Healthy People Consortium Meeting and Public Hearing
"Building the Next Generation of Healthy People"
November 12 and 13, 1998
Capital Hilton, Washington, D.C.

Injury/Violence Prevention

General Comments and Comments Relating to Crosscutting Objectives #1-#7 :

(A) General comment: Most individuals may not think about violence and injury as part of the same chapter. Since the two areas are combined, there is a need to develop and implement educational efforts so that the user and individuals will know that violence is a part of the Injury Chapter. Need to make a definitive statement so that users will have a reference to know where violence objectives are located.

(B) Question: When and how will OMB classification be incorporated? The reply was that it will be incorporated into the final draft and where appropriate.

(C) Utilization of data from ED visits was suggested as a way to obtain a "broaded picture" of types of injuries. The suggestion was also made that programs could then develop more appropriate interventions and strategies based on that data. It was also suggested that DEEDS should be used as a data source.

(F) Add a general comment for the entire document to clarify whether data includes states and the territories. Some objectives may just relate to the states while others may include the states and the territories. A definition should be added to help the user understand the difference. It was suggested that the definition also be added to all of the appropriate objectives.

(G) Request to from Becca Knox to re-instate the objective (previously 9.15) for child safety and trigger locks. The objective was deleted based on the announcement that manufacturers would voluntarily apply the use of trigger locks, however this is not currently being done. It was felt that this is important enough to re-instate for the 2010 document. Suggestion will be forwarded.

Comments Relating to Cross-cutting Objectives #1-#7:

(#2) Objective should include SCI due to firearms.

(#3) Objective should include suicides due to firearms. It was stated that the narrative should definitely include the high risk of firearms and suicides. This suggestion will be forwarded.

(#5) There was a recommendation to utilize the National Assoc. of Attorney Generals as a potential data source.

(#6) There was a request to change the wording "extend to all". It was felt that there is an indication to the user that there would be resources/funding available to implement this objective. There were no suggestions for re-wording.

(#7) There was a recommendation to add violence prevention to the wording of the objective.

Comments Relating to Unintentional Objectives #8-#32:

General comment: Need to add text in motor vehicle narrative for drivers education and for drunk driving laws. The Motor Vehicle objectives were facilitated by Jane Dion, the DOT/NHTSA representative.

(#11) The suggestion was made that the age group 15-19 should be separated into males and females because of the high risk with 15-19 year old males. Jane Dion commented that the data could be separated into males and females. There was also discussion regarding the clarity of the wording of this objective. The suggestion was made that the objective should be re-worded to emphasize "drivers" versus motor vehicle crashes. It was stated that the current wording is confusing and unclear.

It was suggested that driver license data is available and could be a source of information. However, the point was made that not all drivers have licenses and that it possibly would not account for drunk drivers.

(#13) There was a comment that there should be a focus on the driver for this objective. The recommendation was made to add the word "crashes" or "incidents" after motor vehicles so that it would be consistent with the wording in #11.

(#15) Question was asked why use 93% and not 100%. The reply was that based on available data, the highest ever achieved was 93% in Sweden. Therefore, this is the basis for the percent used for this objective.

Question was asked about why more age groups were not given for this objective. Jane Dion explained that seat belt usage is observational data and it is difficult to project age groups based on an observational basis. It is possible to observe child versus adolescent but not as easy to distinguish adolesent and younger adults. The suggestion was made to add the age group 20-25 as a developmental category.

(#17) Jane Dion stated that this objective also used observational data.

(#18) The recommendation was made by Jane Dion that this objective be deleted based on the current policy that this is a state's rights issue and that NHTSA has been unable to provide strong support for this objective. Final recommendation from the group was to either delete or consider rewording the objective. No suggestions for rewording were provided.

(#16) The request was made to update the data related to this objective to include Puerto Rico and the territories, and have reword to reflect the change.

(#21) Recommended the wording be changed from "habitable" to "residential or non- residential". It was felt that the terms would better distinguish between settings that are different, such as home and school. Each has "habital" floors but home is residential and school is non- residential.

(#23) The question was asked why this objective was specific for only hip fractures? It was recommended that the objective be expanded to include other fractures and possibly other major injuries due to falls. Discussion indicated that this objective be reviewed to possibly include other fractures.

(#25) The comment was made that there seems to be a trend in the increase of laws regarding bicycle helmets in contrast to the trend for motorcycle helmets.

(#26) The comment was made that this objective is stated at 9th-12th grades because YRBS is the only known data source.

(#29) Request was made to add a definition for "unintentional poisonings". It was suggested that the definition for unintentional injuries could be used as a model. Discussion ensued about whether regulated drugs were included or not. The comment was made that CPSC focusses on regulated drugs and that information is available. Recommendation to expand the data source on unintentional poisonings and possibly include ED data. The comment was made that the use of ED data would help clarify "poisonings".

(#31) Recommendation was made to change the word "effective" to "appropriate". A potential data sorce suggested was to look at oral health agencies. There were no specifics provided regarding which agency or group to review as a data source.

(#32) Recommendation was made to use the term "poison control management' versus "Ipecac". The discussion related to situations when Ipecac may not be suitable and other measure that would be utilized. Therefore, if poison control mangement were used, it was felt all measures would be covered. There was a recommendation to add the definition of safe storage for this objective. The comment was made that this was an improvement over the previous version.

Comments Relating to Violence and Abuse Objectives #33-#41:

General Comments:

The Men's Health Network representative stated that he felt that the objectives were "gender biased" and related more to females. He recommended that there be more emphasis on males, in addition to gay and lesbian populations.

A request to modify the term of domestic violence to include all other relationships and not just relate to male/female. Additionally, it was requested that males as victims of domestic violence be indicated in the document.

A request was made add as a developmental objective the requirement of forensic evidence for victims of abuse.

(#33) Recommendation to add the comment that "68% of homicides occur with firearms" to the narrative was made.

The request was made to add a subobjective to reduce the number of firearms available with assaults.

(#35) The comment was made by the NCHS representative that this is a good data source but one of the limitations for the user may be that it can't be broken down into state data.

(#36) There was a comment that the term "forced sexual intercourse" was too limiting. Comments generally stated that the term should be changed to a more standardized term, however no other terms were suggested as a possible substitute.

It was further stated that either term would not include prison populations and that there should be some attempt to include abuse among the prison populations in this area.

(#37) Request was made to change the wording of "battered women and their children" to the term "victims of battering". This would help to reinforce that males are also victims. A recommendation was made, after a discussion regarding the legal definition of the word "rape", that there needs to be a comment in the narrative regarding the variations of the legal definitions of "rape", and add the statement that the definition changes from state to state. The

National Women's Study was recommended as an additional source for looking at the definition for rape.

(#39) The question was asked why "date rape" is not included? It was recommended that it be added as a sub-objective and also be added to objectives #36 and #38. The comment was made that teens are not included in some of the select breakouts. There was a request to include the definition for "physical assault".

(#40) The question was asked whether the objective should use the word "incidence" rather than "prevalence". The response was that the wording will be re-checked with the survey.

Final comment for youth violence objectives was that there is a need to look at grades 6-9 and include as a developmental objective. The rationale was that interventions should start at younger ages to have an impact.

The final recommendation was to add an educational component to the youth violence area.

Tim Groza (note taker) CDC/NCIPC/DUIP
Martha Highsmith, CDC/NCIPC/DVP
There were 16 representatives from other private, state, federal groups that participated.

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