Trends in Unintentional Injury Deaths, U.S., 1999–2005

Age, Gender, and Racial/Ethnic Differences
  • Guoqing Hu
    Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, China
    Search for articles by this author
  • Susan P. Baker
    Address correspondence and reprint requests to: Susan P. Baker, MPH, Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Baltimore MD 21205
    Center for Injury Research and Policy, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
    Search for articles by this author


      The details hidden within the recent increase (1999–2004) in unintentional injury mortality have not been studied.


      The objectives were to analyze the trends in mortality rates from unintentional injuries from 1999 to 2005 and identify changes in rates for specific population subgroups.


      Mortality data came from the CDC's Web-based Injury Statistics Query and Reporting System. Trends during 1999–2005 were analyzed by cause, gender, race, age group, and state separately. Annual percent changes in rates and linear regression were used to measure the increase from 1999 to 2005 and examine its significance. The data were analyzed in 2008.


      Overall unintentional injury mortality in the U.S. increased by 1.8/100,000 per year from 1999 to 2005, rising from 35.3/100,000 in 1999 to 39.0 in 2005. Total unintentional injury mortality increased significantly in whites only, a 2% increase per year for white men/boys and a 2.8% increase for white women/girls (p<0.05). Poisoning mortality increased significantly in adults of all racial groups. Subgroup analyses revealed that the increases in total unintentional injury mortality among whites were mainly the result of increases in falls in adults aged ≥45 years and poisoning in people aged 15–64 years. Large state-specific differences in trends were observed for these two causes. In addition, the increases in death rates from unintentional suffocation in white children aged <5 years, motor-vehicle crashes in whites aged 45–64 years, and drowning and fire/burns in white women aged 45–54 years were large and significant (p<0.05).


      Specific subgroups of whites have recently experienced the most marked increases in fatal unintentional injuries, including falls, poisoning, motor-vehicle crashes, suffocation, fire/burns, and drowning. These increases merit further attention from researchers and policymakers.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • CDC
        Medical expenditures attributable to injuries—United States, 2000.
        MMWR Morb Mortal Wkly Rep. 2004; 53 (Erratum in: MMWR Morb Mortal Wkly Rep 2004;53:66): 1-4
        • CDC
        WISQARS fatal injuries: leading causes of death reports.
        • CDC
        Web-based Injury Statistics Query and Reporting System (WISQARS™): Years of Potential Life Lost (YPLL) Reports, 1999–2005.
        • CDC
        Increases in age-group-specific injury mortality—United States, 1999–2004.
        MMWR Morb Mortal Wkly Rep. 2007; 56: 1281-1284
        • CDC
        Unintentional poisoning deaths—United States, 1999–2004.
        MMWR Morb Mortal Wkly Rep. 2007; 56: 93-96
        • Paulozzi L.J.
        • Ballesteros M.F.
        • Stevens J.A.
        Recent trends in mortality from unintentional injury in the United States.
        J Safety Res. 2006; 37: 277-283
        • Hoskin A.F.
        Trends in unintentional-injury deaths during the 20th century.
        Stat Bull Metrop Insur Co. 2000; 81: 18-26
        • Hu G.
        • Baker S.P.
        Reducing black/white disparity: changes in injury mortality in the 15–24 year age group, United States, 1999–2005.
        Inj Prev. 2008; 14: 205-208
        • Baker S.P.
        • O'Neill B.
        • Ginsburg M.J.
        • Li G.
        The injury fact book, second edition.
        Oxford University Press, New York1992
        • Hoyert D.L.
        • Arias E.
        • Smith B.
        • Murphy S.L.
        • Kochanek K.D.
        Deaths: final data for 1999.
        Natl Health Stat Report; 49(8). National Center for Health Statistics, Hyattsville MD2001
        • National Center for Health Statistics
        Health, United States, 2007.
        With Chartbook on trends in the health of Americans. 2007 (Hyattsville MD)
        • Dowell S.F.
        • Kupronis B.A.
        • Zell E.R.
        • Shay D.K.
        Mortality from pneumonia in children in the United States, 1939 through 1996.
        N Engl J Med. 2000; 342: 1399-1407
        • Warner W.
        • Chen L.H.
        Improving poisoning surveillance at the national level using death certificate literals, U.S. 2003.
        APHA, Washington DCNovember 2007
        • Paulozzi L.J.
        • Annest J.L.U.S.
        data show sharply rising drug-induced death rates.
        Inj Prev. 2007; 13: 130-132
        • Pletcher M.J.
        • Kertesz S.G.
        • Kohn M.A.
        • Gonzales R.
        Trends in opioid prescribing by race/ethnicity for patients seeking care in U.S. emergency departments.
        JAMA. 2008; 299: 70-78
        • Paulozzi L.J.
        • Xi Y.
        Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type.
        Pharmacoepidemiol Drug Saf. 2008; 17: 997-1005
        • CDC
        Increase in poisoning deaths caused by non-illicit drugs—Utah, 1991–2003.
        MMWR Morb Mortal Wkly Rep. 2005; 54: 33-36
        • Paulozzi L.J.
        • Budnitz D.S.
        • Xi Y.
        Increasing deaths from opioid analgesics in the United States.
        Pharmacoepidemiol Drug Saf. 2006; 15: 618-627
        • The National Center on Addiction and Substance Abuse (CASA) at Columbia University
        National Survey of American Attitudes on Substance Abuse XIII: Teens and Parents (August 14, 2008).
        • Fingerhut L.A.
        Increases in poisoning and methadone-related deaths: United States, 1999–2005.
        • Adekoya N.
        • Thurman D.J.
        • White D.D.
        • Webb K.W.
        Surveillance for traumatic brain injury deaths—United States, 1989–1998.
        MMWR Surveill Summ. 2002; 51: 1-14
        • CDC
        Fatalities and injuries from falls among older adults—United States, 1993–2003 and 2001–2005.
        MMWR Morb Mortal Wkly Rep. 2006; 55 (Erratum in: MMWR Morb Mortal Wkly Rep 2006;55:1303): 1221-1224
        • Tarrago S.B.
        Prevention of choking, strangulation, and suffocation in childhood.
        WMJ. 2000; 99 (42): 43-46
        • CDC
        Trends in motorcycle fatalities associated with alcohol-impaired driving—United States, 1983–2003.
        MMWR Morb Mortal Wkly Rep. 2004; 53: 1103-1106
        • CDC
        Alcohol and other drug use among victims of motor-vehicle crashes—West Virginia, 2004–2005.
        MMWR Morb Mortal Wkly Rep. 2006; 55: 1293-1296
        • Quinlan K.P.
        • Brewer R.D.
        • Siegel P.
        • Sleet D.A.
        • Mokdad A.H.
        • Shults R.A.
        • Flowers N.
        Alcohol-impaired driving among U.S. adults, 1993–2002.
        Am J Prev Med. 2005; 28: 346-350
        • Heng K.
        • Hargarten S.
        • Layde P.
        • Craven A.
        • Zhu S.
        Moderate alcohol intake and motor vehicle crashes: the conflict between health advantage and at-risk use.
        Alcohol. 2006; 41: 451-454
        • CDC
        CDC WONDER: compressed mortality, 1999–2005 request.