CDC releases top 10 causes of injury in the US

By Naveed Saleh, MD, MS, for MDLinx
Published August 9, 2019

Key Takeaways

Injuries are the leading cause of death among Americans aged 1 to 44 years, according to the CDC. Each year in the United States, one person dies from an injury every 3 minutes, resulting in 214,000 deaths. And for each person who dies from an injury (or violence), 13 are hospitalized and 129 are treated in an emergency room. Finally, millions are injured each year and survive, some only to grapple with life-long mental, physical, and financial consequences.

The CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS) provides an interactive, online database detailing nonfatal injury, violent death, and cost of injury based on expert sources. This database also breaks down these deaths by ICD-10 code.

Here, according to the most recent research from WISQARS, are the top 10 causes of unintentional injury among all Americans in 2017.

10. Land transport other than motor vehicles (eg, ATV or animal-drawn vehicle)

Number of deaths: 1,332

Percentage of total injury-related deaths: 0.8%

9. Otherwise specified injuries that are classifiable (eg, crush injuries, unspecified electric current, or explosion)

Number of deaths: 1,440

Percentage of total injury-related deaths: 0.8%

8. Natural/environmental causes

Number of deaths: 1,750

Percentage of total injury-related deaths: 1.0%

7. Fire/burn

Number of deaths: 2,902

Percentage of total injury-related deaths: 1.7%

6. Drowning

Number of deaths: 3,709

Percentage of total injury-related deaths: 2.2%

5. Unspecified

Number of deaths: 6,606

Percentage of total injury-related deaths: 3.9%

4. Suffocation

Number of deaths: 6,946

Percentage of total injury-related deaths: 4.1%

3. Fall

Number of deaths: 36,338

Percentage of total injury-related deaths: 21.4%

2. Motor vehicle traffic (eg, motor vehicle, motorcycle, or pedestrian death)

Number of deaths: 38,659

Percentage of total injury-related deaths: 22.7%

1. Poisoning

Number of deaths: 64,795

Percentage of total injury-related deaths: 38.1%

Of note, all other causes of unintentional injury-related death accounted for 3.2% of the 2017 total (5,459 cases).

Injury prevention

During the first 4 decades of life, more Americans die from injuries and violence than from any other cause. Moreover, millions of Americans experience physical, emotional, and financial problems secondary to injury.

Injury prevention has a strong evidence base, but efforts to address it are not fully integrated into clinical practice. Data about injury and violence burden, risk factors, and effective prevention interventions do not magically transform into more effective policy and practice.

Most physicians and other healthcare workers have not yet incorporated injury risk into standardized care. Only an estimated 1 in 5 adult patients are counseled about injury prevention. This lapse could be due to increased demands on practitioners. For instance, according to one estimate, if physicians were to discuss all the clinical recommendations from the US Preventive Service Task Force with all patients, it would take more than 7 hours per day to address preventive healthcare alone. In addition to time, many physicians lack the necessary training and skill to effectively engage in preventive healthcare.

“For maximum adoption, public health researchers must use implementation science to inform best practices for the translation and dissemination of interventions. Reductions in morbidity and mortality will be small until effective interventions are implemented and integrated into the broader health and wellness system,” wrote the authors of a 2014 review article published in Lancet.

According to the authors, messages concerning injury can be enhanced via framing theory, which leverages societal values and focus on prevention. These messages can also be enhanced via social mathematics, which displays statistics in an engaging and illustrative context, as well as success stories to provide action models and more. These approaches require the input of public health researchers and policy makers to be effective.

Practice points

Physicians have the opportunity to advance injury prevention via screening and referral for injury risk factors, such as alcohol misuse, depression, behavioral problems (particularly in children), and domestic violence. Looking forward, such opportunities may extend to other types of screening, such as fall risk in the elderly. Innovations in health information technology and electronic health records (EHRs), including support with clinical decision-making, could enhance the physician’s ability to proffer injury preventive services.

For instance, EHRs can be programmed to trigger alerts for screening-based risk factors for patients. EHRs can also give real-time information about evidence-based treatment guidelines, create reports that share information regarding injury prevention with patients, and issue automatic referrals to community services. Finally, codes embedded within technology can display provision of services by healthcare personnel, and permit clinical practices to record and report clinical quality measures associated with clinical practice, while smoothing the way for reimbursement.

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