Millions of injuries could be prevented every year if states adopted and enforced a set of laws and health policies with proven track records for saving lives, says a report out Tuesday, but many states are reluctant to do so when personal freedoms are at stake and as revenue continues to decline.
Injuries are the leading cause of death for Americans between the ages of 1 and 44, and the third leading cause of death overall. About 50 million Americans get medical treatment for injuries every year. Yet 24 states have enacted five or fewer of 10 injury-prevention measures examined in the report, by the Trust for America's Health and the Robert Wood Johnson Foundation. It's online at healthyamericans.org.
"We have a long way to go to get uniform coverage to protect more people across the country," says co-author Andrea Gielen, director of the Johns Hopkins Center for Injury Research and Policy in Baltimore. "We hope the report moves states and communities to do more. These are common-sense measures that could prevent many injuries and save lives if people were aware of them and supportive of them."
No state has approved all 10 measures, which range from seat belt laws to sports concussion safety laws, drug monitoring, and laws related to teen dating violence. But California and New York scored the highest, with nine each. Montana and Ohio scored lowest, with two each.
"We know injuries are preventable and we'd certainly rather prevent them than deal with the aftermath, which often results in death or long-term disability," says Linda Degutis, director of the Centers for Disease Control and Prevention's Injury Center, which is not associated with the report. "Having certain laws in place helps people follow a safe strategy."
There are impediments. "Some states see requiring people to wear seat belts as a threat to personal liberty," says Jonathan Adkins, spokesman for the Governors Highway Safety Association. "Others see it as a way to allow racial profiling, meaning the police could use it as an excuse to pull anyone over."
But clearly, primary seat belt laws send the strongest signal and are very effective." Primary seat belt laws allow police to issue tickets for not wearing a seat belt without any other traffic offense. Secondary seat belt laws allow police to issue tickets for not wearing a seat belt only if another traffic offense has been committed.
The two groups worked with a committee of top injury-prevention experts from the Safe States Alliance and the Society for the Advancement of Violence and Injury Prevention to develop the list of 10 safety measures.
Among the findings of the report, online at healthyamericans.org:
�18 states do not have primary seat belt laws. Seat belts have saved an estimated 69,000 lives from 2006 to 2010. In states that have switched from secondary seat belt laws to primary laws, fatal injuries have declined 9%, Degutis says.
�34 states and Washington, D.C., do not require mandatory ignition interlocks for convicted drunk drivers. Every day about 30 people die in the USA in car crashes that involve an alcohol-impaired driver, according to the Centers for Disease Control and Prevention.
�31 states do not require helmets for all motorcycle riders. Helmets have saved the lives of about 8,000 people from 2005 to 2009.
�29 states do not require bicycle helmets for children. "Not everyone can afford helmets for their children and it's important for children to get exercise in light of all the concern about childhood obesity," Gielen says. "Sometimes communities can help out by raising awareness and taking action. It doesn't all have to be done by the states."
�17 states do not require that children ride in a car seat or booster seat until at least age 8.
The national rate for injury-related deaths is 57.9 per 100,000, says the report. New Mexico has the highest rate of injury-related deaths in the USA, with 97.8 per 100,000 people, while New Jersey has the lowest rate, at 36.1 per 100,000.
The report also notes only 31 states have full-time injury and violence prevention directors, "limiting injury prevention efforts." Also, federal funding for injury prevention dropped 24% from 2006 to 2011.
The report did not study whether all kinds of injuries are increasing or decreasing over time, but it notes that one kind is soaring.
"The number of prescriptions for pain killers has more than tripled in the past three years and we've also seen a tripling in the number of poisonings," says Jeff Levi, executive director of the Trust for America's Health. "To me that was one of the stunning things to jump out from the numbers."
Among the report's recommendations: every state establish a prescription drug monitoring program.
Adopting that measure and nine others would also greatly reduce health care costs, Levi adds. Every year, injuries generate $406 billion in costs for medical care and lost productivity.
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