What is prevention?
Prevention is a strategy of predicting and avoiding injuries. Most injuries, whether intentional or unintentional, can be prevented if people are aware of potential risks and prepare for them. For example, since we know motor vehicle injuries occur, we wear seat belts to prevent potential injuries.
Most injuries (including violence) have evidence-based prevention strategies. Prevention strategies include laws (which impact environmental factors) and education for the public and professionals. With the financial cost of injury amounting to more than $4 billion a year in New Mexico, and the emotional costs impossible to measure, comprehensive evidence-based prevention efforts are a cost-effective strategy.
Injury prevention should cover a lifetime--from infants to seniors.
Prevention Terms and Strategies
- Alcohol Use and Related Injuries
- Drug-induced Poisoning
- Falls
- Firearm Injury
- Intimate Partner Violence and Teen Dating Violence
- Motor Vehicle Injury
- Protective Factors & Risk Factors
- School and Community-based Harassment and Violence
- Sexual Violence
- Suicide
The following definitions include evidence-based strategies that communities can consider as part of their injury prevention work.
Excessive alcohol use is often a factor in injury and death resulting from motor vehicle crashes, inter-personal and self-inflicted violence, falls, drug overdose, and a variety of other injury causes. Binge drinking (drinking 5 or more drinks during a single occasion for men or 4 or more drinks during a single occasion for women) is strongly associated with increased risk of injury and death from these causes. Excessive alcohol use is also associated with a host of other social problems, including violence, infectious disease, crime, and mental illness. Reducing the prevalence of binge drinking is an important public health goal intended to decrease the overall burden of alcohol-related injury and death. Alcohol use – particularly binge drinking – is especially risky to underage drinkers. The three leading causes of death in the underage population – motor vehicle crashes, homicide, and suicide – are all strongly associated with alcohol use. Reducing access to alcohol by underage persons is an important public health goal. In general, prevention strategies that have been effective include:
- Policies to ensure alcoholic beverage retailers comply with the minimum purchase age.
- Improved enforcement of state laws prohibiting distribution of alcoholic beverages to anyone under 21 years and more severe penalties to discourage such distribution.
- More severe penalties and better enforcement of laws prohibiting alcohol sales and service to intoxicated persons.
- Higher prices for alcoholic beverages. Higher prices are associated with reductions in the probability of frequent alcohol consumption by young persons and in the probability of adults drinking five or more alcoholic drinks on a single occasion.
- Increased use of screening, education and counseling for adults
- Use of screening, education and counseling for adolescents in school-based health clinics is a promising practice.
Prescription, over-the-counter drugs, and illegal drugs temporarily alter a person’s perception and emotional state. Wide promotion by pharmaceutical companies, access to drugs, and easy availability through Mexico increases drugs' availability and makes misuse easier. Well-established distribution networks for illegal drugs exist throughout the state. In general, prevention strategies that have been effective include:
- Enforcement of laws and policies designed to prevent the supply, sale, and use of illegal drugs.
- Enforcement of the 911 Good Samaritan law. This law provides limited immunity from drug possession charges when a drug-related overdose victim or a witness to an overdose seeks medical assistance.
- Promotion of available, accessible, and affordable mental health and recovery services for those needing support.
- Policies supporting the prevention of overuse of prescription and over-the-counter drugs.
A fall can cause serious injury. Younger (ages 1-4) and older (over 65) populations are most at risk from fall-related injuries. For young children, a child-safe home, play, and school environment are key. Older adults also need safe living environments. Serious fall-related injuries have both a physical and emotional impact on the older person. Generally accepted prevention strategies include:
- Creating safe environments for children that reduce the risk of falls and provide protective fall surfaces at home, school, and outdoors.
- Providing attentive supervision of young children in the home, at school and outdoors.
- Promoting the practice among primary care providers of conducting individualized clinical assessments of older patients for fall risk factors combined with strategies directed toward reducing those risks (e.g., home modification, exercise).
- Providing and promoting exercise programs for older adults intended to improve balance, strength, flexibility and/or endurance.
- Reviewing and modifying medications provided to older adults (especially psychoactive medications).
- Assessing and correcting vision problems among older adults.
Firearm-related injury is one of the leading causes of injury and death among young people. In general, prevention strategies that have been effective include:
- Enforcement of laws and policies related to gun sales, possession, accessibility and trafficking including licensing of gun owners and registration of guns.
- Keeping homes with children and adolescents gun-free but when parents choose to bring a gun into the home, keeping the gun locked, unloaded and storing the ammunition separately.
- Comprehensive, community-based gun violence prevention initiatives focused on deterring youth gun involvement.
Intimate partner violence includes physical assault and intimidation between two people in a relationship. Teen dating violence refers to intimidation and physical violence between young people in a relationship. Intimate partner violence and teen dating violence can be described as a pattern of behaviors, including physical, sexual, and psychological attacks, as well as economic coercion, that adults or adolescents use against their partners. The violence may or may not be sexual in nature. The violence is used by the victimizer to control and disempower the victim. Victims can be male or female—though most victimizers are male. The violence or threats of violence can be sporadic or a daily or weekly occurrence. The victim is often torn between feelings of attachment to her or his partner, and feelings of fear. The victim may be economically dependent on the victimizer. The violence and control instigated by the victimizer results in both emotional and physical harm. The damage done by intimidation and violence can have a long-lasting impact on the victim. Parents of teens, friends of teens, school staff, neighbors, and extended family members need to be vigilant and report suspected partner violence. Interventions may include:
- Enforcement of laws and policies protecting victims of relationship violence.
- Available, accessible, and affordable behavioral health services for those seeking support.
Prevention strategies, seen as promising practice, include: educational programs for youth about emotional health, healthy relationships, self-worth, anger management, and related mental health issues
Motor vehicle crashes are the number one cause of injury and injury-related death in NM. Vehicles include cars, trucks, motorcycles, motor scooters, all-terrain vehicles, off-road motorcycles, miniature motorcycles and snowmobiles. Alcohol-impaired driving are a contributing factor in many motor vehicle crashes. Generally accepted prevention strategies involve a comprehensive use of numerous laws and policies including:
- Enforcement of laws related to the use of seat belts, child car seats and booster safety seats.
- Enactment and enforcement of helmet laws.
- Graduated driver’s licensing law for teen drivers.
- Minimum legal drinking age of 21.
- Alcohol server trainer requirements and alcohol seller awareness programs.
- Zero tolerance laws that make it illegal for people under age 21 to drive after any drinking.
- Alcohol roadside sobriety checkpoint programs accompanied by effective publicity efforts to increase the perceived risk of arrest.
- Enforcement of ignition interlock laws.
- Engineering improvements to roads, especially rural roadways, including paved shoulders, mid-lane rumble strips, enhanced pavement markings, skid-resistant pavement surfaces and eliminating shoulder drop-offs.
Protective Factors & Risk Factors
Studies have looked at the lives of children to see which factors strengthened and empowered young people to lead healthy lives. These are called protective factors (or resiliency factors). The same studies also noted which factors put young people at risk for violence, drug abuse and other unhealthy behaviors. These are called risk factors. Protective factors can be found in both the child’s home and community, including the school. Protective factors in the family include:
- A child’s emotional attachment to a parent or caregiver
- Parents’ and caregivers' supervision of their children
- Parents' emotional attachment to a child
- Parents' involvement in the child’s life
- Parents’ expectation for a child to succeed in school
- Parents’ ability to set rules and provide consistent enforcement of discipline
- A child’s access to a living environment free from violence
- A child’s access to a living environment free from alcohol and drug abuse
Protective factors in the community include:
- A child’s attachment to teachers
- A child’s access to safe recreational activities
- A child’s access to a safe school where learning is prioritized
- A child’s access to a community free from violence
- A child’s access to a community free from drug trafficking, alcohol and drug abuse
- A child’s access to pro-social activities (like after school programs and youth groups)
- A child's healthy relationship with an adult outside of his or her family
Children are often exposed to a mix of protective factors and risk factors. The factors may change over time. The more protective factors in a child’s life, the better chance for the child’s safety and healthy development.
Harassment and bullying can include: threats of physical assault (hitting, tripping, pushing), name-calling, cyberbullying (threats via the Internet and texting), and intimidation. The use of weapons represents the most serious form of bullying and harassment. Harassment (including sexual harassment) and bullying can escalate to serious physical injuries, and students no longer learn at school. Prevention strategies may include:
- Available, accessible, and affordable mental health services for those seeking support, including both victims and victimizers.
- Enforcement of laws and policies established to promote school safety and prevent youth violence and sexual harassment.
- Comprehensive evidence-based school-based bullying and harassment prevention programs that provide all of the following: enforcement of school safety policies, on-going education to students, yearly training for school teaching and administrative staff, and educational outreach to parents.
Sexual violence is any kind of unwanted interpersonal sexual behavior. This can include verbal harassment, rape, sexual abuse, incest, and sexual assault. Most perpetrators of sexual violence know their victims. The survivor may be in an intimate relationship with the perpetrator and feel too embarrassed, frightened, or disempowered to ask for help. Sexual violence can be directed at people of any age, race, sexual orientation, gender, gender identity and socio-economic class. Reported cases of sexual violence indicate that most of the survivors are female and most perpetrators are male. The sexual violence can result in psychological, emotional and physical harm. The damage done by sexual violence can have a long-lasting impact on the survivor and their family and friends. Strategies to consider, if part of a comprehensive plan, could provide effective interventions:
- Free and confidential counseling services for victims and others affected by the violence.
- Education for survivors to dispel myths, reduce self-blame and guilt, and reestablish healthy physical and psychological boundaries.
- Rape crisis phone lines available and staffed 24 hours, 7 days a week.
- Enforcement of laws and policies designed to protect the survivors of sexual violence.
- Offender intervention programming.
- Expeditious prosecution of sexual assault.
People threaten and attempt to take their lives for many reasons. Too often, they are successful. Both verbal threats to commit suicide and actual suicide attempts can be seen as calls for help. More than 90% of suicide victims have a diagnosable psychiatric illness, most commonly a mood disorder. Other common conditions include schizophrenia, alcohol abuse/dependence, substance use disorders, and personality disorders. Depression, which can lead to suicidal feelings, can be the result of both biological and environmental factors.
The reasons for suicide attempts may change over a person’s lifetime. Research cannot capture all the causes for suicide but some contributing factors include: lack of healthy emotional connection with friends, family or other caring adults; misuse or abuse of alcohol and other substances, a prolonged sense of hopelessness, despair, and depression; and lack of access to mental health services. Other risk factors include experiencing a recent painful event (such as job loss or loss of loved one), chronic medical illness, and a family history of suicide attempts or completions. In general, suicide prevention strategies that have been shown to be effective focus on targeting high risk individuals with brief behavioral and supportive interventions. Prevention Strategies include:
- Promotion of available, accessible, and affordable mental health services for those seeking support.
- Reducing access to means of suicide (specifically weapons).
Strategies to consider, if part of a comprehensive plan, that could reduce the stigma of suicide and mental illness: Public education programs on emotional health, coping strategies, signs of depression, and warning signs of suicide for youth, parents, educators, and health care providers.
FOR MORE INFORMATION
For more information about evidence-based policies, programs and promising practice, to comment on our prevention strategies, or propose changes, please contact an Injury Prevention team member in the prevention unit.
Copyright 2008 New Mexico Department of Health - Injury Prevention