Trauma Foundation Annual Report Supplement 1998

The Trauma Foundation's mission is to reduce the number of injuries and deaths due to injuries, through prevention, improved trauma care, and improved rehabilitation.

Dear Friends,

Since we published our Annual Report 1996, the Trauma Foundation has continued to expand the scope of its injury prevention policy activities, developing new collaborations among survivors and other prevention policy advocates. We have brought our expertise to bear on a variety of local, state, national, and international injury issues of importance to all of us, as illustrated by the following:

Staff members are also working on several new programs, as well as ongoing programs that have both nurtured collaborations and advanced effective policies. These programs are described briefly in this Supplement, along with our most recent Financial Report. We are grateful to Board members, colleagues, friends, and our many funders for their vital support over the years which has made our work possible.

Andrew McGuire

Executive Director

Table of Contents:

New Programs

Survivors of Gun Violence
Funded by a grant from the Richard & Rhoda Goldman Fund

Most Americans have been affected-either directly or indirectly-by the epidemic of gun violence in the United States. Regional organizations of survivors exist, yet there is no national forum for survivors to articulate the tragedy of gun violence and advocate sound gun policies. In 1998, the Trauma Foundation received a six-month planning grant from the Richard & Rhoda Goldman Fund to organize a national network of survivors of gun violence. This group would advocate, via educating the public, policy makers, and the media, that gun _violence can be reduced by limiting the accessibility of guns. Ultimately, the survivors' network will advance the development and implementation of gun policies at the local, state, and federal levels that will reduce the number of senseless gun deaths throughout the country.

Youth Alcohol Policy Project
Funded by a grant from The California Endowment

Alcohol-related injury and violence among youth constitutes a public health crisis in California. In 1998, The California Endowment provided funding for a planning grant so the the Trauma Foundation could begin to develop a grassroots citizens' movement to address the crisis. This project will develop a statewide coalition of community-based organizations, advocacy groups and professional associations in support of sound alcohol policies. Its policy initiatives will promote a healthy community environment, particularly for young people, by reducing alcohol availability, reforming alcohol marketing practices, and addressing underlying social, economic, and political factors that contribute to community alcohol problems. The coalition will encompass the youth population in underserved, rural communities, including Native American reservations and the Central Valley region of California, as well as youth from the Violence Prevention Initiative.

Violence Prevention Information Services
Funded by a grant from The San Francisco Foundation

The Trauma Foundation's Injury and Violence Prevention Library has an extensive collection of violence prevention resource materials, and responds to reference requests from researchers, advocates, community groups, the media, and others working in the field of violence prevention. However, many community-based organizations in the greater San Francisco Bay Area are not aware of the availability of these resource and reference services. In 1998, The San Francisco Foundation funded the Trauma Foundation to assess the information needs of Bay Area community-based organizations working in the field of violence prevention and provide them with timely information and data. The goal of this project is to facilitate effective violence prevention programs by improving community access to information.

Alcohol-Related Injury and Violence Prevention
Funded by a grant from the Robert Wood Johnson Foundation

Alcohol use is involved in a high proportion of unintentional injuries and injuries resulting from violence. However, prevention efforts are hampered by a lack of easy access to _relevant information. Through the Alcohol-Related Injury and Violence Prevention (ARIV) project, funded by the Robert Wood Johnson Foundation, the Trauma Foundation is bridging this information gap by providing community-based activists and policy advocates with useful, accessible alcohol-related injury and violence information.

Project staff members are summarizing for lay readers the many technical research materials that have been written on this issue. The staff is also responding to reference requests and developing fact sheets, reviews of research, and a directory of researchers and community leaders in the field.

Update of Continuing Programs

Pacific Center for Violence Prevention
Funded by a grant from The California Wellness Foundation

In 1998, the Pacific Center for Violence Prevention completed its first five years as the policy center for The California Wellness Foundation's Violence Prevention Initiative (VPI). In this statewide effort to reduce youth violence in California, the Pacific Center worked collaboratively with members of the VPI (including community action programs, researchers, academic and community fellows), to develop policies that would increase state and local resources for youth violence prevention programs, reduce youth access to alcohol and other drugs, and reduce firearm injuries and deaths among youth. The Pacific Center also provided technical assistance and policy education materials on these issues to members of the VPI, policy makers, community-based organizations, the media, and individuals concerned about youth violence in California.

The Pacific Center's efforts have played a significant role in helping to make prevention measures the focus of Californians' response to youth violence. For example, full-service schools and after-school programs are now viewed as promising youth violence prevention strategies at the state and local levels; communities have become more aware of the harmful influence alcohol billboards and outlets can have on their youth and have come together to pass local alcohol ordinances; a ban on the manufacture and sale of Saturday Night Specials in California was passed by both houses of the state legislature (though vetoed by the Governor); and over 90 local gun ordinances have been passed by cities and counties throughout California.

The Trauma Foundation received a three-year grant in 1998 from The California Wellness Foundation to continue the Pacific Center's policy work in Phase II of the VPI, focusing on the following policy goals:

With a strong violence prevention network now well-established in California, the Pacific Center staff looks forward to building on the momentum to reduce youth violence in the state.

Center on Alcohol Advertising
Funded by a grant from the S.H.Cowell Foundation

The Center on Alcohol Advertising continues to monitor developments in alcohol promotion and provide a public health analysis to journalists reporting on this topic of growing interest. The Center continued its Hands Off Halloween (HOH) campaign, providing advocates and community organizations with the tools necessary to run a "Responsible Merchants Campaign." The Center's staff also published and distributed an HOH newsletter, updating past and prospective participants about Hands Off Halloween 1998 and directing community activists to the Center's web site for supportive materials. More recently, action taken by the Federal Trade Commission to require reporting of the audience age and content of ads placed by eight major alcohol makers has created new opportunities for advocacy. The Center is currently assessing research tools that it might use for a public health analysis of alcohol advertising demographics.

Injury Prevention Research Program
Funded by multiple sources

Health Care Worker Safety

Trauma Foundation researchers continue to work on needle stick injury prevention through the TDICT (Training for the Development of Innovative Control Technology) project, helping to shape the public debate in California and the nation about the importance of needle safety for health care workers. The criteria for syringes developed by TDICT were included in the latest information circular that was sent by the federal Occupational Safety and Healthcare Administration to all health care employers nationally. Investigators are also continuing to develop tools to assist health care workers and product purchasers in the evaluation and selection of safer medical devices for hospitals, home health care, surgery, and dentistry. These tools, as well as performance standards developed by project researchers, are guiding manufacturers in producing safer devices.

Injury Data Surveillance

The Trauma Foundation has collaborated with staff of the National Center for Injury Prevention and Control and the National Center for Health Statistics (NCHS), together with the American Public Health Association (APHA), to improve the usefulness of injury data. A "Recommended Framework for Presenting Injury Mortality Data," published in 1997 by the Centers for Disease Control and Prevention, served as the structure for the NCHS's Injury Chartbook. This data surveillance will provide researchers, advocates, and policy makers with critical information about external causes of injuries and deaths (e.g., the number of firearms used in homicides and suicides). In addition, APHA funded a survey of states' hospital and emergency department injury data systems and their use of external cause of injury coding. A report of the survey was published in the fall of 1998, and is available on the Trauma Foundation's web site.

Domestic Violence

In 1996, the Trauma Foundation undertook a study of _physicians' responses to the California law which requires them to report cases of domestic violence to the police. More recently, staff members surveyed over 700 patients regarding their attitudes about the mandatory reporting law. They have also investigated the impact of ethnicity on patient-provider communications related to domestic violence. The results of these studies indicate a variety of responses and attitudes to domestic violence health care issues. Trauma Foundation researchers believe that their work will help facilitate the development of more effective, sensitive educational materials and interventions for health care providers, as well as inform domestic violence policy decisions being made in other states. Results of these research projects will be published in peer-reviewed journals in 1998 and 1999.

Healthy People 2000: Health Objectives for the Nation established a goal for the year 2000 that at least 90% of the emergency departments (EDs) in the country would have protocols for treating victims of partner abuse. In 1996, the Trauma Foundation surveyed all 369 active EDs in California and a random sample of 92 EDs around the country, _and found that 79% of California's and 64% of the national sample's EDs have protocols in place. The report of these findings, together with a "Protocol Assessment Tool," has been sent to all participating hospitals and posted on the Trauma Foundation's web site.

Youth Empowerment and Violence Prevention

In an effort to bring the voice of youth to the violence _prevention policy arena, the Trauma Foundation has examined the extent to which major cities and counties in California include youth components in their governing bodies. The study also explores ways that youth who are involved in The California Wellness Foundation's Violence Prevention Initiative can collaborate with their peers who participate in city and county commissions. It suggests that young people form policy caucuses as a policy advocacy strategy, and it provides models of peer-to-peer advocacy for youth to work with youth commissions and councils. This study was conducted by Harvard undergraduate student Tuan Tran as part of his summer internship at the Trauma Foundation.

Injury and Violence Prevention Library
Funded by multiple sources

Prevention Program of the San Francisco Injury Center
Funded by a grant from the National Center for Injury Prevention and Control

The Trauma Foundation and its staff continue to play an active role in the prevention activities of the San Francisco Injury Center for Research and Prevention, representing the Injury Center in local, state, national, and international injury prevention efforts. In the last two years, staff members have collaborated with the San Francisco Department of Public Health in preparing the third edition of the Profile of Injury in San Francisco; co-chaired the state Advisory Committee for the _Prevention 2000 federal block grant which funds prevention programs throughout California; served on the Institute of Medicine's Committee on Injury Prevention and Control; organized a national coalition to restore the original requirements of the flammability standards for children's sleepwear; and participated in the International Collaborative Effort (ICE) on injury statistics to improve the usefulness of data for comparing injury rates among countries.

Trauma Foundation Publications

The Trauma Foundation provides the following publications to individuals and organizations interested in the development and implementation of sound injury and violence prevention policies. Many of these materials are also available in Spanish.

Policy Papers & Briefs

Fact Sheets

Other Materials

Changing Policies and Perceptions

Trauma Foundation staff members are actively involved in bringing injury prevention issues to the attention of policy makers and the general public. In their efforts to influence public health policy and change public perceptions about injury prevention, they

Here are some of the Trauma Foundation voices from the last two years.

Distillers win either way, either they gain access to the most powerful medium reaching young people or they knock their prime competition-beer-off that medium.
Laurie Leiber, Director of the Center on Alcohol Advertising, commenting on liquor makers' efforts to advertise on radio and TV. The Washington Post, April 12, 1997.

We're on the brink of a major [gun control] movement.
Eric Gorovitz, Legal Director, commenting on local gun control victories. San Francisco Examiner, June 4, 1998.

The gun industry in the United States, using the NRA as a front, has convinced a great many people that individuals have a "right to keep and bear arms," thus, gun control is unconstitutional. The US Supreme Court has repeatedly told us otherwise. Let's stop listening to the lies and listen to the children-for the sake of the children.
Andrés Soto, Policy Director, in his Letter to the Editor of The West County Times, December 11, 1997.

We can go to the moon, but we still haven't produced a good, passive needle design. We've done it in other areas where solutions were needed to save lives. Why not to protect health care workers?
June Fisher, Director of the TDICT project, interviewed for a series on safe needle policies. San Francisco Chronicle, April 15, 1998.

The tobacco industry has resisted efforts to produce a safer cigarette, in part because it fears a flood of liability lawsuits from relatives of fire victims.
Andrew McGuire, Executive Director, speaking at a press conference about a fire-safe cigarette bill introduced in the California legislature. San Francisco Examiner, February 19, 1998.

My burn injuries occurred in 1952 but my memories are daily, the scars are permanent and the three months in the hospitals as a young child never go away. You don't want any other little child to go through that when it's preventable.
Andrew McGuire, Executive Director, commenting on the U.S. Consumer Product SafetyCommission's change to the children's sleepwear standard that allows the sale of flammable cotton pajamas in addition to flame-resistant sleepwear. Associated Press article, The Washington Post, September 16, 1998.

Drivers have to be told, taught, and forced to drive their cars slowly enough so that when they see a pedestrian step into a crosswalk, they have to be able to stop. The answer is three fold: education - educate the pedestrians and the drivers about what is legal; enforcement - police have to crack down; and engineering - for example, with traffic signals, have a red light on both sides long enough so that pedestrians have control of the street.
Elizabeth McLoughlin, Associate Director, in conversation with reporter Manuel Ramos on red light running in San Francisco. KPIX-TV Channel 5 News, September 18, 1997.

Date: 12/16/98