Data and Surveillance

To set priorities for injury prevention programs, state and local practitioners need morbidity and mortality injury data (see Chapter 3). However, data collected at the local and community levels have not always been available. In the past 10 years a number of specialized, topic-specific state and local surveillance systems (e.g., traumatic brain injury surveillance, firearm injury surveillance) have been funded as demonstration projects by federal agencies. Unfortunately, funding for such programs has generally been intermittent or time limited, preventing long-term implementation, analysis, evaluation, or dissemination (see Chapter 3).

Local hospital discharge data that are accompanied by an external cause-of-injury code (E-codes) are also useful for developing injury prevention interventions (see Chapter 3). These data provide a perspective on the more serious injuries that require hospitalization, allow comparisons to be made with other medical conditions and diseases, and pinpoint localities with higher than normal injury incidence, which then may be targeted for specific programs and resources. Almost half of the states now require E-coding, which allows this information to be routinely analyzed and available on a statewide basis (Chapter 3). However, practitioners cannot access community data directly from the local hospital because such data are available only from a central collecting agency. Other untapped sources of injury data include records of emergency departments, EMS and police investigations. However, those records often are not computerized or not linked to hospital data or other data sets, and unresolved issues of confidentiality make it difficult—if not impossible—to trace the injuries in a useful way for targeted prevention interventions. Technical assistance by state personnel trained in injury surveillance methods can help communities and local professionals access, analyze, and transform locally collected data into useful information.

Strategic Planning

As states embrace injury prevention efforts and work toward strengthening their injury prevention programs, it is important to incorporate injury prevention into many diverse strategic planning processes and documents. For example, the State of Utah Annual Plan for Maternal and Child Health devotes sections to injury control and youth suicide prevention (Utah Department of Health, 1997); New York's Highway Safety Strategic Plan contains a section on injury (Klein et al., 1997); and the Emergency Preparedness and Injury Control Program of the California Department of Health Services has produced a five-year strategic plan dedicated to injury prevention. The California Department of Health Services' strategic plan for 1993–1997 contains specific objectives for reducing injury morbidity and mortality and suggests mechanisms for incorporating injury pre-

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