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First Injury Free Coalition for Kids in Upstate New York Based Here

Golisano Children’s Hospital takes lead in reducing preventable accidents

Wednesday, January 07, 2004

In Monroe County, unintentional injury is the leading cause of death in infants, children, and teenagers. To better identify where and why these accidents occur – and prevent them - Golisano Children’s Hospital at Strong recently started the first Injury Free Coalition for Kids in upstate New York.

            The Injury Free Coalition for Kids, made possible by a grant from the Robert Wood Johnson Foundation, is among the country’s most effective injury-prevention programs. The coalition consists of 27 sites in 24 cities, with each site housed in a trauma center. No two sites are the same, because each program is tailored to a specific community.

Identify hotspots, prevent accidents

Anne Brayer, M.D., and Lynn Babcock Cimpello, M.D., oversee the Injury Free Coalition for Kids at Golisano Children’s Hospital. They have a strong interest in reducing preventable childhood accidents, which they see on a daily basis as pediatric emergency medicine physicians.

Last year, the most common causes of unintentional injury to children visiting the pediatric emergency department at Golisano Children’s Hospital were falls, motor vehicle crashes, poisonings, and bicycle accidents. “We want to know when, where, and how these injuries occur, so we can create intervention strategies and see if they help,” Cimpello says. “We also want to eliminate racial and ethnic health disparities. Some data suggests that the frequency of certain injuries is linked to economic status, so this program could help reduce those disparities.”

The 2000 U.S. census shows that more than 37 percent of city children younger than 18 live below the poverty level. In some zip codes, the rate exceeds 50 percent. “Rochester, like many older cities, is racially and economically diverse, with areas of concentrated poverty and higher frequencies of childhood injury,” Brayer says.

The Injury Free Coalition for Kids in Rochester will expand on an existing Pediatric Injury Coalition that was established last year by Rural/Metro Medical Services of Rochester, and Brooke Lerner, Ph.D., an injury epidemiologist from the Department of Emergency Medicine. Lerner has a Geographic Information System that compiles ambulance dispatch data from Rural/Metro, the city’s exclusive provider of pre-hospital care. “This information helps us identify injury hot spots, and we will devise prevention strategies that focus on specific, high-risk locations,” Lerner says. “When we implement a prevention measure, we will continue to generate maps to show what effect the changes had.”

During the grant-writing process, members of the new coalition identified an accident hotspot in the city – on Clifford Avenue - and met to discuss intervention strategies. As a result, the Monroe County Department of Transportation is studying the feasibility of making engineering changes to several intersections, and awareness classes will be scheduled with community organizations and city recreation centers.

Strong community involvement

Locally, the program works with members of county and city government, law enforcement, school district, emergency medical services, the county health department, and neighborhood organizations such as the Southwest Area Neighborhood Association, known as SWAN. “We are thrilled to be so closely connected to information that is vital to our neighborhood,” says Eleanor Coleman, community asset manager for the organization. “We’ll use the information at the grassroots level to make improvements.”

Other participants include Action for a Better Community, which has Head Start centers in key city communities; the Puerto Rican Youth Development and Resource Center, which will provide a vital link to the Hispanic and Latino communities; and the Orchard Street Community Health Center, which is located in a neighborhood with a high incidence of childhood injuries. “As we address specific injuries and locations, we will add more groups to the coalition,” Cimpello says. “This is a collaborative effort that links the scientific expertise of healthcare professionals with community resources and priorities.”

            The three-year, $160,000 grant is supplemented by matching funds from the University of Rochester Medical Center’s Department of Emergency Medicine.

How it started and is fostered

In 1981, Barbara Barlow, M.D., then Chief of Pediatric Surgery at Harlem Hospital in New York City, established an Injury Prevention Program that became the model for the Injury Free Coalition for Kids. Among other interventions, Barlow helped eliminate community hazards, such as dilapidated playgrounds, and create safe play spaces. Between 1988 and 1998, major injuries requiring hospital admission decreased by 55 percent.

            The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation’s largest philanthropy devoted exclusively to health and health care. It concentrates its grant-making in four goal areas: to assure that all Americans have access to quality health care at a reasonable cost, to improve the quality of care and support for people who have chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social, and economic harm caused by tobacco, alcohol, and illicit drugs. It hopes to have a total of 40 Injury Free Coalition for Kids sites funded within the next year.

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