Childhood Injury in Minnesota: What Do The Numbers Tell Us?

Transcription

1 Minnesota Transitions Childhood Injury in Minnesota: What Do The Numbers Tell Us? Childhood Injury Summit: Minnesota in Transition September 16, 2010 Minneapolis, MN Jon Roesler, MS Minnesota Department of Health

2 Outline Why are we here? Mortality is decreasing! Hospital-treated injury is decreasing! Population is increasing! Measuring outcomes!

3 WHY ARE WE HERE?

4 Why Are We Here Today? 10 Leading Causes of Death Minnesota, All Races, Both Sexes Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Office of Statistics and Programming. CDC WISQARS Leading Cause of Death Reports, , compiled from National Center for Health Statistics, National Vital Statistics System. Accessed at on Sep 15, 2009.

5 Why Are We Here Today? Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Office of Statistics and Programming. CDC WISQARS Years of Potential Life Lost (YPLL) Reports, , compiled from National Center for Health Statistics, National Vital Statistics System. Accessed at on Sep 15, 2009.

6 Minnesota Transitions: Mortality is Decreasing

7 All Age/Cause Mortality, Minnesota 19.4% Decline Age Adjusted Rate per 100k Year Minnesota Department of Health, Minnesota Center for Health Statistics. Minnesota Vital Statistic Interactive Queries (I.Q.), compiled from Death Data Accessed at on February 23, 2010.

8 Number of Deaths Minnesota, Centers for Disease Control and Prevention, National Center for Health Statistics. Compressed Mortality File CDC WONDER On-line Database, compiled from Compressed Mortality File CMF , Series 20, No. 2A, 2000 and CMF , Series 20, No. 2E, Accessed at on Jun 18, :53:43 AM

9 In the long run we are all dead. -John Maynard Keynes

10 Number of Deaths Minnesota,

11 Age-Adjusted Death Rates for the Five Leading Causes of Death United States, MMWR: June 20, 2008 / 57(24);666

12 Number Leading Causes of Death, Minnesota Year Heart Disease Malignant Neoplasm Cerebrovascular CLRD Unintentional Injury Petcoff M, Gaichas A, Roesler J: Cause of Death in Minnesota. In process.

13 3500 3rd - 5th Leading Causes of Death Minnesota Number Year Cerebrovascular CLRD Unintentional Injury Petcoff M, Gaichas A, Roesler J: Cause of Death in Minnesota. In process.

14 General Injury Mortality Leading Causes: #1 - Motor Vehicle Traffic #2 - Falls

15 General Injury Mortality Leading Causes: #1 - Motor Vehicle Traffic #2 - Falls

16 Leading Cause of Unintentional Injury Death, Minnesota Number Year 28% decrease MV Traffic Petcoff M, Gaichas A, Roesler J: Cause of Death in Minnesota. In process.

17 Leading Cause of Unintentional Injury Death, Minnesota Number Year Fall MV Traffic Petcoff M, Gaichas A, Roesler J: Cause of Death in Minnesota. In process.

18 Leading Cause of Unintentional Injury Death, Minnesota Number Year Petcoff M, Gaichas A, Roesler J: Cause of Death in Minnesota. In process. Fall MV Traffic Poisoning

19 Leading Causes of Injury Death Ages 0-14 Minnesota, MV Traffic 241 Suffocation 157 Drowning 96 Fire/burn 40 Other Transport 34

20 Unintentional Injury Mortality Children 0-14, Minnesota, deaths 222 Deaths % Decline! Year Rate

21 Children & Youth, Motor Vehicle Crash Mortality Minnesota, % Decline Number of deaths % Decline Year

22 Minnesota Transitions: Hospital-treated, Unintentional Injury is Decreasing

23 Nonfatal, Hospital-treated Unintentional Injury Children 0-14, Minnesota, Number % Decline! Year

24 Leading Cause of Injury Hospitalization

25 5 Leading Causes Unintentional Nonfatal Hospitalized Injury Minnesota, 2007 Minnesota Department of Health, Injury and Violence Prevention Unit. MDH MIDAS Hospital Data, Accessed at on Sep 16, 2009.

26 Leading Causes Hospitalized Pediatric TBI Reid S, Roesler J, Gaichas A, Tsai A: The epidemiology of pediatric traumatic brain injury in Minnesota. Arch Pediatr Adolesc Med 155: , 2001.

27 Sports & Recreation Concussions AUGUST 30, 2010, 11:30 A.M. ET Researchers See Rise In Children's Sports-Related Concussions

28 Sport & Rec Concussions Minnesota, Ages sport rec

29 Sport Related Concussion by gender 800 Minnesota, Ages Males Females

30 Fall From Window

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33 Fall from Window Resulting in Severe Injury Minnesota Potential for reporting bias: 2007 & 2008 Report of Injury forms added a fall from window check-off box; data from previous years included only keyword searches of text fields Deaths Under * *Incomplete data as of 5/18/09 Year

34 Fall from Window Resulting in Severe Injury Minnesota Potential for reporting bias: 2007 & 2008 Report of Injury forms added a fall from window check-off box; data from previous years included only keyword searches of text fields Nonfatal Under * *Incomplete data as of 5/18/09 Year

35 Minnesota in Transition: Population is Increasing However Population of children is remains around 1 million

36 Minnesota Population ,000,000 5,000,000 Number 4,000,000 3,000,000 2,000,000 Total Population 0-14 Population 19% Increase 3% Increase 1,000, Year Minnesota Department of Health, Minnesota Center for Health Statistics. Minnesota Vital Statistic Interactive Queries (I.Q.), compiled from Death Data Accessed at on September 16, 2010.

37 Minnesota is Aging! Median Age Median Age, Minnesota Year McMurry M: Population Notes: Long-term illustrative population projections for Minnesota. St. Paul, MN: Minnesota State Demographic Center, OSD March 2003 McMurry M: Population Notes: Minnesota age trends, 2000 to St. Paul, Minnesota State Demographic Center, OSD August McMurry M: Faces of the Future: Minnesota Population Projections St. Paul, MN: Minnesota State Demographic Center. May 1998.

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39 Minnesota Transitions: Measuring Outcomes

40 Minnesota TBI Registry Legislative mandate, 1991 Data collection, 1993

41 MN TBI Registry Purposes Timely service information (Resource Facilitation) Epidemiology/Prevention

42 Minnesota TBI Registry 3 rd Purpose Resource Facilitation Epidemiology Outcomes

43 OUTCOMES! INCIDENCE - new cases PREVALENCE extant/unrecovered cases

44 OUTCOMES! & Prevention PRIMARY prevent the TBI from occurring helmets, seat belts, fall prevention SECONDARY minimize effect of TBI trauma system TERTIARY reintegration of TBI survivors rehabilitation, housing

45 RF: Hypotheses RF improves outcomes

46 Continued research is needed: Is RF clearly beneficial? Are there sub-populations to target?

47 TBI Prevalence, RF & Kids Measuring / Reducing Prevalence Tertiary Prevention & Resource Facilitation (RF)

48 OUTCOMES! In Kids Longitudinal Children Outcomes (via telephone interview) Tools: SSS M2PI PedsQL (CHAT)

49 Malec Model for TBI Prevalence Do you use services? Do you need services? Have you been told you need services?

50 CHAT Project: Categorization of health care needs Slomine BS, McCarthy ML, Ding R, Mackenzie EJ, et al. Health care utilization after pediatric traumatic brain injury. Pediatrics 2006; 117(4):e663-e674.

51 RF: Aims Aim1: Estimate the proportion of persons residing in Minnesota with a history of TBI for hospitalized TBI cases. Minnesota Children Age 10-14: 345,000 MN Children w/ a history of hospitalized TBI: 2,400 Aim 2: Estimate the population-based prevalence of TBI-disability among children ages with a history of hospitalized TBI Contact estimate: 1,000 1,500 Slomine et al.: ~40% need services at 12 months post TBI Aim 3: Estimate the prevalence of TBI disability in cases of children with hospitalized TBI, at 4-6 months post discharge MN Children entered yearly into Registry: ~200 Slomine et al.: ~60% need services at 3 months post TBI Aim 4: Describe 6-to-24-month outcomes of TBI-related disability and associated risk factors in children identified from the MTR, with a history of hospitalized TBI, and who participate in RF provided through BIAM. MN Children currently participating in RF: ~100

52 Outline Why are we here? Mortality is decreasing! Hospital-treated injury is decreasing! Population is increasing! Measuring outcomes!

53 I DON T WANT Jon Roesler Epidemiologist Supervisor Injury & Violence Prevention Minnesota Department of Health jon.roesler@state.mn.us!