14, 15–19, and 20–24. The annual cost of motor vehicle–related fatal and nonfatal injuries is $99 billion in medical expenses and lost productivity, which is nearly the equivalent of $500 for each licensed driver in the United States. Motor vehicle travel is the most common form of transportation in the United States, although pedestrians, motorcyclists, and bicyclists are also injured in traffic. The number of registered automobiles in the United States grew from 8,000 in 1900 to 250 million in 2010, yet deaths per 100 million vehicle miles traveled actually declined by 77 percent between 1966 and 2010. Advances in the safety of vehicles, improved roads, and changes in driver behavior have led to this improvement. The conceptualization of this approach was fostered by William Haddon Jr., who developed models for exploring countermeasures to reduce or prevent injuries involving elements in the causal sequence related to the host (driver and passenger), agent (vehicle), and environment (roads and highways). Still, in 2009, the United States lost 33,808 people in traffic crashes. The major risk factors include non-use of seat belts and child restraints, alcohol, speed, non-use of helmets, and distracted driving. According to Rumar (The role of perceptual and cognitive filters in observed behavior, in Human behavior and traffic safety, Edited by L. Evans and R. Schwing. New York: Plenum, 1985) only 3 percent of crashes are due solely to the roadway environment, 2 percent solely to vehicles, and 27 percent to the combination of road environment and drivers. Globally, 1.3 million people die each year from road traffic injuries, or about 3,000 each day. Around 90 percent of those deaths occur in low- and middle-income countries. By 2020, traffic-related injuries will be the third leading contributor to the global burden of disease and injury, up from the eighth leading cause in 2009. This article describes the science of motor vehicle injury prevention and control, and identifies resources on the history, development, and application of principles of injury control to reduce traffic injury. |
Prevention of injury and violence in the USA
Haegerich TM , Dahlberg LL , Simon TR , Baldwin GT , Sleet DA , Greenspan AI , Degutis LC . Lancet 2014 384 (9937) 64-74 In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with physical, emotional, and financial problems. Injuries and violence are not accidents; they are preventable. Prevention has a strong scientific foundation, yet efforts are not fully implemented or integrated into clinical and community settings. In this Series paper, we review the burden of injuries and violence in the USA, note effective interventions, and discuss methods to bring interventions into practice. Alliances between the public health community and medical care organisations, health-care providers, states, and communities can reduce injuries and violence. We encourage partnerships between medical and public health communities to consistently frame injuries and violence as preventable, identify evidence-based interventions, provide scientific information to decision makers, and strengthen the capacity of an integrated health system to prevent injuries and violence. |
Publicized sobriety checkpoint programs: a Community Guide systematic review
Bergen G , Pitan A , Qu S , Shults RA , Chattopadhyay SK , Elder RW , Sleet DA , Coleman HL , Compton RP , Nichols JL , Clymer JM , Calvert WB . Am J Prev Med 2014 46 (5) 529-539 CONTEXT: Publicized sobriety checkpoint programs deter alcohol-impaired driving by stopping drivers systematically to assess their alcohol impairment. Sobriety checkpoints were recommended in 2001 by the Community Preventive Services Task Force for reducing alcohol-impaired driving, based on strong evidence of effectiveness. Since the 2001 review, attention to alcohol-impaired driving as a U.S. public health problem has decreased. This systematic review was conducted to determine if available evidence supports the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-impaired driving, given the current context. The economic costs and benefits of the intervention were also assessed. EVIDENCE ACQUISITION: This review focused on studies that evaluated the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities. Using Community Guide methods, a systematic search was conducted for studies published between July 2000 and March 2012 that assessed the effectiveness of publicized sobriety checkpoint programs. EVIDENCE SYNTHESIS: Fourteen evaluations of selective breath testing and one of random breath testing checkpoints met the inclusion criteria for the systematic review, conducted in 2012. Ten evaluations assessed the effects of publicized sobriety checkpoint programs on alcohol-involved crash fatalities, finding a median reduction of 8.9% in this crash type (interquartile interval=-16.5%, -3.5%). Five economic evaluations showed benefit-cost ratios ranging from 2:1 to 57:1. CONCLUSIONS: The number of studies, magnitude of effect, and consistency of findings indicate strong evidence of the effectiveness of publicized sobriety checkpoint programs in reducing alcohol-involved crash fatalities. Economic evidence shows that these programs also have the potential for substantial cost savings. |
Motorcycle helmet attitudes, behaviours and beliefs among Cambodians
Roehler DR , Sann S , Kim P , Bachani AM , Campostrini S , Florian M , Sidik M , Blanchard C , Sleet DA , Hyder AA , Ballesteros MF . Int J Inj Contr Saf Promot 2013 20 (2) 179-83 Motorcycle fatalities are increasing at an alarming rate in many South-East Asian countries, including Cambodia. Through brief face-to-face roadside interviews in Phnom Penh and four other Cambodian provinces, this article assesses Cambodian motorcyclists' attitudes, behaviours and beliefs related to motorcycle helmets. Out of 1016 motorcyclists interviewed, 50% were drivers, 40% were older passengers and 10% were child passengers. More drivers (50%) reported consistently wearing helmets, compared with older passengers (14%). Saving their life in the event of a crash was the impetus for drivers and older passengers to wear a helmet (96% and 98%, respectively). The top barriers to helmet use were: (1) 'depends on where I drive,' (2) 'I forget' and (3) 'inconvenient' or 'uncomfortable'. These descriptive findings were instrumental in shaping the Cambodian Helmet Vaccine Initiative passenger campaign to reduce the motorcycle-related injuries and fatalities to support the United Nations Decade of Action for Road Safety. |
The state of US health, 1990-2010: burden of diseases, injuries, and risk factors
Murray CJ , Abraham J , Ali MK , Alvarado M , Atkinson C , Baddour LM , Bartels DH , Benjamin EJ , Bhalla K , Birbeck G , Bolliger I , Burstein R , Carnahan E , Chen H , Chou D , Chugh SS , Cohen A , Colson KE , Cooper LT , Couser W , Criqui MH , Dabhadkar KC , Dahodwala N , Danaei G , Dellavalle RP , Des Jarlais DC , Dicker D , Ding EL , Dorsey ER , Duber H , Ebel BE , Engell RE , Ezzati M , Felson DT , Finucane MM , Flaxman S , Flaxman AD , Fleming T , Forouzanfar MH , Freedman G , Freeman MK , Gabriel SE , Gakidou E , Gillum RF , Gonzalez-Medina D , Gosselin R , Grant B , Gutierrez HR , Hagan H , Havmoeller R , Hoffman H , Jacobsen KH , James SL , Jasrasaria R , Jayaraman S , Johns N , Kassebaum N , Khatibzadeh S , Knowlton LM , Lan Q , Leasher JL , Lim S , Lin JK , Lipshultz SE , London S , Lozano R , Lu Y , Macintyre MF , Mallinger L , McDermott MM , Meltzer M , Mensah GA , Michaud C , Miller TR , Mock C , Moffitt TE , Mokdad AA , Mokdad AH , Moran AE , Mozaffarian D , Murphy T , Naghavi M , Narayan KM , Nelson RG , Olives C , Omer SB , Ortblad K , Ostro B , Pelizzari PM , Phillips D , Pope CA , Raju M , Ranganathan D , Razavi H , Ritz B , Rivara FP , Roberts T , Sacco RL , Salomon JA , Sampson U , Sanman E , Sapkota A , Schwebel DC , Shahraz S , Shibuya K , Shivakoti R , Silberberg D , Singh GM , Singh D , Singh JA , Sleet DA , Steenland K , Tavakkoli M , Taylor JA , Thurston GD , Towbin JA , Vavilala MS , Vos T , Wagner GR , Weinstock MA , Weisskopf MG , Wilkinson JD , Wulf S , Zabetian A , Lopez AD . JAMA 2013 310 (6) 591-608 IMPORTANCE: Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy. OBJECTIVES: To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries. DESIGN: We used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010 Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health experienced at different ages. RESULTS: US life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34 OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to 27th, and for HALE from 14th to 26th. CONCLUSIONS AND RELEVANCE: From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations. |
Years of potential life lost from unintentional child and adolescent injuries - United States, 2000-2009
Borse NN , Rudd RA , Dellinger AM , Sleet DA . J Safety Res 2013 45 127-31 INTRODUCTION: Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simple method to identify important causes of premature death. METHODS: CDC analyzed data from the National Vital Statistics System multiple cause of death files for 2000-2009. RESULTS: An average of 890YPLL were lost each year due to unintentional injuries for every 100,000 persons aged 0-19 years. YPLL rates differed by sex, age group, race/ethnicity, injury mechanism and state. CONCLUSIONS: This report provides new information which can be used to prioritize interventions and identify subgroups of the population most at risk. |
Risky play and children's safety: balancing priorities for optimal child development
Brussoni M , Olsen LL , Pike I , Sleet DA . Int J Environ Res Public Health 2012 9 (9) 3134-3148 Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children's outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends indicate children's diminishing engagement in outdoor play is influenced by parental and societal concerns. We outline the importance of play as a necessary ingredient for healthy child development and review the evidence for arguments supporting the need for outdoor risky play, including: (1) children have a natural propensity towards risky play; and, (2) keeping children safe involves letting them take and manage risks. Literature from many disciplines supports the notion that safety efforts should be balanced with opportunities for child development through outdoor risky play. New avenues for investigation and action are emerging seeking optimal strategies for keeping children "as safe as necessary," not "as safe as possible." This paradigm shift represents a potential for epistemological growth as well as cross-disciplinary collaboration to foster optimal child development while preserving children's safety. (2012 by the authors; licensee MDPI, Basel, Switzerland.) |
From modest beginnings to a winnable battle: road safety efforts at CDC's Injury Center
Dellinger AM , Sleet DA . J Safety Res 2012 43 (4) 279-82 There are now more than 200 million licensed drivers, who drive an average of 13,000 miles per year on 4 million miles of roads. In 2010 crashes resulted in nearly 33,000 deaths and millions of nonfatal injuries. This article describes the Injury Center's response to this public health threat from our beginnings as a small Center in 1992, current motor vehicle injury prevention priorities, and emerging road safety issues that will need attention in the future. |
A history of injury and violence prevention in public health and evolution of the National Center for Injury Prevention and Control at CDC
Sleet DA , Baldwin G , Marr A , Spivak H , Patterson S , Morrison C , Holmes W , Peeples AB , Degutis LC . J Safety Res 2012 43 (4) 233-47 Injuries and violence are among the oldest health problems facing humans. And yet, only within the past 50 years has the problem being addressed with scientific rigor using public health methods. The field of injury and violence prevention began as early as 1913, but wasn't approached systematically or epidemiologically until the 1940s and 1950s. It accelerated rapidly between 1960 and 1985. Coupled with active federal and state interest in reducing injuries and violence, this period was marked by important medical, scientific, and public health advances. The National Center for Injury Prevention and Control (NCIPC) was an outgrowth of this progress and in 2012 celebrated its 20th anniversary. NCIPC was created in 1992 after a series of government reports identified injury as one of the most important public health problems facing the nation. Congressional action provided the impetus for the creation of NCIPC as the lead federal agency for non-occupational injury and violence prevention. In subsequent years, NCIPC and its partners fostered many advances and built even greater capacity. Because of the tragically high burden and cost of injuries and violence in the United States and across the globe, researchers, practitioners, and decision makers can improve progress by redoubling prevention efforts in the next 20 years. This article traces the history of injury and violence prevention as a public health priority – including the evolution and current structure of the CDC's National Center for Injury Prevention and Control. |
Injury prevention, violence prevention, and trauma care: building the scientific base
Sleet DA , Dahlberg LL , Basavaraju SV , Mercy JA , McGuire LC , Greenspan A . MMWR Suppl 2011 60 (4) 78-85 Injuries and violence are widespread in society. Unintentional injuries and injuries caused by acts of violence are among the top 10 killers of U.S. residents of all ages. Injuries are the leading cause of death of persons aged 1--44 years and a leading cause of disability among persons of all ages, regardless of sex, race/ethnicity, or socioeconomic status. Nearly 180,000 persons die each year from unintentional injuries or from acts of violence, and one in 10 sustains a nonfatal injury serious enough to require treatment in a hospital emergency department (1). In addition, injuries and violence have a major effect on the well-being of Americans by contributing to premature death, disability, poor mental and physical health, chronic disease, and other health conditions, as well as high medical costs and lost productivity. | | The science of injury prevention and control encompasses activities from primary prevention through treatment and rehabilitation. Since 1961, when MMWR was first published by CDC, progress has been made in developing the science of injury prevention and control, creating surveillance systems to capture injury mechanisms and intent, and establishing a scientific framework to address injury prevention and treatment. |
Scientific evidence and policy change: lowering the legal blood alcohol limit for drivers to 0.08% in the USA
Sleet DA , Mercer SL , Cole KH , Shults RA , Elder RW , Nichols JL . Glob Health Promot 2011 18 (1) 23-26, 115, 150 The United States (US) Centers for Disease Control and Prevention (CDC), and key partners conducted a systematic review of the effectiveness of 0.08% blood alcohol concentration (BAC) laws on alcohol-related traffic mortality. Review findings of strong evidence of effectiveness were presented by partners during US Congressional hearings contributing to the passage of a bill requiring states to lower the legal BAC limit to 0.08% (80 mg of alcohol/100 ml of blood) or lose a portion of their federal highway funds. The bill was signed into law, making 0.08 the new national standard. Extensive and targeted dissemination of the evidence and recommendations to key stakeholders and partners built support for policy change at the state level. |
Announcing a decade of action for global road safety
Baldwin G , Sleet DA . Am J Lifestyle Med 2011 5 (3) 291-292 In March 2010, a “Decade of Action for Global Road Safety, 2011-2020” was declared by the United Nations. According to Michael R. Bloomberg, Mayor of New York City, “Unless we take some vigorous steps now, traf-fi c fatalities are expected to overtake HIV/AIDS, tuberculosis, and lung can-cer to become the fi fth leading cause of death globally by 2030.” The road safety tag (above) is the global symbol of the movement to improve safety on the road (www.decadeofaction.org).Each year, 1.3 million people are killed on the world’s roads, at least 90% in developing countries. Deaths and injuries from road crashes rival those of malaria and tuberculosis, killing 3500 people every day around the world, with 90% of the casualties occurring in the develop-ing world. This annual toll is forecast by the World Health Organization to increase to around 1.9 million deaths by 2020. The cost of road injuries to developing coun-tries is $100 billion a year, roughly equiv-alent to all overseas aid. Even though effective interventions to prevent global road trauma to drivers, vehicle occupants, pedestrians, and cyclists already exist, they are not widely adopted |
The decade of action for global road safety
Sleet DA , Baldwin G , Dellinger A , Dinh-Zarr B . J Safety Res 2011 42 (2) 147-8 Road traffic injuries are the ninth leading cause of death in the world, resulting in 1.3 million deaths and between 20 and 50 million nonfatal injuries each year, and are the leading cause of death among young people aged 15–29 years. They are expected to become the fifth leading cause of death globally by 2030, and at least 90% of these deaths and injuries occur in low- and middle-income countries. Deaths and injuries from road crashes rival those of malaria and TB, killing over 3,000 persons every day around the world (World Health Organization [WHO], 2009, Peden et al., 2004). Projections indicate that, without new and sustained commitment to preventing such injuries, the situation will worsen with a projected increase in deaths of about 65% over the next 20 years (Kopits and Cropper, 2003, Murray and Lopez, 1996). |
Effectiveness of ignition interlocks for preventing alcohol-impaired driving and alcohol-related crashes: a community guide systematic review
Elder RW , Voas R , Beirness D , Shults RA , Sleet DA , Nichols JL , Compton R . Am J Prev Med 2011 40 (3) 362-76 A systematic review of the literature to assess the effectiveness of ignition interlocks for reducing alcohol-impaired driving and alcohol-related crashes was conducted for the Guide to Community Preventive Services (Community Guide). Because one of the primary research issues of interest-the degree to which the installation of interlocks in offenders' vehicles reduces alcohol-impaired driving in comparison to alternative sanctions (primarily license suspension)-was addressed by a 2004 systematic review conducted for the Cochrane Collaboration, the current review incorporates that previous work and extends it to include more recent literature and crash outcomes. The body of evidence evaluated includes the 11 studies from the prior review, plus four more recent studies published through December 2007. The installation of ignition interlocks was associated consistently with large reductions in re-arrest rates for alcohol-impaired driving within both the earlier and later bodies of evidence. Following removal of interlocks, re-arrest rates reverted to levels similar to those for comparison groups. The limited available evidence from three studies that evaluated crash rates suggests that alcohol-related crashes decrease while interlocks are installed in vehicles. According to Community Guide rules of evidence, these findings provide strong evidence that interlocks, while they are in use in offenders' vehicles, are effective in reducing re-arrest rates. However, the potential for interlock programs to reduce alcohol-related crashes is currently limited by the small proportion of offenders who participate in the programs and the lack of a persistent beneficial effect once the interlock is removed. Suggestions for facilitating more widespread and sustained use of ignition interlocks are provided. |
An older adult falls research agenda from a public health perspective
Stevens JA , Baldwin GT , Ballesteros MF , Noonan RK , Sleet DA . Clin Geriatr Med 2010 26 (4) 767-79 This article reviews fall prevention research using the Centers for Disease Control public health model and suggests several critical research questions at each step. Research topics include surveillance and data systems, fall risk factors, development, evaluation and implementation of fall interventions, translation of interventions into programs, and promotion, dissemination, and widespread adoption of fall prevention programs. These broad topics provide a framework for research that can guide future advances in older adult fall prevention. |
A review of unintentional injuries in adolescents
Sleet DA , Ballesteros MF , Borse NN . Annu Rev Public Health 2010 31 195-212 Unintentional injuries are the largest source of premature morbidity and mortality and the leading cause of death among adolescents 10-19 years of age. Fatal injury rates of males are twice those of females, and racial disparities in injury are pronounced. Transportation is the largest source of these injuries, principally as drivers and passengers, but also as cyclists and pedestrians. Other major causes involve drowning, poisonings, fires, sports and recreation, and work-related injuries. Implementing known and effective prevention strategies such as using seat belts and bicycle and motorcycle helmets, installing residential smoke alarms, reducing misuse of alcohol, strengthening graduated driver licensing laws, promoting policy change, using safety equipment in sports and leisure, and protecting adolescents at work will all contribute to reducing injuries. The frequency, severity, potential for death and disability, and costs of these injuries, together with the high success potential of prevention strategies, make injury prevention a key public health goal to improve adolescent health in the future. |
Ecological approaches to the prevention of unintentional injuries
Allegrante JP , Hanson DW , Sleet DA , Marks R . Ital J Public Health 2010 7 (2) 24-31 BACKGROUND: Injury as a cause of significant morbidity and mortality has remained fairly stable in countries with developed economies. Although injury prevention often is conceptualised as a biomedical construct, such a reductionist perspective overlooks the importance of the psychological, environmental, and sociocultural conditions as contributing factors to injury and its consequences. This paper describes the potential of the ecological model for understanding the antecedent causes of unintentional injuries and guiding injury prevention approaches. We review the origins and conceptualise the elements of the ecological model and conclude with some examples of applications of ecological approaches to the prevention of unintentional injury and promotion of community safety. METHODS: A review of the English-language literature on the conceptualization of ecological models in public health and injury prevention, including the application of the ecological model in the prevention of falls and road traffic injuries and in the community safety promotion movement. RESULTS: Three dimensions are important in social-ecological systems that comprise key determinants of injuries: 1) the individual and his or her behaviour, 2) the physical environment, and 3) the social environment. Social and environmental determinants have profound impact on population health and in the causation of injuries. | CONCLUSIONS: Social and environmental determinants of injury should be studied with the same energy, urgency, and intellectual rigor as physical determinants. Application of the ecological model in injury prevention shows the most promise in falls injury prevention, road traffic injury prevention, and community safety promotion. |
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