Office of Injury and Violence Prevention

MISSION AND STRATEGY: The mission of the Connecticut Department of Public Health (DPH) Office of Injury and Violence Prevention (the Office) is to promote a safe and healthy Connecticut by reducing factors associated with intentional (e.g., homicide and suicide) and unintentional (e.g., falls and motor vehicle traffic) injury. The Office focuses on priorities set forth in the State Health Improvement Plan by observing and addressing rates of injury in work environments, homes, schools, communities, on the roads, and at play areas. In addition, the Office, following national recommendations for injury and violence prevention, oversees community-based programs (conducted by contractors) that address risk and resiliency factors associated with injury and violence and implements strategies to decrease injury and violence. The Office promotes environmental and policy change initiatives through collaborative relationships with other key stakeholders working to prevent injury and violence. Specific injury and violence prevention programs, while population-based, are often delivered by community-based agencies and local health departments.

A Public Health Approach to Injury and Violence Prevention

The public health approach to injury and violence prevention is a four-step process that is rooted in the scientific method. The public health approach can be applied toward a specific or localized priority or across health problems that affect larger populations. In keeping with the national trend toward integrating the public health approach for the development of injury and violence prevention strategies, the DPH Office of Injury and Violence Prevention is committed to working with interagency and interdisciplinary partners to promote the collaboration necessary for the implementation of successful prevention strategies.

BRIEF HISTORY:

Statute- the Office was established in 1993 under the statute, Sec. 19a-4i Office of Injury Prevention. There shall be, within the department of public health and addiction services, an Office of Injury Prevention, whose purpose shall be to coordinate and expand prevention and control activities related to intentional and unintentional injuries. The duties of said office shall include, but are not limited to, the following: (1) to serve as a data coordinator and analysis source of mortality and injury statistics for other state agencies; (2) to integrate an injury and violence prevention focus within the department of public health; (3) to develop collaborative relationships with other state agencies and private and community organizations to establish programs promoting injury prevention, awareness and education to reduce automobile, motorcycle and bicycle injuries and interpersonal violence, including homicide, child abuse, youth violence, domestic violence, sexual assault and elderly abuse; (4) to support the development of comprehensive community-based injury and violence prevention initiatives within cities and towns of the state; and (5) to develop sources of funding to establish and continue programs to promote prevention of intentional and unintentional injuries.

International Classification of Diseases, Clinical Modification (ICD–CM) It is important to understand that in the Fall of 2015, the diagnostic system used to code non-fatal injury in the United States, the International Classification of Diseases - Clinical Modification system (ICD-CM), was changed from the ICD-9-CM version to the ICD-10-CM version, which impacted the frequency by which coders included the cause of a non-fatal injury when documenting how severely a specific body part was injured. This can appear as if the rates of specific causes of injury are declining, but instead, it may just be that the cause was not included with the severity of injury to the body part(s).

MECHANISMS OF INJURY IN CONNECTICUT:

The charts below present common mechanisms of injury in Connecticut and are not exclusive to a single individual. A death record can have up to 20 causes contributing to that death and a hospital record can have up to 15 diagnoses contributing to a need for care. Example, an elderly person could have fallen, broken a hip, and hit their head, eventually dying from a heart attack. All three mechanisms of injury may be listed as contributing to the primary cause of death, the heart attack. In another example, a person overdosing on drugs may fall to the ground and hit their head, cracking the skull. All three mechanisms of injury may have been listed as contributing to the need for hospital care.

Drug overdoses and head injuries are the most common (but not exclusive) mechanisms of injury contributing to death. Falling is the most common (but not exclusive) mechanism of injury contributing to the need for hospital care.

INJURY TRENDS IN CONNECTICUT:

Injuries are a major cause of death and disability across the entire lifespan of Connecticut residents. The type, frequency, and degree of risk for a specific injury category often differs by age, sex, race, and ethnicity. Social, environmental, and economic factors of an injured resident are typically not reported with the injury outcome, making analysis of socioeconomic inequities difficult to assess.

It is too soon to tell how the pandemic years of 2020 and 2021 may have contributed to changes in current trends for fatal and non-fatal injuries. However, we do know the total number of injury records reported by Connecticut hospitals dropped 24% from 2019 to 2020. We are aware of trends such as speed-related crashes being on the rise during the pandemic (a potential factor for increasing head injury in Connecticut), while social distancing practices caused the cancelation of many sports-related activities (a potential factor for decreasing head injuries in Connecticut). Further analysis may be beneficial to understand how the pandemic affected the frequency of different injuries.

Health Equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. Many populations experience disparities with being able to attain their highest levels of health, including people from some racial and ethnic minority groups, people with disabilities, women, people who are LGBTQI+ (lesbian, gay, bisexual, transgender, queer, intersex, or other), people with limited English proficiency, and other groups. The data show that racial and ethnic minority groups, throughout the United States, experience higher rates of illness and death across a wide range of health conditions when compared to their White counterparts. In order to maintain high enough group numbers to run analyses, we continue to use the four basic population categories of non-Hispanic Blacks, non-Hispanic Whites, non-Hispanic Other Races, and Hispanics of all races when we look for measures of disparity.

Fatal Injury by Race and Ethnicity: In 2021, 3,169 Connecticut residents died from a fatal injury with non-Hispanic Blacks carrying a disproportionate burden of risk as compared to non-Hispanic Whites, non-Hispanic Other Races, and Hispanics of all races.

Non-fatal Injury by Race and Ethnicity: Nearly 295,000 Connecticut residents were treated at an area hospital for a non-fatal injury in 2021 with a disproportionate burden of risk also with non-Hispanic Blacks as compared to non-Hispanic Whites, non-Hispanic Others, and Hispanics of all races.

UNINTENTIONAL INJURY AND INTENTIONAL VIOLENCE IN CONNECTICUT:

Injury can also be classified into categories of intent. Unintentional injury, or what might often be called an "accident," is now commonly referred to as an injury. Intentional injury, or what might often be called "an act of violence" is now commonly referred to as violence against the self or others.

Unintentional Injury: Unintentional injuries are often referred to as accidental events or those injuries that occur without intent of harm or death. These unplanned events can include falls, motor vehicle crashes, drug overdoses, drownings, poisonings, burns, and sports-related injuries like concussions or broken bones. Intentional injuries can also be classified by some of the same means and mechanisms but are usually excluded from analyses of unintentional injury if the intent can be determined.

Intentional Violence: Intentional injuries are violence-related and include the categories of homicides, suicides, suicide attempts, assaults, domestic violence, sexual violence, and abuse of both adults and children. Intentional injuries account for 1.6% of injury-related deaths and 4.6% of injury-related hospital care.

THE OFFICE OF INJURY AND VIOLENCE PREVENTION (OIVP):

Experiencing injury or violence can have a lifelong impact. People can suffer short-term effects, such as missing work or school, and long-term effects, such as chronic illness or death. Injury and violence cost society hundreds of billions of dollars in medical care and lost productivity each year. The DPH Injury and Violence Prevention Program, in collaboration with outside partners, local health departments, and other state agency programs, provides services to communities, groups, and individuals by offering health education, conducting data collection and analysis, and reporting on injuries and violence.

The Office of Injury and Violence Prevention works collaboratively with others working on intentional injury and related issues such as the Connecticut Suicide Advisory Board (CTSAB) and the Child Maltreatment Domestic Violence Collaborative.'

Focus Areas of Unintentional Injury Prevention

  Concussion and Traumatic Brain Injury Prevention (Head Injury)
  Drowning
  Falls Prevention
  Traffic and Motor Vehicle Safety
Opioids and Drug Overdose Prevention

Focus Areas of Intentional Violence Prevention

Adverse Childhood Experiences Prevention
  Community Gun Violence Prevention
  Commission on Community Gun Violence Intervention and Prevention      Connecticut Violent Death Reporting System (CTVDRS)
Elder Abuse and Maltreatment Prevention
Definition of Elder Abuse
  Suicide and Self-Inflicted Injury Prevention