September 7, 2009

Deaths from unintentional injuries increase for many groups

Rate of poisoning mortality triples in white women between ages of 45 and 64

While the total mortality rate from unintentional injury increased in the United States by 11 percent between 1999 and 2005, far larger increases were seen in some subgroups analyzed by age, race, ethnicity and type of injury by researchers at the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. Their analysis found that white women between 45 and 64 years old experienced a 230 percent increase in the rate of poisoning mortality over the study period, and white men in this age group experienced an increase of 137 percent. The study was published online by the American Journal of Preventive Medicine in advance of the September print edition of the journal.

The study also found mortality rates from falls varied widely across age and gender. The death rate from falls increased 38 percent for white men and 48 percent for white women 65 and older. The mortality rate did not increase significantly for older blacks of either sex. Overall, 89 percent of the total increase in unintentional injury deaths in the United States between 1999 and 2005 was due to poisoning among those 15 to 64 years old and falls among those 45 and older, numbers that increased by about 11,200 and 6,600, respectively.

“The large increases in the number of deaths attributable to poisoning and falls underscore the need for more research on the specific circumstances involved,” said study co-author Susan P. Baker, a professor in the Bloomberg School’s Center for Injury Research and Policy. “While we don’t know the cause behind the recent increase in falls mortality, it appears that the increase in poisonings is largely due to prescription drugs.”

Baker said that national prevention efforts are needed to control the abuse of prescription drugs and limit access. Prescriptions for opioid analgesics to address pain have increased dramatically in the past decade, and data from the Centers for Disease Control and Prevention show that prescription drugs have replaced illegal drugs such as cocaine as the most prominent substances in fatal drug overdoses.

Senior author Guoqing Hu and Baker analyzed data from the CDC Web-based Injury Statistics Query and Reporting System, which provides data on deaths according to cause and intent of injury. WISQARS mortality data are based on annual data files of the National Center for Health Statistics of CDC.

In addition to falls and poisonings, four other leading causes of unintentional injury deaths were identified for subsequent analyses: suffocation, drowning, fire/burns and motor vehicle crashes. Suffocation rates generally decreased or had no significant change, but they greatly increased in white children less than 1 year old. Drowning rates increased among white men 65 and older and among white middle-aged women, but decreased in black males 5 to 24 years old, black females 5 to 14 years old and white females 15 to 24 years old. Mortality from fires and burns decreased the most. The rate of dying due to a motorcycle crash more than doubled in Hispanic males 15 to 24 years old and in white males ages 45 to 64.

“By teasing out the impact of gender, age and race on trends in mortality rates, we are able to better identify changes worthy of attention from clinicians and policy-makers,” Hu said. “As injury continues to be a leading cause of death for all age groups and, in fact, the leading cause of death for adults 44 and younger, it’s critical we redouble our efforts to prevent unnecessary suffering and save lives.”

The research was funded by the Johns Hopkins Center for Injury Research and Policy.