Theme articlesUnintentional injuries in the home in the United States: Part II: Morbidity
Introduction
Despite the significant morbidity in the United States associated with unintentional injury,1, 2, 3, 4, 5, 6 fatalities often receive more attention, probably in part because of the greater accessibility and uniformity of mortality data. However, deaths represent only a small proportion of overall injury incidence.7 In a recent study comparing fatal and nonfatal injuries to young people, there were nearly 1000 injuries that required care in an emergency department for each fatality.6 Also, the causes of fatal and nonfatal injuries are distinct.7 The leading causes of nonfatal unintentional injuries—falls, injuries associated with being struck by or against an object, overexertion, and cut/pierce injuries—are seldom lethal in the otherwise healthy individuals.6, 7 Furthermore, the debilitating long-term effects of nonfatal injuries for individuals and families contribute to significant social costs in the forms of lost days of work or school, and healthcare expenditures.8
The home environment is an important setting for unintentional injuries.9, 10, 11, 12 About one fifth of all fatal unintentional injuries take place in a home.12 However, the incidence of nonfatal unintentional home injuries has not yet been fully established or described. In this study, the magnitude and nature of the problem of nonfatal unintentional home injury in the United States were documented using available data from several sources. The utility of available data was examined to describe the problem, to understand patterns by age and sex, and to identify opportunities for intervention. Finally, the data set characteristics were documented that could result in incomplete analyses or an inability to make comparisons across data sets, or across years, as part of an overall surveillance strategy for unintentional home injury. Specifically, differences were noted between data sets with respect to the definition of the home environment, the definition of populations used for rates, and the presence of systematically missing data.
Section snippets
Data set selection
We compiled a list of injury data sources by searching data systems available from federal agencies and in consultation with an advisory panel selected by the Home Safety Council, the foundation sponsoring the research. We developed a set of criteria for inclusion of data sets into this study, with the main requirement being that any data set be part of an ongoing surveillance system that includes information about nonfatal unintentional injuries occurring at home (Table 1). An additional
Nonfatal unintentional home injuries
The NHAMCS data indicate that nearly 9.8 million emergency department and 1.4 million outpatient hospital visits were made in 1999 for nonfatal, unintentional injuries that took place in a home environment (Table 3). Likewise, self-report data obtained in the NHIS include 12,922,220 nonfatal unintentional home injuries, excluding poisonings, requiring some form of medical advice in the United States in 1998. NHIS data also show that >2.15 million persons aged ≥14 years experienced an injury
Discussion
These analyses confirm that unintentional injury at home is a significant source of morbidity requiring treatment by healthcare providers and resulting in lost workdays and schooldays, especially among young people and older adults. The results also show the critical importance of falls as a major source of morbidity. Our finding that females have similar rates of nonfatal injury rates to males is curious, given that the male:female rate ratio of unintentional home injury deaths is 1.70:1,12
Conclusions
As helpful as these findings are in beginning to understand the problem of unintentional injury at home, the available data contain significant gaps. More careful consideration needs to be given concerning surveillance of home injury given that this is where people spend a substantial amount of time and are, therefore, exposed for long periods of time to the hazards present in the home. The collection of morbidity data, including development of consistent definitions for “home injury” and
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2022, InjuryCitation Excerpt :Though considered safe, the home environment is an important and often neglected setting for injuries around the world. In the US, 12 million unintentional home injuries requiring some form of medical attention were reported in 1998 [2]. In Israel, home injuries accounted for one-third of total hospital admissions [3].
The mortality trends of falls among the elderly adults in the mainland of China, 2013—2020: A population-based study through the National Disease Surveillance Points system
2022, The Lancet Regional Health - Western PacificGeographic gender differences in traumatic unintentional injury hospitalization and youth drinking
2019, Drug and Alcohol DependenceConcordance between sentinel and subsequent injuries: A prospective study of injured New Zealanders
2019, InjuryCitation Excerpt :The setting with the highest concordance between sentinel and subsequent injuries was the home; 36% of participants with a sentinel injury at home had at least one subsequent injury at home in the following 24 months (Table 1). People’s homes have been widely recognised as a common setting for injury [31,32]. Importantly, this current study highlights the recurrent nature of injury events in this setting.