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Injury Prevention Research Center

The University of North Carolina at Chapel Hill

Child Fatality Task Force February 3, 2014

“Effective North Carolina Laws for

Child Death and Injury Prevention”

Stephen W. Marshall, PhD

Director, Injury Prevention Research Center

Professor, Department of Epidemiology,

Gillings School of Global Public Health

University of North Carolina t Chapel Hill

Email: smarshall@unc.edu Voice: 919-966-3916

Overview

• Legislation and Science

• InjuryFreeNC.Org

• Head Trauma

• Motor Vehicle Injuries

Legislation and Injury Prevention

• Personal safety is first and foremost an

individual and family responsibility

• Legislation should not unduly limit individuals

• Legislation should take account of the many

complex nuances of human behavior

Positives of Legislation

• Legislation can reduce of fatal & disabling

injuries and therefore help our children achieve

their full potential in life

• Legislation can reduce the economic burden of

injury to the state

Car Seat Laws for Infants

Legal

Illegal

• Good for Babies

• Good for Parents

• Good for the State

Bicycle Helmet Law

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Science and Policy-Making

Scientists should be able to….

• Summarize Research

Evidence for Policy-Makers

• Quickly and Cheaply Conduct

the Studies Needed by Policy-

Makers

• Appreciate the Complexities of

Human Safety Behavior

Science and Policy-Making

Scientists should be….

• Succinct

• Objective

• Accessible

• Up to Date

BUT …

• Scientists are Often Poor

at Communication

Example of Effective Communication

from Scientists to Policy-Makers Vision for New Website

• Injury Issues Relevant to NC

• Summarize Evidence Base

• One-stop Location for Information and Resources

• Connect with Experts and Practitioners

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• Training for NC Injury Prevention Professionals

• Team-based Network

• Problem-driven

• Mentoring and Access to Experts

• No Cost to Participants

Head Trauma

• Gfeller-Waller Concussion Law

• Motorcycle helmets

• Bicycle helmets

Matthew Gfeller, Age 15

Reynolds High School, Forsyth County, North Carolina

23 Aug 2008 : Single Severe Traumatic Brain Injury

in High School Football Game

Transported to Hospital

24 Aug 2008 : Surgical Repair Unsuccessful

Removed from Life Support

Difficult to Prevent this Fatality

Jaquan Waller, Age 16

Rose High School, Pitt County, North Carolina

17 Sept 2008 : Concussion in School Football Practice

19 Sept 2008 : Second Impact in School Football Game

Transported to Hospital

20 Sept 2008 : Died from Severe Swelling of Brain

Med. Examiner: “Second Impact Syndrome”

Preventable Fatality

Should Not have been Allowed to Play

while Injured

States with Legislation Addressing

Youth Sports-Related Concussions March 2009

NONE!

States with Legislation Addressing

Youth Sports-Related Concussions July 2012

Source: National Conference of State Legislatures (www.ncsl.org)

34 State Laws Passed 14 State Laws Pending

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Tau Protein Deposits

Healthy Control Repetitive Head Trauma

Motorcycle Helmet Law

NC’s motorcycle helmet law

means greater savings in

health care costs and better

productivity, per motorcyclist,

than any other state

MMWR June 15, 2012 / 61(23);425-430

0%

5%

10%

15%

20%

25%

30%

Perc

en

t o

f h

osp

italizati

on

s

Expected hospital charges

Traumatic Brain Injury

non-TBI

Expected charges for NC hospitalizations due to motorcycle crashes

Harmon et al. Motorcycle Crash-related Emergency Department Visits & Hospitalizations & Traumatic Brain Injuries in NC. CDC Rev.

Bicycle Helmet Law

Ride Smart: Protect Your Head

Where’s my

helmet law?

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Bicycle Helmets

• Evidence

– Bicycle helmets reduce head injury by 80%

• Important

– 70% of fatal bicycle crashes involve head injury

• Current Law: <16 Required

– Zero Enforcement

– Expand to Youth

Thompson et al., Cochrane Review 2004

Cummings et al. Accid Anal Prev. 2006;38(3):636-43.

Hagel and Pless, Accid Anal Prev, 2006;38;833-4

Motor Vehicle Crashes

• Cost of MV Injury to People of NC

– Health care

– Lost Work

– By Road User

– By Age

www.cdc.gov/motorvehiclesafety/statecosts www.cdc.gov/motorvehiclesafety/statecosts

Motor Vehicle Crashes

• Occupant Restraints

– Seat Belts, Infant & Child Car Seats

• Teen Driving & GDLS

• Distracted Driving & Electronic Devices

• Child Pedestrians & Traffic Calming

• Stopped School Buses

• Speeding in School Zones

• Safe Routes to School

Thank You Steve Marshall

Smarshall@unc.edu