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Patterns and trends in leading causes of unintentional and violence-related injury mortality: United States, 2000–2009
  1. IRH Rockett1,
  2. MD Regier1,
  3. ND Kapusta2,
  4. J Coben1,
  5. TR Miller3,
  6. RL Hanzlick4,
  7. KH Todd5,
  8. RW Sattin6,
  9. LW Kennedy7,
  10. J Kleinig8,
  11. GS Smith9
  1. 1West Virginia University Injury Control Research Center, USA
  2. 2Medical University of Vienna, Austria
  3. 3Pacific Institute for Research and Evaluation, USA
  4. 4Fulton County Medical Examiner's Center, USA
  5. 5The University of Texas MD Anderson Cancer Center, USA
  6. 6Medical College of Georgia, USA
  7. 7Rutgers University, USA
  8. 8City University of New York, USA
  9. 9University of Maryland, Baltimore, USA


    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.

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