Safety behaviors are actions taken to reduce or eliminate the risk of injury and disease. Behaviors can include motor vehicle safety, fall prevention, vaccination, and many others.
Safety promotion and injury/disease prevention is a hallmark of public health. Through national, state, and local safety campaigns, policy changes, and interventions, public health has dramatically decreased the rate of injury, illness and death associated with accidents and diseases. This includes encouraging safety behaviors from programs like the Safe to Sleep campaign to reduce the risk of Sudden Unexpected Infant Death (SUID) to the vaccination campaigns to eliminate smallpox and polio, for example. Jefferson County residents are impacted by public health safety improvements throughout their lives and may live longer and healthier lives because of the safety-related decisions they make every day.
Two of Colorado’s Ten Winnable Battles (injury prevention and infectious disease prevention) address safety behaviors. Within these winnable battles are four areas of focus: motor vehicle safety, older adult fall prevention, child fatality prevention, and vaccination (1, 2).
Implications and Data for Jefferson County
Motor Vehicle Safety
Colorado has made motor vehicle safety a top priority. Seat belt use is one of the most recognizable and effective motor vehicle safety behaviors, and reduces the rate of fatal or serious injury by 50% (3). Many other motor vehicle behaviors have also been addressed by public health, including decreasing impaired driving (both by alcohol and more recently, marijuana), teen driving (through educational programs and Colorado’s adoption of a graduated driver’s license law), and increased use of safety belts and booster seats (4, 5). Increasing individual’s responsibility and adherence to these safety behaviors has led to reductions in motor vehicle crashes and fatalities. Jefferson County and Colorado have also made strides to decrease pedestrian deaths due to motor vehicles by increasing connectivity of sidewalks and bike lanes. However, Jefferson County residents in our health needs assessment focus groups and key informants voiced continued concerned about the need for better bike and walking infrastructure (including street lighting) (6). These community members stated that many individuals who use bicycles as their primary form of transportation, including members of at-risk populations such as the homeless and the Latino communities, had concerns for their safety over long-distance commutes.
Note: In 2011, the BRFSS methodology changed to include calls to cell phones. Changes between 2010 and 2012 should be interpreted with caution.
Characteristics of motor vehicle traffic fatalities occurring in Jefferson County (2016)
Note: These are fatalities that occurred within Jefferson County and may or may not have included Jefferson County residents. Therefore these numbers are slightly different than numbers reported in the Injuries and Accidents data.
Fall prevention, especially among older adults, is a priority in Colorado. In accidental causes of deaths, falls are the leading cause in those 65 years and older, and are also among the top 5 causes for those 15-64 years. One of the best and easiest activities older adults can do to prevent falls is to exercise. Activities and classes such as Tai Chi help promote balance and stability, while increasing strength (7). In addition, the Centers for Disease Control has developed a program, Stopping Elderly Accidents, Deaths, and Injuries (STEADI) to help providers identify and assess patients at risk for falls and develop fall prevention plans with them (8,9). Some local organizations, such as the Seniors’ Resource Center, also offer material assistance to older adults, like installing rails and grab bars in their home to improve safety at home (10).
In 2015, there were 1,137 hospitalizations and 129 deaths related to falls in those 65 years and older among Jefferson County residents.
- Colorado Injury Hospitalization Statistics data
While falls requiring hospitalization can occur at any age, the majority of severe injury falls occur in those 65 years and older. The rates of hospitalizations and deaths associated with falls are higher in Jefferson County than Colorado and the United States.
In 2015, the majority of those hospitalized due to falls, occurred from:
(1) Slipping, tripping, or stumbling on the same level
(2) From stairs/steps
(3) From ladders/scaffolding
(4) From bed
(5) From chairs/furniture
Child Fatality Prevention
Since 1989, the Colorado Department of Public Health and Environment has been conducting reviews of child fatalities (0-17 years) to identify trends related to causes of death and make recommendations on prevention and interventions. In 2013, these responsibilities shifted to the local level, and Jefferson County established a multidisciplinary Child Fatality Review Team (11).
According to Colorado Revised Statute 25-20.5-405, local Child Fatality Review Teams are responsible for, at a minimum, reviewing the following causes of child fatality within their jurisdiction:
• Undetermined causes.
• Unintentional injury (e.g., drowning, falls, fires).
• Violence (e.g., homicide, any firearm death).
• Motor vehicle incidents.
• Child abuse or neglect.
• Sudden unexpected infant death.
From the risk and the protective factor data collected from the reviews of these deaths and entered into the national database, local review teams create and implement local prevention strategies within their jurisdiction in partnership with the multidisciplinary team and a variety of community stakeholders.
Between 2011-2015, there were 2,950 deaths in Colorado among those age 0-17 years. the Child Fatality Prevention System reviewed 973 of those deaths, including 100% of deaths that were determined to be accidental, suicides, and homicides and 97% of those that had been classified as 'undetermined'. Only 3% of those classified as natural deaths were determined to require review.
The number of deaths related to youth suicide climbed from 2011 to 2015, as did firearm-related fatalities, due to the proportion of suicides that used firearms as a means. Motor vehicle crashes and sudden unexplained infant deaths also remained leading causes of death among this age group.
Number and rate of deaths among children (0-17 years), by leading causes of deaths, among cases reviewed by Child Fatality Prevention System, Jefferson County and Colorado (2011-2015)
For more than 200 years, vaccinations have saved more than a billion lives and prevented countless illnesses and disabilities in the United States. However even with these successes, vaccine-preventable diseases, such as measles, mumps, whooping cough, and others are still a threat. These diseases continue to infect children and adults, resulting in missed school and work days, clinic and emergency department visits, hospitalizations and deaths every year (12). Colorado has a long history of requiring vaccination for school children and college students and in 2015 and 2016 strengthened these requirements. Colorado parents are now required to submit new non-medical exemptions at each age when vaccinations are due and schools are now required to report to the state health department their vaccination compliance and exemptions rates (13). These changes encourage vaccination and are the best way to reduce illness from vaccine-preventable diseases.
The green cells represents those vaccinations where Colorado is exceeding the Healthy People 2020 Goal.
Community Resources within Jefferson County
Jefferson County Vaccination Clinic - Jefferson County Public Health offers immunizations across the life span, including some travel vaccines. Jefferson County Public Health participates in the Vaccines for Children (VFC) program, offering vaccines at no cost to eligible children. Vaccinating on time and on the Advisory Committee on Immunization Practices schedule means healthier children, families and communities.
1. Colorado Department of Public Health and Environment. (2014). Healthy Colorado: Shaping a State of Health, 10 Winnable Battles: Injury Prevention. Retrieved from: https://www.colorado.gov/pacific/sites/default/files/CDPHE_WB_InjuryPrevention.pdf
2. Colorado Department of Public Health and Environment. (2014). Healthy Colorado: Shaping a State of Health, 10 Winnable Battles: Infectious Disease Prevention. Retrieved from: https://www.colorado.gov/pacific/sites/default/files/CDPHE_WB_InfectiousDisease.pdf
3. US Department of Transportation, National Highway Traffic Safety Administration (NHTSA). (2010). Traffic Safety Facts, 2009 Data: Children. Washington (DC): NHTSA. Retrieved from: http://www-nrd.nhtsa.dot.gov/Pubs/811387.pdf
4. CDC. (1999). Achievements in Public Health, 1990-1999 Motor-Vehicle Safety: A 20th Century Public Health Achievement. MMWR, 48(18):269-274. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4818a1.htm
5. Colorado Department of Public Health and Environment. (2012). Comparison of Teen Traffic Fatalities Prior to and After Graduated Driver Licensing Law Implementation. Retrieved from: https://docs.google.com/file/d/0BzR35OF5zfxiVnJ0b1FGX2RWLW8/edit
6. Colorado Department of Transportation. (2018). 2018 Colorado Motor Vehicle Problem Identification Dashboard. Retrieved from: https://cohealthviz.dphe.state.co.us/t/PSDVIP-MHPPUBLIC/views/ColoradoMotorVehicleCrashProblemIDReport/ColoradoMotorVehicleDashboard?:iid=3&:isGuestRedirectFromVizportal=y&:embed=y
7. Stevens, J.A. & Burns, E. (2015). CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults, 3rd Edition. Atlanta, GA: CDC. Retrieved from: https://www.cdc.gov/homeandrecreationalsafety/falls/compendium.html
8. CDC. (March 23, 2017). STEDI: Older Adult Fall Prevention. Retrieved from: https://www.cdc.gov/steadi/
9. Colorado Department of Public Health and Environment. (2018). Clinical guidelines for fall prevention. Retrieved from: https://www.colorado.gov/pacific/cdphe/clinical-guidelines-fall-prevention
10. Denver Regional Council of Governments (DRCOG), Area Agency on Aging. (February 2017). Programs funded by the DRCOG to serve older adults in 2015-2017. Retrieved from: https://drcog.org/sites/drcog/files/resources/AAAFundedProgramsFeb_2017.pdf
11. Colorado Child Fatality Prevention System. (2016). About, History, and FAQs. Retrieved from: http://www.cochildfatalityprevention.com/p/history-faqs-and.html
12. The Immunization Advisory Center. (April 2017). A Brief History of Vaccination. Retrieved from: http://www.immune.org.nz/vaccines/vaccine-development/brief-history-vaccination
13. Colorado Board of Health rule 6 CCR 1009-2. Retrieved from: http://www.sos.state.co.us/CCR/6%20CCR%201009-2.pdf?ruleVersionId=7223&fileName=6
Colorado BRFSS: Colorado Department of Public Health and Environment, Behavioral Risk Factor Surveillance Survey: http://www.chd.dphe.state.co.us/cohid/
CDC BRFSS: Behavioral Risk Factor Surveillance Survey: https://www.cdc.gov/brfss/data_tools.htm
HKCS: Healthy Kids Colorado Survey: https://www.colorado.gov/pacific/cdphe/hkcs
YRBS: Youth Risk Behavior Surveillance System: https://www.cdc.gov/healthyyouth/data/yrbs/results.htm
FARS: Fatality Analysis Reporting System, National Highway Traffic Safety Administration: https://www.nhtsa.gov/research-data/fatality-analysis-reporting-system-fars
Colorado Injury Hospitalization Statistics, CDPHE: Colorado Department of Public Health and Environment: http://www.chd.dphe.state.co.us/cohid/Default.aspx
Colorado Vital Records Statistics, CDPHE: Colorado Department of Public Health and Environment: http://www.chd.dphe.state.co.us/cohid/Default.aspx
CDC WONDER: https://wonder.cdc.gov/
CFPS State Data Overview Report (2011-2015): Child Fatality Prevention System: https://drive.google.com/file/d/0B4u1qfqmSaHjTy0wRTJwdnJzNzA/view
CFPS: 2017 Annual Legislative Report: Child Fatality Prevention System: http://www.cochildfatalityprevention.com/p/reports.html
CDC - National Immunization Survey: https://www.cdc.gov/vaccines/imz-managers/nis/data-tables.html
CDPHE, School and Child Care Immunization Data: https://www.cohealthdata.dphe.state.co.us/Data/Details/1#bydistrict
Published on July 17, 2018
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