January 26, 2004 - Injury Free Coalition for Kids of Rochester
Local doctors adopt program in use nationally By Donna Jackel Staff Writer (January 26, 2004) — Every spring, local doctors Anne Brayer and Lynn Babcock Cimpello treat one or two toddlers who have plummeted from an open window after the winter storm windows have been removed but before the summer screens have gone up. Every winter, they minister to children injured in sledding accidents. And year round, they doctor children seriously hurt because they were not wearing a seat belt or were riding in car seats that were improperly installed. Unintentional injury is the leading cause of death in American children ages 18 and under, according to the Centers for Disease Control and Prevention in Atlanta. Brayer and Cimpello, who specialize in pediatric emergency medicine at Golisano Children’s Hospital at Strong, wanted to play a greater role in preventing such childhood injuries. They applied for a three-year grant to found the Injury-free Coalition for Kids of Rochester. The local initiative is part of a national network that exists in 24 cities and is growing. The doctors will analyze discharge records from the Ronald McDonald Children’s Charity Pediatric emergency department, countywide hospital discharge records and 911 calls to track the frequency, locations and types of injuries occurring to area children. In a pilot project last year, Brooke Lerner, an epidemiologist at Strong’s department of emergency medicine, compiled Rural Metro’s ambulance dispatch information. In 2002 there were 6,031 injury-related visits to the pediatric emergency department at Strong. The most common injuries were falls, assaults, motor-vehicle crashes, poisonings and bicycle crashes.
The Injury-free Coalition of Rochester, which will begin meeting in February, includes representatives from the Rochester School District, the Monroe County Sheriffs Office, the county Health Department, the Department of Transportation and several neighborhood organizations. “We plan to present the data on pediatric injuries to the coalition and let them focus on a particular area, such as falls or accidents in the home,” Brayer said. “If they are invested in the problem, they will be invested in the solution.” The coalition will first target city neighborhoods, later expanding their efforts to the suburbs. Studies indicate that children living in poverty are twice as likely to sustain unintentional injuries as middle-class children. According to the 2000 U.S. census, 38 percent of Rochester’s children 18 and under live below the poverty level. Community involvement will be crucial to the coalition’s success, said Dr. Barbara Barlow, founder of the first Injury-free Coalition in New York City’s Harlem. When Barlow, director of pediatric surgery at Harlem Hospital, first arrived there in the 1970s, she was alarmed to learn that the injury rate of the children there was twice as high as elsewhere in the city. Working with an epidemiologist, she initiated a trauma registry, tracking all childhood injuries in northern Manhattan. She found that drug dealers were driving children out of the playgrounds and parks, forcing them to play in the streets, where they were in danger of being struck by cars. Using grant money from the Robert Wood Johnson Foundation, a nonprofit philanthropy, Barlow hired a small staff to help her run an injury prevention effort. She raised money to make rundown playgrounds safe and helped coordinate after-school activities, like art and dance. Barlow also enlisted the district attorney’s office to arrest drug dealers loitering in parks and playgrounds. Most importantly, she got community members involved. Parents helped build 55 Harlem playgrounds and continue to patrol them to keep them safe. Gradually, the child injury rate in Harlem dropped more than 60 percent. In 1995, the Robert Wood Johnson Foundation committed thousands of dollars to start Injury-free Coalitions in other cities. Barlow heads up the national initiative. Each Coalition addresses the unique needs of its city. In Dallas, where 95 children died from pool drownings from 1995 to 1998, a drowning prevention curriculum was implemented. To reduce the number of children dying in fires, Chicago firefighters went door to door in high-risk neighborhoods installing smoke detectors. Burn deaths fell 66 percent, Barlow said. Rochester’s injuries are very seasonal in nature, Cimpello said. In winter, there are many sledding and snowboarding mishaps, in spring and summer, bike accidents and drownings. Violence occurs year round. In 2003, eight victims, ranging from 18 months to 18, died violently in Monroe County. Because street violence is such a political hot potato, Barlow advises the coalition members against taking it on for their first initiative.
When one’s child has an accident, it is a reminder of the fragility of life, said Michelle Cavalli of Rochester. Her daughter, Alexa Cavalli, 14, suffered a fractured skull in late December during a sledding accident and was hospitalized for three days. Alexa was sitting on her sled at the bottom of a snowy hill at Cobbs Hill Park when another child crashed into her, their heads colliding. The other child was unharmed. If Alexa sleds again, she will wear a helmet, Michelle Cavalli said. Cimpello is most frustrated at the injuries and deaths she sees because often a caregiver failed to latch a child’s seat belt or strap on a bicycle helmet — two devices that have been well publicized for saving lives. Just two weeks ago, she treated a 9-year-old boy seriously injured in a car crash because he wasn’t wearing a seat belt. In January, a 2-year-old was injured in a car crash because her car seat was in the front seat, where the risk of injury is higher. “You can’t necessarily prevent cancer in a 5-year old, but you can prevent a 5-year-old from a fractured femur from getting tossed around in a car crash,” Cimpello said. Deborah DeCaire, an assistant traffic safety specialist for the county Department of Public Safety, is a member of the Injury-free Coalition. “I think it’s a great idea because there will be local data on the kinds of problems we’re having here,” said DeCaire, who teaches traffic safety to county elementary school students. From her offices at the South West Area Neighborhood Association, Eleanor Coleman, another coalition member, watches hundreds of elementary, middle and high school students walking to and from school each day. “You can have 1,000 kids on the street at once,” said Coleman, who is SWAN’s community asset manager. “Having documentation of injury hotspots can help us develop community-driven injury-prevention programs.”
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For information on the article as appeared in the Democrat and Chronicle
Staff Writer, Donna Jackel, DJACKEL@DemocratandChronicle.com
IFCK of Rochester, Karen Knauf, karen_knauf@urmc.rochester.edu
