Unintentional Injuries

Publication Date:

Nov 27, 2018

Key facts about unintentional injuries

  • Fatalities from unintentional injuries among youth ages 10 to 19 have stayed relatively stable since 2010, sitting at 10 deaths per 100,000 population in 2016.
  • Rates of nonfatal injuries requiring a trip to the emergency department remained steady from 2010 to 2013, and decreased to a record low of 9,036 cases per 100,000 population in 2016.
  • In 2016, unintentional fatal injuries were most common among infants (31 deaths per 100,000), followed by adolescents ages 15 to 19 (20 deaths per 100,000), children ages 1 to 4 (8 deaths per 100,000), and children ages 5 to 9 and 10 to 14 (each at 4 deaths per 100,000).
  • In 2016, falling was the most common cause of unintentional injury requiring an emergency room visit among infants and children (birth to age 14), and second-most common among children ages 15 to 19.

Trends in unintentional injuries 

Fatal injuries

From 1981 to 1992, the rate of deaths due to injuries among all children from birth to age 19 fell by 36 percent, from 27 fatal injuries per 100,000 population to 17. Over this period, rates among males declined more than among females (by 39 and 28 percent, respectively) (Appendix 1).

Rates declined at a slower pace from 1992 to 2007, falling from 17 to 14 deaths per 100,000 population. From 2007 to 2010, there were greater declines—a drop of 26 percent over three years. After 2010, fatalities from unintentional injuries have stayed relatively constant. In 2016, there were 10 child and youth deaths per 100,000 population caused by unintentional injuries (13 and 7 per 100,000 for males and females, respectively) (Appendix 1).

Declining death rates related to motor vehicles accounted for the single largest portion of the decrease in fatal injuries. While rates of motor-vehicle-related deaths fell by 42 percent from 2006 to 2016, this remains the leading cause of injury-related deaths among all persons younger than age 20. Rates associated with most other causes of fatal injuries also declined in the past decade, with the exceptions of drowning, suffocation, poisoning, and falls (Appendix 1). Around 90 percent of child and adolescent deaths by poisoning in 2016 were due to drug overdoses or alcohol poisoning; rates of drug poisoning decreased by 1.6 percent from 2006 to 2016.1

Nonfatal injuries 

Rates of nonfatal injuries requiring a trip to the emergency department decreased by 13 percent from 2000 to 2009, from 12,202 to 10,556 injuries per 100,000 population. In 2010, the rate increased to 11,008, and remained virtually unchanged until 2013, when it decreased to 10,091 injuries per 100,000. The rate has since decreased, reaching 9,036 in 2016, the lowest figure on record. Accounting for the greatest proportions of the decade’s decline were pedal-cyclist-related injuries (down by 42 percent from 2006 to 2016), motor-vehicle-related accidents (down by 27 percent), and other transportation-related injuries (down by 37 percent) (Appendix 2).

Differences by age 

Fatal injuries

Unintentional fatal injuries are most common among infants. The 2016 rates per 100,000 population range from a high of 31 among children younger than 1 year, to a low of 4 among those ages 5 to 9. The second-highest rate was among adolescents ages 15 to 19 (20 deaths per 100,000). Fatal injuries have been trending downward for all age groups, except infants; after rising from 1998 to 2008, the rate for infants has been generally constant (Appendix 1).

The most common causes of fatal injuries differ among age groups. For instance, although suffocation is the most common type of fatal injury among infants (84 percent in 2016), it accounts for only 1 percent of unintentional fatalities among adolescents ages 15 to 19. While only 7 percent of fatal injuries among infants are due to motor vehicle crashes, they account for 63 percent among adolescents. While drowning is the most common cause of fatal injury among children ages 1 to 4 (34 percent), drowning accounts for 6 percent of adolescent fatal injuries. Other notable types of injury include poisoning (19 percent of fatal injuries among adolescents), and fire and burn injuries among children ages 1 to 4 and 5 to 9 (9 and 10 percent of fatal injuries, respectively) (Appendix 3).

Nonfatal injuries 

Rates for nonfatal injuries are highest among children ages 1 to 4 (10,634 injuries per 100,000 population, in 2016), followed by adolescents ages 15 to 19 (10,447 per 100,000), children ages 10 to 14 (8,599 per 100,000), children ages 5 to 9 (7,474 per 100,000), and infants less than a year old (5,402 per 100,000) (Appendix 2).

There are also marked age-related differences in the causes of nonfatal injuries. Falls are the most common cause from birth to age 9, and second-most common among 15- to 19-year-olds. Among 10- to 14-year-olds, the rate of nonfatal injuries due to falls was similar to the rate of nonfatal injuries from being “struck by or against an object or person,” although the actual numbers vary by year. However, the proportion of injuries associated with falls decreases with age. Among infants, 57 percent of serious nonfatal injuries were from falls in 2016, compared with 17 percent of nonfatal injuries among adolescents ages 15 to 19. Nonfatal injuries that result from being “struck by or against an object or person” comprised 27 percent of injuries among 10- to 14-year-olds (the single largest category), and 13 percent among infants under age 1 (Appendix 4).

Differences by gender

Males are more likely than females to sustain both fatal and nonfatal injuries. The 2016 rate of fatal injuries among males was 13 per 100,000 population—nearly double the rate among females (7 per 100,000) (Appendix 1). For serious nonfatal injuries, the 2016 rate among males was 10,125 per 100,000, while the rate among females was 7,899 per 100,000 (Appendix 2).

Differences by race and Hispanic origin2

Rates of fatal injury are highest among non-Hispanic black and American Indian and Alaska Native children (14 and 12 per 100,000 population, respectively, in 2016), and lowest among Asian and Pacific Islander children (4 per 100,000). In between are rates for non-Hispanic white children (11 per 100,000) and for Hispanic children (8 per 100,000) (Appendix 1).

In 2016, non-Hispanic white children were more likely than either black (including Hispanic) or Hispanic children to go to an emergency department with a nonfatal injury (8,408 injuries per 100,000 population, versus 6,526 and 3,350 per 100,000, respectively). Information is not available on rates of nonfatal injury for American Indians/Alaska Natives or Asians/Pacific Islanders (Appendix 2).

Other estimates

State and local estimates

The Centers for Disease Control and Prevention published state-level rates of deaths due to unintentional injury among persons ages birth through age 19, for 2000 to 2009, available at www.cdc.gov/mmwr/preview/mmwrhtml/mm6115a5.htm?s_cid=mm6115a5_w.

2007 state-level data on nonfatal injuries (ages 0 to 5) that required medical attention are available from the National Survey of Children’s Health. These parent-reported data can be tabulated by race, family income, and other variables. See http://childhealthdata.org/browse/survey/results?q=119.

International estimates

Estimates of injury-related death rates for selected developed countries are in UNICEF’s 2001 report, A League Table of Child Deaths by Injury in Rich Nations, available at https://www.unicef-irc.org/publications/289/.

Data and appendices

Data source

• Fatal injury data: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017). WISQARS: Fatal Injury Reports, National, Regional and State, 1981–2016 [Data tool]. Retrieved from https://webappa.cdc.gov/sasweb/ncipc/mortrate.html.

• Nonfatal injury data: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2018). WISQARS: Nonfatal injury reports, 2000–2016 [Data tool]. Retrieved from https://webappa.cdc.gov/sasweb/ncipc/nfirates.html.

Raw data source

Fatal injury data: National Vital Statistics System.
www.cdc.gov/nchs/deaths.htm

Nonfatal injury data: National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP).
http://www.cdc.gov/ncipc/wisqars/nonfatal/datasources.htm#5.2

Appendices

Appendix 1. Unintentional Fatal Injury Rates per 100,000 Population Among Children Birth to Age 19, by Selected Characteristics: 1981-2016
Appendix 2. Unintentional Nonfatal Injury Rates per 100,000 Population Among Children Birth to Age 19 Requiring Attention at a Hospital Emergency Department, by Selected Characteristics: 2000-2016
Appendix 3. Rates and Percentages of Fatal Injuries, by Type of Injury and Age Group: 2016
Appendix 4. Rates and Percentages of Unintentional Injuries that Resulted in Emergency Department Visits, by Type of Injury and Age Group: 2016

Background

Definition

Deaths due to unintentional injuries are those in which the attending physician, medical examiner, or coroner ruled that the death was neither a homicide, suicide, nor due to legal intervention (i.e., self-defense or police action). Nonfatal unintentional injuries are defined as “bodily harm resulting from severe exposure to an external force or substance (mechanical, thermal, electrical, chemical, or radiant) or a submersion” which was not intended.3 More information is available at http://www.cdc.gov/ncipc/wisqars/nonfatal/definitions.htm.

Citation

Child Trends. (2018). Unintentional Injuries. Retrieved from https://www.childtrends.org/indicators/unintentional-injuries.

Endnotes

1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017). WISQARS: Fatal Injury Reports, National, Regional and State, 1981–2016 [Data tool]. Retrieved from https://webappa.cdc.gov/sasweb/ncipc/mortrate.html.

2. Hispanic children may be of any race. Estimates for white and black children in this report do not exclude Hispanic children, unless otherwise specified.

3. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2007). Definitions for WISQARS nonfatal. Retrieved from http://www.cdc.gov/ncipc/wisqars/nonfatal/definitions.htm.