Louise and Nick's Driving Contract

Graduated driver licensing systems, now in place in nearly every U.S. state, are an effective strategy for preventing crashes with new drivers. The Injury Center strongly supports GDL systems, which help teens get initial driving experience under low-risk conditions. Research suggests that GDL systems are associated with reducing injury crashes by up to 40 percent in 16-year-old drivers. Learn the details of the GDL system in your state - or better yet, encourage your teen to research the requirements and inform you, as mine did!  

 As helpful as laws on the books can be, we know a parent’s involvement with and supervision of their novice driver is a major factor in why GDL systems are so successful.  With this in mind, the Injury Center has launched a pilot communications campaign called “Parents Are the Key”. You will be hearing more about this campaign in the future, but I’d like to share with you one of its key features and one I plan to implement with Nick, the parent/teen driving contract.

This contract is designed to clarify expectations about driving behaviors, such as the use of safety belts, NO cell phone talking or texting, NO drinking and driving, strict limits to the number of underage passengers, restricted night time driving and more.  As in my contract with Nick, it is also helpful to spell out consequences for violating rules as well as include graduating steps to new privileges when guidelines are followed and experience is gained.  Finally, as empowering as communicating with our teens and agreeing rules in writing can be, parents must lead by example.  Nick’s eyes are on me each time my blackberry buzzes and beeps while I am behind the wheel.  This experience taught us both that we can easily avoid the temptation when we turn the phone off before we turn the key!

We parents cannot minimize our role in helping our teens develop into safe and competent drivers, as much for them as for others sharing the roadways.  And my reward for such intense focus on my son’s driving?  The three little words I love to hear from my 16 year old: “Mom, I’m home.”  I hope you will do all you can to hear those words from your teen and that they bring you as much peace as they do me.

Burns-Smith co-founded the National Alliance to End Sexual Violence, a group instrumental in working with Congress 15 years ago to pass the National Violence Against Women Act. This watershed event was recently recognized by President Barack Obama, when he commemorated the anniversary of the act and called upon “men and women of all ages, communities, organizations, and all levels of government to work in collaboration to end violence against women.”

The Injury Center works closely with partners to end intimate partner violence (IPV) - the physical, sexual or emotional abuse by a current or former partner or spouse.  While many resources are dedicated to responding to violence against women after it happens or working to prevent its recurrence, our data tell us that all forms of IPV are preventable.  Our goal is to Break the Silence and Stop the Violence  before it starts.  To this end, we support youth targeted evidence-based programs designed to stop or prevent emotional, physical, and sexual abuse between individuals involved in a dating relationship.

A key strategy in preventing IPV is to promote respectful, nonviolent intimate partner relationships, fostering changes at individual, community and societal levels.  CDC’s DELTA program employs a coordinated community response (CCR), or an organized effort that coordinates the work of diverse service sectors to prevent and respond to IPV in a community. DELTA supports the work of local, domestic violence programs through public education, public policy development, training, technical assistance, and program development.

At the Injury Center, we celebrate the life and work of Gail Burns-Smith by carrying forward the task of realizing a dream we know is wholly attainable.  Join us!  Stop the violence!

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A quality education goes hand-in-hand with the provision of healthy and safe environments in which our children can learn and excel.  We’ve heard a great deal about H1N1 prevention and care already this year, but as much as we emphasize this health risk, we must equally stress the importance of school safety.  Are you aware that nearly two-thirds of all deaths among children and adolescents result from injury-related causes, many of them preventable?  Awareness of the types of injuries that can occur in schools is the first step to prevention. 

Roughly 55 million students just began again their commute to U.S. classrooms, so our first assignment must be to get them safely to and from school. Motor vehicle injuries are the leading cause of death among children in the United States. These deaths can be prevented. For example, if your children walk to school, be sure they know basic pedestrian safety rules.  And, since teens have a particularly high crash risk, getting informed about teen driving can help parents counsel their young drivers about the risks and responsibilities of getting behind the wheel.

Of course, arriving at school safely is just the beginning.  Before children can fully focus on their education, they must first feel they are in a safe and healthy environment in the classroom and on the playing field.  Informed parents and educators can help and encourage children to develop healthy relationships and learn to manage conflict, anger and jealousy without violence.  As a society, we should all be attentive to signs of bullying, as it often takes root in our schools and has harmful, long-term consequences for both victim and perpetrator.  

To help spread the word about the importance of these and other school safety concerns, we encourage you to add our School Safety Banner to your website, providing a direct link to CDC Injury Center information.  Join us in keeping our children and our schools safe throughout the year. It’s important that we work together to ensure that every child in every community can live to their full potential.

Our concern is justified. Statistics show that the risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. Motor vehicle crashes are the leading cause of death for U.S. teens.

For many adults, driving seems almost automatic. Yet we can’t forget that driving is a complex activity mastered over time. Most young drivers lack the maturity and experience to judge even everyday hazardous driving situations. The risk of a motor vehicle crash is particularly high during the first year that teenagers are eligible to drive independently.

At the Injury Center, the Motor Vehicle Team provides public health leadership to keep people safe on the road every day. As such, our concern about teen drivers has led to research and strategies for keeping teens safer on the road. Still, for prevention strategies to be more effective, we need to know more about teens themselves: how they develop skills, assess risk, and interact with others. To get these answers, input is needed from a variety of fields.

So in 2006, the Injury Center, the National Institutes of Health, and State Farm Insurance Companies co-funded a workshop to begin collecting this information. Sponsored by the National Research Council and the Institute of Medicine, the workshop brought together experts to explore and report on  how new insights and understanding of adolescent development and teen risk behaviors could inform prevention strategies to reduce motor vehicle crash rates and promote responsible behavior among teen drivers.

Last September, the American Journal of Preventive Medicine followed up with a supplemental issue on the topic, “Teen Driving and Adolescent Health: Strategies for Prevention,” funded by the National Highway Traffic Safety Administration. Access to this supplement is now available for free on the National Academy of Sciences Website.

We know that information about the risks teens face - including the high risk of motor vehicle crashes - is shared among a number of scientific disciplines. We believe, then, that strategies for prevention must include input from the behavioral, cognitive, social, health, and biological sciences. Let’s build on the efforts begun at the workshop and commit to using all of the resources available to help our young people live to their full potential.

That’s why we’ve taken an increasingly active role in the intersection of public health and acute injury care. We’ve made significant investments in ensuring that injured patients get to the right emergency care facility for treatment.

Emergency medical service providers respond to about 16 million transport calls each year. When a person is injured, EMS providers have only minutes to decide which emergency facility is best for them. Our research shows that a severely injured person taken to a Level I trauma center has a 25% decreased risk of death. Yet not all injured persons can or should be transported to a Level I trauma center. So how do pre-hospital providers quickly make the decision that can make the difference in someone’s life?

We hope they use the Field Triage Decision Scheme. CDC, with the assistance of key partners and a panel of experts, updated this tool to help EMS providers make the on-the-scene decision about the level of care an injured person needs. The algorithm quickly leads EMS providers through a four-step process matching clinical needs of an injured patient to resources and expertise of a given facility, based on current best practices in trauma triage.  The process and rationale used to revise the scheme were outlined earlier this year in a report on field triage.

On July 15, the CDC’s Dr. Richard Hunt will present a webcast to provide details of the newly revised Decision Scheme. He will also share encouraging news about using vehicle telematics to help EMS providers begin to evaluate those injured in motor vehicle crashes before they even arrive on the scene. I hope you’ll take a moment now to register for the webcast.

Help us implement  the new Decision Scheme among the 1 million EMS providers across the country. Together, we can save lives, lessen disability and reduce costs from injuries, improving the lives of all Americans. That’s our job. We hope you will make it yours too.

Shaken Baby Syndrome -  a form of abusive head trauma (AHT)  -is the leading cause of child abuse death in the United States.  A North Carolina study suggests that every day, three to four children experience severe or fatal head injury from child abuse. Of those children, one will die. Among those who survive, 80% will suffer permanent disability. This severe maltreatment happens every day and babies, newborn to one year-especially those babies ages 2 to 4 months-are at greatest risk.

No one expects to shake a baby. The most common trigger is the child’s inconsolable crying - crying that is a normal phase in infant development. Information from the National Center on Shaken Baby Syndrome and Shaken Baby Alliance, among other sources, can help new parents who are unprepared for the stress that accompanies normal child care. Educating parents and other caregivers about the dangers of shaking a baby and safe ways to cope with infant crying is essential. However, we don’t know whether education alone will effectively prevent all AHT.

That’s why CDC joins partners in exploring more direct intervention strategies to inform new parents and caregivers about how to deal with the frustration of a crying baby and to equip them with effective coping skills. We are exploring intervention strategies that include health professionals instructing parents at key immunization checkups as well as using technology to deliver messages directly to expectant and new mothers.

We believe prevention includes sharing ways to lessen the load on stressed out parents and caregivers. CDC wants parents and caregivers of young babies and children to know that:

• It is normal for healthy babies to cry much more in the first four months of life. Remember it will get better.
• If your baby cannot be consoled and you feel pushed to the limit, put the baby in a safe place, take a break, and call for support.
• If your baby cannot be consoled. You may need to focus on calming yourself and let your baby cry while still checking on him/her. Remember it will get better.
• Tell everyone who cares for your baby about the dangers of shaking a baby and what to do if they become angry, frustrated or upset. 
• It is OK to ask for help from a friend or family member or to call a Parent Helpline.

We can prevent abusive head trauma and change outcomes for children. Today, and every day, we ask you to join us in testing and developing effective strategies that support new parents and caregivers.  Let’s reach out so all children can live every day to their full potential.

This month in particular, our partners at the National Sexual Violence Resource Center and others raise public awareness about sexual violence.  Unfortunately, sexual violence can happen anywhere, including the workplace.  Employees and employers have an important role to play in preventing sexual violence.  The focus of this year’s effort, “Respect Works,” highlights that respectful behavior in individual and organizational roles helps maintain safe, healthy communities and workplaces.

Sexual violence is a significant public health issue.  Stopping sexual violence from happening in the first place - prevention - is the goal for all of us at the Injury Center. We are leading research on primary prevention and early intervention, and once we learn more through research, we move science into practice.  As effective strategies to prevent sexual violence are identified, we determine how best to share these with the public health community so that they are lived out.

Through our national Rape Prevention and Education (RPE) program and EMPOWER program we support the development, implementation, and evaluation of sexual violence prevention strategies in all 50 states, the District of Columbia, Puerto Rico, and six U.S. territories.  Our RPE and EMPOWER partners are the frontline practitioners working to build capacity and implement strategies that will ultimately prevent sexual violence perpetration and victimization.

With our emphasis on sexual assault awareness this month, we recognize the important work that has been done by many of our partners. This work has ensured that we have crisis intervention, victim advocacy, and health services critical to the long-term well being of those affected by sexual violence. Through focused research and national sexual violence prevention programs, CDC contributes to sexual violence prevention by promoting efforts to modify or eliminate the individual, relationship, community and societal influences that result in perpetration, victimization, and bystander attitudes that allow sexual violence to occur.

An estimated 1,500 children die of child maltreatment every year, and substantiated cases of child maltreatment approach over 900,000 annually. Yet these data are actually believed to severely understate the problem, because research shows that many cases often are not reported. Child maltreatment has immediate consequences for the child. And when children who have been mistreated grow up, their adverse childhood experiences can affect the long-term development of their brains, resulting in adult problems that range from cardiovascular disease and diabetes to anxiety disorder and depression.

We know that child maltreatment is a critical public health issue. Yet intervention usually takes place after maltreatment has occurred. What happens if we focus on prevention? What if we cultivate communities in which parents and caregivers receive messages of encouragement and in which healthy relationships between children and key adults are openly discussed?

We’ve found that great things can happen. A key study funded by the Injury Center shows that when all families have access to proven parenting information, we see lower rates of confirmed abuse cases, child out-of-home placements, and hospitalization and emergency room visits for child injuries. This study tracked the implementation of the Triple P - Positive Parenting Program in nine South Carolina counties. The Triple P System encompasses five levels of support that increase in intensity, from communicating positive parenting messages through various local media and public seminars to providing direct intervention to families.

By taking a public health approach to parenting and involving the entire community, parents have increased access to information about how to deal with common child-rearing issues.  When we normalize parenting difficulties, the study shows that more parents are prompted to seek help, information, or advice.

Let’s change the headlines. Together, we can create communities where our children are raised in nurturing environments that give them the opportunity to live to their full potential.

Traumatic brain injury (TBI) is usually caused by a bump or blow to the head or body that causes the brain to move rapidly inside the skull. Not all blows or jolts to the head result in TBI, yet even what appears to be a mild bump can change the way the brain normally works.  Some 50,000 people die from TBI every year. For survivors, the injuries can cause a wide range of functional changes affecting memory, concentration, thinking, balance, vision, learning, language and/or emotions.

Recreation- and sports-related TBIs like Ms. Richardson’s are not uncommon. Based on information from hospital emergency departments, we’ve learned that about 200,000 sports- and recreation-related TBIs, including concussions, occur each year.  The highest incidence of TBI is among children who are 10 to 14 years old, followed by those aged 15 to 19 years.  

Recognizing the risk to our youth, CDC’s Injury Center - in partnership with medical, sports, and educational organizations - launched an effort to educate those involved in youth sports about the danger of concussions. We developed an initiative with information about the risk and seriousness of concussions, ways to prevent these injuries, how to recognize the symptoms, and, importantly, what to do if a concussion is suspected. Called “Heads Up: Concussion in Youth Sports,” the initiative contains a number of materials targeted to coaches, parents and athletes.

We can honor Natasha Richardson by helping to prevent and lessen the effects of traumatic brain injuries. Commit to be better informed about the dangers of TBI, more conscientious about preventing these injuries, and ever-diligent about protecting our youth from the adverse effects of TBI.  

Learn the signs and symptoms of TBI and order materials today for yourself, your coach, and your athlete.

Yet we’re busy individuals who feel pressed to multi-task even when we’re on the road. We talk on the phone, study GPS screens, read emails on our PDAs, fiddle with our music systems, and eat lunch as we drive. We live in a demanding world, and we try to get as much done as we can during our limited time.

Sometimes the community pays a high price for that.

Our Injury Center data show that, in 2005, motor vehicle traffic fatalities accounted for 37 percent of unintentional fatal injuries - more than 43,600 deaths. Research from the National Highway Traffic Safety Administration tells us that nearly 80 percent of crashes involve some form of driver distraction. Clearly, paying full attention while we’re driving can save lives and reduce non-fatal injuries.

That’s why we commend the National Safety Council for its call for a nationwide ban of all cell phone use while driving. Notably, the NSC makes no distinction between using hand-held and hands-free devices. Studies show that driver distraction is not created by where your hands are, but by where your head is. Although there are activities that may be more dangerous while driving, cell phone use occurs more frequently and lasts longer than other distracting behaviors.

We can prevent crashes and the resulting deaths and life-altering injuries caused by driver distraction. When we get behind the wheel, we must give our full attention and focus to driving. We owe that to ourselves and everyone on the road with us. It’s a matter of trust.