Primary care doctors credited with helping patients prevent injuries

Primary care physicians have been essential in helping reduce the number of preventable injuries that occur among their patients and in their communities, public health officials say.

Such efforts include doctors advocating for more comprehensive child safety seat laws in motor vehicles, encouraging patients to wear seat belts and screening female patients for intimate partner violence.

Data show that those efforts, coupled with injury-prevention laws such as requiring drivers to buckle up, have made a difference. For example, seat belt use has been credited with saving an estimated 69,000 lives between 2006 and 2010, according to a report on injury prevention issued May 22 by the Trust for America’s Health and the Robert Wood Johnson Foundation.

Still, about 50 million Americans (18% of the population) are medically treated each year for injuries, including those caused by vehicle crashes and violence, the report said.

“Physicians have been some of [public health officials’] greatest allies in preventing injuries, because they see the devastating results,” said Andrea Gielen, ScD, director of the Johns Hopkins Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health in Baltimore. “While tremendous progress has been made in preventing and treating injury, it remains a leading cause of death for people of all ages and the No. 1 cause of death for children.”

Gielen, who helped develop the report, also is past president of the Washington-based Society for the Advancement of Violence and Injury Research.

To help decrease injuries that occur in the U.S. each year, the report’s authors are calling on states to continue adopting research-based injury prevention policies. Such policies include requiring motorcycle riders to wear helmets (mandated in 19 states and Washington, D.C.) and implementing a prescription drug monitoring program (found in 48 states).

The authors recommend that physicians:

• Learn about how aging impacts driving and talk to older patients about the risks and benefits of continued driving to help prevent motor vehicle crashes.
• Review data in their state’s prescription drug monitoring program before prescribing a painkiller to be sure the patient is not using opioids inappropriately.
• Regularly examine the medications older patients are taking and identify drugs that might cause dizziness or drowsiness to help prevent falls.

The report urges all levels of government to enhance funding of injury-prevention policies and increase investments in injury-prevention research.

“Without continued research, the progress we’ve made is at risk,” said Jeffrey Levi, PhD, an author of the report and executive director of Trust for America’s Health.

Research also is essential in helping health professionals learn how to best address emerging problems, including a surge in prescription drug abuse, bullying and motor vehicle crashes due to drivers text messaging, Levi said. “Information is essential for injury prevention,” he said.

Implementing prevention strategies

More than 180,000 people die of injuries each year, and 2.8 million are hospitalized, according to the report. New Mexico has the highest rate of injury-related deaths (98.7 deaths per 100,000 people). New Jersey has the lowest rate — 36.1 deaths per 100,000. The national rate is 57.9 injury-related deaths per 100,000 Americans.

One possible reason for the variation is that some states place a greater emphasis on injury prevention than others, Levi said.

For the report, public health experts developed a list of 10 measures shown to reduce injuries and save lives. Those indicators include: laws that allow a driver to be ticketed for not wearing a seat belt; requirements that car seats or booster seats be used for children up to at least age 8; and the ability of people in dating relationships to get protection orders.

Researchers examined how many of the strategies were implemented across the country and awarded states one point for each measure enacted. No state achieved the maximum score of 10.

The best-performing states were California and New York, which each earned nine points. Montana and Ohio were the lowest-scoring states, with two points each.

This “is not a comprehensive review, but it is a strong composite snapshot of trends of important, scientifically backed-policies,” Gielen said. “Only two states scored [9 out of 10], meaning the other states have a long way to go.”