Unintentional Injury Death Rate Increased 40% Since 1999

R. Henry Olaisen, MPH, PhD

The unintentional injury death rate has increased 40% between 1999-2017, according to a new brief from the National Center for Health Statistics (NCHS).

Unintentional injury is a leading cause of death in the US, with motor vehicle traffic, drug overdose, and falls being the most common drivers. Between 1999-2017, the unintentional injury death rate increased from 35.3 deaths per 100,000 to 49.4 deaths per 100,000. It now accounts for 8% of all deaths in the US.

Motor vehicle traffic injuries increased across rural, small metro, large fringe metro, and large central metro areas since 2014. However, between 2006-2009, motor vehicle injuries fell 8.5% annually, but rose 3.7% annually between 2014-2017. How urbanized an area was corresponded with motor vehicle injuries. The more urbanized the area was, the less motor vehicle deaths, per 100,000. Large central metro areas had a motor vehicle death rate of 8.3 per 100,000 in 2017 while rural areas had a death rate of 19.7 per 100,000.

Age-adjusted death rates for drug overdose increased from 4.0 in 1999 to 19.1 in 2017, with a 16.1% annual increase between 2014-2017. The unintentional drug overdose rate surpassed the motor vehicle traffic death rate in 2013.

Historically, rural areas have been associated with higher rates of drug overdoses, and in 2014, rural areas had the one of the highest rates of drug overdose—with a death rate of only .3 lower than small metro areas, who had the highest. However, in 2017, rural areas had the lowest rate of unintentional drug overdose deaths. Rural counties had the lowest rate at 17.3 per 100,000 deaths while large fringe metro areas had the highest rate with 20.3 deaths per 100,000 in 2017.

“Unintentional deaths are preventable,” lead investigator R. Henry Olaisen, MPH, PhD, told MD Magazine®. “With so much reporting that rural areas have a higher rate of unintentional injury... I think when we look at things as an aggerate, we don’t get to the real stories.”

The Centers for Disease Control and Prevention (CDC) has also seen a drop in life expectancy. In 2018, the NCHS reported that life expectancy fell from 78.7 in 2016, to 78.6 in 2017.

“Tragically, this troubling trend is largely driven by deaths from drug overdose and suicide,” CDC director Robert R. Redfield, MD, said in a 2018 statement. “Life expectancy gives us a snapshot of the nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable.”

Unintentional falls also increased an average of 3.8% annually between 1999-2017. Small metro areas had the highest rate of age adjusted unintentional falls with 10.1 deaths per 100,000 in 2017. However, rural areas had the largest increase in deaths from unintentional falls with a jump from 8.9% in 2014 to 9.9% in 2017. Large central metro counties had the lowest rate of age-adjusted death rates for unintentional falls at 8.5 deaths per 100,000 in 2017.

Olaisen said that the big thing with unintentional deaths is that they are preventable, and steps can be taken to bring the number of avoidable deaths down. Part of the reason why this report is so crucial is because it breaks down statistics by region.

“It’s important to pay attention to where people live and get the message out,” Olaisen said.

The report, “Unintentional Injury Death Rates in Rural and Urban Areas: United States, 1999-2017," was published on the CDC website.