The Cheyenne River Sioux Tribe (CRST) is located in north central South Dakota, encompasses the counties of Dewey and Ziebach, and boasts a population of 14,000+. Cheyenne River Sioux Reservation Headquarters are in Eagle Butte, SD.

The CDC had established that injuries are the leading cause of death for Native Americans 1-44. Because of this sad fact, development of a database to report what is happening with injuries, called Severe Injury Surveillance, for the years 1997-2001 was initiated and completed with assistance from the I.H.S. Aberdeen Area and Pierre, SD District offices and Co-Step personnel. The results of the Severe Injury Surveillance were not a huge surprise; falls accounted for the highest percentage of treated injuries but motor vehicle crashes were the most deadly. The percentage of occupant restraint use for motor vehicle crashes in the year 1997-2001 was 3.2 %. The percentage of non-use of restraints was 75.8 % with 21 % accounting for “unknown.” Based on existing Indian Health Service (I.H.S.) cost protocols, the treatment costs for severe injuries for the years 1997-2001 on the Cheyenne River Sioux Reservation resulted in the conservative estimate of $1,040,000 being spent. According to the I.H.S. IP Fellowship Paper written by Lovetta Phipps, the cost for each crash where seatbelts were not used was $2,395.00. When seatbelts were used the cost went down to $470.00 per crash. An earlier I.H.S. Fellowship Paper project had also established that the costs incurred from non-use of seat belt restraints far outweighed the treatment costs of those with seat belts in use. An occupant restraint observational survey was initiated in January 2005 with 1,000 vehicles being observed in a two-week time period. The result was a 10 % overall restraint usage rate and a 5 % municipal usage rate.

To help pull these percentages up, the Injury Prevention Coalition Task Force, under the leadership of Randolph Runs After, was created and formally recognized by the CRST Tribal Council in February, 2005. Membership includes CRST Tribal Health Programs (Environmental Health, Health Education, Mental Health and CHR’s), CRST Law Enforcement, I.H.S. & Emergency Services, BIA Transportation Dept., CR Housing Authority, CRST Head Start, City of Eagle Butte, Black Hills Center for American Indian Health, Northern Plains Epidemiology Center – AATCHB, and the SD Dept of Transportation.

The task force worked with two focus groups in May of 2005, North American Indian Women’s Association (NAIWA) and the Elderly Nutrition Group. Three predominant themes resulted from the focus groups, 1. Most had NO knowledge of any existing seatbelt laws on CRST, 2. Most felt there was NO education for the public regarding existing seat belt laws that there was NO enforcement, and 3. Most felt that seatbelts save lives and prevent injuries and that fines were a necessary part of having a law. An occupant restraint aptitude survey was completed within CRST Tribal Programs, two Tribally-Affiliated Organizations and BIA employees. The results showed that 65 % of respondents were unaware of the present seat belt ordinance and an overwhelming 82% believed there should be an ordinance.

With these numbers in mind, the CRST Injury Prevention Coalition recommended to the Judiciary Committee that the 1992 Tribal Traffic Code be adopted and enforced, and that the existing secondary seat belt and primary child seat law be enforced. The coalition also recommended enhanced public education with emphasis on cultural/historical safety aspects, using the theme “Awakening the Spirit”. Mr. Runs After stated, “There is graphic and canvass technology available and in use by utility and other entities that go above and beyond the ‘normal’ paint and plywood billboards and that can be utilized for highway traffic safety and injury prevention promotion. The procurement and installation of one of these billboards with a pertinent message and cultural theme near the reservation headquarters of Eagle Butte in the very near future is a goal of our injury prevention task force with another one to be installed in a different location. The use of visible, well lit signs placed in good locations can advertise health promotions & statistics, traffic safety protocols, events & activities, and other relevant information. Procurement of one or two of these types will be a goal.”

One facet of building a foundation of health and traffic safety is the development of new education materials that will be conducive to learning important aspects of motor vehicle traffic safety. Existing and effective presenters will be utilized and new materials and presentations will be developed.

“We want to know if our efforts are having an impact for the prevention of severe injuries.” Future occupant restraint surveys will provide an evaluation tool for understanding rates of occupant restraint usage. More stringent penalties and/or adoption of a primary seat belt ordinance may be warranted and pursued if severe injury rates and occupant restraint usage does not improve. For more information regarding this project, contact Randolph Runs After, MPH, REHS, Environmental Health Specialist / Tribal Sanitarian at sanitarian@lakotanetwork.com.