Choctaw Community Injury Prevention Program
Choctaw Health Center
Mississippi Band of Choctaw Indians (Choctaw, MS)

Contact:
Ms. Sharon Williams
Injury Prevention Program Director
Mississippi Band of Choctaw Indians
210 Hospital Circle
Choctaw, MS 39350-6781
Phone: (601) 389-6251
E-Mail: sharonclegg6288@hotmail.com

In 2000, two Mississippi Choctaw citizens organized the Choctaw Community Injury Prevention Program to combat the reservation community's rising level of preventable injuries and accidental deaths. In hopes of significantly reducing emergency room visits, their efforts—as well as the efforts of other volunteers inspired by their example—have introduced thousands of Choctaw children and adults to safety education and resulted in the distribution of hundreds of child safety seats and bicycle helmets. The Choctaw Community Injury Prevention Program proves that the programmatic efforts of concerned individuals can make headway against one of Indian Country's most pervasive and daunting problems.

Accidental deaths and preventable injuries exact an enormous toll on American Indian communities. For example, American Indian deaths from motor vehicle accidents occur at over twice the rate of such deaths in the US generally. The overall accidental death rate among American Indians is nearly twice that among the US population at-large. The Mississippi Band of Choctaw has not been exempt from these sobering statistics. In 1996, 11 percent of Mississippi Choctaw men and 14 percent of women had experienced an accidental death in their family. In addition, approximately 10 percent of all adults reported that a household member had been injured as a result of a motor vehicle accident.

At Mississippi Choctaw in the late 1990s, several of the causes of these accidental deaths and preventable injuries were easily identifiable. The reservation's many dark, winding, and unpaved roads resulted in frequent single car accidents. The Tribe's phenomenal economic success brought thousands of employees and visitors to the reservation each day, creating traffic congestion and stressful road conditions. In spite of these dangers, only 30 percent of male and 26 percent of female tribal members used seat belts while riding in or operating a motor vehicle. The resulting injuries and deaths had a devastating impact upon individuals and families and took an increasingly high toll on the Choctaw community in the form of escalating health care costs. As early as 1992, injury rates were identified as one of the leading causes of health care cost increases on the reservation.

Despite the enormity of these problems, the Tribe lacked any programmatic means to address preventable injuries and accidental deaths; indeed, such programs are rare in Indian Country.

In 2000, two Choctaw citizens who were deeply troubled by a series of accidents that killed or injured young children on the reservation set out to make a change. Under the supervision of the director of the Community Health Services Department, and working within the Choctaw Health Center , they established the Choctaw Community Injury Prevention Program. From the initial efforts of these two citizens, the Program now relies on more than fifty volunteers who educate parents, children, teachers, health providers, law enforcement officials, tribal leaders, and other individuals and organizations in injury and accidental death prevention. Volunteers host injury awareness and prevention activities within the seven Choctaw tribal schools for the benefit of children. At the same time, the Program works through Choctaw community groups, the Choctaw Newspaper, Choctaw Cable, and other public forums to reach the population at-large.

The Program pursues a number of clear objectives. It works to improve the use of seatbelts among Choctaw drivers and to secure adult participation in ensuring that all passengers wear seatbelts or are secured in appropriate child safety seats. The Program also seeks to reduce the DUI/DWI rates among tribal citizens and to enhance the enforcement of the Mississippi Department of Highway Safety and Passenger Restraint Laws on the reservation. As its successes in improving transportation safety have grown, the Program has expanded its focus to include bicycle safety, home safety, and poison control.

The Choctaw Community Injury Prevention Program has realized impressive and measurable successes. The Program has instructed over sixteen hundred Choctaw children up to age eighteen in safety awareness and injury prevention. It has distributed over two thousand toddler and infant safety seats to Choctaw and non-Indian parents across the state of Mississippi , and assisted other state programs in raising awareness. Utilizing funds from a grant, the Program has established the first and only designated safety seat Fitting Station in Mississippi . It has encouraged a year of "Click It or Ticket" checks to ensure the appropriate use of safety equipment. And, by the end of 2004, Program inspectors will have visited over two hundred homes of children fourteen and younger to install needed fire alarms, fire extinguishers, carbon monoxide alarms, door latches, outlet covers, and other safety devices.

These preventative measures are enhancing the safety of Choctaw citizens. Through the Program's public education, more Choctaw adults are now aware of the importance of using seat belts and child restraint seats in motor vehicles. “Click It or Ticket” inspections of 3,210 cars measured an increase in child seat belt and safety seat use from 63 to 78 percent over a ten month period. Emergency room statistics are equally impressive. Between 1998 and 2002, emergency room visits for preventable injuries dropped by more than 25 percent (from 4,106 to 3,012), while injuries resulting from motor vehicle accidents between 1999 and 2002 were cut in half (from 533 to 272).

These successes are particularly notable considering the Program's structure. The Program's extensive volunteer network stands in stark contrast to an earlier effort when, in 1992, the Choctaw Health Center's Community Health Services Department received an IHS Community Injury Prevention Program grant and staffed a small office to conduct all prevention activities. Prevention by nature, however, requires broad informational outreach that is impossible to achieve with limited funding and employee efforts alone. Thus, in 2000, it was the passionate investment of volunteers that reestablished the Choctaw Community Injury Prevention Program as an ongoing concern. Two dedicated citizens have inspired years of service from dozens of additional volunteers who work through various tribal and non-tribal entities. Not only does this volunteer commitment ensure the long-term sustainability of the Program, but it also serves as an inspiration throughout the Choctaw community which sees, first-hand, that volunteers can bring about widespread positive change.

The Choctaw Community Injury Prevention Program also convincingly demonstrates that concerned community members are among those best positioned to respond to community crises. The early volunteers' familiarity with the Choctaw community, combined with their ability to draw judiciously from non-Choctaw injury prevention programs, resulted in remarkably productive tribal-non-tribal partnerships. For example, the Program adapted the Mississippi SafeKids program to meet the Tribe's specific needs and quickly maximized Choctaw participation in the SafeKids model. This partnership enables the Mississippi Choctaw to leverage the resources, expertise, and funding sources of a larger prevention effort. The Program receives continuing support from Mississippi SafeKids, the Office of Public Highway Safety, Ford Motor Company, General Motors, the United Auto Workers, and National SafeKids. It initially secured a grant to distribute one thousand booster seats through the efforts of the Mississippi SafeKids director and is eligible for still other grants as a SafeKids coalition member. Its volunteers have a statewide professional network available for their assistance.

Finally, it should be noted that the Program's significant reduction of preventable injuries and accidental deaths through community awareness activities has lessened the financial burden accidents place on the Choctaw health care system. The IHS has never sufficiently covered the costs of building, maintaining, and staffing adequate health facilities in Indian Country, and tribes have felt pressured to raise supplementary resources or limit their service offerings. Through the success of its Injury Prevention Program, however, the Mississippi Choctaw Tribe is experiencing less of this pressure from unmet needs. Their accident prevention has reduced demands on the tribal health care system and promoted a more optimal distribution of health care resources. The Program's strategic efforts mean these benefits will continue: it works closely with other tribal and non-tribal health programs and integrates its injury prevention education with the full range of community health and treatment programs.

Accidents are the leading cause of death among American Indians. Through the Choctaw Community Injury Prevention Program, the Mississippi Choctaw have begun to address this devastating problem. The passionate efforts of volunteers and the partnerships they have formed with tribal schools, community clubs, the Choctaw newspaper, Choctaw cable station, and non-tribal injury prevention programs have resulted in the education of community members in safety awareness and in measurable decreases in preventable injuries and accidental deaths. Every success the Program enjoys is a celebration of prolonged and protected Choctaw lives.

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