Army Burden of Injuries Defining the Problem and Prevention

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Army Burden of InjuriesDefining the Problem and
Prevention

• BG Timothy Adams
• AUSA, Washington Convention Center
• 6 OCT 2009

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Relative Burden of Injuries and Diseases, U.S.
Army Active Duty, 2008
Source Defense Medical Surveillance System,
Armed Forces Health Surveillance Center, 2009
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Army Deployment Injuries and DiseasesOIF Medical
Evacuations, 2003 - 20081
ICD-9-CM Code Groups
1 Total evacuations n 38,619
Source USACHPPM Deployment Injury Surveillance
System
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• Five Steps of the Public Health Approach
• Surveillance
• Research field investigations
• Intervention trials systematic reviews
• Program and policy implementation
• Public health evaluations monitoring

• Five Key Public Health Questions
• Is there a problem and how big is it?
• What causes the problem?
• What works to prevent the problem?
• Who needs to know and do what?
• How effective is what we have done?

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Leading Causes of Injury Hospitalizations U.S.
Army Active Duty, 2008
Source Defense Medical Surveillance System,
Armed Forces Health Surveillance Center, 2009
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Leading Causes of Deployment Non-Battle
InjuriesArmy OIF Medical Evacuations, 2003-2008
Source USACHPPM Deployment Injury Surveillance
System
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USACHPPM Top Ten Injury Prevention Priorities
Results of a prioritization process conducted
by Army members of the DoD Health Affairs
Military Injury Prevention Priorities Working
Group, 2006
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Recommendations for Prevention
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Injury visit rates among Army trainees, 2000-2008
New PT Program
Source Defense Medical Surveillance System,
Armed Forces Health Surveillance Center, 2009
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USACHPPM Injury Prevention Services Products

• Detection
• Surveillance surveillance analysis
• Response
• Field investigations
• Systematic scientific reviews of science
• Recommendations for policies and programs
• Evaluations of policies and programs
• Dissemination
• Consultations Information Requests (phone,
  e-mail, site visits)
• Lay information products (web, magazines, news
  articles, talks, etc.)
• Scientific information (tech reports,
  peer-reviewed publications, presentations, etc.)
• Customers
• Examples Training Doctrine Command, Forces
  Command, Medical Command, Deputy Assistant Secy
  of Army/Safety Occupational Health, Army Combat
  Readiness/Safety Center, Assistant Secy of
  Defense/Health Affairs, Under Secy of
  Defense/Personnel Readiness, Unit Commanders,
  other Fed Agencies

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Army Injury Prevention Partners and Activities

• USACHPPM
• Lead for injury surveillance and prevention
• Key Partners and Activities
• Army
• Office of the Surgeon General Proponency Office
  for Rehabilitation Reintegration
• Musculoskeletal Action Plan (MAP)
• TBI Surveillance and Prevention
• Army Medical Research and Development Command
• Army Combat Readiness /Safety Center
• DOD
• Defense Safety Oversight Council
• Military Training Task Force
• Deployment Operations Task Force
• Joint Military Vehicle Safety Working Group

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The Public Health Approach

• Surveillance
• Research and field investigations
• Intervention trials and systematic reviews
• Program and policy implementation
• Public health evaluations and monitoring

A problem this large complex requires a
systematic approach to prevention.
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Conclusions Future Directions

• Keys to Injury Program Success
• Routine use of surveillance data to identify
  monitor problems
• Strategic planning and established priorities
• Credibility and durability of science derived
  from peer-reviewed publications
• Partnerships
• Quick response capabilities
• Requirements for Future Success
• Disseminate injury data to MACOMs and units
• for visibility
• for accountability
• Wide adoption of evidence-based public health
  approach by Army and DOD
• Enhanced dissemination and training for Injury
  Prevention within Army and DOD
• Establish DOD, Army, Installation and large unit
  committees to set priorities, share information,
  and monitor success
• Enforcement of Safety and Injury Prevention
  standards

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Contact information and resources

• Contact Information
• USACHPPM Injury Prevention Homepage
• http//chppm-www.apgea.army.mil/DEDS-Injury/
• [phone]
• DSN 584-3534
• Resources
• Physical Training Injury Prevention Toolbox
• http//chppm-www.apgea.army.mil/ptipt/default.aspx
  
• Injury Prevention Through Leadership Course
• Available through the PT Injury Prevention
  Toolbox homepage (above)
• US Army Combat Readiness/Safety Center Knowledge
  Publication
• https//safety.army.mil/Knowledge_Online/Default.a
  spx?aliassafety.army.mil/Knowledge_Online/October
  2009