SAFE COMMUNITY APPLICATION - .GLOBAL · 2018-01-23 · Sande is the northernmost municipality in Vestfold, bordering Holmestrand, Hof, Re, Svelvik and Drammen municipalities. Approximately

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SAFE COMMUNITY APPLICATION

Sande municipality in Vestfold county Norway, seeking approval as

Safe Communities in the International Safe Community Network 2013

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Illustrations: Front; Maritime Safety Day (photo Sandes newspaper) 2011, Photo 1) overview of the village and Sande Gulf 2) New square as a gathering place after relocation of the railway, 3) collection of boats in Fantebukta (photo Anders Aaserud) 4) prospect of future development of NJB pier (photo NJB), 5) and 6) King Crab maritime safety project, practicing with boats and training of Marius from the rescue company, 7) Bike Pro Rune use, maintenance and safety in adult education "buoyant and excited-project "8) Pupil at Uniqe fill sand bins.

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Index: Section A Community Overview ............................................................................................................................ 5

Section C Indicator 1 ............................................................................................................................................ 23

Section D Indicator 2 ............................................................................................................................................ 26

Section E Indicator 3 ............................................................................................................................................. 47

Section F Indicator 4 ............................................................................................................................................. 52

Section G Indicator 5 ............................................................................................................................................ 58

Section H Indicator 6 ............................................................................................................................................ 61

Section I Indicator 7 .............................................................................................................................................. 63

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Becoming a Member of the International Safe Community Network - Guidelines

Version to be in action from 2012

WHO Collaborating Centre on Community Safety Promotion-

on behalf of the International Safe Community Network (Final: 2012 01 24)

Form A Application and checklist for the results of applications and site-visit(s) The Form A will soon be available for on-line use. The checklist consists of two parts - one to be filled in by the community and one to be filled in by the certifiers. The following information in column 1 is the application, therefore please describe also all details: Column 1 Column 2 Questions to be answered by the community

Questions to be answered by the certifiers

The Consilier Olav Grande and the Major Karl Einar Haslestad

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Section A Community Overview Are the descriptions sufficient? ¤ yes ¤ no If no! What is missing:

A.1 Briefly describe the community and its historical development.

Sande is the northernmost municipality in Vestfold, bordering Holmestrand, Hof, Re, Svelvik and Drammen municipalities. Approximately 8700 persons living in Sande (01/01/2012), and the municipality has an area of 178 square kilometers. Sande is the municipality in Vestfold with the highest population growth. The main communication road E 18 between southern Norway and Oslo and Vestfold railway between Skien and Hamar went until - 1990s right through Sande center. The road and railway still goes through the municipality, but the E 18 is moved outside the centre, and the railroad is moved slightly to give room for a new plattform. Relocation of the Highway outside of town centre and upgrading this to 4 field has resulted in a reduction of 86% of serious injuries and deaths related to traffic Relocation of the railroad gave room for expansion of the city with new residential and commercial space. Distances from Sande center by car: Drammen and Holmestrand 15 min., Tønsberg 35 min., Torp airport 50 min. and Oslo 50-55 min. The municipality is a traditional agricultural village, but had a cornerstone cellulose factory until 2002. The factory area is now a transformation area of about 300 acres being developed until 2020 including 1,600 new homes and about 24,000 m commercial area, as well as 1,000 moorings for summer boats. There are about 300 agricultural properties in the municipality and 120 farms operating. It is fruit, vegetabels, corn and livestock produced. A large part of this is organic products. The settlement pattern is scattered, but mainly concentrated in the center and the area from the center towards the northern Jarlsberg pier (the old paper mill site). There are two villages Galleberg and Kjeldaas north of the main center. Four elementary schools, one middle school and one high school. The high school includes students from neighboring Svelvik Hoff and Drammen.

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All public servicefunctions such as medical services, police, NAV, health etc. and shops are placed in the center. Sande center has gotten more dense settlement in the past 10 years with buildings of 3-4 floors. Elsewhere in the village there are mainly terraced houses and villas , except the NJB area that have higher buildings and more dense living. In total, the schools include 1,000 students. The municipality has one nursing home with 54 beds. Sande municipality has the longest Vestfold coastline and more than 1,000 second homes located mainly in the coastal zone. The municipality has deposits of clay, especially is this the case in the center along the Sande river. The municipality has few workplaces and nearly 60% is commuting, mainly to Drammen. Unemployment is low (2, 3% by the end of 2011, Norway 2.6%). The largest employer in Sande is the municipal administration. The municipality wants more focus on business development and provides for large new commercial areas in the municipal planning process. The village has many volunteer associations and established a volunteer bureu in 2008. The cooperation between the local authorities, associations and non-governmental units have increased. There is good support from citizens and organizations in the municipality planning processes, including public thematic meetings. Sande newspaper that comes out once a week have many subscribers in the community and write about local events and what is happening in the community. A.2 Describe the strategy, ambitions, objectives and work in the community in regard to safety. It must be a higher level of safety than average for a community in the country or region.

Are the descriptions sufficient? ¤ yes ¤ no If no! What is missing:

Sande municipality sees the injury and accident prevention as part of the council's public health work. In February 2008, the Mayor and the Councillor wrote a partnership contract with the County Governor and the County Municipality, stating commitment to work with targeted health promotion and specifically injury and accident prevention in the Safe Communities concept. To establish a long-term, sustainable effort of the injury and accident prevention work, the municipality sees this work as part of the council's public health initiative. The municipality has for many years, and especially since 2007, focused on safety and security of citizens. In this regard, Sande municipality has been ahead of the other municipalities, and well ahead of new Public Health Act that came into force in 2012. Sande municipality have by the Mayor and Councillior committed to be a local community with MOT. The Norwegian word “MOT” means “COURAGE”. MOTis an educational organization that works for and with young people. TOWARD its goal is to contribute to robust youngsters and safe teen environment. Against his vision is: the courage to live, courage to care and the courage to say no. Courage is also established in South Africa and has pilot project in Thailand and Namibia. (http://www.mot.org.za/index.html) (www.motnamibia.com)

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The cornerstones of the municipal public health are: 1. Sub-plans anchored in main municipal plan and in the "Action plan for public health and the work of safe communities" 2. Anchoring politically and administratively and among organizations and professionals. 3. Participation of politicians, organizations, citizens and professionals, through broad participation in seminars and public meetings. 1. Plan Anchoring and 2. Political foundation It was already in the municipal master plan, adopted in June 2007, formulated objectives and strategies that gave a good political basis to proceed with the public health and injury and accident prevention work. It is tradition in the village for the involvement of residents and along with the municipal planning politicians attended village meetings in all primary schools. There were citizens and politicians who jointly concluded that the municipality's vision would be "Together we create security and prosperity." (- sammen skaper vi trygghet og trivsel). Objectives in this plan 2007-2019 and 2011-2023 are given below. These goals, which are policy adopted by the council, gives legitimacy to the work of public health and safe communities in Sande at all levels and in all activities. Goals and Strategies: The municipality aims to fulfill the vision of "together we create prosperity and security" is founded on the following values: Participation Commitment Dialog Liability Innovations Interaction Vitalization Work satisfaction Respect (In Norwegian language the first letters of these words creates the word “joint responsibility”

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In order to underpin and develop goals and areas of concentration given in the municipal plan and in order to show the results of ongoing efforts, is there prepared an action plan for public health and safe community work and a status report. This is done on an annual basis from February 2010. In 2012, the 2012 action plan and status report for 2011 submitted in a document. The plan will be presented of all local government councils and committees . Some goals and strategies in the municipality plan 2011-2023: (adopted may 2012) (excerpts relating to the TL-work) Sande municipality are to ensure safe and good upbringing and living conditions of children and adolescents. Sande municipality is going to be a healthy and safe place to live, where everyone has equal opportunities and rights to participation and welfare. Citizens should be able to live "the good life" The following actions is intended to help achieve our goals. Prevention of lifestyle diseases in the population and managing new health reforms. Achiving acceptance as "Safe communities". Increased efforts in addictions to approve good mental health and prevent drug addiction. A strengthened position in the local community for the Volunteer bureu and the cooperation of the NGOs. The following strategies will be employed to achieve the objectives: Strengthen cooperation with NGOs and the cooperation between public agencies and government levels. Creating meeting places and good networks for Sandes population and non-governmental organizations. Work with injury and accident prevention for safe community principle Facilitate early efforts to contribute to good living habits, increased physical activity and healthy diet. Continue and further develop the offer of healthy foods, and organic foods in SFO (After school club), kindergarten and junior high school. public health aspect should be incorporated in all area programs and other related programs. Public health profiles and other data about the challenges in the field of health of the municipality will be part of the knowledge base of all government planning.

Some Goals and strategies in the municipal plan 2007 – 20(June 2007) • Promote good health and healthy lifestyles in the population • Create a healthy and safe living environment and physical environment in relation to various factors such as air, noise, accidents, radon and pollutants • Ensure safe and healthy environment for children and youth • Sande municipality will be a safe municipality for the citizensens • Promoting road safety and safe conditions for motorists. The following strategies should be implemented to achieve these aims: • Incorporate considerations of health and healthy environments in the municipal spatial- and community planning, and emphasize crime preventing measures. • Establish a collaborative venue for substance abuse and crime prevention. • Establish arenas across disciplines and departments in the municipality and other government agencies, and between municipalities, residents and voluntary organizations. • Develop traffic plan as a political management tool. Achievement: 2007; establishing Police counsel, 2008: Signing of partnership contracts including applications for Safe Communities, the establishment of voluntary exchange. 2012 SLT-established scheme (Local substance abuse and crime prevention) + more concrete measures

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The consideration of child and adolescent interests to be safeguarded in all planning. Children's and Youth Council shall be heard in all matters affecting children and adolescents. Implement measures in line with the adopted traffic security plan, especially the construction of hiking and bike trails with energy-efficient lighting. Focus on crime prevention when planning new construction areas and further development of the Village centre. Strengthen measures that can participate to good mental health.

Participation The municipality has emphasized broad participation among politicians, organizations and professionals to participate in seminars and theme meetings. There have been three workshops on topics of public health since 2008. In 2008 the seminar "together we create safety and well being" held as a kick-off meeting for public health and safe community workers. It was approx. 60 participants including politicians, professionals, organizations, county / county governor and other local networks. In 2009, a similar seminar entitled "Health for Life" included approx. 80 participants. The aim of the workshop was to share knowledge about public health and safe communities work, present local projects and to bring out proposals to key priority areas. In 2010, a workshop 'Good upbringing and safe communities; two sides of the same coin "for two days outside the municipality gathered 30 participants from the administration, politicians and organizations. In addition to providing knowledge in prioritized areas the seminary reviewed and prioritized proposals from previousmeetings on the topics "childhood" and "health and welfare", which was held in conjunction with the municipal planning process. A broad participation like this is helping to raise awareness among the population as well as politicians, staff and NGO`s. Due to different reasons there were no seminar in 2011,but selectedNGO`s and the Municipal administration collaborated in arranging a seminar on the subject “Mental health” in 2012 “Desire for living” (target group 65years pluss) was one of the projects that was presented in this seminar. In November 2013 there will be a seminar in connection with the designation as a Safe Community. Different local projects will be presented.

We also include an example from the action part of the economic plan for 2013 -16 showing actions / goals to be implemented in 2013. This is to show the context of the governing documents. • Obtain an overview of resident's health condition • Accountability citizen to take responsibility for their own health and lifestyle by offering low- threshold measures for nutritional counseling and physical activity. • Sande municipality must be approved as safe communities • Implement the Action Plan for Public Health • Increase efforts in substance abuse and mental health • Adopt road safety plan

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A.3 How are the mayor (or similar function of the community) and the executive comity involved. Who is chairing the cross-sektor group?

Are the descriptions sufficient? Is the mayor involved? ¤ yes ¤ no Is the executive committee involved? ¤ yes ¤ no Who is chairing the cross-sectional group? ¤ …………

The mayor is the head of the steering committee of the safety communities work. He has been involved in the work from the beginning, along with the Conciliar, signing the partnership contract for Public Health collaboration with Vestfold county municipality and the County of Vestfold. The contract specifies the work of the Safe Communities. The steering committee and the coordination group had the main function in startup when the work was organized as a project. As stated in A2, the foundation and prioritization of measures and areas are included in the municipality's master plan. Working groups are created when required. As far as possible we try to use existing meeting forums. 5 of the 10 members of the steering committee is from the management team. The magistrate management team is an administrative steering committee. The Conciliar management team are central in formulating goals and getting them implemented. The members of that currently are included in the steering committee, and not belonging to the management team, are all actively involved in ongoing projects. It is the municipality's public health coordinator, who is also the coordinator of Safe Local community work and is secretary of the steering committee. The coordinator participates in the working groups as required. The steering committee Coordinating group Working groups

• Mayor (Chair) • Conciliar • Local authority health and welfare • Local authority for Childhood and Culture • Inter-municipal environmental health • Local authority for technical • Manager of volunteer bureau • Manager of Uniq • Leader for Sande farmers ass • Coordinator of SLT, MOT and emergency (staff advisor) • Public Health Coordinator

Participants have been project managers and volunteer- center, as well as coordinator for TL-work

• Maritime Safety • MOT • Injuries in Agriculture • Preventive home visits to elderly • Prevention outdoor / sand bins • Preventive work for refugees Police/SLT

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A.4 Describe the injury risk-panorama in the community.

Is the risk-panorama sufficiently described? ¤ yes ¤ no If no! What is missing:

Municipal health profile that was prepared for 2011 (NHI) shows that Sande municipality was located on the national average on most conditions described. This applies, for example, life expectancy, unemployment, disability, persons with low income. The municipality have a slightly larger proportion of citizens with only primary education and a higher number of pregnant women smoking. Smoking in general in the municipality's population is not registered. There seems to be no more than the average treated for COLS (reduced lung functions). Mortality from cardiovascular diseases and cancer are slightly higher, but not significant. Several of these factors might be related to living habits, but the cause-effect relationship is often complex and we cannot say that the population in Sande have worse habits than those in other municipalities. In the case of hospital-treated injury accident the municipality is below the national average. See the figures below. Beyond a compilation record called “accident injuries”, few parameter specify the municipality's injury and accident profile. Efforts are taken nationally to improve records. Description of the municipality's risk profile is based on 1. National and regional statistics 2. Local surveys (survey among farmers and Quest Back in secondary school) 3. Local conditions on the basis of location and natural conditions 4. Perceived risk manifested through thematic meetings and seminars The status of municipal health in Sande as a whole is better off than the other municipalities in Vestfold (ref. health profiles). When it comes to injuries see. figure above. Based on the three information sources mentioned one may say that the risk profile for injuries and accidents in Sande is in the following areas: 1. Femoral bone and pelvic fractures in older people living at home 2. Traffic injuries among pedestrians 3. Crime and drug prevention among youth 4. Injuries and accidents related to agriculture 5. Accidents and injuries associated with the sea and boating 6. Avalanche risks due to specific areas with clay 7. Injuries among youth in connection with sports at school or leisure time. Femoral bone and pelvic fractures in older people living at home Through the Norwegian Patient Registry Sande municipality in 2010 had 25 patients with fracture of the pelvis or femoral bone. 23 of these individuals were hospitalized and 22 of the people are over 65 years old. One of the assaults was at the nursing home, but for the other cases we have no additional information. Municipal physio-and occupational therapy services are working to get a better statistics on elderly being treated in hospital for broken bones. General in terms of fractures, it appears that Sande has a higher incidence in relation to the population, recorded in NPR, than the other municipalities in Vestfold working for Safe Communities principle, but not compared with the national average. Overall, it is approx. 7% of the population in Sande which is exposed, while the figure for the other municipalities (Re, Andebu, Sem, Larvik and Sandefjord) is between 5 and 6%. Fractures and surface injuries treated at hospitals seem to be higher in our community. Conclusion: The risk profile associated with hip and pelvic fracture in Sande is not alarmingly high,

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but there is potential for prevention. Focus further : Develop system for recording and monitoring by getting detailed reports from the local health service and get targeted measures and arrangements for the prevention for high risk groups. 2. Traffic Injuries Norwegian Public Roads Administration in Vestfold has secretariat for the county's Traffic advisory, and they coordinate the Safe Communities municipalities in Vestfold. They produce statistics for the municipality on injuries and fatalities. The summaries shows that the number of serious injuries and fatalities in Sande has decreased dramatically after the road E 18 was moved out of the center, and upgraded to 4 lane highway. The result is that the number of accidents with serious injuries and fatalities have decreased by 86%. In 2011, there were two accidents with minor injuries registered in the municipality. Traffic risk is now primarily associated with "perceived risk" among parents and children in safe school transport, as well as pedestrians along roads in the county that have not yet got cycling corridor. (See Section D Item 1 trafick) In the QuestBack survey from secondary school, we got the following results related to youth and road safety: • Approximately 46% of those who use bikes never or almost never bike helmet • The majority of over 90% using a seat belt in the car, just as many do not use seat belts in the school bus. Conclusion: The risk situation in traffic is not disturbing. Focus further: Awareness-raising efforts and continuing to build out walking and cycle corridors to increase safety for motorists. 3. Crime In almost all areas that the police make statistics the number of cases has decreased in recent years in Sande(see statistics section D, Section 2.6). The prevention work among youth is still a priority area for the police. In the thematic meeting on health and welfare in connection with the municipal planning process participants specified crime and drug prevention work among children and young people as a key priority in safe community work. There has also been a local survey in connection with the start of SLT (local substance abuse and crime prevention) efforts. None of the businesses reports specific challenges in crime and substance abuse in the community. In the QuestBack survey conducted in secondary school, there were few students who said they used tobacco or snuff and few students who had tried drugs. However, those who had tried were very young (12 and 13 years) when they tried the first time. There will be a larger study of adolescents in the Vestfold County Council in 2013 and the findings of Quest Backen may be confirmed / disproved. The study will be conducted in intervals. Conclusion: No specific risk Focus further: Proceeding with a broad prevention efforts as early as possible and focus on prevention work. 4. Accident in agriculture Sande is an agricultural village and agriculture is the sector that has the highest rate of injuries and deaths associated with the work situation. The agribusiness has a high risk of injury and it's probably a magnificent under registration. Looking at injuries per 1000 employed (figures from 2008 ref. Nationen newspaper) it was reported 5 in agriculture, 14 in construction and 17 in the industry. Study in Nord Trøndelag suggests that it is as much as 112 per 1,000 employed getting wounded in agriculture. ( It is estimated that 1 of 10 farmers get injuried) Occupational Medicine Department at St. Olav's Hospital in Trondheim conducted in 2010 -2011 a large survey among farmers in Nord Trøndelag (7,004 farmers) where 2699 responded. Sande wanted

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to conduct a similar survey to see if our municipality had the same profile. We used the questionary they had prepared for our study, and our results can therefore be compared with their datas. There seems to be a correlation between our results and the study of Nord Trøndelag. We can thus conclude that injuries among farmers in Sande is similar to the Nord Trøndelag, although the absolute number of injuries in our registration was not particularly high. The response rate in Sande was 60% and the number of injuries reported for 2012 totaled 7 Conclusion: Injury picture in farming in Sande does not seem to be different from the rest of the country, but they have a high risk of injury and accidents. Focus further: Maintain coordination between the municipality, farmers' association and agricultural safety and continue to focus on preventing injuries and accidents among farmers. 5. Risks in connection with boat / swimming Sande municipality have the longest coastline in Vestfold County, and the roads are close to the beach and recreation areas. This creates at times chaotic traffic safety conditions in summer. We have a large number of marinas and small boat traffic in the archipelago. Attitudes and behavior when using boat is considered important to focus on, even if the municipality has not had any recorded drowning accidents in recent years. A school and a kindergarten are located near the sea. Risk situation in this field is difficult to keep track of because minor accidents are not recorded. In general, there are many drowning accidents in Norway. Compared with Sweden, Norway has 2.5 times as many accidents. Conclusion: The risk in Sande is high because of the long coastline and high boating activity and swimming on the beaches. Focus further: Continue training pupils in school and focus on educational work in connection with the use of boats and beaches. 6. The risk of landslides and mudslides Mapping of clay areas and danger of avalanches is done in conjunction with the municipal development plan. Maps are available on the council's website. Consequences of building in areas of landslides should be studied in connection with the regulation and development. Conclusion: Sande has areas of clay that can trigger landslides. Focus further: Sande river is particularly vulnerable and detailed mapping in collaboration with the Norwegian Water and Electricity Authority is ongoing. The municipality must have a strong focus on this issue in future plans. 7. Injuries among youth in connection with the provision of sports at school or leisure. The municipality does not have a good reporting system for documenting injuries in the various sports clubs. The QuestBack survey included 2 questions regarding injuries that the students had experienced in the past two years. About 60% of students reported medical treatment for injuries and 22% of these (69 people) were treated three or more times. (Numbers in this study must be read carefully) Of those injured during training 57% were injured during exercise. 24% reported it was through organized training, 11% during unorganized training and 22% of injuries occur during school hours. This picture is supplemented by national statistics. The strategic plan for the prevention of injuries and accidents.(link) stated that sports amounted to 15% and is the most common type of accident aged 10-30 years. Ball Sports dominate with less than 63% and skiing with snowboarding is about 17%. (Injury Registry, Trondheim, Harstad, 2000-01). In addition the damage associated with physical activity counts for much of the school accidents. Conclusion: The municipality does not have good overview of this area and must intensify effort in this field

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Focus further: Increase collaboration with sports clubs and schools to support registration and promote targeted efforts.

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Section B Structure of the community Is the demographic structure

and the different risks sufficient described? ¤ yes ¤ no If no! What is missing:

B.1 Describe the demographic structure of the community Sandes population increased in 2011 with 151 people, an increase of 1.8%.The population around 8700. The largest increase is due to net immigration. The diagram in Fig. 2. show how population growth over the past three years, for different age groups. The largest population growth in the last three years have been in the age group 20 years and above. Almost 30% of the growth over the past three years, is the population aged 67 years and above. This will probably give great pressure on social care in the years to come. Population Development (www.ssb.no ) The municipality had a high population growth in recent years as the curve in Figure 1 shows. Population growth is mainly in the youngest and the oldest part of the population

Antall personer 2007 2008 2009 2010 2011 Population 1/1 7 827 7 999 8 214 8 303 8 529 Population growth 172 215 89 226 151 Folketallet 31/12 7 999 8 214 8 303 8 529 8 680

Figur 1. Population Figur 2. Population

Befolkningsutvikling 1951–2010[b]

Sande (Vestfold) på Commons a^ SSB: Befolkningsstatistikk (1. juli 2012) b^ Red mark indicate changes in borders between municipals. Kilde: S

B.2 Describe the SC/IP at present and the plans for the future.


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The municipality's priorities in injury and accident prevention for Safe Community is discussed in the municipal action plan for public health. The municipality has five main priorities for 2012 which are continuing from 2011: • Prevention of fall injuries - Prevention of fall injuries outdoor (sand bucket project) - Preventive home visits - Prevention of hip fractures (balance training) • Road Safety Work • Maritime Safety Work • Preventing injuries in agriculture • Substance abuse and crime prevention The priorities and actions in relation to them are described in Section D. Single measures is shown in a schematic overview. These priority areas will continue to be important in the future. For 2013, the road safety priority by preparing a special plan for this. Prevention of injuries related to sport, recreation and physical education at school is an area that should be further developed to achieve targeted reduction measures. Action plan and status report are meant to be an annual event so that new initiatives and priorities are discussed there. B.3 Describe the support for sustained injury prevention of the local politicians in the community Which parts of the program have been undertaken and/or supported by the regional government?


How local politicians support the work Politicians in Sande (the mayor) has signed a partnership contract with Vestfold county council for cooperation on injury and accident prevention in Safe Communities. Before starting the work, the council decided that the municipality should initiate work. Politicians give their support to the work by adopting objectives in the municipal plan related to public health and safety and security work. Every year action plans adopted for public health and safe communities are made, including reporting on measures implemented to all political committees and councils. It is first and foremost greater road safety measures such as the development of pedestrian- and bicycle paths, lighting and securing school buildings that must be reflected in the municipal budget. How does the county administrator and the county work The regional government has been actively to support the municipality to commit to work on public health and specifically with injury and accident prevention for safe communities principle. The regional government operates a professional network for those municipalities that are working within safe communities. This has altso been academic support from Vestfold University Collage. The municipality has received funding each year for. Injury prevention forum Injury prevention forum is an independent national arena and a central meeting place for the development of preventive work in Norway, both nationally and locally. The forum meets regularly, TL-coordinators are invited and get the opportunity to exchange experiences and new information. The forum is supported by the Health Directorate B.4 Describe the strategic program concerning the safety promotion and injury prevention work, which has been formulated!

Are the descriptions sufficient? ¤ yes

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¤ no If no! What is missing:

This figure illustrates the approach and the relationship between municipal plans adopted every 4 year and action plan and status report adopted annually. The action plan will be sent to all businesses and collaborators for comments before it is treated political. The municipal plan adopted in 2012 and plan to finance the plan specified that the municipality aims to be certified as safe community in 2013. The action plan shows the challenges the municipality has in public health and safe communities work, and refer to municipal profiles and other available statistics. Safe Community work is specifically mentioned in the masterplan, including accident prevention measures. The priorities within the Safe Communities for 2012 • Prevention of fall injuries - Prevention of fall injuries outdoor (sand bucket project) - Preventive home visits - Prevention of hip fractures (balance training) • Road Safety Work • Maritime Safety Work • Preventing injuries in agriculture • Substance abuse and crime prevention (SLT) The municipality has a partnership with NGOs in all the mentioned focus areas. They become more specified under each priority area in Section D. As an exampel from the program we will describe the prevention in the agrcultural business , the project: “Farmers without injures” Background

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Sande municipality is an agricultural municipality with 120 farms that receive operating subsidies. The agricultural industry is high on the national statistics of fatal accidents. The number of fatalities varies from year to year. 2008 was a "dark year" with 13 fatalities nationwide. It is also assumed that the large underreporting of injuries and accidents in this industry. Agriculture accounts for 2-3% of the total workforce in the country and about 30% of work-related fatalities. (Source Agricultural HMS) was therefore initiated a major research project in Trøndelag to acquire more knowledge. The project was conducted by the occupational medicine department at ST. Olav's Hospital in Trondheim in 2010 - 2011. The findings confirm the suspicion of under-reporting and confirmed the hypothesis that there are more injuries and accidents in agriculture than in other industries. On this basis Sande municipality wanted to test if the situation was similar in our municipality. Periode 2011-2014 The project "Injuryfree-farmer" was started in January 2011. Participants include representatives from Sande bondelag, Sande female farmers, Agricultural Safety, local chief of agricultural and public health (and TL-) coordinator. Work Medical Institute was asked if we could use the same questionnaire as used in Trøndelag to be able to compare data afterwards. Theme meetings on safety in agriculture and the introduction to the survey was conducted in March 2011. The survey was conducted in spring 2011. Conducted HSE courses Sande in fall 2012 Future goals are: Continuation of working group and theme nights / courses with a focus on safety in agriculture. Further actions and initiatives in the area will be addressed in the action plan for public health revised every year. B.5 Who is responsible for the management of the SP/IP program and where are they based in the local political and administrative organization?


The work of TL is anchored politically in the council and administratively in the municipality management team. The municipality considers TL work as the injury and accident prevention part of health promotion and has a coordinator working 65%, primary responsibility for coordinating the work of the municipality and representing the municipality in the national and regional network of Safe local communities municipalities. The coordinator is administratively related to the sector of public health. For specification of the participants in the steering comity see illustration in section A 3 B.6 Which is the lead unit for the SP/IP program?


The mayor is the head of the steering committee; for a list of other participants see illustration and description in A3. Working groups are created as needed. If possible, existing interdisciplinary forums are used. B.7 Is the Safe Communities initiative a sustained program or a project?


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The work began as a pilot project, but many of the measures are incorporated into regular operation in the community. Priority areas and plans and reports are incorporated in council management and planning system. Safe Community work is a part of the municipality's public health, and public health is one of the council's priorities as reflected in the municipal plan and the finance plan. The annual action plan and status of public health is reported to the politicians. B.8 Are the objectives decided by the local politicians covering the whole community? Which are they?


In the Community Board item KST-23/09 Safe Communities - information about the municipality work toward approval, the following was stated: "Work with safe communities in Sande municipality continue in accordance with the agreements signed with Vestfold county, county administrator and NPRA (National Road Administration). The goal is to be approved by WHO's criteria by the end of 2011 » In relation to the agreement with the regional authorities (partnership contract) Sande is committed to work in the following areas: • Prevent injuries among elderly people living at home • Prevent drowning accidents • Prevention of injuries from falling out (sand bucket project) • Prevention of road traffic injuries Prevention of accidents in agribusiness Action plan for public health and safe communities are prioritied and new initiatives described. The action plan for 2010, work on maritime safety and the prevention of injuries in agriculture made priority areas. A challenge for the municipality has been to obtain good local statistics to make it possible to evaluate the efficacy of interventions. It has therefore been put in place measures with local registration survey among farmers and quest backs in junior high schools. Through the public health seminars and special meeting in conjunction with the municipal planning process politicians, organizations, and people helping to make contributions to key prevention priorities. Traffic safety and crime prevention was considered an important area to work on. In a two days seminar with politicians, organizations and professionals, the focus was on maritime safety and security in agriculture. The justification of this aims are founded in the facts that the municipality has a long coastline and it is an agricultural area. And it is founded in National statistics which indicates high-risk areas that is most likely to be identical for Sande. B.9 Who have adopted these objectives?


The action plan adopted by the politicians is normative for the municipal organization and also adapted to voluntary organizations, business and individuals. See the description of the measures. An example can be maritime safety day ,where all 7 graders in the community participate. This is a project in collaboration with maritime rescue service, police, Red Cross and fire department. The initiative is run in partnership with the private development operator Northern Jarlsberg. The volunteer bureau and

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individual volunteers are also included. The municipality's volunteer bureau has contact with volunteer organizations and individual volunteers in its work. B.10 How are the Safe Community objectives evaluated and to whom are the results reported?


How are the Safe community objectives evaluated: Juring the last years Sande have been working to integrate evaluation into all prosjects. The development of a solid evaluationpractice have been challenging. We have conducted a largescale electronic questback servey to pupils aged 14-17 years in 2011, and this have given us valuable baseline data. In addiction the new Public Health law has boost the access and awareness of quantitative data at a national level. To elaborate we are now working with : Qantitative evaluation based on: Statistics from national and regional registers Trafic accidents Fractures of hip Deaths from drowning Deaths from fire Local statistic Crime and violence Questback Occupational injuries during work in the Municipal administration Counting participants on events connected to Safe Community Counting delivered sand buckets Counting installation of aid equipment Qualitative evaluation Feedback on forms delivered to the paricipants on different events/seminar, and unformal oral information . / Feedback from participants in the Sand bucket- and the Installation of aid equipment projects Description of the activity and the experience with the projects and how the goals have been obtained. (Reported in the annual status report) To Whom are the results reported: Politicians and employees in the municipal administration are the aim for the annual and quarterly reports and plans. All documents are available to the public trough the Municipal website. The public health work and injury and accident preventing work are reported to the County administration and to the county counsel. How are the results taken advantage of. Feedbacks from policymakers are included in the future work. It is reported on public health matters through the ordinary channels which will be quarterly reports, annual reports and the budget which all are compulsory documents. Documentation and statistics which is revealed and gathered through the work of public health plan and the Safe community work will be implemented into other municipal action plans and programs, but also in the Municipal master plan. An example is results from the quest back in secondary school

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which gave valuable information used in the “action plan for sport and leisure” and in the “action plan for drug abuse”. What kind of reporting is conducted 1. Municipal reporting In Sande we report through an action plan system to inform and involve politicians. These are: Annual report considering all actions in the community Quarterly report from the activities in the different municipal sections. Annual Cross sectional action plan for public health matters, including injury- and accident prevention. It includes a status report for the work previous year and action plan for the coming year have been prepared the last three years Sande volunteer bureau have their own annual rapport. M any of the public health projects and injury prevention projects are in cooperation with the volunteers and will be reported on through this document to all non-governmental organizations. Good examples here are the Sand bucket- project and the commemoration of world mental health day. The local newspaper comes out in paper once a week. It renders a lot of local stuff in the context of projects and initiatives in the field of injury and accident prevention. Police office report in a small column of events such as thefts, controls, fires, road accidents etc. 2. Regional reporting Annual report on public health matters is conducted to the Vestfold County public health administration. They are publishing a journal with includes the work of every municipal in the county. They report to the County counsel. A specific report is conducted from the municipal to the regional network for the Safe Community work. It includes a description of the different actions conducted the last year, target of the action, involvement of volunteers, anchorage and economy and evaluation. Here is an example of the form we are using.

Activity Targets Partici -pants

Economy Target group

Anchorage (KF)

Evaluation Status 2011

Plan for 2012

Sandbucket project

Prevent falls outside

Voulantary center youts

10 000

Eldery people living at home

Action plan for public health and safe community

Counting delivered buckets. Register requests

200 buckets delivered

Continue delivering buckets. Start balance training groups.

B.11 Are economic incentives in order to increase safety used? If yes, how are they used?


The municipality allocates funds through the budget, as greater fence at the schools and upgrading of playgrounds etc. Regional incentives and other project funds are used for every project and reported annually through the form above. The money allocated through the application of specific projects / areas are described in public health plan and the form described above. The municipality has not used financial incentives to change habits through the use of private car. It

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will be considered whether this is a policy instrument that can have an effect on other areas such as in terms of getting the sports associations to work with the registration of damage and injury prevention. B.12 Are there local regulations for improved safety? If so, describe them


The municipality has its own police regulations which contain provisions applicable to public places, as the prevention and clearing of snow and ice on roofs etc and the police's ability to prohibit traffic on the frozen lake and sea for safety reasons. (lenke her)

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Section C Indicator 1 1.1 Describe the cross-sector group responsible for managing, coordinating, and planning of the SP/IP program.


Styringsgruppe for TL- arbeidet Interkommunale samarbeid Arbeidsgrupper Mayor Local authority health and welfare Local authority for the upbringing and culture, Local authority for technical, Representative from inter-municipal environmental health Adviser to staff (coordinator of SLT, MOT and Emergency) Head of volunteer center, Police Superintendent in Sande, Representative for project Unique in Sande high school Representative from Sande bondelag

Intermunicipal cooperation on Fire Interkommunnalt cooperation Casualty clinic Police Waste chemicals Food Safety Safety (HMS)

• Maritime Safety • MOT • Injuries in Agriculture • Preventive home visits to elderly • Prevention of outdoor falls • Prevention of accidents among refugees • Police / SLT

1.2 Describe how the local government and the health sector are collaborating in the SC/IP work. .


The Councillor and his management team is responsible for ensuring that politicians get information through politicial channels . It means also that important topics in public health and injury and accident prevention are discussed as political affairs. Local authority health and welfare is part of the management team and is responsible for municipal health care services. The municipality has a council of elders, a council for the disabled and a counsel for youth in addition to the main Committee for health and social care. They may ask the municipality to address issues / and do this by action plans and status report being treated in all political Committees and the municipal council. The Municipals head of Public Health is responsible for care and health services, mental health and physical / occupational therapy service and they report to the committee of Health care. The health and care service in Sande like the nursing home, the health clinic for children, and so forth are municipal services and not private. There are a few private doctors and physiotherapists who have agreement with the municipality and also regular collaborative meetings. Challenges that the sector faces will be accounted for in the annual report and through cooperative programmes. The municipality has a collaborative forum where all sectors are represented and where plans and projects are discussed. Department of environmental health gets all spatial plans for commenting and are also consultants in other municipal plans and projects. Statistics on health status in the community collected by the department of public health and will be

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disseminated to other sectors and politicians through the status report and action plan for public health. An example would be the statistics of falls injuries in the County that were communicated to the Physiotherapist service. They began to look more closely at this statistics and organised an action (balance groups) to prevent further fall among elderly people already exposed for this. New public health law in Norway clarifies that public health efforts should be cross-sectoral. It requires that all municipals should have good cooperation procedures and practices for securing information and knowledge transfer between the departments. We have due to the systematic in the Safe community work started to implement this, but we will still have to focus on this in the future. 1.3 How are NGOs: Red Cross, retirement organizations, sports organizations, parent and school organizations involved in the SC/IP work?


In the municipal and public health plan it is described that voluntary center is a coordinator between the NGOs and the local authority for communications in connection with projects that are either initiated by the municipality or by the organizations. The municipality has about 100 NGOs. Female farmers (Bondekvinnelaget), Sande Health Association, and LHL (Association for Heart and Lung) is particularly active in preventive work in the community. Associations collaborating on some events as commemoration of World Mental Health Day. The associations often take initiatives towards the volunteer bureau and the public health coordinator. The municipality will assist in convening meetings, participate and coordinate meetings and activities when necessary and assist with meeting facilities. Sand Bucket Project Voluntary pensioners use their private cars to take students from Small job central (UNIQUE students who attend alternative education) to supply sand buckets to people 70 years pluss. Sande voluntarily central warehouse supply address lists and contacts volunteer drivers. The municipality is responsible for the sand. The operation is advertised in the newspaper so that people not in the target group who want to get sand can contact the center. Less Injuries for farmer Female farmers and the Farmers' association, in partnership with agricultural safety (HMS) working group dealing with the prevention of injuries connected to agriculture. Sea safety The Rescue Society work with the municipality on maritime safety for NJB kindergarten. On the main maritime safety day also the police, the firebrigade and Red Cross is represented, as well as volunteers. School and parent groups (FAU) Contact with the school FAU in traffic safety issues have been organized through either the principal or directly to the public health coordinator. A competent teacher at Galleberg school is heading the safe traffic (safety ambassador) and will be a the main coordinator between teachers, students and parents. 1.4 Are there any systems for ordinary citizens to inform about risk Are the descriptions

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environments and risk situations they have found in the community?

sufficient? ¤ yes ¤ no If no! What is missing:

The municipality is small and transparent, people calling in to the service or directly to the employees in the municipality. It is the duty of the staff to quickly resolve the factors that may pose a security risk. In connection with the development of the area NJB, a separate project office will hold kindergarten area and the nearby primary school informed of construction activities and security measures. It is the work platform in DIKT cooperation (Drammen region's ICT) called “Speak out” (Si D). This is a system that will respont to public inquiries and quickly sending it to the appropriate officer, It is used for holes in the road, traffic hazards, and the places are mapped. 1.5 Describe how the work is organized in a sustainable manner.


The municipality has good political and administrative basis for the health and safe community work and this is the focus of the municipality's overall planning. Examples are municipal, annual and finance and action plan for public health. See Section B 4

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Section D Indicator 2 Target area 1 Safe traffic

Anchoring: Municipal plans Objective: The municipality will be a municipality without fatalities and injuries in traffic Safe school routes with reduced number of accidents and injury. Traffic SafetyPlan

Partners: Technical- and the educational sector, Safe traffic and Parental groups at schools (FOU)


In Norway there are about 1200 people being killed or seriously injured in road traffic accidents each year. In Vestfold county is number 57. The road safety plan for Vestfold 2010-2013 aims to reduce the number of fatalities and serious injuries to a maximum of 40 by 2020. The National Transportation plan for Norway has a zero vision in terms of fatalities and permanent injuries in traffic. It requires a broad effort by a number of different players to prevent and reduce accidents and risks. The main challenges in road safety plan for Vestfold are grouped as follows: - Risk - Types of accidents that result in serious harm - Risk Behavior - types of behavior that causes severe damage - Risk Groups - specific groups at risk of serious injury For the current four-year period (2010 - 2013)are accidents involving pedestrians, speeding and young drivers prioritized. The local traffic safety will have different focus in the different municipalities, but road safety around schools and school routes and especially in connection with the school is always a high priority. In Sande municipality accident situation drastically changed after the new highway was established in 2001. There has been a decrease of 86% in serious accidents. The focus in recent years has therefore been focused on pedestrians and attitudes in general. Below are some of these measures

Development of pedestrian and bicycle paths Target group: all citizens Goal: Consistently safe roads through the community Results: There are 16 million NOK allocated to road safety measures from 2011-2014. This is primarily for cycle paths, but also other road safety improvements like setting up barriers and trafficsigns along Bekkestranda that have very strong increase in traffic and parking in the summer.

BEFORE-AFTER FOR E18 AND FV313 (OLD E18): Accidents Killed/hurt Killed Seriously hurt Minor wounds BEFORE highway H 245 21 69 176 AFTER highway 92 134 3 10 124 % reduction 29 45 86 86 30

BEFORE-AFTER ONLY FOR FV 313 (OLD E18): BEFORE 123 235 20 66 169 AFTER 25 34 0 2 32 % reduction 86 100 97 81

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Traffic safety in schools Target group: Students 6-14 years, teachers and parents at primary schools Goal: Secure stopping points for bus Bus stops are upgraded and placed on the same side of the road as the school, regardless of direction like in Selvik. Haga and Bjerkøy schools. Haga school has made improvements that have increased the general safety of pedestrians.

1) 2) 3) The sketches show Selvik primary school as an example of the development to improve the traffic safety. 1)The sketch at the left shows the situation before 2001. There were a bus stop at each side of the road and the children had to cross this heavily trafficked road.2) The sketch in the middle show the situation of today. The busses deliver the children so they do not have to cross the road, but there are some parking spaces there and some traffic during opening and closing time of the school. The sketch 3) on the right shows the situation to be in 2014/2015 when the rehabilitation of the school is finished. Then there will be no mingle with other traffic and cars cannot stop when they deliver children. Even further in the future it will be considered to set up the delivery point further away from the school premises.

Picture of the situation today at Selvik primary school.

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Traffic Safety Training / awareness raising activities “Tarkus” Safe Traffic national training program Target group: Children in kindergarten Goal: Teach children about how to behave in traffic. The Traffic school Target group: 1 graders and parents Purpose: Provision of reflective vests and pamphlets about Safe route to school from the Road Safety. Traffic counting points at schools Target group: Students 6-14 years, teachers and parents at primary schools Goal: Raise awareness and teach students and parents. The schools themselves are responsible for counting twice every year the number of students who walk, cycle or run. Over the past three years there have been little change in the distribution of cyclists and those transported in a car. It's more bikes in the spring than in the autumn “Speak out!” (Si fra!) Target group: Youth 17-20 years (Sande high school with approximately 500 pupils) Objectives: Raising awareness of young drivers who are high school students Young people aged 15-24 years are over represented in accident statistics. Despite the 15-24 age group represents only 14 percent of the population, the group is involved in 30 percent of all accidents nationally. In Vestfold, we have had a decline in fatalities and severe injuries in all age groups from the period 2001 - 2004 to 2005 - 2008 of about 20%. For youth groups, there is a very positive development, redused by 50% the severely injured and killed in the age group 15 to 19 years. The decline has occurred mostly among 18 and 19 year old drivers and passengers, where the number is more than halved. Through Safe Communities, we committed in 2005 at “Speak out!”, and has since 2006 met all pupils attending the second year of high school in Sande, approximately 170 students in the driving license age. The cornerstone of the Speak Out! is a two-hour training program in secondary school. It is particularly focused on situations involving high speed, non-use of seat belts, drugs and fatigue. The main focus is on the passenger role. In addition, the police and NPRA specific adolescent traffic controls. The goal is to change young people's behavior. We want fewer injuries and fatalities, by motivating young people to dare to speak out; set boundaries and speak up when they are afraid during the ride. Campaign conducted by the Public Roads Administration in cooperation with the police and schools. NPRA conducted a major evaluation of the Speak Out! spring 2007 and Sintef concludes that the campaign has succeeded to get the attention of the target group. Those who have participated in the campaign, to a greater extent than those who have not participated, got drivers to reduce speed, got other passengers and drivers to put on seat belts and prevented drivers from driving influenced by drugs. 60-70% of drivers have acted positively on the passengers' requests to reduce speed and 50% of those who were drunk dropped driving. Youth have school meetings were they are motivated to make good choices that reduce risk. It is reasonable to assume that this has prevented accidents. Speak out is a consistently chain of measures with regard to young people, traffic and risk. The Speak out! concept is an important complement to the established series of initiatives related to youth and traffic. It also include information about driving practice in 10th class. Moreover, the basic road traffic knowledge and first meeting with a driving school is central to many as they reach age 15 and 16. Girls' traffic action is offered to all girls in Safe Communities municipalities. The idea is to recruit girls as traffic ambassadors. For the 3rd graders at the high school is the “Russ activities” (graduate students), with seminars, cars, road safety and traffic Health Day.

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Traffic and refugees Committed and enthusiastic - road safety in Norway Target group: Refugees and immigrants in adult education program (about 10 to 15 persons each year) Goal: Communicate traffic and attitudes when driving, bike and traffic in Norway for foreign language persons. Part of Adult Education program. Revision of road safety plan Revision of the plan is initiated. Focus on Parents Councils (FOU) at the various schools in developing walking and biking paths. There is also an aim to reduce transport in the school area both from private cars and vehicles delivering goods. The schools are not big and as there are no offering of school lunches so it is only SFO (the children’s club after school) who need food supplies. These are stored in a central place and taken out to the school in private cars when needed.

Overview of the number of students who walk, cycle, use taxi / car at the various schools. Counting is important for raising consciousness

0,0

10,0

20,0

30,0

40,0

50,0

60,0

Haga

Selvik

Kjeldås

Galleberg

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Table with overview of road traffic accidents in 2005 – 2011( NPRA) Kommune

Sande

Deaths, car accident 2 Number of very serious injuries, car accident

1

Car accident, seriously injured 2 Car accident slightly injured 25 Motorcycle accident slightly injured

3

Bicycle Accident, seriously injured

1

Bicycle Accident slightly injured

0

Pedestrians involved or participating

1

Oversikt over gang sykkelveier. Planlagte og eksisterende.

The number of serious injuries and fatalities have decreased dramatically in the municipality after the European road was moved and upgraded to 4 lane highway. In 2011, there were two accidents with minor injuries registered in the municipality.

Overview of traffic accidents 2005 -2008

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Area 2 Safe homes and leisure times

Anchoring Municipal plan and plan for sports and outdoor activities Action Plan for Public Health / Safe Communities Plan for health and school health services Objective: Early efforts to prevent injuries and accidents Target groups: Children / Youth / Elderly resident

Partners Technical department / associations Preventive team Sandetun, “smalljob group”, voluntary center Health center service


Playgrounds / community greens Objective: Functional and safe playgrounds in communities. Target group: All, but especially children and young Sande Municipality owns 30 playgrounds / community green areas. The sites is checked once a year. There is a plan for the rehabilitation of the playgrounds. Play areas can be divided in 2 categories. Those who are affiliated with a school or a kindergarten and those who might be called community facilities and public places associated with the residential areas. The safety of children in kindergarten and students in schools is regulated by several laws. In particular, there are several paragraphs that deal with the safety regulations for environmental health in schools and kindergartens. Here it is the municipality itself by its environmental health service that supervises. Conditions relating to safety and preparedness in the kindergarten or schools, must be in place in order for approval to operate. It is the municipal maintenance staff who oversee the equipment and the playgrounds. Once a year the areas are checked by an external reviewer who checks that the playground equipment follow the National regulations on the safety of playground equipment. Safety at home for elderly Objective: Early contact with elderly living in their homes in order to facilitate a safe and secure life. Target group: Older people living at home In connection with sand bucket project, people who get sand buckets also get help for replacing the battery in fire alarms or other odd jobs at home. This is organized through ” småjobbsentralen” and voluntary bureu. As part of preventive home visits to elderly also checklists for safety is reviewed. Safety in the home with toddlers / infants. Objective: To increase awareness and knowledge among parents about how the home can be ensured for avoiding injuries in young children. Target group: Parents with newborn babies All who get children are offered a home visit, where checklist for home security are discussed. Topic such as safety in cars is also covered in the clinic. Area 3 Safe children

Anchoring Action Plan for Public Health /

Partners All municipal sectors

Are the descriptions sufficient?

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Safe Communities Plan for health and school health services Plan for good upbringing

In some projects: air ambulance rescue company

¤ yes ¤ no If no! What is missing:

Good raising of children This is a regional priority and the municipality has a separate project with a project plan adopted in 2010 Objective: Collaboration across on prevention and measures for the the children, young persons, family and community. It is made an action plan for the topic. Target group: All professionals who work with children in the community BIR (Children in families with substance abuse problems) have a human resource development program for employees Objective: refurbishing those working with children and young people to early detection of children living in families with substance abuse and/or mental health issues, in order to detect this early and to act. Target group: Employees of schools and kindergartens. Strategic plan against bullying. Target group: schools and kindergartens. Purpose: Each school and kindergarten have a plan for how they work with bullying and unwanted behavior. In the first class, a program Zippy friends. In the other classes, "this is my choice" Other First Aid Courses for kindergarten employees and teachers Target group: daycare center Purpose: Maintaining hired competence to be able to provide first aid courses are held approximately every 3 year Sea safety in NJB kindergarten in collaboration with rescue company Target group: The oldest children (king crabs) and staff Purpose: To increase the security and mastering the use of boats and the sea area. Increase employee competence regarding maritime safety and communicating this to the kids. Priority in the spring time each year.

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Area 4 Safe elderly

Anchoring Action Plan for Public Health / Safe Communities Sandetun Goal: Prevent injuries and accidents among older Audience: persons over 67 years

Partners All municipal sectors Prevention team, Sandetun.Small job-center and volunteer center


Preventive home visits Target group: older than 75 years The measure is incorporated into the daily rutines and no longer a project. Checklists for the security to be reviewed during home visits and information given out. Help to set up shower grips, smoke alarms etc. In 2009, all persons over 75 years who wanted the home visit. In 2010, we made 92 home visits to people plus 75. It is put into action contact with the physiotherapist for assessment of needs. The reason for few measures in 2010 is that there have only been 2. or 3 visist. The main impression is that most of the persons visited are very happy to have visitors and they think it's safe to have a contact person in the district. After 3 years, the project are under review and changes will be made. This is because we see that many people between 75 and 80 years is in good health and doing fine. They have no need for yearly visits. The change will be made so that 75 year olds are invited to an information meeting to discuss the need for a home visit. First home visit will be at 78 years, and then annually after age 80 Those between 75 and 78 who want individual visits can contact us to get a home visits. Small job central The volunteer center has a partnership agreement with Unique - a group at high school. Students run a pupil enterprises which they call "small job central". This center is offered to residents in Sande municipality that does not have the ability / opportunity to do these tasks themself, or who do not have a network that can assist them. This way young people learn how to meet people who have needs. They offer help to practical tasks like shoveling, mowing, carrying wood, besøksvenn / companion, some maintenance work and repairs. The Volunteer Center had 32 missions given to the small job center. Drop in Target group: For people past 67 Objective: Provision of training to maintain and increase level of function Training 2 times a week with equipment and guidance. Transport service for those in need. The offer is very popular. Balance Training Target group: elderly people who have suffered a fall and reported to the council physiotherapy services by GPs. Goal: Improve balance and physical fitness Downtown Trail Target group: All Purpose: Preparation for simple exercise and training. Special benches / gyms are set up in the city so that people of all ages, including older people and those with disabilities, can use them for training and have the opportunity for tours including resting. It is t a collaboration with NGOs for the training groups who use the trail. Sandetun activity center

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Target group: All interested seniors in the community. Purpose: The activity center has facilities in connection with the nursing home. It hosts various activities for the elderly in the community. Sand Bucket Project: Target group: Anyone over 67 years and other interested Purpose: Preventing falls in the elderly by offering a bucket of sand in winter. The bucket is filled when needed. In 2009/10 it was awarded 50 sand buckets and in 2010/2011 200.. People who want this offer, but do not automatically get it, can call Sande volunteer center. “Fancy Life” (Lyst på livet): Target group: Seniors in Sande Purpose: Promote seniors to take care of their own health and quality of life by influencing habits and patterns in everyday life. The initiative began in autumn 2012. Senior Dance: Target group: People over 55 years Purpose: The group has 55 members and meets once a week to dance at the municipal hall. The purpose is to keep physically fit and socialize with others with the same interests. Senior center: Target group : all seniors in the municipal. Purpose: Initivate different kinds of activities for seniors. Sosial gatherings eith conserts, dinnergatherings, focus themes on matters like safety at home, fire prevention and safe driving.

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Area 5 Safe work

Anchoring Plan for Safety (HMS) Action Plan for Public Health / Safe Communities Goal: Reduce occupational injuries

Partners All municipal sectors


The municipality's priority in this area is concentrated on the village's workplace including 700 employees. Most injuries reported has been reported from the workplace Sande Municipality. In addition, the municipality has made an effort to identify and prevent injuries in agriculture. Sande municipality workplace Injuries / accidents staff involved in the work reported on a form included in the quality system EQS. The employee fills out the form with his manager and local safety representative. The forms which are reported all claims notifications (own cause with a copy of the damage messages in all meetings of AMU). This also applies to "events" that do not necessarily have caused damage, but that the employee may have experienced as uncomfortable / threatening / etc. Most of the "incidents" are related to employees subject to bad behavior from students, patients, clients, etc. (including verbal abuse, pushing, pulling, etc.) There are relatively few injuries leading to medical treatment and / or sick leave . Without having gone through all the damage reports in recent years, I would assume that we get about 5 claims notifications, perhaps up to 10 each year, where the employee reports that he had to seek medical treatment and / or had shorter or longer sickleave. There are normally only a few reports to the insurance company, when the damage can lead to compensation. Most reports are related to "events" to working with students, patients, clients, etc. In the case of sickleave, it is primarily musculoskeletal disorders and light mental disorders. Safety is an important part for the leaders in Sande municipality. It is general guidelines for HMS. Goal: "Sande municipality will focus on health, safety and work to increase productivity and service in the community by: • Increase presence • Reduce absenteeism • Reduce the number of injuries • Reduce the number of accidents • Facilitate job satisfaction • Facilitate that the municipality's vision and values are present. The municipality has a Working Environment Groups, rehabilitation committee and at Sandetun we also have a local presence commity. All safety representatives, members of the AMU, magistrat management team and business leaders must have the necessary training in first aid. Our occupational health service, Rubicon BHT, organizing at least every other year 5 day course in first aid and a more condensed course for managers It's a trend that employees to a larger extent are exposure to disruptive behavior by students, patients etc. This gives strains that can lead to health problems. Otherwise minor mental disorders increasing somewhat. The "Pregnant and Job" is now implemented in the daily operations and a midwife takes care of this. The project has been aiming to facilitate the work day and work for the pregnant women to reduce stress and injury in the prenatal period.

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Arrangements in the municipality: • road safety courses for employees who use vehicles in municipal work, • regular 2-hour first aid course for all staff (available approx. every 3 years), all jobs are offered locally first aid courses run by occupational health personnel. • different activities run by occupational health to reduce injuries and accidents. Prevention in agriculture Purpose: Create agriculture-related injuries in order to focus on safety promotion and injury prevention efforts in the community. Target group: Persons engaged in agriculture. A survey was sent out in spring 2011 to 120 farms in Sande receiving subsidy, we got back 73 forms. It is a response rate of approximately 60%. There were seven reported injuries, five of the farmer and two of the staff. In six of these cases, a physician was contacted. This means that approximately 7% of the farmers in Sande has been injured in the past year (9% in N-Trøndelag reported injuries, of which about 60% were medical treatment). Other interesting information is that 45 people, more than 50%, report that they have completed safety courses. 22 people claim to be members of an HMS-system. The survey confirms that the farming industry has a high risk of injury and that there is an underreporting in public records. Looking at injuries per 1000 employed in the country (figures from 2008 ref. Nationen Newspaper) it was reported 5 injuries in agriculture, 14 in construction and 17 in industry. Study in Nord Trøndelag suggests that it is as much as 112 per 1000 employed injured in connection with agriculture work. We will have on the injuries that occurs in the agricultural industry. The goal now is to start a program. Fire Prevention and HMS on the farm is relevant topics. In the autumn of 2012 we ran a specialized course in Sande in connection with the nationwide campaign "Safety and health in agriculture". Focus is: - Safe use of tractors - Safer handling of large animals - Fire and handling fires - Reduction of dust exposure in the work environment - Reduction of fall hazards - Safety in the woods The challenge ahead is to use the survey results to make targeted measures and to develop evaluation systems that provide data to measure whether efforts affects the incidence rate.

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Area 6 Violence prevention

Anchoring The municipal plan Action Plan for Public Health / Safe Communities Objective: Preventive efforts to avoid negative development of substance abuse and crime among children and adolescents.

Partners All municipal sectors police Sports Council


All types of crime, including violent related injuries have shown a reduction in the municipality. The exception is a murder in 2011, where a person was found dead in a car at a rest stop along the highway that runs through the municipality. In connection with the strategic area of about adolescence (God oppvekst), the municipality has chosen to initiate SLT (Coordination Model for local preventive measures against drugs and crime) with priority adolescents aged 13 to 18 years. Work began in February 2011. Crime statistics for Sande 1999 - 2011

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Forb. 457 362 362 421 387 341 356 327 331 429 305 263 261 Fors. 352 277 271 314 204 95 130 156 175 192 195 211 148 Totalt 809 639 633 735 591 436 486 483 506 621 500 474 409 Nark. 68 28 49 93 50 20 38 54 35 28 58 59 27 Oppkl. 47 42 47 37 42 36 30 43 31 39 38 45 32 Gr.tyv. 34 37 84 95 80 70 84 74 62 111 53 48 47 Pers.sk 5 6 3 7 13 11 3 2 0 Mat.sk 4 3 6 8 6 10 3 9 4 Voldssk.

25 15 10 8 11

Drap 0 0 0 0 1 Tall/statistikk for Sande lmk. Forb.= Crimes. Fors. = minor crimes. Nark. = Narkotics Oppkl. = solved cases. Gr.tyv. = Serious thefts Pers.sk. = Traffic accidents including injuries. Mat.sk. = Traffic accidents including damage In Sande has occurrences of nearly all types of crime declined in recent years. There has also been a decline from 2011 to 2012 in all areas except recorded drug cases increased slightly when the police had a special initiative in this area in 2012. Voldssk. Reported injuries §§228 og 229. The municipality has two priority areas to prevent substance abuse and crime. It's MOT and SLT work. MOT - booted 2010 Target group: Students in secondary school (13-16 years) and the sports council. Sande municipality is a local community with MOT. MOT's vision is: "Warmer and safer childhood

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environment» Goals: Raise awareness among young people to make choices that make them cope with their life. Strengthen youth courage to take care of themselves and each other. Work attitudes, focusing on values, choices and faith in their own abilities. Basic values in MOT is: Courage to say no Courage to live MOT to care The goal of this initiative is to foster robust youth and youth safe. MOT has a comprehensive model for how communities can work together with youth. The overall model consists of the program in middle school, high school and youth recreational arena. Through the young to young-contact, exercises, stories, dialog games help young people to make their own choices, take care of each other and show courage. MOT was started by Norwegian athletes in 1997. Initiators were skaters Atle Vårvik and Johann Olav Koss. Sande started this work in 2010. The mayor and city manager have been key initiators of the work. (reference to the evaluation of the work of MOT http://www.mot.no/?side=11367 . At Sande secondary school has the following activities have been a part of the program in 2011/2012: Support to people in the community affected by the terrorist attack on July 22 MOT and joy days MOT concerts Marking the World Day of Mental Health Day. Otherwise, participation in other events in the community. SLT (Coordinated local substance abuse and crime prevention) starting March 2012 Target group: Youth 13-18 years Objective: The municipality of children and young people get the right help at the right time, a support system that works well across departments and disciplines. SLT model to ensure cooperation between the police and local authorities in the area of substance abuse and crime prevention. SLT is mainly aimed at children and young people and their parents and guardians. SLT model was introduced in Norway KRÅD early 1990's, based on the Danish SSP model. Sande municipality began its work in February 2012. There are police advised that serves as the Council's steering committee. Sande chose to prioritize group 13 to 18 years who are pupils at the secondary school. The work began with a survey among municipal enterprises to produce risk scenario. None of the enterprises report any particular trends or problem areas in the community that stands out.

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Area 7 Suicide prevention

Anchoring Plan for health and school health service Goal: • Provide a specific offer to all students in elementary and middle school with a focus on health • Provide facilities for pupils in secondary education with special emphasis on preventing lifestyle diseases, substance abuse and psychosocial problems • Increase understanding and openness about mental health for all groups.

Partners Education sector and health sector. In connection with World Mental Health Day two celebrations is a collaboration with volunteer center, Mental health, women's group and as well as local professional authorities.


Paramount on suicide in Norway: Every year an average of 530 suicides in Norway. Around 150 women and 400 men take their lives each year. It is common to assume that it is 10 times more suicide attempts than suicides.Referanse : Nasjonalt folkehelseinstitutt. Helsetilstanden i Norge: Selvmord og selvmordsforsøk. Elektronisk publisering http://www.fhi.no/faktaark. Sist oppdatert 05.12.2012.

Figure: Number of suicides per 100 000 men (blue) and females (red) in different age groups. The figures are an average for the period 2007-2011. Diagram: Division of Mental Health, Public Health. Source: National Cause of Death Register. Around 60 percent of all suicides occur in the age groups under 50 years, and therefore causes suicide numerous loss of life years in the population. Suicide among children under age 15 is extremely rare. Suicide risk is relatively constant from 15 to around 60 years (Figure 1) and men have about 2-3 times greater risk during this period. In the older age groups, we see two different trends: the risk decreases in women but grows in men and in the oldest age group, men have five times higher risk. The most common method of suicide is hanging, followed by poisoning, shooting and drowning. Total,

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these methods are used in 85 percent of all suicides in Norway. There has been an increase in the number of people who used hanging as a method compared to shooting and poisoning. The municipality has not obtained official statistics to document the number of suicides at the municipal level. One of the reasons is that the municipality has few inhabitants that does not secure anonymity. The national register for “causes of death” operates with numbers in Norway and counties. Vestfold county is above the national average of registered suicide. The municipal health services in Sande do have knowledge about suicide incidents in the community, though it is not official verified. The municipality will participate in a larger study of adolescents' Ungdata, May 2013 "organized by the county and through this we can also get more detailed information related to youth psychosocial factors. Sande municipality does not have suicide prevention as an assigned target area, but suicide prevention is incorporated in work with a focus on good psychosocial preventive interventions for children and youth, and other groups in the population. Several measures are intended to increase coping and strengthen the individual's mental health, included facilitating arenas and stimulating the ability to talk about personal challenges. The municipality's priority 'Good Childhood' main goal is to implement the appropriate measures as early as possible for vulnerable children. The municipal have prioritized to have public health nurse available for consultation for the pupils in every school. There is also a public health center for youths. The municipal have a special team of professionals and a plan for handling crisis and catastrophes. Other measures that may have an impact on youth self-esteem and coping: Zippy's Friends program and "this is my choice" Target Group: All children in 1st class participates in Zippy's Friends and the other classes in "this is my choice" Objective: to get children to identify and talk about feelings, mastering everyday challenges and to support others who are less fortunate. Group conversations with the nurse Target group: Children in elementary school who live in two homes. Purpose: Children in this situation (experience separation) the opportunity to talk about their own feel and to meet others in the same situation. "Young girls" Method: Group conversations with young girls in secondary school. Purpose: Focus on preventing abortions, coping with life and their own limits. “MOT” http://www.mot.no (see section 6) Target group: pupils at secondary school Purpose. Attitudes and promotional work in secondary school. Secondary school have measured increased satisfaction after the introduction in 2009. The MOT school means they have a special focus on attitude, discipline or to create robust youth and youth safe. Motto: The courage to live, courage to care, courage to say no. “World Mental Health Day” at the high school and junior high Target group: Students and teachers at the high school and Sande Sande ungdumsskole. Purpose: Focus on youth mental health

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High school has recently marked World Mental Health Day with a special event that focuses on mental health. In this connection the students made essays, lyrics and revue focusing issues that affect mental health. It is a common breakfast for school pupils and a joint event with a special theme focus in mental health. Secondary school also decided to make a mark of this day. “world mental –day”for all citizens On World Mental health day 20.10. 2011 organizes the municipality in cooperation with volunteers organisajoner an open meeting on mental health. If the event is successful it will be repeated annually. Audience: All residents and NGOs. Purpose: More openness about mental health Courses in "psychological first aid" KFB (Women's Voluntary Defence) part of the Society of Rural Women who have taken the initiative to offer courses. Cooperation with the municipality and other volunteers. Participants: Interested persons in Sande. The course was conducted in autumn 2012 with about 10 participants Purpose: Courses offered to interested persons in the municipal whith an interest in of "Mental First Aid" – Aim in the course is to learn about how to meet people in crisis, what to do and who to contact. "Meeting Place" Target group: everybody who are struggling in life. Purpose: To be a meeting place where people that does not have a regular job or place to go to or are in a difficult situation can meet for various activities. Offer is governed by cultural sector and is working closely with the volunteer center and the Department of Mental Health. The offers are developed based on needs and interest. “Fancy Life” (Lyst på livet) Target group: Elderly people (65+) Purpose: Focus on different matters in old age such as safety at home, healthy eating, physical training and being together with other people in same situation. Preventing lonliness. Area 8 Disaster pre-pardednes and response

Anchoring: National legislation, municipal master plan Goal: Sande municipality will maintain and develop effective and innovative solutions for municipal infrastructure, emergency response and public safety.

Partners: Intermunicipal Cooperation with neighboring municipalities, all municipal enterprises, emergency council, NGOs


The municipality is working actively with the emergency preparedness. The municipality is associated with inter-municipal cooperation in Vestfold about emergency planning. It is held regular exercises , arranged by county. In relation to "Acute pollution" there is a local inter-municipal cooperation with Buskerud county. The municipal have a “Kriseteam” – a team of professionals which is contacted in case of crisis and catastrophes. The municipality's emergency plan was revised last time in 2009 and will be revised again in 2013. It is

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prepared risk assessments for events of all types of businesses in the municipality. Loss of electricity for a long time is one of the greatest risks. It is according to the national Planning and Building Act, compulsory to perform a risk analysis of the municipal development plan. Area 9 Safe public places

Anchoring The municipal plan Traffic Safety Plan, police

Partners Engineering sector Police, private sector


Sande municipality have a village center where many people can gather. The municipality has procedures for gritting and snow clearing of their own areas. The municipality has maintenance responsibility for other public areas along the seaside. In municipal police regulations it is clear what responsibility the individual landlord or parties have for their properties. See also section B12 http://www.lovdata.no/cgi-wift/ldles?doc=/lf/lf/lf-19970120-0049.html Area 10 Safe hospitals Anchoring

not relevant Partners


Sande municipality has no hospitals. Population uses the hospitals in Tønsberg and Drammen. The municipality has not targeted work towards these institutions in relation to this subject. Area 11 Safe sports

Anchoring Goal: Future priority

Partners All municipal sectors Police


The municipality, in cooperation with the sports council urged all clubs to report the injuries through their annual reports to the sports council. This has not been successful and Sande have to find other ways to map injury situation in the local sports associations. This should be a future priority. Area 12 Safe water

Anchoring The municipal plan Action Plan for Public Health / Safe Communities Objective: To increase awareness and knowledge among children and adolescents in related of stay on and by the sea to prevent drowning accidents.

Partners Schools, voluntary center, rescue company, police, fire brigade, Red Cross


Priority so far have been to increase awareness and knowledge among children in the kindergarten located near the sea, and adolescents in 7.th grade, of how to behave in a boat at sea and at the seashore, to prevent drowning accidents . For the two objects described here use of alcohol related to sea activities has not been priorities. (see also pkt. 3.2 and 4.1) Safety at sea in NJB kindergarten Measure Group: The oldest children and staff of the department Crab 2011: 24 children and 5 adults. 2012: 28 children and 5/6 adults. Purpose: To increase the safety and security when children and adults are traveling on and near the water. Background of the project: Kindergarten is close to Northern Jarlsberg brew. The building has round windows providing a maritime expression. Staff

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worked fall of 2008 to create kindergarten profile and identity as a maritime KINDERGARTEN. Departments, children's groups and some rooms have maritime name and logo of the nursery is a ship. The logo used as tools in personnel work. The kindergarten opened in December 2008 and in April 2009 the all staff CPR courses, and renewed the samples in 2010. This gave impetus to the work of maritime safety and awareness in kindergarten. We bought life jackets for children and adults in 2009. Procedures for activities at sea are continuously developed. In 2010 we were fortunate that the public health coordinator and nursery RMO tip about Marius, a former employee of the rescue company. He could help us with maritime safety. We made a plan with him and three employees were given additional training. Roklubben had its first year in 2011. The club is in 3 weeks in May / June and the oldest king crabs participating. Implementation: First, we prepared one rowing club with their children. Now we have bought the rescue educational programs for use in 2013. Rowing club borrow three dinghies from the rescue company. In the fall, we also got a boat with a small motor. There's room for four children and two adults. The staff adapt the rowing club to the group of children and give children new challenges. The goal is that all 5 year olds mastered rowing boat, and those who want may try alone. The rowing club takes place in the harbor v / Northern Jarlsberg port. Target: Summer last day for King crabs are held every year in June after ending a trip to Kommersøya . Then the children and staff made a show for members of rowing club etc. Parents appreciate the rowing club and parents' requests rowing club. This helps to draw new clients to the nursery, creating a good reputation of the nursery. The children and staff are satisfied with the days of rowing club. This is great! Staff have been reporting that this is the best days at work. Success Factors: The staff are safe at sea and transfer this to the kids. The kids will love and sees the value in mastering a rowboat. The children obtain knowledge about the sea and what it takes to be safe / take care of themselves and others. Preventive sea race ( Action day arranged by the sea rescue service and police, first aid, sea rescue, fire brigade ) (http://www.redningsselskapet.no/ung/forsiden/artikler-h%C3%B8yre/p%C3%A5-sj%C3%B8sikkerhetsseilas) Target group: all 7 graders in the municipality (about 100 pupils) each year. Purpose: Through a full-day program annually increasing their knowledge and understanding of how they behave close to the sea and using small boats, as well as first aid and fire prevention in the boat. Area 13 Safe schools

Anchoring The municipal plan Growing Up Plan Objective: Give students the knowledge and confidence to handle their own security.

Partners School and various other bodies as the fire department, air ambulance


Injury surveillance at Haga school Audience: students at Haga school Purpose: Systematic recording of all injuries and accidents involving students. Long term it is envisaged that all schools should use the same form. Road Safety Patrol at Haga school Some students will be responsible for road safety around the school at the beginning and end of the school day. Mini-Anne - cooperation with the air ambulance Audience: students in 7th grade Purpose: First aid training. BIR (Children in families with substance abuse) human resource development program for employees Objective: refurbishing those working with children and young people to early detection of children living in families with substance abuse and or mental health issues, in order to detect this early and to take action. Target group: Employees of schools and kindergartens. Strategic plan against bullying. Target group: schools and kindergartens. Purpose: Each school and kindergarten have a plan for how they work with bullying and unwanted behavior. Schools using the program "this is my choice" and Zippy's Friends http://www.determittvalg.no/

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http://www.psykiskhelseiskolen.no/default2.asp?id=143 Fire Safety Working in partnership with Drammen Fire Brigade. Target group: children in primary school Objective: The children gain knowledge of fire and fire prevention. Traffic safety week in collaboration with Safe Traffic Target group: children in primary school Purpose: Give kids knowledge of proper behavior in traffic and raise awareness about road safety. Speak out Traffic Safety campaign in secondary schools. The campaign is specially aimed to urge girls to tell their opinion when they see or hear of friends conducting hazardous behavior, like speeding, drinking or not using seatbelts in traffic.

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2.2 Describe the work with genders, all ages and all environments and situations.

Describe all activities like falls prevention and how the work is done.


As described earlier in the document, the municipality has tried to achieve a sustainable structure of its health promotion and prevention using the community plan as a tool. The accident and injury prevention is a part of public health initiatives and priorities and targets set in the context of the municipality's total preventive efforts. We include a selection of the public health action plan 2013 showing initiatives in the field of injury and accident prevention for safe local community principle. There will be measures described in the TL document that are not described under this heading, but under the psychosocial environment.i Measures and activities Status 2012 Operational Programme

2013 Administrators / partners

Prevention of fall injuries outdoor.

Sprinkle Buckets are awarded to individuals over 75 years, for the season 2012/13. citizents are offered help through small job center. Sand Gritting of sidewalks, bike and walking paths, outside public buildings that have large crowds

Continuation for winter 2013/14 with a possible extension of the number of buckets to be distributed. Regular help for citizense to walk safely

A: FS and FK P: The small job center A: Housekeeper

Fall Prevention Balance Group in 2012 Continuating in 2013

A: VF P: home care, primary care physicians, physical / ergonomics

Preventive home visits. Preventive home visits conducted for people over 78 years, where they get some information from the municipality and a checklist of what can prevent injuries and falls in the home is reviewed.

The project which began in 2008 has continued.

The project is included in regular operation and the measure is developed after experiences. Exposed - continues in 2014.

A: Section Sandetun

Traffic Safety Work Reflexes to all who were vaccinated in 2012; 2nd grade - girls and boys 6th grade - girls and boys 7th grade - girls 9th grade - girls and boys Reflexes and education about traffic safety at Adult Education

Focus continued through rotation of road safety community plan spring 2013 To be continued in 2013 To be continued for new students at the Adult

A: VF P: Public health nurse Service, Adult Education, Road Safety

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Fall 2012. Received educational programs and reflexes from the Road Safety

Education

Making school route safer. School Patrol makes everyone feel safer on the way to school

With a focus on safety Haga school started "school patrol project" after fall break 2012 16 students distributed on all three 7th grade at the school take part in school patrol

To be continued in 2013 A: The head teacher P: FAU, pupils

"Speak up" - campaign Traffic Safety Campaign for VG2 - students, Sande high school

Campaign in October 2012; make young people to put boundaries and speak up in situations they feel unsafe in traffic, and the risks they expose themselves and others by bad behavior in traffic.

To be continued in 2013 A:VGS S: Norwegian Public Roads Administration, pupils

Prevention of injuries in agriculture sector.

Theme Evening held and survey conducted in 2011 .. Theme evenings focusing on fire prevention and extinguishing equipment in 2012 is postponed.

Summer 2013 - theme meeting on fire prevention and fire extinguishers

A: FK and agricultural Chief P: Farmers' Association, Society of female farmers, agriculture HMS

Safety at sea The focus on safety at sea consisted of two parts. 1) This work has been aimed at the largest nursery in the municipality 2) The campaign "Safe on the sea"

The staff has been trained by Rescue Company, the oldest children (king crab) had training in maritime safety and training in the use of boats and rowing a boat borrowed from the rescue company. The project has given children and staff increased focus on safety near and on the water and is perceived as very positive. . Buy of boats. Safety at sea Course for 7th grade pupils June 2012, 100 students participated. The northern pier Jarlsberg students went through a lot of marine traffic activities; extinguish with dry chemical, maritime knots, row education, throwing buoy and first aid.

Kindergarten advance the efforts and cooperation with rescue company. Swimming lessons for children and young

A: FK, Childhood sector P: Sea safety Company, Police, Red Cross NJB kindergartens, schools, physical education, FS

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Section E Indicator 3 3.1 Identify all high risk groups and describe what is being done to increase their safety. Groups at risk are often: Indigenous people Low-income groups Minority groups within the community, including workplaces Those at risk for intentional injuries, including victims of crime and self-harm Abused women, men and children People with mental illness, developmental delays or other disabilities People participating in unsafe sports and recreation settings Homeless People at risk for injuries from natural disasters People living or working near high- risk environments (for example, a particular road or intersection, a water hazard etc. People at risk due to religion, ethnicity or sexual preferences


The municipality tries to work broadly in the injury and accident prevention. As it has come forward earlier municipality has not any problem areas that are particularly striking. For example, the municipality has no registered homeless people. There are about 10 refugees who come every year to Sande, these seem to be integrated smoothly, most go on to education or employment after introduction program. We have chosen to describe two areas in this section. Both are preventive measures. 1. "BIR" Children who live in families with substance abbuse. The measure is part of the priority area 'Good Childhood' 2. UNIQUE (youth competance building). 1.) Children who grow up in homes with substance abuse problems are at higher risk than other children to develop mental and physical ailments. Through "Children -early intervention" we want to focus on how important it is that children receive early intervention to prevent reduse damage. Target group: Employees in kindergartens, primary schools, health clinics, PP - service and child protection. Goal: Increase the competence of early identification and early intervention among employees who come into contact with vulnerable children and young people. Instruction and guidance: Council's staff have participated in the training program "Children -early intervention" by Borgestadklinikken Centre for intoxication. This has given a competence of staff through education and counseling. 2) history: UNIQUE (Youth Competence) was started on the initiative of Sande High School in 2008. Given that more students did not complete his secondary school education we identified a need for an alternative training adapted to this group of peers. Evaluation after starting highlighted the need to develop

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cooperation about the switch between school and Sande Sande High School and from 2010 has Sande School participated in the project by providing tenth graders offers of school place by UNIQUE. Description of the measure: UNIQUE is a measure to reduce dropout in high school. Through practical organization of education offered students a variety of training programs based on building social skills and improve their academic skills. The initiative is anchored by a partnership between the Sande school and Sande high school, where students from respectively 10 steps and VG1, given the opportunity for education places by UNIQUE. The measure has its own premises in the center of Sande. It has proven useful to facilitate a learning environment outside the school district, where students develop a sense of belonging to the school situation and the student group as a whole to new premises. For the school year 2012/13 has six tenth graders, one student is a resident of Holmestrand municipality and 6 pupils VG1 and VG2 two students places at UNIQUE. Personal Group consists of a chairman, a youth supervisor (Child Care), a teacher. These full-time employee by Unique, while in addition a 50% teaching post related to vocational subjects was added aas well as a 50% assistant. Target Group • Young people who are uncertain of their career and study choices • Young people who are in need of a practical educational opportunities • Young people who are in need of stabilization with close monitoring and supervision Goal: • Social skills • Accountability • Improve pupils' basic skills • Clarify students' future vocational or educational choices • Stabilization of attendance and participation in work practices Method and success factors: • Positive reinforcement, relationship building • Involvement • Conveniently accessible educational opportunities • Individual learning objectives related to social competence • Placement of business, practical experience through their own youth • Individual supervision and guidance • Parental Guidance A three-part curriculum: • Teaching with a focus on practical arrangements o Practical adapted curriculum o Basic skills in focus o Reading o Writing o Calculation o IOP and individual competence goals o Grades in all subjects for 10.klassingene • Placement of business o Safe pupil educational / vocational o Testing of skills and interests

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• The graduate o Experiencing mastery and meaningful training o Be familiar with and benefit the local community Social competence All students have their own individual education plans related to social competence, focusing on topics: • Cooperation • Assertiveness • Self-Control • Empathy • Accountability 3.2 Give examples of high risk environments Describe how risk environments in the community are identified Describe prioritized groups and/or environments Are there specific programs for their safety in the community Describe the timetable of the work Are these groups involved in the prevention aspect of these programs?


Areas municipality has identified a higher risk than others through the work of the Action Plan is the sea, agriculture, falls among the elderly and road traffic. Politicians and organizations have been involved throughout the process towards the decision. Many voluntary organizations are involved in the implementation of efforts. • Sea Background The municipality has Vestfolds longest coastline and drownings are a national problem even though in Sande municipality in the past two years have not been drowning accidents resulting in death . We consider it a risk that injuries and accidents related to boating and swimming along the coast and at sea can occur. Fatal accidents at sea most commonly affect boys over 15 years and men in boat. It is their behavior at sea not using personal floating devises leads to drowning. 27% of the deaths due to drowning are related to use of alcohol. The municipality wants to give priority to educational work among groups of children (in kindergarten) and students in 7th grade for the time beeing. Further on other target groups will be involved. The time aspect Kindergarten started their project in 2011, the work will be incorporated into the daily operation. Safety at sea Training 7 grade began in spring 2011 and is part of the rescue company safety at sea sailing implemented annually. Desired monitoring are: Proceed with safety at sea as annually event for pupils at the primary school. A possible further development could be to collaborate with the local boat club on activities associated with security at sea. Continuing with the focus on maritime safety at NJB kindergarten and including several more kindergartens.

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Both national statistics and feedback from NGO`s and citizens point at targeting on use of alcohol connected to recreational use of boats. This will be a target in the future work with the local marinas and boat- clubs and also for the crime preventing work in secondary school. The program On and Off” will be considered. (http://avogtil.no/sone/pa-sjoen/). OFF-AND-ON aims to help reduce the negative consequences of alcohol use in the community and make life safer for all • Agricultural Background Sande municipality is an agricultural municipality with 120 farms that receive operating subsidies. The agricultural industry is high on the national statistics of fatal accidents. The number of fatalities varies from year to year. 2008 was a "dark year" with 13 fatalities nationwide. It is also assumed that the large underreporting of injuries and accidents in this industry. Agriculture accounts for 2-3% of the total workforce in the country and about 30% of work-related fatalities. (Source Agricultural HMS) was therefore initiated a major research project in Trøndelag to acquire more knowledge. The project was conducted by the occupational medicine department at ST. Olav's Hospital in Trondheim in 2010 - 2011. The findings confirm the suspicion of under-reporting and confirmed the hypothesis that there are more injuries and accidents in agriculture than in other industries. On this basis Sande municipality wanted to test if the situation was similar in our municipality. Periode 2011-2014 The project "Injuryfree-farmer" was started in January 2011. Participants include representatives from Sande bondelag, Sande female farmers, Agricultural Safety, local chief of agricultural and public health (and TL-) coordinator. Work Medical Institute was asked if we could use the same questionnaire as used in Trøndelag to be able to compare data afterwards. Theme meetings on safety in agriculture and the introduction to the survey was conducted in March 2011. The survey was conducted in spring 2011. Conducted HSE courses Sande in fall 2012 Future goals are: Continuation of working group and theme nights / courses with a focus on safety in agriculture. Further actions and initiatives in the area will be addressed in the action plan for public health revised every year.

• Prevention of falls in the elderly Background Elderly people, both living at home and in institutions, are more vulnerable than others to fall. Hip fractures and severe pain for those who are exposed to increased risk of death. Hip fractures constitute a significant social cost estimated at an average cost of 300 0000 respectively. Municipality a project with home visits in people over age 75 in 2009, and by handing out sand buckets to elderly people living at home. The time aspect 2009-20011 for home visits, sand bucket project in 2009 and both will continue. Project with home visits are now gone into daily operation in the municipality. Sand Bucket is a collaborative project with Sande voluntary center, small job center and the municipality.

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Plans: Outcalls scheme included in daily operating, but some changes will be made based on experience. Sand bucket project will continue as long as one gets positive feedback and it is experienced positively by users.

• Road Traffic Background Sande Municipality is located on the eastern and the "route" between southern Norway and Oslo. The municipality has also European Highway E18 road along the bay and is a connection to the Østfold and Sweden. The "old E18" still goes through the village, and has relatively high traffic load. The municipality decided in road safety plan in 2007 a zero vision for the municipality regarding the number of fatalities and serious injuries in traffic. The vision is almost reached, but not quite. The vision is also the desire of local inhabitants to feel confident when they walk in traffic. Many pedestrians experience the way to school as unsafe. The time aspect: Continuous Traffic Safety Plan is being revised 2013. Plans: Continued development plans of the municipality for walking and bike trails.

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Section F Indicator 4 4.1 Describe the evidence-based strategies/programs that have been implemented for different age- groups and environments.


The work in the community is in line with The national strategy for the prevention of accidents and injuries 2009-2014. Work has been initiated on the basis of national statistics and supplemented by local records when possible. The municipality's strategy for health promotion and preventive work is to establish and prioritize efforts through municipal and Action Plan for Public Health and Safe Communities and road safety plan. It referred to the municipal planning strategy, which provides an overview of the municipality's plans and when they are revised. A new law on public health in Norway (01.01.2012) provides that municipal public health shall be designed for a strategy that follows the figure below. Sande municipality has including the goals of public health and Safe community in this plan and the action plan for public health and safe communities.

Description of some of the priority areas and the data base for these efforts. 1) Fall Prevention for people over 65 years living at home. We have reliable national statistics on the matter of hip fractures among elderly people at the NPR register (Norwegian national register and injuries) and there are good evidence based research which support the significant of working with preventive programs for elderly people at risk. These data are used in our work to reduce accidents (http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_providers/documents/publications_promotion/prd_ctrb118334.pdf) Some facts: Every 3. home resident elderly over age 65 and 40-50% of those over 75 years fall at least once annually (Skelton D, Todd c. Interventions to prevent accidential falls among older people. 1-28.2004. School of Nursing, Midwifery and Health Visiting, University of Manchester, Prevention of Falls Network Europe, HEN/WHO Document. http://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf) 10-20% of the falls require treatment in hospital (Pettersen R,: Fall tendency in the elderly. http://tidsskriftet.no/article/504076/ Half of those admitted to hospital after the fall, dying during the first year (Rubenstein l. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing 2006 http://www.ncbi.nlm.nih.gov/pubmed/16926202) There are 9000 hip fractures every year I Norway. The vast majority are due to falls inside the house. Hip

Overwiev

Strategi

measure-ments

Action

Evaluation

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fractures alone was estimated to cost Norway 1.5 billion per year. (Action programme for the prevention and treatment of osteoporosis and osteoporotiske violations, health and Social Affairs http://helsedirektoratet.no/publikasjoner/nasjonal-faglige-retningslinje-for-forebygging-og-behandling-av-osteoporose-og-osteoporotiske-brudd/Publikasjoner/nasjonal-faglige-retningslinje-for-forebygging-og-behandling-av-osteoporose-og-osteoporotiske-brudd.pdf) In NPR (National injury register) it is registered a total of 25 hip fractures in Sande in 2011 and in 2010. Of these 24 people are over 65 years old. Only one person is registered living at the nursing home. For 2012 the number of incidents was approximately the same, but there were more incidents at the nursing home. The Sande municipality has an insidens which is roughly equal to the national average. At the national level most injuries happen at home and not outside during the winter. NPR- 2011 (Norsk Pasientskaderegister ) Sande municipality

Total Number of injuries

Diagnostic Group at nasjonal level Age 65-79 år

Age 80 +

Total number injuries

Other injuries 4 8 75 Facial Fracture 1

6

Fracture pelvis, hip, femoral neck 6 16 25 Fracture leg and foot 5 3 62 Fracture in hand, finger 1 1 32 Fracture in wrist 7 6 47 Fracture clavicle, scapula, upper arm and forearm 6 3 39 Fracture ribs, sternum 1 5 13 Fracture, sprains, whiplash back, neck 1 5 24 Sprains ankle, foot 1

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Sprains hip, knee 1 1 11 Sprains shoulder, arm, hand, finger 1 2 29 Concussion 1 1 17 Surface Damage 11 13 178 Open wounds 2

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Figure 1. Hip fracture in women in different countries, the number per 10 000 observation years (Lofthus 2001)

Figure 1 The risk of hip fracture increases with age in both sexes. In particular, increases the risk sharply after 70 years of age.Figur: Omsland, Folkehelseinstituttet).

(Ref www.fhi.no)

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Total 49 64 619 Based on these evidences we conduct different measures for elderly people. The “drop-in” program is voluntary training in the training room at the nursing home. It is an important low threshold -offer available for everyone. Sand buckets for people living at home are also available for everyone. We have now stated a “balance group”, in which the participants will be carefully selected. A screening using a simple test will be used on the participant to evaluate if he or she should participate in the program, supplemented with some criterias: It must be documented a need for balance requisition training from a doctor. The elderly person is living at home The person had a fall during the past year and/or increased fall risk on the basis of failure related to motor function balances (balance/strength/reduced time function). The person must be able to take advantage of the verbal and visual instruction The person must be motivated for training that could improve balance and function in everyday life, and cooperate with the administrator of the balance group. 2) Prevention of injuries in agriculture aimed at farmers. (mostly adult people between 20 and 67 years) The work is based on national statistics and research report Injury-free farmer. And data from the Agricultural HSE (health and safety) see also the discussion in the boxes D.5 and E 3.2. Agriculture is an industry where accidents often occur. The Labour authority's statistics tell that about a quarter of the fatal accidents in land-based industry occur within agriculture, this despite the fact that it is less than 3% of those employed working within this industry. The registrations of other work-related injuries in the agriculture business are inadequate. In 2008, there were 12 registered work injury deaths in agriculture In 2011 it was 4. The 2008 numbers is equivalent to 21.4 per 100 000 persons employed. In comparison, there were 3.5 deaths per 100 000 in manufacturing and 3.3 in the construction industry. That same year, it reported a total of 337 other work injuries in the fields of agriculture, forestry and aquaculture, this equates to 5 injuries per 1,000 persons employed. Corresponding figures in industry was 17 and in construction 14 work injuries per 1,000 persons employed. This disparity between the number of injuries and deaths gives us grounds to assume that there is a significant under-reporting of work-related injuries within agriculture. http://www.arbeidstilsynet.no/artikkel.html?tid=227601 It has been done very little research in this area. In 2011 The Norwegian institute of work-medicine at the ST. Olav Hospital in Trondheim conducted a survey in Nord- Trøndelag County. These data’s have been used in Sande and we were able to use the same Questionnaire to confirm the situation in our municipal. http://www.arbeidstilsynet.no/artikkel.html?tid=227601 A simular accident profile is confirmed I Sande. A further program of prevention efforts have not yet been rolled out. It will be developed in cooperation with the municipality, farmers' association, Country women’s association and agriculture HMS will continue to prior safety among farmers and agricultural workers . 3) Safety at sea Drowning is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury related deaths. (http://www.who.int/mediacentre/factsheets/fs349/en/index.html)There are an estimated 388 000 annual drowning deaths worldwide. Global estimates may significantly underestimate the actual public health problem related to drowning. Children, males and individuals with increased access to water are most at risk of drowning. Age is one of the major risk factors for drowning. This relationship is often associated with a lapse in supervision. In general, children under 5 years of age have the highest drowning mortality rates worldwide. Canada and New Zealand are the only exceptions, where adult males drown at higher rates.

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Norwegian People’s Aid and the Institute of Public Health present statistics on drownings in Norway. http://www.folkehjelp.no/Presse/Drukningsstatistikk. We also use information and statistics gathered from the Norwegian counsel for drowning. http://www.skafor.org/no/Hoved/Forebygging/Drukningsforebygging/ In Norway, the number of deaths caused by drowning have steadily decreased, but the number is still high compared to Sweden. Sande has had no deaths related to drowning in the last two years. In Vestfold county, there were 8 deaths in 2011 and 1 in 2012. As an average there have been 33 deaths related to use of leisure time boats every year in Norway. A report describing the facts around leisure time boats and accidents were published by the Norwegian maritime authority ( http://www.sjofartsdir.no/PageFiles/12472/rapport_lavopploest.pdf.) This report describe the fact that the accidents are decreasing and the persons involved in accidents are 90% men, 26% have used alcohol and 61% did not use life jackets. In spite of the facts that grownup men are most at risk for drowning, Sande municipal have chosen the oldest children in kindergarten 5-6 years and 7 graders (12-13 year olds) as a target group, focusing on attitudes and skills. In the years to come we will address the adults attitude of “drink and drive” in boats as well as the use of safety equipment. At the national level they are now considering compulsory use of personal floating devices for all in recreational boats 4) Prevention of injuries in traffic The Norwegian road authority (Statens vegvesen) keep a very god record an very accurate statistics of road accidents wich is available for the municipal and they make annual reports. They also conduct researches considering different matters due to traffic and preventive work. (http://www.vegvesen.no/Fag/Fokusomrader/Forskning+og+utvikling)

The reduction in killed and seriously injured in traffic for the new E 18 is 86%. Norwegian Public Roads Administration prepares reports with statistics and maps where injuries and accidents occurred. Latest report concerning injuries in the community from 2008 to 20011. The statistics show a positive trend. The material used by municipal technical agency si based on the traffic safety plan and rotation of the road safety plan. Despite the decline of serious injuries and accidents prevention continue. Si-fra (Speek out) This program is aimed to prevent hazardous driving amongst adolescents and is used at Sande highschool .It has been evaluated by SINTEF . The main result shows that pupils who have attended to the meetings at the school more often share their opinions and attitude towards hazardous driving and drug abuse while driving and the statistics shows positive results. The severe accidents among adolescents have decreased. http://www.sintef.no/upload/Teknologi_og_samfunn/Veg%20og%20samferdsel/Rapporter/A3827_Evaluering%20av%20kampanjen%20Sei%20ifra%20i%20Vestfold%20og%20Aust-%20og%20Vest%20Agder.pdf

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5) Preventing crime and drug abuse For this work there are international, national and local data’s and expertise that can support the local work. International The harmful use of alcohol is a global problem which compromises both individual and social development. It results in 2.5 million deaths each year. Alcohol is the world’s third largest risk factor for premature mortality, disability and loss of health; it is the leading risk factor in the Western Pacific and the Americas and the second largest in Europe. Alcohol is associated with many serious social and developmental issues, including violence, child neglect and abuse, and absenteeism in the workplace. It also causes harm far beyond the physical and psychological health of the drinker. It harms the well-being and health of people around the drinker. An intoxicated person can harm others or put them at risk of traffic accidents or violent behaviour, or negatively affect co-workers, relatives, friends or strangers. Thus, the impact of the harmful use of alcohol reaches deep into society. World Health Organization 2011 has made a global status report on alcohol and health. Norway is described at page 34 . Every country is described in one page. http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsreur.pdf. In this report there are made a figure which shows different countries patterns of drinking. The higher score, the greater the alcohol-attributable burden of disease for the country. In a scale between 1 and 5, Norway scored 3, and this means we do have some work left to do. Norway has a relatively strict alcohol policy so the problem will be mostly related to attitudes and behaviour towards alcohol. National/regional The National research institute for substance use (SIRIUS) publish an annual report on this matter. They have regional units that assist the municipals in education and programs related to the subject. (www.forebygging.no) The white paper NOU 2012 “safe homes” http://www.regjeringen.no/en/dep/jd/dok/nouer/2012/nou-2012-4.html?id=670699 Gives statistics and facts of the situation on fires in homes in Norway. Who are at risk and how to prevent fires. Inappropriate use of alcohol are one of the risks. Local Sande have implemented SLT (http://www.krad.no/slt) as a model for preventing crime – and drug abuse amongst youth. SLT is a coordination model for local preventive measures against drugs and crime, and were scientifically evaluated for the first time in 1995 (NIBR), by Myrer, Strype, Egge and Gundhus (Police Academy 2008) and is also thoroughly tested by 200 Norwegian municipalities. http://www.krad.no/slt/modellen. The model will ensure cooperation with the police and the local authority in the area of substance abuse and crime prevention. The target group for the effort is primarily aimed at children and young people and their parents and relatives. In Sande, we see this work in the context of the efforts described earlier as BIR (Prevention for children in families with substance abuse). Sande have also conducted a quest back survey at the secondary school that gave some data on substance use, these data’s will be underlined in a regional survey called “Ung data” that was conducted in the spring 2013. “MOT” is a program that are used in the secondary school with the purpose to underline the youths self esteme and their attitudes. The evaluation states that “ MOT” have a positive impact on teenagers ' self-esteem, optimism and courage. In terms of the pupils ' perception of school and class environment, well-being and bullying guards against the most negative manifestations in adolescence. There are fewer who thrive badly, and fewer with no friends, fewer who experience the class and school environment as bad, and fewer are being bullied often. When we look at the average development, we find no or little effect on satisfaction of the class and school environment, believe in the ability to resist peer pressure, or conduct such as bullying and alcohol use. “MOT” have had a clear positive impact on smoking. The students of the schools using “MOT”also have an overall positive

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assessment of the MOTs significance. (http://www.proba.no/files/2013/04/Rapport-2011-05-Evaluering-av-MOT-i-ungdomsskolen-Sluttrapport.pdf) Drug abuse amongst adult people have not been a special target for the municipals safe community work yet, but might be a future target as the program “ Sometimes” (av og til) is considered as an extension of the SLT work. 4.2 Has any contacts been established with ASCSCs , WHO CCCSP, other scientific institutions, or knowledgeable organizations about the development and/or implementation of evidence-based strategies? Which ones? What has been the extent of their counsel? Notice! WHO links to evidence- based interventions are found at the end of form B!


No

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Section G Indicator 5

5.1 What local data is used to determine the injury prevention strategies? For example, registering injuries can be done at hospitals, health centers, dentists, schools, care of the elderly organizations and the local police. Household surveys can also be used for collection of data about injuries and risk environments and risk situations. Which methods are used in the community?


In order to get an overview of injury and accident statistics we used mainly figures from national and regional sources. Municipalities are small and the numbers are therefore small. Not all statistics are possible at the municipal level. Sande municipality belong to the Hospital of Buskerud located in Drammen, and is therefore not one of the municipalities in Vestfold who participated in the injury project at Tønsberg hospital. Systematic injury registration does not take place today at the hospital Buskerud where most inhabitants of Sande is treated. Summary of annual physician treated accidental injuries in Norway (ref. nasjonal strategi 2009 -2014)

Workplace accidents 70 000 Traffic accidents 40 000 Home based accidents 150 000 Sports, sports and recreational accidents 80 000 Road, not traffic accidents 50 000 Educational accidents 30 000 Open air, sea, maritime accidents 20 000 Kindergarten, playground accidents 15 000

Municipal Public Health Profiles are a good source to get an overview of the challenges facing the municipality. This will eventually develop and become better in terms of accidents.

We have chosen to perform two local surveys to supplement national data. This was in relation to the

From Public Health Profiles 2011; hospital treated injuries per . 1000 inhabitants. The column on the left is the country and the right column is Sande municipality.

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registration of injuries in the agricultural sector and in relation to secondary school students and injuries. Some other areas are described here where we have obtained local numbers. In fall injuries (fractures), we have data on the Norwegian patient register at the municipal level. Older home residents who fall and are either hospitalized or in need of municipal services are registered within physiotherapist services in the municipality. (See section 4.1) The local surveys among respectively students and farmers are based on other surveys conducted on a larger scale in other municipalities. The questionnaire was sent out to farmers was absolutely identical to the questionnaire used in Northern Norway. In our case there were 120 forms that were sent out and we got in excess of 70 forms back. We mailed out paper forms and processed them manually afterwards because the material was overcoming. With such small amount of material, it was significant that one could compare the results with the wider survey to confirm that it is the same injury picture in our municipality as the larger survey shows. The questbac in High school and secondary school. The questions here were prepared by TL-Coordinator, working with an Advisor from the College of Vestfold, who also prepared the online version adapted to the school's IT -system. 270 of 350 secondary school students responded to the survey. The results of this study have been used in various municipal plans. Substance abuse plan, plan for sports and outdoor activities and action plan for public health. Some of the questions were picked from a survey with a larger scope which have implemented in other municipals. Some questions were also specially-designed to be used in connection with the drafting of local government plan. The Student Council were contacted in advance and some students from both the secondary school and high school reviewed the questions . The survey secondary school was conducted during the ordinary class at the initiative of the class teacher. Response rates were therefore high of about 77%. In high school the survey did not have the same response due to a different conduction and the unfortunate fact that it was the exam period. Some results: 46% of bikers never or almost never wear helmets. 60% of students stated that they had been treated for medical injuries the past two years, 22% are treated 3 or more times. 30% of injuries happened in training and 22% of these were in school. These data are presented through action and handed over to the school management. In 2013, Vestfold county conduct a large study of adolescents who were followed up regularly. This provides an opportunity for long-term follow-up of the start-up work and to make a comparison with the other municipalities in the county. Injury accidents in traffic will be registered by the NPRA . The municipality's technical agency supplement data from NPRA with traffic counts and speed measurements locally as needed. 5.2 Describe how data are presented in order to promote safety and prevent injuries in the community.


It has been organized two seminars with target organizations, politicians, professionals and other interested parties. Also day seminars in relation startup SLT work. The ordinary channels in the municipality like annual and quarterly reports are used to report on public health matters and on the injury and accident preventive work. Public meetings have been used for example in connection with the project "Injury-free farmer."

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Projects with background data are presented. One example is the project Injury-free Farmer where data from Agricultural Safety was presented to professionals, politicians and organizations at a seminar and a theme meeting with farmers and organizations. Each year, injury and prevention is submitted to all political committees and councils, and council. Appropriate statistics are presented. Local newspaper covering current events and activities, so that local people are informed of this in addition to the official plan documents. 5.3 Describe how the community documents and uses knowledge about causes of injuries, groups at risk and risky environments. How does the community document progress over time?


As mentioned earlier the priorities and challenges in public health and injury and accident prevention is presented to politicians in the municipality through the Action Plan for Public Health. Efforts to achieve good systems for analyzing, evaluating measures will continue. In this connection, both the Institute and the Vestfold County Council will contribute. Implementation of a UNG data survey in all Vestfolds municipalities. This should be repeated and should provide good data over years about the living conditions of young people in the community. Sande will also be able to compare with other municipalities in the county. Through the new data will possibly some of the tendencies that appeared in the locally conducted QUESTBACK be verified. An example of the use of data is the "Fall prevention in the elderly": Based on statistics from NPR included in the Action Plan for Public Health 2011. Municipality physiotherapy services in 2012 had a special focus on this issue. Also registered details of the patients with hip fractures and reported to the local health service. From January to November 2012 registered 20 fractures including 5 in institutions. The majority of women and over 80 years. This is consistent with national figures and statistics from NPR. It is in each case registered which medicines people used to see if it can be traced a connection between type of medication use and fall. There is research that supports the benefits of prevention of falls. Ortagomodellen http://clinicaltrials.gov/ct2/show/NCT01313481?term=fallfor&rank=1 . The data is used to start balance groups. From March 2012 there have been 19 participants in this program. In order to get and monitor future developments routines for nursing and physiotherapy are established.

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Section H Indicator 6

6.1 How does your community analyze results from the injury data to track trends and results from the programs? What is working well and has given you good results. What are the plans to continue? What needs to be changed?

Are the methods used sufficient? Yes No If no, What is missing?

Processing of data to determine risk exposure and targets: The rationale for initiating action in priority areas have been national statistics and an assessment of risks municipality basis of location and industry structure. The priorities and work is in line with the regional plan for public health and the partnership agreements are revised annually. In connection with the annual report to the county and to the network of safe communities initiatives are described, the status and how they will be evaluated. Evaluation so far has mainly consisted in counting participants and by the number of sand bins provided. What works well: The municipality has had a major focus on anchoring and systematics of Public Health and safe communities work. In this area, we have achieved a good result and ensure the sustainable development of future work in public health and injury and accident prevention. The municipality experience, we have made a good start in terms of fullfilling expectations in the new Public Health Act. Challenges: We have room for improvement in developing measurable goals and to develop better assessment tools. The youth surveys in connection to the regional registry, we will be able to see developments among middle school students. In connection with the new national legislation, the statistics will be gradually improved so that issues related to accident injuries are available at the municipal level. New legislation in both public health and the Building Code sets goals for municipalities to have an overview of the factors that influence population health. Here Illustrated through a figure by Dahlgren and Withead in 1991

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6.2 Describe how the results from the program evaluations are used


Using the results from analyzes and data As mentioned previously results and priorities in this work is communicated to politicians through annual status reports and an annual action plan. This also requires cooperation between sectors and development potential of individual initiatives are discussed. An example is data collected for hip fracture from the Norwegian Patient Register. As these data were presented to the nursing home, they have developed a system for collecting fractures and they also get more details about patterns. In this way, the balance group was initiated. 6.3 Describe the changes in pattern of injuries, attitudes, behavior and knowledge of the risks for injuries as a result of the programs.


• Fatalities in traffic is reduced by 86% since moving the the E18. • Attitudes about coping in relation to marine traffic and the use of boats increases • Efforts in relation to fall prevention among the elderly has increased knowledge and interest to develop new initiatives. • Young people involved in the sand project is positive to make an effort of importance to seniors. • The MOT-project improve job satisfaction in junior high school

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Section I Indicator 7 7.1 Describe how the community has joined in and collaborates in national and international safe community networks.


The municipality participates in the regional network which meets 4-6 times every year. This is an important arena for the municipalities in the county that are either certified or want to be. Sande has benefited greatly from the network and has collaborated with other municipalities that are in the certification process. The municipality has participated in national and international network meetings. We have presented local cases and experiences to the network: National Network: Injury prevention Forum invite both to network meetings and annual conferences. Sande municipality has recently participated in these conferences: • Tønsberg: National Conference - prevention and Safe Communities Tønsberg 27 - 28 October 2008 (8 participants from Sande) • Voksenåsen: We make Norway safer 17.-18. November 2009, (3 participants from Sande) • Drammen: Cooperation for Security, 11 and 12. October 2010. (1 participant from Sande) International networks: 7.2 Will the designation ceremony coincide with any international conference, seminar or other forms of international or national exchange?


No 7.4 Which international conferences and national Safe Community conferences has the municipality participated in?


Sande has also attended international conferences: • The Second European Regional Safe Community Conference Incorporating the 7th conference for Safe Communities, Reykjavik, Iceland, May 19-20, 2010 (three participants from Sande) 7.5 In which Regional Network for Safe Communities is the community a member or planning to seek membership? (Asian, European, Pan-Pacific, African or Latin-American Regional Network for Safe Communities) We apply for membership in the European Safe community network.


WHO links to evidence- based interventions Referring to the new Indicator 4. Programs that are based on the available evidence: Please see the following publications published by WHO. Violence Prevention Evidence Base and Resources Violence prevention: the evidence http://www.who.int/violence_injury_prevention/violence/4th_milestones_meeting/publications/en/index.html

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Child injury prevention: World report on child injury prevention http://whqlibdoc.who.int/publications/2008/9789241563574_eng.pdf Road traffic injury prevention: World report on road traffic injury prevention http://www.who.int/violence_injury_prevention/publications/road_traffic/world_report/en/index.html Seat-belts and child restraints: a road safety manual for decision-makers and practitioners http://www.who.int/roadsafety/projects/manuals/seatbelt/en/index.html Helmets: a road safety manual for decision-makers and practitioners http://www.who.int/roadsafety/projects/manuals/helmet_manual/en/index.html Drinking and driving – an international good practice manual http://www.who.int/roadsafety/projects/manuals/alcohol/en/index.html Speed management : A road safety manual for decision-makers and practitioners http://www.who.int/roadsafety/projects/manuals/speed_manual/en/index.html

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Documents

SAFE COMMUNITY APPLICATION - .GLOBAL · 2018-01-23 · Sande is the northernmost municipality in Vestfold, bordering Holmestrand, Hof, Re, Svelvik and Drammen municipalities. Approximately