Background Methodology Infrastructure Data Programs Technical Support & Training Public Policy...

2011

STATE OF THE STATES

Background• Background

• Methodology• Infrastructure• Data• Programs• Technical Support &

Training• Public Policy

Injuries and violence have a significant impact on the overall health of Americans including:

• Premature death, • Disability, and • Burden placed on the health care system.

1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online] (2007) [accessed 2012 Aug 4]. Available from URL: http://www.cdc.gov/injury/wisqars.2. Finkelstein EA, Corso PS, Miller TR, Associates. Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press; 2006.

Background• Background

• Methodology• Infrastructure• Data• Programs• Technical Support &


Methodology• Background

• Methodology

• Infrastructure• Data• Programs• Technical Support &


4th administration of the Safe States Alliance State of the States (SOTS) Survey

2011 SOTS was administered in early 2012

47 states participated

The results presented in this report were analyzed using:• SPSS Version 16.0,

• SAS Enterprise Guide 5.1, and

• ArcGIS 10.1.

IVP Program Infrastructure • Background• Methodology

• Infrastructure– State Mandate– Program Location– Strategic Planning– Funding– FTEs– Partnerships &

Collaboration

• Data• Programs• Technical Support &


BUILD A SOLID INFRASTRUCTURE FOR INJURY AND VIOLENCE PREVENTION INCLUDES…

State MandatesProgram Location Strategic PlanningFundingFull Time Equivalents (FTEs)Partnerships and Collaboration

State Mandate• Background• Methodology


Collaboration



2011 (N=47)

2009 (N=49)

2007 (N=50)

2005 (N=48)

17%

24%

16%

25%

83%

73%

84%

69%

2%

6%

Yes No Don't Know

States with a Mandate for a Comprehensive Injury and/or Violence Prevention Program

Program Location• Background• Methodology


Collaboration



60%

13% 13%9%

2% 2%

59%

8%12%

6%2%

13%

50%

16%12%

4% 2%

16%

57%

19%

6% 4% 2%

11%

2005 (N=45) 2007 (N=50) 2009 (N=49) 2011 (N=47)

Location of Injury and Violence Prevention Programs in State Health Departments

Program Location• Background• Methodology


Collaboration



2009 (N=49) 2011 (N=47)

77%

89%

2009 (N=49) 2011 (N=47)

71%57%

6% 32%

Primarily Responsible for IVP ActivitiesIVP Activities are Decentralized

States with an Identified Injury and Violence Prevention Program

Strategic Planning• Background• Methodology


Collaboration



Statewide Health Plan

State Injury and Violence Prevention Plan

Health Department Health Plan

Health Department Injury and Violence Prevention Plan

18%

29%

29%

24%

23%

53%

47%

43%

2011 (N=47)2009 (N=49)

States Reporting the Existence of State and/or Health Department Plans

Funding• Background• Methodology


Collaboration



Federal• All states spent federal

sources• 11 (23%) states spent

federal sources only47

Federal and State

• 36 (77%) states spent federal and state sources

• 17 (36%) states spent federal and state sources only

36

Federal, State, and

Other

• 19 (40%) states spent federal, state, and other sources

19

Funding Source Types Awarded to State Health Department IVP Program



Collaboration



Number of States Reporting Spending Funding Sources vs. Total Provided by Each Funding Source

($Millions) in FFY 2011



Collaboration



Funding Allocations for State Injury and Violence Prevention Programs, FFY 2011

In Federal Fiscal Year 2011, $101.5 million was invested nationally in state public health injury and violence prevention program



Collaboration





Collaboration



State Health Department Injury and Violence Prevention FFY 2011 Funding per Capita:

State Funding per Capita Compared to National Funding per Capita ($0.32 per capita)

Full Time Equivalents (FTEs)• Background• Methodology


Collaboration



Distribution of FTE Primary Roles in State Injury and Violence Prevention Programs, FFY 2011

Full Time Equivalents (FTEs)• Background• Methodology


Collaboration



Distribution of FTEs Working in State Injury and Violence Prevention Programs, FFY 2011

Partnerships & Collaboration• Background• Methodology


Collaboration



Partnerships among different organization types:Agencies within the state health department (23 entities)

Other state agencies (16 entities)

Non-governmental organization (23 entities)

Federal Agencies (7 entities)

Description of the nature of the partnership:Sharing data;

Program planning;

Exchange of funding;

Collaborated on policy efforts; and

Training/technical assistance.

Overview of Partnerships



Collaboration



Rank Shared Data Actively Involved in Planning,

Programs, Etc.

Funding Exchanged Collaborated for Policy

IVP Program Provided/ Received Training/ Technical

Assistance

IVP Program Provided

Funding TO

IVP Program Received

Funding FROM

1 Vital Statistics Maternal and Child Health

Epidemiology Maternal and Child Health

Maternal and Child Health

Aging

2 Epidemiology Aging Aging Aging Aging Environmental Health

3 Maternal and Child Health

Health Promotion

Chronic Disease

Chronic Disease

Emergency Medical Services

Chronic Disease

4 Emergency Medical Services




Mental Health


5 Aging Sexual Health Sexual Health Health Promotion

School Health Occupational Health

Ranking of IVP Partnerships within the State Health Department



Collaboration




Programs, Etc.



Assistance


Funding TO


Funding FROM




Aging



Health Promotion

Chronic Disease

Chronic Disease


Chronic Disease





Mental Health







Collaboration




Programs, Etc.



Assistance


Funding TO


Funding FROM




Aging



Health Promotion

Chronic Disease

Chronic Disease


Chronic Disease





Mental Health







Collaboration



Ranking of IVP Partnerships with Other State Agencies

Rank Legal Agreement

or MOU

Shared Data Actively Involved in Planning, Programs,

Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO

IVP Program Received Funding FROM

1 State Universities

Highway Safety

Elder's Affairs/ Aging



Highway Safety

Attorney General's

Office

2 Criminal Justice/Law

Enforcement

Fire Dept/Fire Marshall

Highway Safety

State Universities

Highway Safety

Child Welfare Agencies,Dept of

Transport.


3 Child Welfare Agencies

Criminal Justice/Law

Enforcement

Mental Health


Enforcement

Dept of Transport.

Attorney General's

Office

Elder's Affairs/Aging

4 Attorney General's

Office

Dept of Transport.



Child Welfare Agencies

Mental Health

Education

5 Dept of Transport.


State Universities

Attorney General's

Office


Enforcement


Enforcement

Dept of Transport.



Collaboration





or MOU


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO



Highway Safety




Highway Safety

Attorney General's

Office


Enforcement


Highway Safety

State Universities

Highway Safety


Transport.




Enforcement

Mental Health


Enforcement

Dept of Transport.

Attorney General's

Office

Elder's Affairs/Aging


Office

Dept of Transport.




Mental Health

Education



State Universities

Attorney General's

Office


Enforcement


Enforcement

Dept of Transport.



Collaboration





or MOU


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO



Highway Safety




Highway Safety

Attorney General's

Office


Enforcement


Highway Safety

State Universities

Highway Safety


Transport.




Enforcement

Mental Health


Enforcement

Dept of Transport.

Attorney General's

Office



Office

Dept of Transport.




Mental Health

Education



State Universities

Attorney General's

Office


Enforcement


Enforcement

Dept of Transport.



Collaboration



Ranking of IVP Partnerships with Non-Government Organizations


or MOU


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO


1 Academic Institutions

Safe Kids Coalitions





Children's Safety

Network

2 Safe Kids Coalitions

Brain Injury Association



Businesses Sports Associations

Academic Institutions

3 ICRCs ICRCs Academic Institutions

Academic Institutions,

Youth Serving Orgs


ICRCs Safe Kids Coalitions

4 Brain Injury Association

Children's Safety

Network

ICRCs American Red Cross

Chapters

Safety Council Brain Injury Association

ICRCs

5 Youth Serving Orgs

Healthcare Assn

Healthcare Assn

ICRCs ICRCs MADD MPOs



Collaboration





or MOU


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO








Children's Safety

Network









Youth Serving Orgs




Children's Safety

Network


Chapters


ICRCs


Healthcare Assn

Healthcare Assn




Collaboration





or MOU


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO








Children's Safety

Network









Youth Serving Orgs




Children's Safety

Network


Chapters


ICRCs


Healthcare Assn

Healthcare Assn




Collaboration



Ranking of IVP Partnerships with Federal Agencies


or MOU

Shared Data

Actively Involved in Planning, Programs,

Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO


1 CDC CDC CDC Admin. on Aging

CDC CDC CDC

2 SAMHSA SAMHSA SAMHSA IHS SAMHSA NHTSA IHS

3 HRSA NHTSA FHA HRSA Admin. on Aging

NHTSA

4 IHS HRSA IHS NHTSA IHS SAMHSA

5 Admin. on Aging

FHA NHTSA FHA FHA HRSA



Collaboration





or MOU

Shared Data


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO



CDC CDC CDC


3 HRSA NHTSA FHA - HRSA Admin. on Aging

NHTSA

4 IHS HRSA IHS - NHTSA IHS SAMHSA

5 Admin. on Aging

FHA NHTSA - FHA FHA HRSA



Collaboration





or MOU

Shared Data


Etc.


IVP Program

Provided/ Received

Training/ TA


Funding TO



CDC CDC CDC


3 HRSA NHTSA FHA - HRSA Admin. on Aging

NHTSA

4 IHS HRSA IHS - NHTSA IHS SAMHSA

5 Admin. on Aging

FHA NHTSA - FHA FHA HRSA

IVP Access and Use of Data• Background• Methodology• Infrastructure

• Data– Use of Core

Datasets– Access to and Use

of IVP Data– Access to Data

Professionals– Dissemination of

Reports

• Programs• Technical Support &


COLLECT AND ANALYZE INJURY AND VIOLENCE DATA INCLUDES…

Use of Core DatasetsAccess to and Use of Injury and Violence DataAccess to a Data ProfessionalDissemination of Reports

Use of Core Datasets• Background• Methodology• Infrastructure





Reports



Accessed Dataset (N)

Used the Data N (%)

Vital Records 47 43 (91%)

Behavioral Risk Factor Surveillance System (BRFSS) 46 33 (72%)

Hospital Discharge Data (HDD) 43 38 (88%)

Web-based Injury Statistics Query and Reporting System (WISQARS)ⱡ 43 31 (72%)

Youth Risk Behavior Surveillance System (YRBSS) 42 32 (76%)

Child Death Review (CDR) 33 22 (67%)

Emergency Department (ED) 33 26 (79%)

Fatality Analysis Reporting System (FARS) 33 20 (61%)

Medical Examiner 32 24 (75%)

Emergency Medical Services (EMS) 31 18 (58%)

Uniform Crime Reporting System (UCR) 30 19 (63%)

National Violent Death Reporting System (NVDRS) ⱡ 25 20 (80%)

State Surveys ⱡ 23 19 (83%)

National Occupant Protection Use Survey (NOPUS) 19 14 (74%)

National Trauma Data Bank ⱡ 11 3 (27%)

ⱡNot part of the 11 Core Datasets

Access to Core Datasets and Use of Core Datasets for Programmatic Decisions






Reports




Used the Data N (%)























Reports




Used the Data N (%)


















Access to and Use of IVP Data• Background• Methodology• Infrastructure





Reports



Access to IVP Datasets and Use of Datasets

Access to Data Professionals• Background• Methodology• Infrastructure





Reports



2009 2011

41%59%

4%

9%51%

30%

4% 2%

0% of the time

1 - 50% of the time

51-99% of the time

100% or more of the time (i.e., equivalent to one or more FTE)

Access to Data Professional, 2009 (N=49) and 2011(N=47)

Dissemination of Reports• Background• Methodology• Infrastructure





Reports



60%

34%

6% 4%

Types of Reports Released by State IVP Programs2011(N=47)

IVP Programs and Evaluation• Background• Methodology• Infrastructure• Data

• Programs– Areas of Program

Focus– Methods for

Selecting IVP Topic Areas

– Implementation & Evaluation Activities

• Technical Support & Training

• Public Policy

DESIGN, IMPLEMENT, AND EVALUATE PROGRAMS INCLUDES…

Areas of Program FocusMethods for Selecting IVP Topic AreasImplementation & Evaluation Activities

Areas of Program Focus• Background• Methodology• Infrastructure• Data






• Public Policy

Top Primary Focus Areas

2011 2009 2007 2005

1 Motor vehicle injury Motor vehicle injury Suicide attempts Suicide attempts

2 Fall injury Child passenger safety

Child passenger safety Sexual assault/rape

3 Sexual assault/rape Fall injury Motor vehicle safety Child passenger safety

4 Injuries to children Injuries to children Sexual assault/rape Traumatic brain injury

5 Child passenger safety Sexual assault/rape Injuries to children Injuries to children

Primary Programmatic Focus Areas2005, 2007, 2009, & 2011







• Public Policy


2011 2009 2007 2005







Primary Programmatic Focus Areas2011, 2009, 2007, 2005







• Public Policy


2011 2009 2007 2005














• Public Policy


2011 2009 2007 2005














• Public Policy


2011 2009 2007 2005














• Public Policy


2011 2009 2007 2005














• Public Policy

Legend

states

<all other values>

Motor vehicle injury

<Null>

Primary Focus

Secondary Focus

Minimal Focus on this topic

Did not address in FFY 2011

No Data Available

Motor Vehicle Injury Prevention

Child Passenger Safety

34 States indentified Motor vehicle

injury prevention as a primary focus area

25 States indentified Motor vehicle

injury prevention as a primary focus area

Methods for Selecting IVP Topic Areas

• Background• Methodology• Infrastructure• Data






• Public Policy

44%

28% 29% 31% 28%

94% 97%

71%

85% 80%

0%

45%

61%

42%32%

Local Data State Data National Data

All states used data for selecting their IVP topic areas for programmatic focus…

Methods for Selecting IVP Topic Areas

• Background• Methodology• Infrastructure• Data






• Public Policy

Implementation & Evaluation• Background• Methodology• Infrastructure• Data






• Public Policy

Reported Levels of Programmatic Planning & Evaluation for the Top Three Focus Areas, 2011

Provide Technical Support & Training

• Background• Methodology• Infrastructure• Data• Programs

• Technical Support & Training– Technical Support

and Methods– Technical Assistance

Resources

• Public Policy

PROVIDING TECHNICAL SUPPORT & TRAINING INCLUDES…

Technical Support and MethodsTechnical Assistance Resources Used by States

Training Support & Methods




Resources

• Public Policy

84% 84%

41%

20%

84% 82%

40% 38%

2009 (N=49) 2011 (N=47)

Methods Used by IVP Programs to Provide Technical Support and Training

Training Support & Methods




Resources

• Public Policy

Programs that had a full-time director were significantly more likely to implement the following methods of providing technical assistance and training:

Offered practical experience to students (p=0.037)Responded to request for technical assistance (p=0.010)Offered courses for academic credit or CEUs (p=0.004)





Resources

• Public Policy

Top Technical Assistance Resources Used2011 & 2009

Federal Agencies

Safe States Alliance

Internet

Resource Centers

Peer to Peer

Regional Networks

Other national Organizations

University/Academic Institions

Injury Control Research Centers

87%

83%

79%

72%

68%

64%

53%

51%

47%

90%

90%

82%

71%

74%

42%

59%

55%

55%

2009 (N=49) 2011 (N=47)





Resources

• Public Policy

Top Technical Assistance Resources Used2011 & 2009

Federal Agencies

Safe States Alliance

Internet

Resource Centers

Peer to Peer

Regional Networks

Other national Organizations

University/Academic Institions

Injury Control Research Centers

87%

83%

79%

72%

68%

64%

53%

51%

47%

90%

90%

82%

71%

74%

42%

59%

55%

55%

2009 (N=49) 2011 (N=47)

Affect Public Policy

• Background• Methodology• Infrastructure• Data• Programs• Technical Support &

Training

• Public Policy– Methods to Inform

Policy– Mechanisms for

Communicating – Implementing Policy

Strategies

AFFECT POLICY INCLUDES…

Methods to Inform PolicyMechanisms for Communicating with Policy MakersImplementing Policy Strategies

Methods to Inform Policy


Training




Strategies

2011 Methods Used by State Injury and Violence Prevention Programs to Inform Public Policy and Change



Training




Strategies

2011 Methods Used by State Injury and Violence Prevention Programs to Inform Public Policy and Change



Training




Strategies

State IVP programs that had access to an evaluator, epidemiologist, and/or a full-time director were significantly more

likely to engage in specific methods to inform public policy.

Method Used

Full-time Director

(p-value)

Full-time Epidemiologist

(p-value)

Access to Evaluator

(p-value)

Worked to create/encourage adoption of organizational policies for IVP 0.168 0.226 0.033

Worked to increase public awareness of laws 0.037 0.226 0.763

Participated in boards and/or commissions 0.326 1.000 0.009

Requested opportunity to review bills 0.008 0.561 0.041

Sent materials to policymakers 0.310 0.018 0.009

Testified at state and local hearings 0.464 0.025 0.330

Invited state or local legislators to meetings events 0.021 0.047 0.042

Mechanisms for Communicating


Training




Strategies

2005 (N=45) 2007 (N=50) 2009 (N=49) 2011 (N=47)

81% 82%89%

74%

Mechanisms or Protocols for Communicating with Policy Makers about Injury and Violence Prevention Issues

2005, 2007, 2009, and 2011

Implementing Policy Strategies


Training



Communicating – Implementing

Policy Strategies

Top Programmatic Focus Areas that Implemented Policy Strategies

Injury and Violence Topic AreaNumber of States Selecting Area as Primary Focus (N)

IVP Program that Implement Policy Strategies, N (%)

Motor vehicle injury 34 100%

Fall injuries 29 41%

Sexual assault/rape 28 61%

Injuries to children 26 69%

Child passenger safety 25 100%

Questions & Answers…• Background• Methodology• Infrastructure• Data• Programs• Technical Support &


Shenée BryanSafe States Alliance

[email protected]

Download full 2011 State of the States Report

www.safestates.org/sots

http://www.safestates.org/sots

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