7 Ways to Stop the Biggest Killers of All: Injuries and Accidents

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7 Ways to Stop the Biggest Killers of All: Injuries and Accidents

When someone dies from an injury or accident it seems even more tragic since it didn’t have to happen. And it’s perhaps even more heartbreaking to realize that young people are the hardest hit: Injuries are the third-leading cause of death nationally, and the top cause of death for Americans between the ages of one and 44. Young adults are especially risk-prone, which is hard on the economy. Though young adults comprise less than one-third of the population, they make up 44 percent of all injury-related productivity losses.

This left us wondering what could be done to prevent more of these injuries from happening—what would really make a difference? The truth, of course, is that every one of us can help cut our risk, mostly by using some common sense and resisting the urge to do something impulsive and often stupid.

But a report by the Trust for America’s Health and the Robert Wood Johnson Foundation concluded that millions of injuries could be prevented each year if more states adopted policies that are known, through scientific research, to cut injuries. Currently, states vary on what they do to prevent injuries. The report ranked their efforts, and found 21 states scoring a five or lower on a set of ten key indicators of steps they can take to prevent injuries. Two states, California and New York, received the highest score (nine out of a possible ten), while Montana scored the lowest, with two out of ten.

Here are seven policies that all states should adopt to help more people avoid injuries and stay safe.

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Allow Police to Ticket People Who Don’t Wear a Seatbelt

It’s hard to believe, but 18 states do not have primary seatbelt laws despite decades of evidence that wearing seatbelts saves lives. Primary seatbelt laws allow law enforcement officers to ticket a driver or passenger for not wearing a seatbelt, even if the driver did nothing else wrong.

One recent study found that 69,000 lives were saved from seatbelt use in the years from 2006 to 2010. Motor vehicle accidents are the leading cause of death for Americans ages five through 34—despite the fact that the number of children and teens killed in crashes fell by 41 percent from 2000 to 2009. Men and people ages 18 to 24 are less likely to use seatbelts.

According to research, most drivers and passengers—53 percent—killed in car crashes were not wearing seatbelts. People not wearing a seatbelt are 30 times more likely to be thrown from a vehicle during a crash, and more than 75 percent of those who are ejected during a crash die from their injuries.

Seatbelt laws have evolved over the last 50 years, says Richard Hamburg, deputy director of Trust For America’s Health. “Things can move incrementally. But, over time, you see stronger laws,” he says. “You saw the development of societal norms that, over time, led to the placement of seatbelts in all cars, first in the front seat, then in the back seat. Now we understand that shoulder harnesses are even safer, and those were required. Now we’ve seen policies evolve that allows police officers to ticket someone not wearing a seatbelt. We’re seeing similar policies develop…over cell phone use and distracted driving.”

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Require Mandatory Ignition Locks for All Convicted Drunk Drivers—Even First-Time DUI Offenders

Despite efforts to keep intoxicated people from getting behind the wheel, drunk driving deaths continue to devastate: About one out of every three highway deaths is caused by a drunk driver. While men between the ages of 21 and 34 make up only 11 percent of the adult population, they are responsible for almost one-third of all drinking and driving behavior.

The use of ignition interlocks—which require a driver to breathe into an alcohol-detection device before being able to start a car—has gained traction to keep drunk drivers off the roads. According to the Centers for Disease Control and Prevention (CDC), studies on ignition interlocks show that they can dramatically lower re-arrest rates for alcohol-impaired driving, with reductions ranging from 50 to 90 percent.

In spite of that, 33 states and Washington, D.C. do not require ignition interlocks for convicted drunk drivers. Seventeen states do require the devices, even for first-time offenders. “The figures are scary. The number of Americans that died from alcohol-related crashes was 11,000 in 2009,” Hamburg says. “Over the course of the last 20 or 30 years we’ve seen all these blood-alcohol concentration (BAC) laws put into place. The next intervention has been the mandatory interlock. These policies appear to really make a difference. But there are a lot of different interventions. BAC laws, stronger and stronger punishments for DUI, sobriety checkpoints—there are a lot of things that can be done.”

Photo: Fred Tanneau/Getty Images

Require Booster Seats Until at Least the Age of 8

It used to be that only babies and toddlers were strapped into child-restraint seats or booster seats. But studies over the past decade show that children are not fully protected by seatbelts until they reach the age of eight. The American Academy of Pediatrics estimated that child-safety seats saved about 1,800 lives from 2005 to 2009.

Each day, an average of four kids under age 15 die in a motor vehicle crash. More than 500 are injured each day in crashes. Even more lives could be saved if all states adopted uniform laws on child-safety seats that reflect the scientific evidence. Still, 17 states do not require that children ride in a car seat or booster seat until at least the age of eight.

Public education campaigns are often just as important as a new regulation, Hamburg says. “The seats themselves have become safer and safer,” he says. But there are issues around the seats themselves: Since car seats can be confusing to install, some states help parents figure out how to put the seats in the car correctly, which can be an important part of lowering injuries.

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Make Bicyclists and Motorcyclists Wear Helmets

This is another injury-preventer that practically everyone knows—but too often it just doesn’t happen. Bike crashes account for about 700 deaths and more than half a million emergency-room visits each year in the United States. Most of the deaths and injuries are among men and boys.

That said, bicycle deaths are on the decline, thanks in part to better helmet use: Bike-related deaths fell by 25 percent from 1995 to 2009, and bicycle injuries dropped by 16 percent. Public health experts believe those rates would fall even more if more states adopted helmet laws. Only 21 states and Washington, D.C. require bicycle helmets for all children.

Motorcycle helmet laws could also make a big difference. The National Highway Traffic Safety Administration estimates that motorcycle helmets reduce the likelihood of death by 37 percent. “There are a lot of factors that go into whether states enact policies,” Hamburg says. “There is pretty universal science that motorcycle helmet laws are going to reduce injury rates. Nineteen states require helmets but, surprisingly, 31 states don’t, after all these years. Why haven’t the other 31 states taken action? I don’t know. I think in some states there is more push-back on the idea of additional regulations.”

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Allow People to Get Protection Orders Even if They’re Not Married

Violence among people who are dating causes more than 2,000 deaths a year, and 70 percent of the victims are female. Nearly three in ten women and one in ten men in the U.S. have experienced physical violence, rape, or stalking by a partner or former partner. Oftentimes, violence in dating relationships begins in the teen years. According to the CDC, one-quarter of adolescents are verbally, physically, emotionally, or sexually abused by a dating partner each year and one in ten students nationwide report being physically hurt by a boyfriend or girlfriend in the past year.

Now that there’s more recognition that dating violence begins early in life, more public health experts are talking about how to better protect someone who’s afraid of being hurt. Today, 44 states and Washington, D.C. allow people in dating relationships to get protection orders. But there are no laws in Georgia, Kentucky, Ohio, South Carolina, South Dakota, or Utah. States should consider other services for victims, too, such as legal assistance and shelters, and protection orders should protect both victims and their families.

Policies regarding intimate partner violence are thorny, Hamburg notes. Some states allow a teen to obtain a restraining order without parental permission; others require schools to teach violence prevention. Some laws recognize same-sex partner violence, while others don’t. “Here’s a situation where there’s recognition that some policies are better than others,” he says. “There are a lot of different pieces to this issue.” Under the Affordable Care Act, most private insurance plans must cover screening and counseling for victims of intimate partner violence with no out-of-pocket costs to the patient.

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Put a Strong Concussion Law in Place

Traumatic brain injuries (TBIs) are now recognized as a major cause of death and disability in the U.S. People who suffer TBIs also have a lower quality of life and can be plagued by pain and symptoms for many years.

About 1.7 million people sustain such an injury every year, and TBI-related medical costs, as well as indirect costs such as lost productivity, totaled $60 billion in the United States in 2000. About three-quarters of all TBIs in this country are concussions or other forms of mild TBI.

Not surprisingly, TBIs often happen during youth and adult sports and recreation activities, and most often in football and girls’ soccer. Among boys ages ten to 19, TBIs also frequently occur while bicycling; males account for almost three-quarters of all sports- and recreation-related TBI emergency-room visits.

States should have policies informing young athletes and their parents and requiring a signed concussion information form, says the new report. More school districts and sports leagues are adopting policies to keep a youth athlete who has sustained a concussion out of play or practice until the athlete is cleared by a doctor to play. Forty-three states and Washington, D.C. have laws that meet this standard. The remaining seven U.S. states need to comply with this same standard.

It’s taken many years to connect the well-known statistics about concussions in sports to actual policies, Hamburg says. “Any time you’re looking at a range of policy interventions, particularly in an area like injuries, we see a range of attempts…to help solve the problem,” Hamburg says. “It takes to time to understand which are the most impactful.”

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Link Drug Prescription Monitoring to Electronic Health Records

You might be surprised to hear that accidental poisonings are a huge cause of injuries. One of the most common causes? Abuse of prescription painkillers. The number of painkillers prescribed has tripled in the past decade; they’re now responsible for around 15,000 deaths and 475,000 emergency room visits a year. Among the 708,000 non-fatal poison-related emergency room visits in 2008, opioid painkillers and benzodiazepines were the most frequent reasons for treatment.

Today 49 states have enacted prescription-drug monitoring programs, which, experts say, will help reduce this type of substance abuse. Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases used to track the prescribing and dispensing of controlled prescription drugs to patients. They’re designed to look for suspected abuse or diversion, and can give a doctor or pharmacist critical information about a patient’s controlled-substance prescription history, which can then help them identify high-risk patients who’d benefit from early intervention.

The CDC recommends that PDMPs link to electronic health records systems so that the information is better integrated into healthcare providers’ practices. However, that’s not happening in most states. Policies to control abuse of prescription drugs only emerged when it became clear that illegal drugs like heroin and cocaine no longer constituted the majority of the nation’s drug problem, Hamburg says. “I think the barrier is just how available these drugs are,” he says. “They are legal products being used improperly. The idea that 16 million Americans over the age of 11 took a sedative for non-medicinal purposes? That’s a major problem.”