Nearly 80 percent of US deaths in the first three decades of life are due to unintentional injury or violence

A new report on unintentional injury and violence in the United States, published in The Lancet as part of a new Series, The health of Americans, has found that prevention strategies across society show a great deal of promise in preventing unintended deaths and injuries.

According to the report, by CDC researchers from Atlanta, USA, more Americans between the ages of one and 30 die from than from any other cause. Every year, nearly 180 000 people in the USA die from preventable causes such as automobile crashes, drowning, firearm-related injuries, falls, assault, and ; equivalent to one injury death every 3 minutes.

In 2010 alone, the top three causes of death for those aged between one and 30 were unintentional injury, suicide, and homicide. Almost four fifths of deaths among people in this age group were due to injuries, with only one fifth due to and only 1% due to infectious diseases. In 2010, among people of all ages, 121 000 died due to unintentional injuries, including , poisoning, and suffocation.

Rates of suicide and homicide are unequally distributed across groups, the report found. Suicides were twice as common as homicides (38 364 deaths in 2010 alone, versus 16 259). The highest rates of suicide are found in Native American and Alaskan Natives (16.9 per 100 000) and non-Hispanic whites (14.9). Homicide rates for African Americans (18.6) were double those of the nearest group (Native Americans and Alaskan Natives) and several times higher than other groups. Large disparities between men and women were also observed in the rates of suicide (19.8 vs 5.0) and homicide (8.3 vs 2.2).

Opioid painkillers such as oxycodone and hydrocodone are also a large source of injury deaths. The number of deaths from these painkillers has nearly quadrupled since 1990, with 38 329 people dying from drug overdoses in 2010 alone.

In 2010, the 31.2 million unintentional and violence-related nonfatal injuries had an estimated cost of over US$500 billion dollars in medical care and lost productivity. According to the report, that figure "does not include the costs associated with non-medically treated injuries, legal costs or indirect costs from other health problems associated with or exacerbated by violence and injuries."

According to lead author Dr. Tamara M. Haegerich, PhD, at the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, there is a lot that can be done to prevent injuries and death. "Injuries and violence are not accidents and are not inevitable. They can be prevented. Yet, although figures in public health maintain a common understanding of the definition, causes, and solutions to injuries and violence, this recognition might not be widely accepted by other audiences, including policy makers, clinical health professionals, and the public."

"The scientific evidence to support prevention of injury and violence is strong. We know the factors that place people at risk and it is possible to intervene with cost effective interventions. Child safety seats, seatbelt laws, and drink driving laws are good examples of interventions that have been proven effective at reducing the number of deaths due to injury, as well as reducing costs. Other interventions, such as in-home visitation by nurses and therapeutic foster care as an alternative to juvenile incarceration, and universal school-based violence programs have proven effective, and expanding these programmes could reduce the numbers of injuries even further."

More information: The Lancet , www.thelancet.com/journals/lan… (14)60074-X/abstract

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