Patterns and trends in leading causes of unintentional and violence-related injury mortality: United States, 2000–2009

Abstract

Background Trending upwards, the US unintentional and violence-related injury mortality rate needed disaggregation. Aims/Objective/Purpose To analyse rate patterns and trends in total injury mortality and its five leading external causes. Methods An observational study using negative binomial regression to analyse annual cause-of-death data for US residents for the period 2000–2009 from the Web-based Injury Statistics Query and Reporting System (WISQARS). Results/Outcome The mortality rate declined by 25% for unintentional motor vehicle traffic crashes, and increased by 128%, 71%, and 15% for unintentional poisoning, unintentional falls, and suicide, respectively. Suicide is now the leading cause of injury mortality, followed by motor vehicle traffic crashes, poisoning, falls, and homicide, respectively. Females had a lower total injury mortality rate than males (0.39; 95% CI 0.38 to 0.40). Blacks (0.92; 95% CI 0.89 to 0.95) and Hispanics (0.86; 95% CI 0.84 to 0.89) had lower motor vehicular and suicide mortality rates (Blacks: 0.47; 95% CI 0.45 to 0.49) (Hispanics: 0.43; 95% CI 0.41 to 0.45) than Whites, and higher homicide rates (5.55; 95% CI 5.22 to 5.91) (1.92; 95% CI 1.80 to 2.05). The poisoning mortality rate showed a strong time trend; for example, 2009 vs 2000 (1.96; 95% CI 1.75 to 2.20). The fall mortality rate displayed a positive age gradient. Significance/Contribution to the Field Suicide, unintentional poisoning, and unintentional fall mortality pose major challenges for prevention in the USA. Suicide has become the leading cause of unintentional and violence-related or intentional injury mortality. Epitomised by successes in motor vehicle traffic safety, injury prevention needs to be evidence-based, proactive, multifaceted, integrated, systematic, flexible, ethically defensible, and sustained.

Negotiating the Maze: Risk Factors for Suicidal Behavior in Chronic Pain Patients

“…The current prevalence data on suicidality across both developed and developing countries are truly sobering. As the tenth most common cause of death in the US [5], and the third most common cause of death in the 18-24 year group [6], suicide remains a major health problem despite substantial public health efforts to address it. Data from Australia are illuminating.…”