Safe Community Rapla

Name of the Community: Rapla County
Country: Estonia
Number of inhabitants: 37,270 (01.01.2003)
Program started year: (2001) 2002
International Safe Communities Network Membership:
Designation year: 2004
Info address on www for the Program: http://tiit.fr.ee/raplamv/mail.html

The program covers the following target groups and safety promotion activities:

Rapla county started with small-projects, including one or very few interventions and targeting on some population groups (1996 – 2001). Thus, in conclusion, that has been a continual development since 1996 towards the more extensive program.

The three years program (2002-2004) has reached its comprehensiveness and covers both genders and all ages, environments and situations. However, there are always many opportunities to meet new challenges and to assure a better quality.

The target groups will be listed as following:

• kids (0 – 3 years old)
• preschool-age children (4 – 7)
• parents of 0 - 3 and 4 – 7 y.o.´ children
• pupils (in particular, 16 – 18 y.o.)
• pupils´ councils at schools
• kindergarten-teachers
• health education teachers
• elderly people (65 y.o and up)
• municipal social workers
• municipal governers
• the whole population

Associated (target) groups

• family doctors
• workers for welfare centres
• heads for day-care centres
• associations for retired persons
• editors for municipal newspapers
• county-level newspaper "Nädaline"
• sport-clubs

Children

The program mainly focus on children from newborn-age up to 7 years old kids. It was considered that injury prevention for 7-14(15) old pupils is carried out by National Health Program for Children and Youth. However, most probably some revaluations in that respect are needed in very nearest future. Injury prevention at schools is part of health education curriculum and responsibilty of schools´ health care system.

Family doctors and nurses are important in this field. They are the first point of contact when new born children arrive home from the hospital, and the first instance where accident prevention can be taught. Family doctors counsel all parents of up to 1 year old babies. Additionally, a topic-relevant brochure has been handed out. The parents were asked to fulfil a checklist regarding the contents of that brochure, and among those parents a safe-seat of a passanger car has been disposed of by lot.

The similar method was used, as to parents of pre-school age children, and that, in turn, based on good collaboration with kindergartens´ teachers.
Kindergartens mainly focus on safe-traffic-skills and reasonable use of protectice equipment. Interactive traffic-play, performed in all kindergartens highlighted significance of reflectors, helmets and other necessary protective equipment for cycling. Kids must wear helmets when cycle – that is a rule in all municipal kindergartens.
Our traffic-safety specialists are very frequent visitors in kindergartens and in schools.

Another interesting example of injury prevention is seminars for kindergartens´ teachers and practical trainings for kids „Look for Ott!“ (how a child has to behave if he has lost the right way in forest?).
Injury prevention and safety promotion in kindergartens could also be characterised by changes in physical environment.

Youths

As regards the pupils of age 16 -18 and young adults we work in very tight collaboration with drug prevention program both on national and local level. An emphasis has been placed on the relation between youth and alcohol and also alcohol related violence and accidents. In general, the given problem is complicated and challenging but at least schools have made efforts for looking for effective control mechanisms to guarantee alcohol-free events.
Our efforts and interventions have been followed to threatening results about alcohol consumption and abuse based on data of surveys in 2001, 2002, 2003, 2004, carried out among pupils of 10-11, 13-14, 17-18 years old.

Likewise, another critical approach is worth to mention: first medical aid trainings for teachers and gymnasium-pupils has regularly been realised by the specialist of county fire and rescue service.

Adults

The adults population of age 25-65 is involved into program through all situations and enviroments. We counsel parents of kids up to 7 years old. That is targeted on safe home enviroment and leisure time.
Work place as one of most critical settings for grown up people. Work safety is responsibility of institutions, of employers and observed by county level labour inspection and health protection administration.
Road safety programs serve safe traffic conditions both for pedestrians and drivers. Positive changes in local and national alcohol policy should also prevent accidents and injuries – in different settings, environments and situations. For better information and communication we use county and municipal level media.

The Elderly

The elderly has been one of the main target groups of the three-years-program. Municipal social counsellors, social workers and representatives of associations of retired persons are in tight communication with those people. A brochure for that critical target group has been compiled by the country-wide project, and just that brochure is used to inform aged people about injury prevention (incl falls). Another brochure about home-gymnastics for elderly also serves the falls´ prevention.
The home-visiting- social workers should register all possible accident related places and find solutions in order to decrease the risk of accident. The municipal social workers passed a special seminar on risk analysis and injury prevention for aged. The same risk-analysis approach is used in old-peoples homes, and in those more attention and efforts has been given for safer physical environment.
County and municipal newspapers have published articles about injury prevention and safe environment promotion for elderly people.

Home

In fact, home and leisure time injury prevention has been the main objective of the program! All interventions targeted on different poulation groups are very tightly related to that objective. In that respect all associated groups have been involved, i.e. faminly doctors, municipal social workers, local media, sport-clubs etc.

Road-safety

Estonian Road Administration is responsible for road safety as regards national roads. That administration also provides with targeted resources for road safety promotion its local (county level) branches. All other roads are municipal´ concern. Road safety programs target the whole population, an emphasis has been plased on children´ and young adults safety. As quite a many road accidents are due to alcohol consumption, special campaigns for drivers have been initiated.

County level undertakings, e.g. distribution of light reflectors for first graders and elderly people support general programs. With respect to reflectors we have done a good collaboration with „if...“ insurance fund and Estonian Red Cross.

Special topic-specific sticking tape highlights the helmets use by cycling. Those tapes will be given to everyone at cycling tours and competitions, at varios children´ events.
Traffic-bahaviuor is a part of health education in kindergartens and in schools.
Road accidents and injuries are also documented in all details.

Industry

The head of county level labour inspection belongs to intersectoral group since 1998. The work related accidents prevention is systematically coordinated and evaluated by country level institution. Our team is regularly informed about the Rapla county situation. The registration of work related accidents is as precise as possible and each case will be very carefully followed and assessed just by our colleague.

School

Injury prevention at schools is part of health education curriculum and responsibilty of schools´ health care system. School nurses play here an important role.
Likewise, traffic-bahaviuor and safe cycling is a part of health education in schools.

First medical aid trainings for teachers and gymnasium-pupils have been regularly carried out by the specialist of county fire and rescue service.

We do have quite informative data about pupils health behaviour: that is why it is reasonable for different county level programs and projects to work hand in hand, e.g injury prevention with drug prevention program. Schools have made efforts for effective control to guarantee alcohol-free events.
As mentioned above, it was considered that injury prevention for 7-14(15) old pupils is carried out by National Health Program for Children and Youth.

Sports Clubs

Those are defined as associated (coherent) target groups. Sport clubs are facing stricter regulations on safety at their venues. Training methods and protection in sports has also been targeted in order to prevent accidents. There is an ongoing campaign, supported by our program to persuade people to use helmets while cycling or roller-skating.
We work in tight collaboration with local Basketball-club and local Bike-club. We also do have a good contact to local sport and leisure time shops as concerns safe equipment advertising.

Alcohol

Regrettably, Estonian national alcohol policy is very liberal. Quite a many municipals over the whole country have fixed their own rules to decrease access to alcoholic drinks. Rapla county is the first and the only one up to now where almost all municipals have enacted the ban of retail of any kind of alcoholic drinks at night time. Long discussions preceded to that political decision. The surveys, carried out in Rapla county in 2001-2004 among pupils, and health behaviour study among adults helped to understand the necessity of that ban.
Parallel to above mentioned decision all municipals are working on plans for youth to offer them a variety of different alternative activities and to more involve them into community life.

Rapla county example has had an impact to some other Estonian counties supporting relevant discussions and decision-making in local alcohol policy. Among others, we also have influenced the national alcohol policy.

Interventions target high-risk groups and environments and promote safety for vulnerable groups

Considering the program objectives and data of statistics available the high-risk groups and areas were identified as children, young adults, elderly, road-safety, home and leisure time environments.
However, we have given more weight just to target groups while they happen to experience different situations and have to learn to avoid risky-behaviour, e.g children at homes, at school, in traffic, attending the leisure time events, doing a lot of sport.

Violance prevention:

in collaboration with county level alcohol and drugs prevention program and Rapla police.

Suicide prevention:

in collaboration with county level alcohol and drugs prevention program

Surveillance of injuries:

Ministry of Social Affairs of Estonia (nation-wide statistics)
Number per year: 5,401 (2003)
Population base: 37,270
Started year: continuous

There does not exist a common injury registry in Estonia. We use data available from official health care statistics where injuries as diseases are documented, although the causes of injuries could be not clearly appeared. It is to be hoped that national injury registry will fulfil that gap.

We also have used statistics from police and fire and rescue service, from county hospital, from county labour inspection and local traffic safety department.

There could be some additional surveys and studies mentioned what have been in assistance of making conclusions:
Health Behaviour among Rapla County Adult Population, Survey-2002 (Kasmel, A., Lipand, A., Markina, A., 2003)
Social Health Determinants among Rapla County Adult Population, Survey-2003 (Kasmel, A., Lipand, A., Markina, A., 2003)
Survey 2001-2004 among Rapla County pupils regarding alcohol and drugs and using drugs (Rapla County Drugs Prevention Council)

Publications:

Download the application report:

Rapla, Estonia- Application to Become a Member of the Safe Community Network

1. Aastaraamat, 1998 (Annual Report 1998), 1999, Eesti Tervisekasvatuse Keskus (Estonian Centre for Health Promotion and Education – ECHPE), p.52 (in Estonian), Tallinn
2. Annual Reports of Rapla County Program 2002-2004 (not published, available only in Estonian), compiled by Laasner,Ü
3. Laasner, A et al „ Safe County in Estonia – Rapla County“, abstract and paper for 5th Nordic Conference on Safe Communities, 2003, p.30, Helsinki
4. Laasner, A et al „ Rapla County (Estonia) injury prevention project: development of networks“, abstract and paper for 13th International Conference on Safe Communities, in Sustanainability within Safe Communities (ed by Svanström et al), pp.124-125, Prague, 2004
5. Paikkondlik areng: Kuidas alustada vigastuste ennetamise programmi? „Turvaline kodukant“ (Community Development. How to start with „safe community“ program?), compiled by Laasner, A., (ed.by Ernits,T.) 1999, (in Estonian) ECHPE, Tallinn
6. Safety in Modern Society, 2000, Proceedings of the European Conference, pp. 39-43,
Finnish Institute of Occupational Health, Helsinki
7. Tervise edendamine. Aastaraamat 2001 (Health Promotion. Annual Report 2001), 2002, ECHPE, p 80 (in Estonian), Tallinn
8. Tervisedendus Raplamaal (Health Promotion in Rapla county). In Kümme aastat tervisedendust Eestis (Ten years of Health Promotion in Estonia), 2003, ECHPE, p.80 (in Estonian), Tallinn
9. Working Towards the Safe Community in Estonia: Rapla County. In Safe Community
Weekly News, No 33, October, 2003

Produced informatiom material, pamphlets: yes (both county program, and in collaboration with nation-wide project)

Staff

Number: 3 (1 health promotion specialist + 2 project-based persons)
Professions:part-time/ full time: part-time (2 persons)
Temporary: yes (2 - project-based)
Specific intersectoral leadership group: yes (the group of 15 members at the county government).



General public health/ health promotion group: health promotion specialist (1 person) at the county government

International commitments: not yet

Study visits:

1998, April, Rapla county intersectoral group of 11 members visited Finland (seminar in Helsinki, organised by Ministry of Social Affairs and Health of Finland, and site-visit to Äänekoski municipal)
2003, December, a group of 10 members from Finland (Folkhälsan i Nyland) - site-visit for them in Rapla.

Participation in Safe Community conferences:

- The 9th International Conference on Safe Communities „Setting Child Safety Priority within Safe Community Framework“ in Dhaka, Bangladesh, 2000 (A.Laasner)
- The 5th World Conference on Injury Prevention and Control
in New Dehli, India, 2000 (A. Laasner – poster presentation)
- The 5th Nordic Safe Community Conference in Helsinki, Finland, 2003 (Ü.Laasner,
T.Peterson, K.Toomet, A.Laasner, A.Heinvee – oral presentation)
- The 13th International Conference on Safe Communities in Prague, Czech, 2004 (T.Peterson, Ü.Laasner, A.Laasner – oral presentation)

Hosting Safe Community Conferences: not yet

Hosting „Travelling Seminars“: not yet

For further information contact:

Ülle Laasner

E-mail: ylle@raplamv.ee

Aili Laasner

E-mail: aili.laasner@student.uib.no
aililaasner@hot.ee aililaasner@hot.ee
Rapla County Government
Str Tallinn 14
EE-79513 RAPLA
ESTONIA
Phone: +372 51 35 396

Info address on www for the institution: http://tiit.fr.ee/raplamv/mail.html