Injury, the leading cause of death for Americans ages 1 to 44 years, is largely preventable. CDC leads federal efforts to prevent and control injuries with a program that addresses the main causes of death and disability from injury: fires and burns; poisoning; drowning; violence, including homicide and suicide; motor vehicle crashes; and lack of use of bicycle helmet, seat belts, and child restraint seats. Injury has a disproportionate impact on children, youth, and young adults. Every day 60 children die from injury, almost 3 children every hour. Each year over 150,000 Americans die from injuries, and 1 in 3 persons suffers a nonfatal injury. Injuries, one of our most expensive health problems, cost $224 billion per year as a total lifetime cost of injuries sustained. While the CDC and our public and private partners have made tremendous progress in injury prevention and control during the past several years, examples of the magnitude of the injury problem are highlighted below:

• Home fires and falls among older persons cause thousands of deaths and injuries each year and result in high medical costs and property losses;
• Violence continues to result in staggering numbers of lives lost, and frequently this is violence among intimate partners -- each year over 30% of women murdered in the U.S. are killed by a spouse or ex-spouse;
• The rates of homicide and suicide for young Americans, particularly men, are alarmingly higher than for any other Western industrialized nation;
• An estimated 2 million Americans suffer a traumatic brain injury (TBI) each year, of which about 50,000 die and another 50,000 to 70,000 are disabled;
• Approximately 4 million poisonings occur each year costing the health care system approximately $3 billion/year; and
• Each year about 153,000 children receive treatment in hospital emergency departments for bicycle-related head injuries.

Through the National Center for Injury Prevention and Control, CDC provides national leadership for designing programs to prevent premature death and disability and reduce human suffering and medical costs caused by injuries. CDC accomplishes its mission through: extramural and intramural research; developing, evaluating, and implementing prevention programs; assisting state and local health jurisdictions in their efforts to reduce injuries; and conducting prevention activities in partnership with other federal and private-sector agencies. Evaluation of intervention programs is a key component of CDC's overall strategy to discover what works and determine how to deliver programs to the American people.

As the lead federal Center for injury prevention and control NCIPC continues to discover and deliver proven interventions. For example:

• Funded five states to conduct three-year programs aimed at increasing the number of working smoke alarms in homes. During the project period, over 15,000 long life, lithium-powered smoke alarms were distributed and/or installed.
• Funded six states for programs aimed at increasing bicycle helmet use among riders of all ages. Measurable increases in helmet use has resulted from the implementation of this intervention.
• NCIPC and the National Institute of Justice co-sponsored a study that identified gaps in our knowledge of violence against women and developed a research agenda to better understand and control the problem. Violence against women research centers are being established.
• Community and school-based efforts to prevent youth violence have been launched, including evaluation of promising violence prevention strategies such as peer mediation and conflict resolution training, mentoring and role playing, and efforts to improve parenting skills.
• Work to prevent suicide among our Nation's elderly and youth continues, including taking steps to establish the first research center focused on suicide prevention.
• In an effort to a develop uniform reporting system for TBI, funding was provided to fifteen state health departments to conduct TBI surveillance. Data from these surveillance systems will enable NCIPC to estimate the magnitude and severity of TBI nationally and to assist states in TBI prevention program.
• To ensure that data is available to study and improve trauma care, NCIPC is leading a national effort to develop uniform data elements for emergency department records.
• Registries that link persons with TBI to medical services are being established.
• Improving institutional and community living environments for elderly citizens as a means of reducing the risks and consequences of falls;

Focus of the FY 2000 Performance Plan

The performance measures for injury prevention and control best represent NCIPC's mission to provide leadership in preventing and controlling injuries through research, surveillance, implementation of programs, and communication. Priority areas for the FY 2000 Performance Plan include:

  1). Youth violence prevention
  2). Intimate partner violence prevention
  3). Bicycle helmet usage and head injury prevention
  4). Fire-related injury prevention

Links to the DHHS Strategic Plan:
Each of the NCIPC performance objectives and measures are related to DHHS Goal 1: Reduce major threats to the health and productivity of all Americans.

Validation/Verification - Data Source Descriptions

The following data collection sources will be utilized to verify baselines and to track performance measures.

The National Electronic Injury Surveillance System (NEISS): The system is comprised of a sample of hospitals that are statistically representative of hospital emergency rooms nationwide. From the data collected, estimates can be made of the numbers of injuries associated with consumer products and treated in hospital emergency departments. Data is collected on a broad range of injury-related issues, covering hundreds of product categories, and provides national estimates of the number and severity of product-related injuries. (Consumer Product Safety Commission).

National Vital Statistics System: The National Vital Statistics System is responsible for the Nation's official vital statistics. These vital statistics are provided through state-operated registration systems. The registration of vital events--births, deaths, marriages, divorces, fetal deaths, and induced terminations of pregnancy -- is a state function. However, standard forms for the collection of the data and model procedures for the uniform registration of the events are developed and recommended for state use through cooperative activities of the states and the National Center for Health Statistics (NCHS). (National Center for Health Statistics, CDC).

National Health Interview Survey: The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States and is one of the major data collection programs of the National Center for Health Statistics (NCHS). NHIS data are used widely throughout the Department of Health and Human Services (DHHS) to monitor trends in illness and disability and to track progress toward achieving national health objectives. The data are also used by the public health research community for epidemiologic and policy analysis of such timely issues as characterizing those with various health problems, determining barriers to accessing and using appropriate health care, and evaluating federal health programs. (National Center for Health Statistics, CDC)

Youth Risk Factor Surveillance System (YRBSS): The purpose of the YRBSS is to provide a framework that will: 1) focus the nation on risk behaviors among youth causing the most important health problems; 2) assess how risk behaviors change over time; and 3) provide comparable national, state, and local data. (National Center for Chronic Disease Prevention and Health Promotion, CDC)

Behavioral Frequency Scales: This instrument is used to measure aggressive and delinquent behavior in among program participants in CDC-funded youth violence prevention programs. The inventory includes scales that assess the 30-day frequency of specific delinquent behavior (10 items), violent behaviors (5 items), gateway drug use (6 items), other drug use (4 items). An additional 16 items assess frequency of use for other drugs, concerns about safety, the use of conflict-resolution skills, and the use of the peer mediators. Reliability ranges from .64 to .87. (The Center for the Study and Prevention of Violence, Boulder, Colorado - Peter Tolan & Nancy Guerra).