Background Recent changes in unspecified unintentional injury mortality for the elderly by state remain unreported. This study aims to examine state variations in mortality from unspecified unintentional injury among Americans aged 65+, 1999–2013.

Methods Using mortality rates from CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS™), we examined unspecified unintentional injury mortality for elderly individuals aged 65+ from 1999 to 2013 by state. The proportion of unspecified unintentional injury was calculated to quantify the cause specificity of data. Linear regression examined the statistical significance of changes in proportion of unspecified unintentional injury from 1999 to 2013.

Results Of the 36 states with stable mortality rates, over 8-fold differences were observed for both the mortality rates and the proportions of unspecified unintentional injury for Americans aged 65+ during 1999–2013. 29 of the 36 states showed reductions in the proportion of unspecified unintentional injury, with Oklahoma (−89%), Massachusetts (−86%) and Oregon (−81%) displaying the largest changes. The decrease in unspecified unintentional injury mortality was negatively correlated with the change in mortality from falls in 26 states and poisoning in 3 states, and positively correlated with mortality from suffocation in 15 states, motor vehicle traffic crashes in 12 states, and fire/burn in 8 states.

Conclusions The cause specificity of elderly unintentional injury has improved for many states in the United States during 1999-2013. The improved cause specificity should be considered in trends analysis at the state level and comparisons between states for cause-specific injury mortality.