Unintentional Injury Death Rates in Rural and Urban Areas: United States, 1999–2017

July 16, 2019

Questions for Lead Author Henry Olaisen, EIS Fellow, of “Unintentional Injury Death Rates in Rural and Urban Areas: United States, 1999–2017.”

Q: Can you define what an unintentional injury death is?  Is there a difference in the term accidental death?

HO: Unintentional injury deaths consist of those deaths involving injuries for which there are no evidence of predetermined intent, meaning intention of harm to self or others. In 2017, the leading causes of unintentional deaths in the U.S. were drug overdose, motor vehicle crashes, and falls.

Unintentional injury deaths are a subset of injury deaths, and exclude those that are intentional (e.g. where there is intent to harm) and those where intent is unknown. Among drug overdose deaths, unintentional drug deaths comprise 87% of all deaths due to overdose.


Q: Do you have data that directly corresponds with this report that goes back further than 1999?

HO: We here at the CDC’s National Center for Health Statistics have data dating back to 1959. Given our focus on unintentional injury and the changing patterns of where people live and work in the U.S., we focused on the most recent 18 years, as they are trend patterns that not only tell an important story, but can guide decision-makers and inform new policies to avoid these types of preventable deaths in the near future.


Q: Was there a specific finding in your report that surprised you?

HO: We were surprised that drug overdose death rates are not only growing fastest in the last three years in suburban counties (“large fringe counties”), but that the rate of drug overdose deaths is now (in 2017) highest in small metro and suburban counties(“large fringe counties), and lowest in rural counties.


Q: Why do you think there is a difference in unintentional injury deaths from rural and urban areas?

HO: We observed differences in trends and patterns of unintentional injury deaths using mortality data from the   National Center for Health Statistics. Determining the reasons for the difference is a really important next step, and not something we looked at in this report. We at the National Center for Health Statistics encourage scientists to use these data to help us understand the underlying causes for these observed trends and patterns.


Q: What is the take home message for this report?

HO: Unintentional injury death rates – which are preventable deaths, are on the rise, with a steeper increase since 2014. Between 2014 and 2017, large fringe metro counties had the largest increase in unintentional drug overdose rates; small metro had the largest increase in motor vehicle death rates; and rural counties had the largest increase in death rates due to unintentional falls. While motor vehicle deaths have historically been the leading cause of unintentional deaths for several decades, in 2013 unintentional overdose deaths became the leading cause of unintentional deaths.


2017 Final Deaths, Leading Causes of Death and Life Tables Reports Released

June 24, 2019

NCHS released a report that presents the final 2017 data on U.S. deaths, death rates, life expectancy, infant mortality, and trends, by selected characteristics such as age, sex, Hispanic origin and race, state of residence, and cause of death.

Key Findings:

  • In 2017, a total of 2,813,503 deaths were reported in the United States.
  • The age-adjusted death rate was 731.9 deaths per 100,000 U.S. standard population, an increase of 0.4% from the 2016 rate.
  • Life expectancy at birth was 78.6 years, a decrease of 0.1 year from the 2016 rate.
  • Life expectancy decreased from 2016 to 2017 for non-Hispanic white males (0.1 year) and non-Hispanic black males (0.1), and increased for non-Hispanic black females (0.1).
  • Age-specific death rates increased in 2017 from 2016 for age groups 25–34, 35–44, and 85 and over, and decreased for age groups under 1 and 45–54.
  • The 15 leading causes of death in 2017 remained the same as in 2016 although, two causes exchanged ranks.
  • Chronic liver disease and cirrhosis, the 12th leading cause of death in 2016, became the 11th leading cause of death in 2017, while Septicemia, the 11th leading cause of death in 2016, became the 12th leading cause of death in 2017.
  • The infant mortality rate, 5.79 infant deaths per 1,000 live births in 2017, did not change significantly from the rate of 5.87 in 2016.

NCHS also released the 2017 U.S. Life Tables and Leading Causes of Death Reports.


Updated Provisional Drug Overdose Death Data: 12-Month Ending from November 2017- November 2018

June 12, 2019

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


Drug Overdose Deaths Involving Fentanyl, 2011–2016

March 21, 2019

Questions for Lead Author Merianne Spencer, M.P.H., Health Statistician, of “Drug Overdose Deaths Involving Fentanyl, 2011-2016.”

Q: Why did you decide to do a report specifically on drug overdose deaths involving fentanyl?

MS: Fentanyl, a synthetic opioid, is of interest to public health officials because of its increased involvement in drug overdose deaths and contributing role in the opioid epidemic. Understanding trends in drug overdose deaths involving fentanyl by demographic and regional characteristics can provide insights to better target interventions for populations at risk and to inform agencies working to combat this public health problem.


Q: Do you have any data that is more recent than 2016? 

MS: Mortality data for deaths occurring in 2017 are currently available for research use.  However, these data were not available at the time of the analysis for this study, and the text analyses required for preparing this report are time intensive.


Q: How did drug overdose deaths involving fentanyl vary by age, sex and race?

MS: The rates for drug overdose deaths involving fentanyl varied by age with the largest rates among adults aged 25-34 and 35-44. Exponential increases occurred in all age groups, with the greatest increases per year among adults aged 35-44, 25-34 and 15-24.

The rates for males and females were similar in 2011, 2012 and 2013.  In 2013, the rates for males and females began to diverge such that by 2016, the rate for males (8.6 per 100,000) was roughly 2.8 times the rate for females (3.1).

For race/ethnicity, non-Hispanic whites had higher rates than non-Hispanic blacks and Hispanics for the entire study period.  However, the annual percentage changes were greater among non-Hispanic blacks and Hispanics.


Q: Was there a specific finding in your report that surprised you?

MS: I was surprised to see how high the average annual percentage change in rates was for teenagers and young adults aged 15-24. While the death rate for this age group was not as high as the rates for persons aged 25-34 and 35-44, the average annual percentage increase in the rate was among the greatest, increasing an average of almost 94% each year from 2011 through 2016.


Q: What is the take home message for this report?

MS: The rise in drug overdose deaths involving fentanyl was noticeable in certain subpopulations and regions.  Overall, death rates, which were stable in 2011 and 2012, significantly increased from 2013 through 2016.

Death rates for males and females were similar in 2011 and 2012, but then diverged, with rates for males increasing faster than the rate for females starting in 2013. Non-Hispanic whites had the highest death rates; however, the rates for non-Hispanic blacks and Hispanics increased at a greater pace than those for non-Hispanic whites.  All age groups had increasing rates, but the greatest increases were among those aged 15-24, 25-34 and 35-44.  There were also regional differences, with the highest rates and greatest increase in rates occurring in the East Coast and Upper Midwest regions.


Strategies Used by Adults Aged 18–64 to Reduce Their Prescription Drug Costs, 2017

March 19, 2019

A new NCHS report examines changes over time in the percentage of adults aged 18–64 who were prescribed medication and reported using these selected strategies to reduce their prescription drug costs in the past 12 months.

Key Findings:

  • Among adults aged 18–64 who were prescribed medication in the past 12 months, the percentage who used selected strategies to reduce their prescription drug costs in the past 12 months decreased from 2013 through 2015 and then remained stable from 2015 through 2017.
  • In 2017, among adults aged 18–64 who were prescribed medication, women were more likely than men to use selected strategies to reduce their prescription drug costs.
  • In 2017, strategies for reducing prescription drug costs were most commonly practiced among those who were uninsured compared with those with private insurance or Medicaid, as 39.5% asked their doctor for a lower-cost medication, 33.6% did not take their medication as prescribed, and 13.9% used alternative therapies.

Updated Provisional Drug Overdose Death Data: 12-Month Ending from August 2017-August 2018

March 13, 2019

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm


Updated Provisional Drug Overdose Death Data: 12-Month Ending from July 2017-July 2018

February 13, 2019

Link: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm