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.

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Quickstats: Rates of Injury from Sports, Recreation, and Leisure Activities Among Children and Adolescents Aged 1–17 Years, by Age Group — National Health Interview Survey, United States, 2015–2017

May 24, 2019

In 2015–2017, the rate of sports, recreation, and leisure injuries among children and adolescents aged 1–17 years was 82.9 per 1,000 population.

The rate of sports, recreation, and leisure injuries increased with age from 48.4 for those aged 1–4 years, to 72.7 for those aged 5–11 years, and to 117.1 for those aged 12–17 years.

Source: National Health Interview Survey, 2015–2017.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6820a6.htm


QuickStats: Death Rates for Motor Vehicle Traffic Injury, by Age Group — National Vital Statistics System, United States, 2015 and 2017

February 15, 2019

From 2015 to 2017, death rates for motor vehicle traffic injury increased for persons aged 15 years or older.

For infants and children younger than 15 years there was no statistically significant change from 2015 to 2017, and this group had the lowest death rate (2.0 deaths per 100,000) in 2017.

The highest death rate in 2017 was for persons aged 75 years or older (19.1), followed by a 15.3 death rate for persons aged 15–34 years, and 12.8 for persons aged 35–54 and 55–74 years.

Source: National Vital Statistics System. Underlying cause of death data, 1999–2017.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6806a8.htm?


QuickStats: Percentage of Persons of All Ages Who Had a Medically Attended Injury During the Past 3 Months by Age Group

February 8, 2019

During 2015–2017, 2.8% of persons of all ages had a medically attended injury in the past 3 months, and this varied by age.

The percentage who had a medically attended injury increased from 1.8% among those aged less than 10 years to 3.2% among those aged 10–19 years, declined to 2.5% among those aged 20–44 years, and then increased to 3.0% among those aged 45–64 years and to 3.7% among those aged 65 years or older.

Source: National Health Interview Survey, 2015–2017. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6805a7.htm


QuickStats: Percentage of Injury Deaths That Occurred in the Decedent’s Home for the Five Most Common Causes† of Injury Death — United States, 2016

July 9, 2018

In 2016, 31% of deaths from all causes of injury occurred in the person’s home.

The percentage varied by the cause of injury. More than half of the deaths attributable to poisoning (52%) occurred in the home.

Approximately 44% of deaths from firearms and suffocation occurred in the home.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality File. https://www.cdc.gov/nchs/nvss/deaths.htm.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6726a6.htm


Recent Increases in Injury Mortality Among Children and Adolescents Aged 10–19 Years in the United States: 1999–2016

June 4, 2018

NCHS released a new report that presents numbers of injury deaths and death rates for children and adolescents aged 10–19 years in the United States for 1999–2016.

Numbers and rates are presented by sex for 1999–2016, by injury intent (e.g., unintentional, suicide, and homicide) and method (e.g., motor vehicle traffic, firearms, and suffocation). Numbers and rates of death according to leading injury intents and methods are shown by sex for ages 10–14 years and 15–19 years for 2016.

Findings:

  • The total death rate for persons aged 10–19 years declined 33% between 1999 (44.4 per 100,000 population) and 2013 (29.6) and then increased 12% between 2013 and 2016 (33.1).
  • This recent rise is attributable to an increase in injury deaths for persons aged 10–19 years during 2013–2016.
  • Increases occurred among all three leading injury intents (unintentional, suicide, and homicide) during 2013–2016.
  • Unintentional injury, the leading injury intent for children and adolescents aged 10–19 years in 2016, declined 49% between 1999 (20.6) and 2013 (10.6), and then increased 13% between 2013 and 2016 (12.0).
  • The death rate for suicide, the second leading injury intent among ages 10–19 years in 2016, declined 15% between 1999 and 2007 (from 4.6 to 3.9), and then increased 56% between 2007 and 2016 (6.1).
  • The death rate for homicide, the third leading intent of injury death in 2016, fluctuated and then declined 35% between 2007 (5.7) and 2014 (3.7) before increasing 27%, to 4.7 in 2016.

Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016

February 9, 2018

Questions for Lindsey Black, Health Statistician and Lead Author of “Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016.”

Q: What was the reason you undertook this research?

LB: Previous research has indicated that the incidence is increasing and much of this trend is being driven by an increase among adolescents. Current incidence of concussions among children is estimated to be 3.5-16.5/1,000. Despite what is known, studies conducted thus far regarding the epidemiology of childhood concussions have either been regional and limited in size, focused on injuries related to sports, dependent on insurance claims, or based on emergency department visits.

There is a lack of a national prevalence and we need to understand the problem outside of the scope of sports injuries. Depending on ED visits are also problematic because evidence is emerging that there is an increasing trend in the use of primary care physicians and specialty clinics as the point of entry into the healthcare system for concussion diagnosis and treatment. Also relying on ED or medical claims will not include non-medically attended concussions.

Further, much research focuses on high school and collegiate athletes and therefore there is not much data on younger children. Despite this, there has been recent recognition for concern and appropriate treatment by the medical community. The goal of this study was to provide a national estimate of parent-reported significant head injuries as well as examine disparities by various demographics and socioeconomic indicators.


Q: What did you find most significant?

LB: There was a steady increase in the percentage of children that had ever had a significant head injury by age group. Although overall boys were more likely than boys to have ever had a significant head injury, the difference was only significant for the 15-17 age group.


Q: Are there any data that look at what sports might be contributing to the number of significant head injuries among children?

LB: Yes, in fact there are many studies that focus on sport related injuries. Our survey and study did not. What sets our study apart is that it was not limited to sports related injuries, so it is going to include a wider range of causes of injuries. Please see “Emergency Department Visits for Concussion in Young Child Athletes” (Bakhos, 2010) and “Epidemiology of Concussion and Mild Traumatic Brain Injury” (Laker 2011) to learn more.


Q: Do you have any insight about whether this percentage who’ve had significant head injuries has increased or declined over time?

LB: Unfortunately we do not have any other historical data on this topic from our survey. At this time, these questions were asked only in 2016 as part of content sponsored by the National Instutite of Health’s National Institute on Deafness and Other Communication Disorders.


Q: Any other points you’d like to make about this study?

LB: We found that about 1 in 10 children in the oldest age group 15-17 had ever had a significant head injury. We also found that overall, boys were more likely than girls to have ever had a significant head injury and there were also disparities by race and parental educational attainment.