QuickStats: Rate of Deaths Attributed to Unintentional Injury from Fire or Flames, by Sex and Urban-Rural Status — National Vital Statistics System, United States, 2020

April 8, 2022

In 2020, the death rate attributed to unintentional injury from fire or flames was higher in rural areas than in urban areas for females and males.

The rate for females was 1.4 per 100,000 in rural areas and 0.6 in urban areas.

The rate for males was 2.4 per 100,000 in rural areas and 0.9 in urban areas.

Males had higher death rates than females in both rural and urban areas.

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2020. https://www.cdc.gov/nchs/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7114a5.htm


QuickStats: Rate of Unintentional Traumatic Brain Injury–Related Deaths Among Persons Aged ≤19 Years, by Age Group and Sex — National Vital Statistics System, United States, 2018–2020

March 18, 2022

During 2018–2020, death rates for unintentional traumatic brain injury among persons aged ≤19 years were higher for males than for females in each age group.

Rates were highest for males (6.1 per 100,000) and females (2.9) among persons aged 15–19 years.

Rates were lowest for males and females aged 5–9 years (1.1 and 0.8, respectively) and for males and females aged 10–14 years (1.3 and 0.8, respectively).

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

https://www.cdc.gov/mmwr/volumes/71/wr/mm7111a5.htm


Concussions and Brain Injuries in Children: United States, 2020

December 1, 2021

A new NCHS report presents national estimates of lifetime symptomatology and health care professional diagnoses of concussions or brain injuries as reported by a knowledgeable adult, usually a parent, in children aged 0–17 years using data from the 2020 National Health Interview Survey.

Key Findings:

  • In 2020, 6.8% of children aged 17 years and under had ever had symptoms of a concussion or brain injury.
  • Non-Hispanic White children were more likely than children of other race and Hispanic-origin groups to have ever had symptoms of a concussion or brain injury.
  • The percentage of children aged 17 years and under who had ever had a diagnosis of a concussion or brain injury by a health care provider was 3.9%.
  • Compared with their peers, boys (4.7%) and non-Hispanic White children (5.2%) were more likely to have ever had a diagnosis of a concussion or brain injury.

Q & A with Author: Rural-urban Differences in Unintentional Injury Death Rates Among Children Aged 0-17: United States, 2018-2019

October 27, 2021

DB421_fig1Questions for Matthew Garnett, Health Statistician and Lead Author of “Rural-urban Differences in Unintentional Injury Death Rates Among Children Aged 0-17: United States, 2018-2019.”

Q: Can you describe what unintentional injury deaths are?

MG: Unintentional injury deaths include fatal injuries that were unintended, unplanned, and did not occur on purpose. In contrast, intentional injuries include homicide or assault and suicide or self-harm. Unintentional injury deaths include a wide array of mechanisms, with the four most common being: poisoning, motor vehicle crashes, drowning, and falls.


Q: How did the data vary by age groups?

MG: Rates of unintentional injury deaths differ across age groups. In both urban and rural areas, unintentional injury death rates were highest among children aged under 1 year, followed by a decline in the 1–4 and 5–13 age groups, and then increasing in the 14–17 group. Although this pattern was seen in both urban and rural areas, rural rates were consistently higher than urban rates for all age groups.

The high rates experienced among children under the age of 1 year were driven by high rates of suffocation (includes choking, asphyxiation, and strangulation). Among children aged 1-4 years, the leading mechanisms diverged based on urban-rural status, with drowning being the leading mechanism in urban areas, and with both drowning and motor vehicle traffic being the leading mechanism among in rural areas. In the older age groups, including those aged 5-13 and 14-17, motor vehicle traffic was the leading mechanism.

The decrease in overall rates from the under 1 year group to the 1-4 age group can be explained by a lower suffocation rates, which decreased from 24.9 in urban areas and 42.1 in rural areas among children under 1, to 0.7 and 1.1, respectively, in the 1-4 age group. The increase in overall rates between the 5-13 and 14-17 age groups is partially due to the increase in motor vehicle traffic rates, which increased from 1.5 in urban areas and 3.1 in rural areas among the 3-13 age group to 5.1 and 12.5, respectively, in the 14-17 age group.


Q: Do you have trend data that goes further back than 2018?

MG: This information is not presented in the report, but additional national data is available through CDC’s query system – CDC WONDER. Since 1999, rates of unintentional injury death among children aged 0-17 years have decreased from a high of 12.7 (per 100,000 population) in 1999 to 7.2 in 2019, a 43% decrease. Decreases were seen both in urban and rural areas. In urban areas the rate decreased from 11.0 in 1999 to 6.4 in 2019, a 42% decrease. In rural areas, the rate decreased from 21.5 in 1999 to 12.7 in 2019, a decrease of 41%. The unintentional injury death rate has decreased among children in both areas between 1999 and 2019; however, the gap between urban and rural rates has been maintained over time.

Rates of Unintentional Injury Death Among Children Aged 0-17 Years by Urban-rural Status, United States, 1999-2019

Year

Total

Rate per 100,000

Urban

Rate per 100,000

Rural

Rate per 100,000

1999

12.7

11.0

21.5

2000

12.3

10.7

21.1

2001

11.9

10.4

20.3

2002

11.9

10.6

19.7

2003

11.5

10.0

20.2

2004

11.7

10.2

20.3

2005

11.1

9.7

19.4

2006

10.8

9.4

18.6

2007

10.7

9.5

17.6

2008

9.3

8.1

16.6

2009

8.6

7.5

14.9

2010

8.1

7.0

14.4

2011

8.0

6.9

14.2

2012

7.7

6.7

13.8

2013

7.4

6.4

13.2

2014

7.2

6.3

12.9

2015

7.6

6.7

13.6

2016

7.8

7.0

13.2

2017

7.7

6.8

13.4

2018

7.1

6.3

12.2

2019

7.2

6.4

12.7

NOTES: Unintentional injury deaths are identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes V01–X59 or Y85–Y86. The decedent’s county of residence was classified as urban or rural based on the 2013 NCHS Urban–Rural Classification Scheme for Counties. Rates shown are crude rates (deaths per 100,000).

SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.


Q: What is the main takeaway message here?

MG: There are two main takeaways here. The first is that when discussing unintentional injury deaths, there are disparities for children between urban and rural areas. These disparities are found across age groups, and across multiple injury mechanisms.

The second takeaway is that the reasons for unintentional injury deaths change with age. Among the youngest children, under 1 year of age, suffocation is the leading mechanism of death, with the highest rate of any mechanism for both urban and rural children across all age groups. Among slightly older children aged 1-4 years, the leading mechanism becomes motor vehicle traffic and drowning. After this age group, the mechanism with the highest rates is motor vehicle traffic for children aged 5-13 and 14-17. For all of these leading mechanisms, rates were higher for children in rural areas.


Q: What are the reasons why unintentional injury death rates are higher in rural vs. urban areas?

MG: Data from this report suggests that different mechanisms drive the overall unintentional injury rate for each age group. Urban-rural disparities between mechanisms provide insight into the larger disparities seen in the overall unintentional rates. For example, among children under the age of 1, the rural rate of deaths involving suffocation were significantly higher (42.1 per 100,000 population) than urban rates (24.9). For that age group, suffocation was a major driver of disparity seen in the total unintentional injury death rate, which was 48.8 for rural areas and 29.3 for urban areas.

Among children aged 1-4, all reportable mechanisms show significantly higher rates among children in rural areas compared to children in urban areas. For some mechanisms, these disparities are smaller, such as natural or environmental deaths where the rural rate was 0.5 compared to the urban rate of 0.3. In other mechanisms the disparity is larger, such as for deaths involving fire or flames, where the rural rate was 1.7 compared to the urban rate of 0.4, more than 4 times higher.  

Among children aged 5-13 and 14-17, not all mechanisms show a significant disparity. However, some of the largest drivers of the overall unintentional death rate (that is, mechanisms with a larger number of deaths) for each group did. For example, motor vehicle traffic death rates were twice as high in rural areas compared to urban areas for both age groups. 

This data brief does not get into the specific reasons for disparities within specific mechanisms. However, there is a wide body of research that has associated urban-rural differences in injury mortality to a variety of factors. These include differences in types of activities undertaken by children living in rural and urban areas and the built environments that they undertake these activities in. Studies have also suggested that differences in patterns of safety equipment use and the practice of safety-related behaviors may play a role in differing mortality rates. Access to care has also been pointed to as an issue, when considering first responder response times in rural settings compared to urban settings, and access to medical facilities, including high level trauma care. The introduction to the report cites several of these studies.

Additional information on unintentional injuries, and strategies to address unintentional injuries are available from the CDC’s National Center for Injury Prevention and Control.


QuickStats: Injury Deaths as a Percentage of Total Deaths, by Age Group — National Vital Statistics System, United States, 2019

August 6, 2021

mm7031a3-f

Injuries accounted for the majority of deaths among persons aged 15–39 years, with the highest percentages among those aged 15–19 (76.0%) and 20–24 years (78.2%).

The percentage of injury deaths was lowest among those aged <1 year (7.9%), 60–64 years (7.5%), and ≥65 years (3.4%).

Source: National Center for Health Statistics, National Vital Statistics System, Mortality Data, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7031a3.htm


QuickStats: Age-Adjusted Death Rates for Four Selected Mechanisms of Injury — National Vital Statistics System, United States, 1979–2019

May 21, 2021

In 1979, of the four mechanisms of injury, age-adjusted mortality rates were highest for motor vehicle traffic deaths and lowest for drug poisoning deaths.

From 1979 to 2019, the age-adjusted rate of motor vehicle traffic deaths decreased from 22.1 per 100,000 to 11.1, and the rate of firearm-related deaths decreased from 14.7 to 11.9.

During the same period, the rate of drug poisoning (overdose) deaths increased from 3.0 to 21.6, and the rate of fall-related deaths increased from 6.2 to 10.1. In 2019, the rates were highest for drug poisoning deaths and lowest for fall-related deaths.

Source: National Vital Statistics System compressed mortality file, underlying cause of death. https://wonder.cdc.gov/mortsql.html

https://www.cdc.gov/mmwr/volumes/70/wr/mm7020a4.htm


QuickStats: Rate of Unintentional Traumatic Brain Injury (TBI)–Related Deaths Among Persons Aged 24 Years and Under, by Age Group

October 16, 2020

From 1999 to 2018, death rates for unintentional TBI among persons aged 24 years and under declined across all age groups.

During the 20-year period, TBI-related death rates declined from 3.7 per 100,000 to 1.5 among children aged 0–4 years, from 3.0 to 0.9 for children and adolescents aged 5–14 years, from 14.7 to 4.4 for adolescents and young adults aged 15–19 years, and from 14.1 to 6.9 for young adults aged 20–24 years.

For most of the period, rates were highest for persons aged 20–24 years followed by those aged 15–19, 0–4, and 5–14 years.

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

https://www.cdc.gov/mmwr/volumes/69/wr/mm6941a5.htm


Emergency Department Visits for Injuries Sustained During Sports and Recreational Activities by Patients Aged 5–24 Years, 2010–2016

November 15, 2019

Questions for Lead Author Anna Rui, Health Statistician, of “Emergency Department Visits for Injuries Sustained During Sports and Recreational Activities by Patients Aged 5–24 Years, 2010–2016.”

Q: What do you think is the most significant finding in this report?

AR: The top activities that caused emergency room (ER) visits for sports injuries by patients ages 5-24 years were football, basketball, pedal cycling, and soccer. There was wide variation by age and sex in the types of activities causing ER visits for sports injuries.


Q: Out of all of the sports, which sport or activity was found to have the largest increase in ER visits over time?

AR: We did not assess trends over time in the report.


Q: Is it accurate to say that the sports in the study are the most dangerous? Or do they have the most ER visits because they are simply the most popular?

AR: There are likely other health care utilization measures besides ER visits that others would want to look at as well, but the purpose of the report was to estimate the number of ER visits for sports injuries, and these are the sports that account for the most visits.


Q: What are some limitations of the report?

AR: The definition of sports and recreational activities relied on data processing and manual review of medical records, which could have resulted in over- or under-estimation of the sports injury ER rate. The study did not include patients who sought care in other settings or who did not seek care; thus the estimates in the report are an underestimate of all health care utilization for sports injuries.


Q: Why is this report important?

AR: Many young Americans engage in some type of sports or recreational activity each year, and sports and recreation-related injuries are a common type of injury seen in hospital ERs. It’s important to understand the types of injuries that are most commonly seen in the ER and which sports account for those injuries in order to monitor and guide injury prevention efforts. In addition, we provide updated estimates of treatments administered in the ER for sports injuries, which provides new information that can be used to monitor improvements to the quality and value of care and serve as a benchmark for future studies.


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.


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