Project Name: Injury Prevention Program at TCRHCC
Applicant Organization Name: Tuba City Regional Health Care Corporation, Inc (TCRHCC)
Address: 167 N. Main St., P.O. Box 600, Tuba City, AZ 86045
Contact: Dollie Smallcanyon Phone Number: 928-283-2801
Funds Requested: $125,000 per year
TCRHCC is a nonprofit, tribal 638 organization in Coconino County, Arizona, and is the sole health care provider in this region of over 33,000 Navajo, Hopi and San Juan Southern Paiutes. TCRHCC is proposing to expand its Injury Prevention Program (IPP) through TIPCAP to add focus areas in falls prevention and suicide prevention. Mortality due to all causes for American Indians in Arizona is 15 years younger than the state average (61 years for American Indians versus state average of 76 years). The mortality rate in Navajo Nation (949 per 100,000 persons) far exceeds the Arizona state average of 692. Unintentional injury is the leading cause of death among American Indian residents in Arizona. The age-adjusted unintentional injury mortality rate for American Indians is nearly triple the state average (142 versus 55, respectively), and the Navajo Nation’s rate of mortality due to accidents is even higher (175).
American Indian residents have the highest fall mortality rate of all Arizonans (17.1 deaths per 100,000 residents in 2018, compared to a state average of 12.4). TCRHCC cared for a total of 115 patients who had experienced fall injuries in FY 2019, 60% of those were ages 61 or over. Falls are the leading cause of unintentional injury related deaths among Arizonans over age 65.
The rate of suicide is three times higher among American Indians in Arizona than other racial/ethnic groups. In Navajo Nation, the intentional self-harm mortality rate (35.1 per 100,000 persons) far exceeds the state average of 25.5. TCRHCC cared for a total of 78 patients with intentional self-harm injuries in FY 2019, and 10 of those resulted in fatalities. At almost 15%, the suicide attempt rate of Navajo high school youth is nearly double the national average and nine times higher than the Healthy People 2020 objective.
TCRHCC’s goals for this IPP are to reduce the annual number of injuries from falls by 25% within the Tuba City service area by 2025, and to reduce the annual number of suicide attempts by at least 10% among adults and youths in the Tuba City service area by 2025. TIPCAP funds will support the hiring of a new Injury Prevention Coordinator (IPC) at TCRHCC, who will be primarily responsible for the activities required to meet the project’s goals and objectives.
TCRHCC’s falls-related IP work will utilize the evidence-based strategy of elder fall prevention since the data referenced above demonstrates that our elders are at disproportionate risk of experience falls and having severe injuries or death from falls. As interventions for this strategy, we will implement home assessments to identify and correct fall hazards in elders’ homes and an elder Balance/Exercise class called “Matter of Balance”.
TCRHCC’s suicide prevention IP work will utilize the evidence-based strategy of Gatekeeper training – specifically focusing on administrators and staff at our local schools, and educating them on how to recognize and effectively respond to warning signs. Interventions connected to this strategy will include delivering Applied Suicide Intervention Skills Training (ASIST), SafeTalk and Mental Health First Aid training to administrators and staff at local schools, as well as developing and distributing a toolkit that will assist schools in reviewing their suicide prevention policies and protocols.