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Material appearing in this report is in the public 

domain and may be reproduced or copied without 

permission; citation as to source, however, is 

appreciated.

Suggested citation

Bergen G , Chen LH, Warner M, Fingerhut LA. Injury in 

the United States: 2007 Chartbook. Hyattsville, MD: 

National Center for Health Statistics. 2008.

Library of Congress Cataloging-inPublication Data

Injury in the United States: 2007 Chartbook / [Gwen 

Bergen ... et al.].

 p. ; cm. -- (DHHS publication ; no. 2008–1033)

“March 2008.”

Includes bibliographical references and index.

ISBN 0-8406-0616-8 (alk. paper)

1. Wounds and injuries--United States--Statistics. 2. 

Accidents--United States--Statistics. 3. Mortality--

United States--Statistics. 4. United States--Statistics, 

Vital. I. Bergen, Gwendolyn S. II. National Center for 

Health Statistics (U.S.) III. Series. 

[DNLM: 1. Wounds and Injuries--epidemiology--

United States. 2. Accidents--statistics & numerical 

data--United States. 3. Vital Statistics--United States. 

WO 700 I584 2007]

RD93.8.I62 2007

614’.30973--dc22

 2007037285

For sale by Superintendent of Documents

U.S. Government Printing Office

Washington, DC 20402

iii Injury in the United States: 2007 Chartbook

National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Acting Co-Deputy Director

Michael H. Sadagursky, Acting Co-Deputy Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Jennifer H. Madans, Ph.D., Acting Associate Director for Planning, Budget, and Legislation

Michael H. Sadagursky, Associate Director for Management and Operations

Lawrence H. Cox, Ph.D., Associate Director for Research and Methodology

Linda B. Torian, Acting Director for Information Technology

Linda B. Torian, Acting Director for Information Services

Linda T. Bilheimer, Ph.D., Associate Director for Analysis and Epidemiology

Charles J. Rothwell, M.S., Director for Vital Statistics

Jane E. Sisk, Ph.D., Director for Health Care Statistics

Jane F. Gentleman, Ph.D., Director for Health Interview Statistics

Clifford L. Johnson, M.S.P.H., Director for Health and Nutrition Examination Surveys

Office of Analysis and Epidemiology

Linda T. Bilheimer, Ph.D., Associate Director for Analysis and Epidemiology

Christine Cox, M.A., Chief, Special Projects Branch

Lois Fingerhut, M.A., Special Assistant for Injury Epidemiology
iv Injury in the United States: 2007 Chartbook

Acknowledgments

The Injury in the United States: 2007 Chartbook

was prepared in the Centers for Disease Control 

and Prevention’s (CDC) National Center for Health 

Statistics (NCHS) Office of Analysis and Epidemiology 

(OAE) by Gwendolyn Bergen, Li-Hui Chen, and 

Margaret Warner under the direction of Lois A. 

Fingerhut. Diane Makuc and Linda Bilheimer, OAE, 

and Jennifer Madans, Office of the Center Director, 

provided detailed reviews. Technical assistance was 

provided by NCHS staff Robert Anderson and Arialdi 

Miniño, Division of Vital Statistics (DVS); Deborah 

Ingram and Mitchell Pierre, OAE; and Stephen Pegula 

from the Bureau of Labor Statistics. Participants of the 

International Collaborative Effort on Injury Statistics 

provided data for international comparisons.

The authors appreciate reviews by the following NCHS 

staff: Marni Hall and Linda McCaig in the Division 

of Health Care Statistics, Arialdi Miniño in DVS, and 

Patricia Barnes in the Division of Health Interview 

Statistics. In addition, peer review was provided by 

J. Lee Annest from the National Center for Injury 

Prevention and Control. This chartbook was edited 

by Demarius V. Miller and Megan Cox, CDC/CCHIS/

NCHM/Division of Creative Services, Writer-Editor 

Services Branch, and graphics were produced by 

Sarah Hinkle, CDC/CCHIS/NCHM/Division of Creative 

Services.
vi Injury in the United States: 2007 Chartbook

Contents

Acknowledgments....................................................................................................................................................iii

List of Chartbook Figures.........................................................................................................................................vii

Executive Summary....................................................................................................................................................1

Introduction...............................................................................................................................................................5

Accident: Crash, Incident, or Event?.........................................................................................................................9

Injury Chartbook

1. Injuries in the United States.......................................................................................................................12

2. Injury Mortality and Morbidity: Age...........................................................................................................14

3. Injury Mortality and Age.............................................................................................................................16

4. Mortality Trends: Intent of Injury.................................................................................................................18

5. Mortality: Intent of Injury and Age.............................................................................................................20

6. Mortality Trends: Mechanism of Injury........................................................................................................22

7. Mortality: Mechanism of Injury and Age....................................................................................................24

8. Mortality: Body Region and Nature of Injury..............................................................................................26

9. Mortality: Mechanism and Body Region of Injury.......................................................................................28

10. Mortality: Mechanism by Race, Hispanic Origin, and Age.........................................................................30

11. Mortality: Intent and Mechanism of Injury and Level of Urbanization........................................................32

12. Occupational Injury Mortality ....................................................................................................................34

13. Motor Vehicle Traffic Deaths: Driver Mortality and Alcohol........................................................................36

14. Mortality: International Injury Death Rates.................................................................................................38

15-1. Hospital Discharges for Injury: Trends by Age...........................................................................................40

15-2. Hospital Discharges: Trends by Injury Severity for Adults 25–64 Years of Age..........................................42

16. Hospital Discharges for Injury: Sex and Age..............................................................................................44

17. Hospital Discharges: Nature and Body Region of Injury.............................................................................46

18. Hospital Discharges: Fractures by Body Region of Injury and Age............................................................48

19. Emergency Department Initial Injury Visits: Age and Sex..........................................................................50

20. Emergency Department Initial Visits: Mechanism of Injury and Age.........................................................52

21. Emergency Department Initial Visits: Mechanism and Nature of Injury......................................................54

22. Episodes of Injury: Sex, Age, and Mechanism of Injury..............................................................................56

23. Episodes of Injury: Race, Hispanic Origin, Age, and Education.................................................................58

24. Episodes of Injury: Activity at Time of Injury and Place of Occurrence......................................................60

25. Mortality and Morbidity: Mechanisms of Injury...........................................................................................62

26. Morbidity: Body Region and Nature of Injury............................................................................................64

Data Tables for Figures 1–26..........................................................................................69
vii Injury in the United States: 2007 Chartbook

Appendixes...........................................................................................................................................135

Contents

I. Data Sources.............................................................................................................................................135

II. Appendix Tables I–VI................................................................................................................................148

II. Definitions and Methods..........................................................................................................................163
viii Injury in the United States: 2007 Chartbook

List of Chartbook Figures

1. Injuries in the United States, 2004..............................................................................................................12

2. Injury rates by age: United States, 2003–2005...........................................................................................14

3. Injury deaths as a percentage of total deaths and injury death rates, by age: United States,

2003–2004..................................................................................................................................................16

4. Age-adjusted injury death rates by intent and year: United States, 1985–2004.......................................18

5-1. Injury death rates by intent and age: United States, 2003–2004...............................................................20

5-2. Distribution of injury deaths by intent: United States, 2003–2004............................................................21

6. Age-adjusted injury death rates for leading mechanisms of injury, by year: United States,

1985–2004..................................................................................................................................................22

7. Injury death rates for leading mechanisms of injury, by age: United States, 2003–2004..........................24

7-1. Injury death rates for leading mechanisms of injury, for infants and children under 5 years of age:

United States, 2003–2004 ..........................................................................................................................25

8-1. Percent distribution of injury deaths, by body region of injury: United States, 2003–2004......................26

8-2. Percent distribution of injury deaths, by nature of injury: United States, 2003–2004...............................26

9. Percent distribution of deaths by body region of injury, for motor vehicle traffic accidents, firearm

suicides, and firearm homicides: United States, 2003–2004......................................................................28

10-1. Injury death rates for leading mechanisms of injury for persons under 25 years of age, by race and 

Hispanic origin: United States, 2003–2004................................................................................................30

10-2. Injury death rates for leading mechanisms of injury for persons 25–64 years of age, by race and

Hispanic origin: United States, 2003–2004................................................................................................30

10-3. Injury death rates for leading mechanisms of injury for persons 65 years of age and over, by race and 

Hispanic origin: United States, 2003–2004................................................................................................30

11. Age-adjusted injury death rates by intent of injury and level of urbanization: United States,

2003–2004..................................................................................................................................................32 

11-1. Age-adjusted injury death rates for motor vehicle traffic accidents, firearm suicides, and firearm 

homicides, by level of urbanization: United States, 2003–2004................................................................33

12. Selected occupational injury death rates for employed persons 16 years of age and over, by 

occupational group: United States, 2004–2005.........................................................................................34

12-1. Percent distribution of occupational injury fatalities, by type of event or exposure: United States,

2004–2005..................................................................................................................................................35

13. Percentage of fatally injured drivers of passenger vehicles with blood alcohol concentration of 0.08 

percent or greater, by driver age: United States, 1982–2004....................................................................36

14-1. Injury death rates for teens and young adults 15–24 years of age, by leading mechanisms of injury: 

Selected countries, most recent data years available.................................................................................38

14-2. Injury death rates for persons 65 years of age and over, by leading mechanisms of injury: Selected 

countries, most recent data years available...............................................................................................38

15-1. Injury hospital discharge rates by age group and year: United States, 1988–2005...................................40

15-2. Injury hospital discharge rates for persons 25–64 years of age, by level of severity: United States,

1988–2005..................................................................................................................................................42

16. Injury hospital discharge rates by sex and age group: United States, 2004–2005....................................44
ix Injury in the United States: 2007 Chartbook

17-1. Percent distribution of hospital discharges for injury, by nature of injury: United States,

2004–2005..................................................................................................................................................46

17-2. Percent distribution of hospital discharges for injury, by body region of injury: United States, 

2004–2005..................................................................................................................................................46

18. Hospital discharge rates for fractures, by age and body region of injury: United States, 2004–2005......48 

19. Initial emergency department injury visit rates by sex and age group: United States, 2004–2005...........50

20. Initial emergency department injury visit rates by leading mechanisms of injury and age group:

United States, 2004–2005..........................................................................................................................52

21. Percent distribution of initial emergency department injury visits, by nature of injury and leading 

 mechanisms of injury: United States, 2004–2005..........................................................................54

22-1. Injury episode rates by sex and age group: United States, 2004–2005.....................................................56

22-2. Injury episode rates by leading mechanisms of injury and age group: United States, 2004–2005...........56

23-1. Injury episode rates by race and Hispanic origin and age: United States, 2004–2005..............................58

23-2. Injury episode rates by race and Hispanic origin and education, among people 25–64 years of age: 

United States, 2004–2005..........................................................................................................................58 

24-1. Percent distribution of injury episodes, by activity at time of injury: United States, 2004–2005...............60 

24-2. Percent distribution of injury episodes, by place of occurence: United States, 2004–2005......................60

25. Percent distributions by leading mechanisms of injury for deaths, hospital discharges, initial 

emergency department visits, and episodes of injury: United States, 2003–2005....................................62

26. Percent distributions of injuries by body region of injury, for hospital discharges, initial emergency 

department visits, and episodes of injury: United States, 2004–2005.......................................................64
1 Injury in the United States: 2007 Chartbook

Executive Summary

Overview

Injury imposes a heavy burden on society in 

terms of both mortality and morbidity.

In 2004, more than 167,000 deaths —7% of all deaths 

in the United States—resulted from injury. In addition, 

1.9 million hospitalizations and 31 million initial visits 

to emergency departments were attributable to injury 

and accounted for 6% of all hospital discharges and 

almost one-third of all initial emergency department 

visits. Another 35 million initial visits to physicians’ 

offices and outpatient clinics were for the treatment of 

injuries. 

Injury imposes a large economic burden on 

society.

Injury death and disability that occurred in 2000 are 

estimated to cost $80 billion in lifetime medical care 

treatment costs for physical injuries and another $326 

billion in lifetime lost productivity, totaling more than 

$400 billion for the combined economic burden of 

medical treatment and lost productivity. 

Many fatal and nonfatal injuries are 

preventable.

Knowing the characteristics of people at high risk for 

injury is a key to developing prevention strategies. 

Also important is understanding how trends in 

external causes of injury, both mechanism and 

intent, are changing and identifying the factors that 

contribute to those changes.

The purpose of this chartbook is to enhance 

understanding of the factors contributing to 

injury mortality and morbidity.

Using data from national surveys and vital statistics, 

the Injury in the United States: 2007 Chartbook

presents a comprehensive picture of injury to provide 

insights into potential prevention strategies for 

policymakers, researchers, and the general public. 

The chartbook also provides national benchmarking 

data for state injury prevention practitioners and 

epidemiologists. The data and charts focus on injury 

variation by age, mechanisms or external causes 

of injury, and comparisons of injury mortality and 

morbidity across data sources.

Current Patterns of Injury 

Mortality

Risks of injury death vary by age and sex.

Although unintentional injury, suicide, and homicide 

are the three leading causes of death for teenagers 

and young adults, elderly people have the highest 

rates of injury death. Males have higher rates of injury 

death than those for females, regardless of age group.

The majority of injury deaths are 

unintentional, with elderly people at 

particularly high risk of death from 

unintentional injuries.

Unintentional injuries continue to be the fifth leading 

cause of death in the United States and accounted 

for two-thirds of all injury deaths from 1999–2004. 

At every age, the majority of injury deaths are 

unintentional, but the risk of death from unintentional 

injury rises dramatically for those over 70 years of age. 

Persons living in rural counties also have higher risks of 

death caused by unintentional injuries. 

Overall, suicides greatly exceed homicides, 

but rates vary by age, sex, and urban or rural 

residence.

Suicides, the 11th leading cause of death in the 

United States, outnumber homicides by 2 to 1. 

However, homicides exceed suicides among young 

adults. Homicide rates are highest in the most urban 

counties, and suicide rates are highest in the most 

rural counties. 
2 Injury in the United States: 2007 Chartbook

The leading mechanisms of injury death also 

vary by age.

Falls are the leading mechanism of injury death for 

elderly people over 72 years of age. For midlife 

adults 35–53 years of age, poisoning is the leading 

mechanism of injury death. Motor vehicles in traffic 

are the leading mechanism of injury death for all other 

age groups, except for children under 2 years of age.

Risks of injury death on the job vary by 

occupation.

On average, more than 5,700 deaths per year were 

due to injuries at work in 2004 and 2005, resulting in 

a fatality rate for occupational injury of 4 deaths per 

100,000 employed workers 16 years of age and over. 

Farming, fishing, and forestry occupations had the 

highest injury fatality rates, but the highest numbers of 

fatal work injuries occurred in construction, extraction, 

and transportation and material moving occupations. 

The United States compares unfavorably with 

other countries in terms of fatal injuries.

Among 18 countries with detailed national injury 

death data available for analysis, the United States had 

the fifth highest injury death rate for teens and young 

adults 15–24 years of age. Only Colombia, South 

Africa, Brazil, and Puerto Rico had higher rates. For 

older adults 65 years of age and over, the U.S. rates 

were comparable with those of South Africa, Brazil, 

and Canada, but were lower than rates in Denmark, 

Mexico, Nicaragua, Austria, Colombia, and Chile.

Current Patterns of Injury 

Morbidity

Risks of hospitalization for injury vary by age 

and sex, with elderly women at particularly 

high risk.

Males have higher hospitalization rates for injury 

among all age groups except for those 65 years of age 

and over. Women 75 years of age and over have the 

highest hospitalization rates for injury of all age and 

sex groups, primarily because of hip fractures. 

Teens and young adults have the highest rate 

of initial emergency department visits for 

injury.

The two leading injury mechanisms resulting in a 

high rate of initial emergency department visits by 

teens and young adults are motor vehicles and being 

struck by or against an object or person. Falls are the 

leading mechanism of injury for all other age groups.

Many injuries occur around the home.

About one-half of all injury episodes occur around 

the home, either inside or outside, with injuries inside 

the home predominate for all age groups except 

teens and young adults, who were equally likely to 

be injured inside the home, at school, on streets and 

highways, and at sports facilities. About one-quarter 

of injury episodes for all age groups resulted from 

leisure activities.

Recent Trends in Injury 

Mortality and Morbidity

Overall injury death rates declined slightly 

during the 1985–2004 period, with some 

variation by intent of injury.

Death rates from unintentional injury and suicide 

were relatively stable throughout the period; both 

were slightly lower in 2004 than in 1985. Homicide 

rates, by contrast, fluctuated more during the period, 

peaking in the early 1990s and then declining. The 

decline has leveled off in recent years.

Injury mortality trends vary considerably 

by mechanism of injury; some causes are on 

the rise, whereas others have declined and 

stabilized.
3 Injury in the United States: 2007 Chartbook

A notable trend over the past two decades is the 

dramatic growth in poisoning deaths; fatal poisoning 

rates doubled from 1985–2004. More recently, death 

rates from falls have also started to increase rapidly.

By contrast, motor vehicle traffic death rates 

declined from the mid-1980s to the mid-1990s 

before stabilizing. In a potentially related trend, the 

proportion of fatally injured drivers who were legally 

intoxicated decreased from one-half in 1982 to onethird in 2004, a decline of 37%. Firearm death rates 

increased from the mid-1980s to the mid-1990s, then 

declined steeply before leveling off in recent years.

Injury morbidity rates have demonstrated 

declining trends among all age groups except 

the elderly.

Hospital discharge rates for injury decreased for all 

age groups except for persons 75 years of age and 

over. These older adults also had much higher rates 

of hospitalization for injury than persons in other age 

groups throughout the 1988–2005 period. Rates for 

adults 65–74 years of age decreased less rapidly than 

the rates for younger age groups. 

Data Sources

This chartbook presents data primarily from the 

Centers for Disease Control and Prevention’s National 

Center for Health Statistics, including the National 

Vital Statistics System, the National Hospital Discharge 

Survey, the National Hospital Ambulatory Medical 

Care Survey, and the National Health Interview 

Survey. Other data sources include the National 

Highway Traffic Safety Administration’s Fatality and 

Analysis Reporting System and the Bureau of Labor 

Statistics’ Census of Fatal Occupational Injuries. In 

addition, many of the participants in the International 

Collaborative Effort on Injury Statistics provided 

international mortality data.
5 Injury in the United States: 2007 Chartbook

Introduction

Injuries caused 1 out of 14 deaths in the United 

States in 2004 (1), including 3 out of 4 deaths among 

adolescents and young adults. In 2005, one in nine 

people in the United States sought medical attention 

for an injury (2). Injury death and disability that 

occurred in 2000 are estimated to cost $80 billion 

in lifetime medical care treatment costs for physical 

injuries and another $326 billion in lifetime lost 

productivity, totaling more than $400 billion for the 

combined economic burden of medical treatment and 

lost productivity (3). 

In order for injury prevention to be effective, both the 

kind of injury sustained as well as what caused the 

injury to occur must be known; that is, did a fractured 

arm result from a fall from playground equipment or 

a fall from a bicycle? Prevention has been particularly 

successful in reducing the traffic-related death toll 

in the past 40 years. Through a combination of 

surveillance, legislation, regulation, enforcement, and 

behavior change programs, a substantial decrease of 

about 70% in the rate of motor vehicle deaths per 100 

million miles traveled occurred during the latter half 

of the 20th century (4). From the early 1990s through 

the end of that decade, the age-adjusted firearm 

death rate declined an average of 6% per year, a total 

decline of 33%. Those years of rapid declines are 

often attributed to a multitude of prevention measures 

that cross the fields of public health, criminal justice, 

and economics (5–7). Public attention to motor 

vehicles and firearms both mobilized and enhanced 

prevention efforts. 

Objectives

The data presented in this book focus on three areas: 

1) how fatal and nonfatal injury rates vary by age, 2) 

the importance of knowing the mechanism of injury 

for prevention purposes, and 3) the comparisons 

of injuries across demographic groups and health 

care settings using standard data categorization 

tools that include the injury diagnosis and external 

cause matrices. This information should provide 

practitioners and policymakers with insights into 

prevention and facilitate comparisons to state-level 

data. All data shown in this chartbook are national in 

scope.

The data in this chartbook can serve as a benchmark 

for states and other locales that desire comparable 

national data on injury. In addition, the frameworks 

for presenting the data in the following figures are 

important standard tools that can foster comparability 

of data.

Describing injuries

In this chartbook, an attempt has been made to 

highlight the most important aspects of injury in the 

United States. Multiple approaches using many data 

sources and classification tools have been used to 

address different aspects of the injury burden. 

Injuries are described by two dimensions: the external 

cause (e.g., car crash) and the diagnosis (e.g., 

fracture). Each dimension has two axes—the external 

cause is categorized by the mechanism (e.g., firearm) 

and the intent (e.g., homicide), and the diagnosis is 

categorized by the nature of the injury (e.g., open 

wound) and the body region of the injury (e.g., chest).

In order to design effective prevention programs to 

reduce injuries or to lessen their severity, one must 

know the mechanism that caused the injury. Common 

examples of mechanisms include motor vehicles, 

firearms, and falls. The intent describes whether the 

mechanism was one of the following:

 Unintentional or accidental (see inset: “Accident 

Crash, Event, or Incident?”).

 Suicide (if fatal) or a self-inflicted event with intent 

to harm oneself (if nonfatal).
6 Injury in the United States: 2007 Chartbook

 Homicide (if fatal) or assault (if nonfatal).

 Undetermined intent.

 Legal intervention or operations of war that 

occurred in the United States. 

The development of two sets of matrices has 

standardized the presentation of injury data. One 

set is for external causes of injury, and the other set 

is for injury diagnoses. The set of external cause of 

injury matrices cross tabulate mechanism of injury by 

intent of injury, with the cells of the matrices being the 

individual International Classification of Diseases (ICD) 

codes for the intent and mechanism. Two external 

cause matrices are for fatal injuries and are based 

on the two most recent revisions of the ICD: ICD–9 

(effective in the United States from 1979–1998) and 

ICD–10 (effective in the United States since 1999). The 

ICD–9 external cause of injury codes were referred to 

as E codes, but with the introduction of ICD–10 and 

its alphanumeric code structure, the external cause of 

injury codes begin with V, W, X and Y, and the term E 

codes could therefore be misleading and should be 

avoided. The third external cause matrix is based on 

the clinical modification of ICD–9 (known as ICD–9–

CM) and is used for classifying nonfatal injury codes 

(8,9).

The second set of matrices is based on the cross 

tabulation of ICD diagnosis codes for the nature of 

the injury (e.g., fracture) by the body region of the 

injury (e.g., hip). The Barell Injury Diagnosis Matrix 

was developed for morbidity data and is based on 

ICD–9–CM codes from Chapter XIX (10). With the 

growing attention to injury diagnoses listed on death 

certificates (referred to as multiple causes of death), 

another matrix was developed for ICD–10 diagnosis 

S and T codes. This matrix is referred to as the Injury 

Mortality Diagnosis Matrix (11). Each of the five 

matrices is shown in Appendix Tables I–V. 

A serious shortcoming of injury data in the United 

States is the paucity of state-level data on the external 

causes of nonfatal injuries. Because no financial 

incentive exists for states to collect the information 

and because there is a lack of understanding of 

how this information could be used to develop 

programs to prevent injuries, only 26 states and the 

District of Columbia have a mandate to require the 

routine collection of external cause codes in their 

hospital discharge data sets (12). Two national groups 

are working to expand the number of states that 

collect the data and to improve the quality of the 

data collected—the Public Health Data Standards 

Consortium (13) and the Workgroup of External Cause 

Codes for Injury, facilitated by the Council of State and 

Territorial Epidemiologists (14). 

 

Data sources

This chartbook compiles data from national surveys 

and the vital statistics system to aid policymakers, 

researchers, and the general public in understanding 

and making policy decisions regarding programs 

aimed at preventing injury death and morbidity. 

The data are primarily from the National Center for 

Health Statistics (NCHS) and include the National 

Vital Statistics System (NVSS), National Hospital 

Discharge Survey (NHDS), National Hospital 

Ambulatory Medical Care Survey (NHAMCS), National 

Ambulatory Medical Care Survey (NAMCS), and the 

National Health Interview Survey (NHIS). Data were 

also obtained from the National Highway Traffic 

Safety Administration’s (NHTSA) Fatality and Analysis 

Reporting System (FARS) as well as the Bureau of 

Labor Statistics’ Census of Fatal Occupational Injuries 

(CFOI). Participants in the International Collaborative 

Effort (ICE) on Injury Statistics provided international 

injury mortality data.

Counting injuries

Injury deaths are annual counts of persons who died 

for whom the death certificate listed an external cause 

as the underlying cause of death. Injury deaths are 

described by both the external cause and the multiple 

causes or injury diagnoses that caused or contributed 
8 Injury in the United States: 2007 Chartbook

to the death. Injury hospitalization estimates are based 

on a national survey of hospital discharges of persons 

whose first-listed diagnosis was an injury as defined 

by the Barell Injury Diagnosis Matrix (10). Emergency 

department (ED) utilization for injury is estimated by 

the annual number of initial visits for an injury to the 

ED for which the first-listed diagnosis was an injury or 

for which there was a valid first-listed external cause of 

injury (15). Episodes of injury are national estimates as 

reported in household interviews. 

This chartbook does not include nonfatal, 

nonmedically attended injuries because these injuries 

are not captured in the medical records or population 

based surveys which are the source of most NCHS 

data. These, for the most part, are not serious injuries. 

As an example, a child who falls and sustains a bruised 

knee may be cared for at home by the parents; this 

injury is not captured in this chartbook.

The incidence of injuries (i.e., number of new cases 

of injury) occurring in the United States cannot be 

readily estimated from existing national data sources 

for several reasons. First, the same injury can appear 

multiple times in a single data system. As an example, 

an injured person may have multiple health care 

encounters for one injury. Each encounter would 

be recorded separately in different data systems 

without the ability to unduplicate them. An injured 

person may be seen in the ED and followed up as 

an outpatient either in a clinic or a private physician 

office. Each of these contacts would be recorded in 

the respective system but would not be identified as 

the same injury.

Race and Hispanic origin

Injury rates vary among racial and ethnic groups, and 

these differences are shown in several charts using 

mortality data from death certificates and injury 

episode data from NHIS. Charts showing mortality 

data by race and Hispanic origin must be interpreted 

with caution. First, the number of people in the 

population that is used as the denominator in the 

calculation of the death rate comes from U.S. Census 

Bureau estimates, and the characteristics of those 

who died used in the numerator comes from either 

the funeral director or the medical examiner. To the 

extent that race and Hispanic origin are reported 

inconsistently by the different data sources for the 

numerator and the denominator, rates will be biased. 

Second, bias in estimates by race and ethnicity also 

results from undercounts of specific populations in the 

census; this results in overestimation of death rates. 

See Appendix II, Race and Hispanic origin, for more 

information. The differences in health status by race 

and Hispanic origin documented in this chartbook 

may be explained by factors including socioeconomic 

status, health practices, psychosocial stress and 

resources, environmental exposures, discrimination, 

and access to health care (16). Because these factors 

are not routinely collected, analyses of injury mortality 

and morbidity by race and ethnicity may lead to 

incorrect inferences. With specific regard to data on 

violence, estimates may be misinterpreted because 

attention could have been directed to the victim 

rather than to the offender, for whom sufficient data 

are not routinely collected. The National Violent 

Death Reporting System (17) promises to improve this 

particular problem by collecting data, when possible, 

on the perpetrator as well as the victim.

Chartbook organization

This chartbook is organized by data source beginning 

with injury mortality and followed by hospitalization 

data, ED data, and household interview level data. The 

first two figures and the final two figures combine data 

across data sources. Each figure has accompanying 

text and one or more data tables which can be found 

in a separate section before the appendices. Many of 

the data tables contain more detail than what is shown 

in the figure as well as detailed figure notes. Appendix 

I includes a detailed description of each of the data 

sources used, and Appendix II contains definitions of 

terms and descriptions of methods used. 

The Web version of this chartbook has an index 
7 Injury in the United States: 2007 Chartbook

to readily locate figures related to a specific risk, 

measure, or data source. Figures are available on the 

Web for use in presentations. 

References: 

1. Miniño AM, Heron MP, Murphy BS, Kochanek KD. Deaths: Final 

data for 2004. National vital statistics report; vol 55 no 20. 

Hyattsville, MD: National Center for Health Statistics. 2007.

2. Adams PF, Dey AN, Vickerie JL. Summary health statistics for 

the U.S. population: National Health Interview Survey, 2005. 

National Center for Health Statistics. Vital Health Stat 10(233). 

2007.

3. Finkelstein EA, Corso PS, Miller TR, et al. The incidence and 

economic burden of injuries in the United States. New York, 

NY: Oxford University Press. 2006.

4. CDC. Achievements in public health, 1900–1999 motor-vehicle 

safety: A 20th century public health achievement. MMWR 

48(18):369–74. 1999.

5. Christoffel T, Gallagher SS. Injury Prevention and Public Health. 

2d ed. Sudbury, MA: Jones and Bartlett Press. 2006.

6. Hemenway D. Private Guns, Public Health. Ann Arbor, MI: 

University of Michigan Press. 2004. 

7. National Research Council. Firearms and violence: A critical 

review. Committee to Improve Research Information and 

Data on Firearms. Wellford CF, Pepper JV, Petrie CV, editors. 

Committee on Law and Justice, Division of Behavioral and 

Social Sciences and Education. Washington, DC: The National 

Academies Press. 2005.

8. World Health Organization. International Statistical 

Classification of Diseases and Related Health Problems, Tenth 

Revision. Geneva: World Health Organization. 1992.

9. Public Health Service and Health Care Financing 

Administration. International Classification of Diseases, Ninth 

Revision, Clinical Modification. Washington: Public Health 

Service. 1980.

10. Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, et 

al. An introduction to the Barell body region by nature of injury 

diagnosis matrix. Inj Prev 8(2):91–6. 2002.

11. Fingerhut LA, Warner M. The ICD–10 Injury Mortality Diagnosis 

matrix. Inj Prev 12(1):24–9. 2006.

12. Council of State and Territorial Epidemiologists. How states 

are collecting and using cause of injury data: 2004 update 

to the 1997 report. A Report by the Council of State and 

Territorial Epidemiologists: Data Committee, Injury Control and 

Emergency Health Services Section. Atlanta, GA. March 2005. 

13. Public Health Data Standards Consortium [online]. Available 

from: http://www.phdsc.org/. 2007.

14. Council of State and Territorial Epidemiologists. CSTE 

committees and consultants [online]. Available from: http://

www.cste.org/committees/EOICommittee.asp. 2007.

15. Fingerhut LA. Recommended definition of initial injury visit to 

emergency departments for use with the NHAMCS-ED data 

[online]. Hyattsville, MD: National Center for Health Statistics. 

Available from: http://www.cdc.gov/nchs/products/pubs/pubd/

hestats/injury/injury.htm. 2006.

16. Williams DR, Rucker TD. Understanding and addressing racial 

disparities in health care. Health Care Finan Rev 21(4):75–90. 

2000.

17. Steenkamp M, Frazier L, Lipskiy N, DeBerry M, Thomas S, 

Barker L, et al. The National Violent Death Reporting System: 

An exciting new tool for public health surveillance. Inj Prev 12 

Suppl 2:ii3–5. 2006. 
9 Injury in the United States: 2007 Chartbook

Accident: Crash,

Incident, or Event?

Finding the appropriate language to define or 

categorize the circumstances leading to injuries has 

posed problems for many in the injury prevention 

and control field because accident may imply that an 

event could not be prevented (1,2,3). In fact, the first 

definition for accident in Webster’s New Collegiate 

Dictionary is “an event occurring by chance or arising 

from unknown causes,” but the second definition 

is “an unexpected happening causing loss or injury 

which is not due to any fault or misconduct on the part 

of the person injured” (4). In this chartbook, the word 

accident is used synonymously with unintentional; it 

does not mean not preventable. 

The word accident is used in the International 

Classification of Diseases and Related Health 

Problems, which is the international standard for 

defining causes of mortality and morbidity (5). 

Accidents are the fifth leading cause of death 

according to the official ranking by the National 

Center for Health Statistics (NCHS); however, in 

deference to often preferred terminology, NCHS 

has added “unintentional injuries” as a parenthetical 

phrase following “accidents” in its standard mortality 

publications (6). 

The National Highway Traffic Safety Administration 

(NHTSA) prefers to use the term crash instead of 

accident. A crash is defined by NHTSA as “an event 

that produces injury and/or property damage, involves 

a motor vehicle in transport, and occurs on a trafficway 

or while the vehicle is still in motion after running off 

the trafficway” (7). However, not all traffic-related 

events are crashes; some are rollovers or noncollisions 

(e.g., being thrown from a vehicle). The Bureau of 

Labor Statistics uses the word incident, as in “highway 

and nonhighway incidents” (8). In the International 

Classification of External Causes of Injury, the term 

accidental is an accepted synonym for unintentional 

(9).

The word accident is often used in this chartbook 

as a noun following “motor vehicle traffic” when 

other phrases are too cumbersome (e.g., motor 

vehicle traffic crashes and noncollisions), confusing 

(e.g., motor vehicle traffic incidents), or not quite 

appropriate (e.g., motor vehicle traffic related injuries). 

References:

1. Pless IB, Hagel BE. Injury prevention: A glossary of terms. J 

Epidemiol Community Health 59(3):182–5. 2005.

2. Davis RM, Pless B. BMJ bans “accidents.” BMJ 

322(7298):1320–1. 2001.

3. Girasek DC. How members of the public interpret the word 

accident. Inj Prev 5(1):19–25. 1999.

4. Webster’s New Collegiate Dictionary. Springfield, MA: G. & C. 

Merriam Company. 1975.

5. World Health Organization. International Statistical 

Classification of Diseases and Related Health Problems, Tenth 

Revision (ICD–10). 1992.

6. Miniño AM, Heron MP, Murphy BS, Kochanek KD. Deaths: Final 

data for 2004. National vital statistics report; vol 55 no 20. 

Hyattsville, MD: National Center for Health Statistics. 2007.

7. National Center for Statistics and Analysis. Fatality analysis 

reporting system (FARS) Web-based encyclopedia. Washington, 

DC: National Highway Traffic Safety Administration. Available 

from: http://www-fars.nhtsa.dot.gov/Help/Terms.aspx.

8. Bureau of Labor Statistics. National census of fatal occupational 

injuries in 2005 [press release]. Washington, D.C.; 2006 Aug 10. 

Available from: http://www.bls.gov/news.release/pdf/cfoi.pdf.

9. ICECI Coordination and Maintenance Group. International 

Classification of External Causes of Injuries (ICECI) version 1.2. 

Consumer Safety Institute, Amsterdam, and AIHW National 

Injury Surveillance Unit, Adelaide. 2004.
Injury Chartbook
12 Injury in the United States: 2007 Chartbook

Figure 1. Injuries in the United States, 2004

33 million episodes 

of medicallyattended injuries 

were reported in a 

national household 

survey.

35 million initial visits for 

injury to physician offices and 

outpatient departments 

 (12%) 

167,184 injury 

deaths (7%)

Initial physician office and outpatient

department visits

1.9 million hospital 

discharges for injury 

(6%)

Hospital

discharges

Deaths

31 million initial

emergency department 

visits for injury

(32%)

Initial

emergency

department

visits

NOTE: The injuries reported by data sources are not 

mutually exclusive. 

SOURCES: CDC/NCHS, National Vital Statistics 

System, National Hospital Discharge Survey, 

National Hospital Ambulatory Care Survey, National 

Ambulatory Medical Care Survey, National Health 

Interview Survey. 
13 Injury in the United States: 2007 Chartbook

Injuries in the United States

Injury deaths and hospitalizations are a relatively small proportion of all deaths and hospitalizations in the United States, whereas emergency department (ED) visits for injuries account for a 

relatively high proportion of all ED visits. However, both pose a high cost to the health care system.

Two methods for assessing the public health impact 

of injuries are counting the annual numbers of fatal 

and nonfatal injuries observed in different health care 

settings and measuring the economic burden posed 

by injuries.

 In 2004, 167,184 people died as a result of injury, 

and injury deaths accounted for 7% of all deaths 

(Figure 1). Furthermore, 1.9 million hospitalizations 

were the result of an injury, accounting for 6% of all 

hospital discharges, and 31 million initial visits for 

injuries were made to the ED, accounting for 32% of 

all initial emergency department visits. Another 35 

million initial visits for injuries were made to physician 

offices and hospital outpatient departments, which 

was 12% of all such visits in 2004. 

 One measure of the economic burden of injury 

is the lifetime medical treatment costs for injuries. 

Injuries that occurred in 2000 are estimated to cost the 

U.S. health care system $1.1 billion for fatal injuries, 

$33.7 billion for injury hospitalizations, $31.8 billion for 

injury emergency department visits, and $13.6 billion 

for other outpatient visits (1). These costs reflect 

treatment for physical injuries only; cost estimates for 

associated mental health and psychological treatment 

are not available.

 Lifetime productivity costs are another dimension 

of economic burden. In 2000, estimated lifetime 

productivity costs were $142 billion for injury 

deaths, $58.7 billion for injury hospitalizations, and 

$125.3 billion for nonhospitalized injuries. Lifetime 

productivity costs include lost wages and benefits as 

well as costs that are due to an inability to perform 

household activities for an injury sustained in 2000 (1).

Reference:

1. Finkelstein EA, Corso PS, Miller TR. The Incidence and 

Economic Burden of Injuries in the United States. New York 

(NY): Oxford University Press. 2006. 
14 Injury in the United States: 2007 Chartbook

Figure 2. Injury rates by age: United States, 2003–2005

0.1

1

10

100

1,000

10,000

Under

1

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

and

Age in years over

Deaths

Hospital discharges

Initial emergency department visits

Events per 10,000 population (log scale)

NOTE: See Appendix II, Hospital discharge for injury; 

Initial injury emergency department visit; Logarithmic 

scale.

SOURCES: CDC/NCHS, National Vital Statistics 

System, National Hospital Discharge Survey, and 

National Hospital Ambulatory Medical Care Survey. 
15 Injury in the United States: 2007 Chartbook

Injury Mortality and Morbidity: Age

Elderly people, especially those aged 85 years and over, are at the greatest risk for both fatal and 

nonfatal injuries. Injury death rates, hospital discharge rates, and emergency department (ED) visit 

rates have secondary peaks among older teenagers and young adults. 

Knowing how injury mortality and morbidity vary by 

age is useful in designing prevention programs and in 

allocating medical resources for treatment. 

 Injury death rates by age were U-shaped for young 

people under 16 years of age, with the death rate for 

infants (3.5 deaths per 10,000 population) in 2003–

2004 as high as the rate for 16-year-old teenagers (4.0 

deaths per 10,000 population) (Figure 2). Children 

6–11 years of age had the lowest injury death rate at 

0.6 deaths per 10,000 population.

 For young adults 18–24 years of age as well as 

older adults 41–48 years of age, death rates averaged 

6.9 deaths per 10,000 population in 2003–2004. 

Beginning with older people in their mid-70s, death 

rates increased steadily, and for those 85 years of age 

and over, the injury death rate reached 29.8 deaths 

per 10,000 population.

 Similar to injury mortality, injury hospital discharge 

rates were U-shaped for those younger than 16 years 

of age, with the discharge rate for those at 1 year of 

age (53.6 discharges per 10,000 population) in 2004–

2005 similar to that for 15-year-old teenagers. Injury 

discharge rates fluctuated from 37 to 65 discharges 

per 10,000 population for those 16–64 years of age; 

the rates then increased for person 85 years of age 

and over, reaching just over 500 discharges per 10,000 

population. 

 Initial injury-related ED visit rates were U shaped 

for young people in 2004–2005, with peaks at about 

1,400 to 1,700 visits per 10,000 population for young 

children 1–3 years of age, and rates ranging from 

1,300 to 1,600 visits per 10,000 population for young 

people 12–28 years of age. ED visit rates declined 

through the middle adult years before rising once 

more for those at the oldest ages. 
16 Injury in the United States: 2007 Chartbook

Figure 3. Injury deaths as a percentage of total deaths and injury death rates,

by age: United States, 2003–2004 

0

10

20

30

40

50

60

70

80

90

Under

1

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

and

over

Age in years

0

50

100

150

200

250

300

350

Injury deaths as percent of total deaths

Injury death rate

Percent

Deaths per 100,000 population

SOURCE: CDC/NCHS, National Vital Statistics System.
17 Injury in the United States: 2007 Chartbook

Injury Mortality and Age

In 2003–2004, injuries accounted for more than one-half of all deaths among teens and young 

adults; injury death rates were higher for people 75 years of age and over, but injury as a percentage 

of all deaths was low.

To understand the impact of injury on society, 

injury deaths by age should be examined both as a 

percentage of all deaths and as the number of deaths 

per 100,000 population. The former is an indicator 

of the relative burden of injury on particular ages, 

whereas the latter is considered an indicator of relative 

frequency of injury in the population.

 Injury deaths accounted for more than one-half of 

all deaths among people 13–32 years of age (Figure 

3). Four out of five deaths among people 18 and 

19 years of age were due to injury. For people over 

60 years of age, less than 5% of deaths were due to 

injury.

 Age-specific injury death rates peak first among 

teenagers and young adults and then again among 

older people 65 years of age and over. Injury death 

rates for all ages are lowest for children 6–11 years of 

age (6 deaths per 100,000 population) and highest 

(at close to 300 deaths per 100,000 population) for 

people 85 years of age and over. 

 At every age, injury death rates for males are 

higher than those for females. The mortality sex 

ratio (the ratio of death rates for males to females) is 

highest, at 4 to 1, for young people in their twenties 

and is lowest for children under 11 years of age (less 

than 2 to 1). For all other ages, injury death rates for 

males are two to three times the rates for females (see 

data table for Figure 3). 
18 Injury in the United States: 2007 Chartbook

Year

Deaths per 100,000 population ( log scale)

Figure 4. Age-adjusted injury death rates by intent and year: United States,

1985–2004

1

10

100

1985 1990 1995 2000 2004

ICD–9 ICD–10

All injury

Unintentional

Suicide

Homicide

NOTES: ICD is International Classification of Diseases. 

Rates are age adjusted to the 2000 U.S. standard 

population. See Appendix II, Age adjustment; 

Logarithmic scale.

SOURCE: CDC/NCHS, National Vital Statistics 

System. 

 

 
19 Injury in the United States: 2007 Chartbook

Mortality Trends: Intent of Injury

Injury death rates changed little from 1985 through 2004; homicide rates decreased more than 

unintentional injury or suicide rates, although declines for all three rates appear to have leveled off 

in recent years.

Examining injury death rates by intent over a period 

of years can aid in determining where prevention 

efforts have helped reduce injury-related deaths and 

where prevention efforts need to be directed (1). 

Intent indicates whether the act that caused the injury, 

according to the medical examiner or coroner, was 

purposeful or not. 

 The age-adjusted injury death rate in 2004, 56.4 

deaths per 100,000 population, was 6.5% lower than 

the rate in 1985. The rate declined an average of 

1.1% per year from 1985 through 1999, and then it 

increased at an average annual rate of 1.3% through 

20041

 (Figure 4). 

 Trends in the age-adjusted unintentional injury 

death rate were somewhat more episodic than the 

overall injury death rate pattern. The rate declined 

3.5% annually from 1988 through 1992 and increased 

at an annual rate of 1.9% from 2000 through 2004. 

Overall, the rate was relatively unchanged, from 38.6 

deaths per 100,000 population in 1985 to 37.7 deaths 

per 100,000 in 2004.

 The age-adjusted suicide rate was 12.7% lower 

in 2004 than in 1985. From 1985 through 1995, the 

rate fell by an average of 0.8% per year, followed 

immediately by a period of more rapid decline of 2.4% 

per year through 2000. The age-adjusted rate did not 

change through 2004.

 Trends in age-adjusted homicide rates differ 

from trends in unintentional injury and suicide. The 

homicide rate in 2004 was 25.9% lower than that in 

1985. From 1985 through 1993, the homicide rate 

increased an average of 2.7% per year, followed by 

rapid annual declines of 8.3% through 1998. Homicide 

rates during the last several years have not changed 

significantly. Preliminary 2005 data from NCHS show 

that the homicide rate remained unchanged (2). 

However, preliminary data for 2006 released by the 

Department of Justice show that the homicide trend 

has reversed and that rates are increasing (3). 

References:

1. Fingerhut LA, Warner M. Injury Chartbook. Health, United 

States, 1996–1997. Hyattsville, MD: National Center for 

Health Statistics. 1997.

2. National Center for Health Statistics. Deaths: Preliminary Data 

for 2005 [online]. Available from: http://www.cdc.gov/nchs/

products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.

htm. 2007.

3. Federal Bureau of Investigation. Crime in the United States, 

2006. Washington DC: U.S. Department of Justice. Available 

from: http://www.fbi.gov/ucr/prelim06/t3datadec.htm. 2007.

1

 All average annual percent changes were calculated by fitting 

regression lines to the data points. See Appendix II, Average 

percent change and test of trends.
20 Injury in the United States: 2007 Chartbook Deaths per 100,000 population

Figure 5-1. Injury death rates by intent and age: United States, 2003–2004

Under

1

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

and

over Age in years

Unintentional

Suicide

Homicide

278 per 100,000

0

20

40

60

80

100

120

140

160

NOTES: Suicide rates are not calculated for children 

under 5 years of age. Rates are not shown when 

based on fewer than 20 deaths; they are considered 

unreliable. See Appendix II, Relative standard error.

SOURCE: CDC/NCHS, National Vital Statistics 

System. 
21 Injury in the United States: 2007 Chartbook

Mortality: Intent of Injury and Age

At every age, the majority of injury deaths are unintentional. For people 28 years of age and 

over, suicide rates consistently exceed homicide rates. 

In 2003–2004, unintentional injuries for all ages combined accounted for 67% of all injury deaths and were 

the 5th leading cause of death in the United States, 

suicides accounted for 19% of all injury deaths and 

were the 11th leading cause of death, and homicides 

accounted for 11% of all injury deaths and were the 

15th leading cause of death. Injury deaths of undetermined intent accounted for 3% of all injury deaths, and 

deaths from legal intervention or operations of war 

accounted for less than 1% of all injury deaths (Figure 

5-1).

 Unintentional injury deaths account for more injury 

deaths at each age than any other category of intent 

(Figure 5-2). 

 For all ages combined, there continue to be 

nearly twice the number of suicides than homicides. 

Suicide is the second leading intent of injury death for 

people 28 years of age and over. For people 17–27 

years of age, homicide rates exceed suicide rates. 

For people 28 years of age and over, the suicide rate 

stays relatively constant, whereas the homicide rate 

decreases as age increases. For children 11–12 years 

of age and for teenagers 15–16 years of age, suicide 

and homicide rates are similar; suicide rates exceed 

homicide rates for teens 13–14 years of age.1

 Unintentional injury death rates peak for young 

people 18–22 years of age, attain a secondary peak 

for adults in their 40s, and then rise continually 

with age among adults 70 years of age and over. 

Unintentional injury death rates are higher for males 

than for females; the disparity is greatest among 

people 19–36 years of age, with rates for males 

averaging three times those for females (see data 

table for Figure 5-2). 

 Suicide rates first peak for adults in their 40s and 

early 50s and then begin to rise once more at 75 years 

1

 Suicides are not reported for children younger than 5 years of age, 

and in some jurisdictions, medical examiners do not consider them 

for children up through 9 years.

of age. Suicide rates for young men 20–25 years of 

age are about six times those for women, with greater 

sex disparities for the oldest ages.

 Homicide rates are highest for young people 

18–27 years of age. Homicide rates for males exceed 

those for females. For those at the oldest ages, rates 

for men and women are similar. The sex disparities 

are highest for young people 16–29 years of age, 

where rates for males are five to seven times those for 

females.

Figure 5-2. Distribution of injury deaths

by intent: United States, 2003–2004

Unintentional

67%

Suicide

19%

Homicide

11%

Undetermined

3%

Legal intervention or

operations of war–

less than 1% 

SOURCE: CDC/NCHS, National Vital Statistics System. 
22 Injury in the United States: 2007 Chartbook

Figure 6. Age-adjusted injury death rates for leading mechanisms of injury,

by year: United States, 1985–2004

0

5

10

15

20

1985 1990 1995 2000 2004

Deaths per 100,000 population

ICD–9 ICD–10

Year

Motor vehicle traffic

Firearm

Poisoning

Fall

Suffocation

NOTES: ICD is International Classification of Diseases. 

Rates are age adjusted to the 2000 U.S. standard 

population. See Appendix II, Age adjustment.

SOURCE: CDC/NCHS, National Vital Statistics System. 
23 Injury in the United States: 2007 Chartbook

Mortality Trends: Mechanism of Injury

Poisoning death rates are rising rapidly, even as motor vehicle traffic death rates remain flat and 

firearm death rates have leveled off after a rapid decline in the 1990s.

Trends1 in the leading mechanisms of injury can 

provide insights concerning the impact of prevention 

efforts. The injury death rate trends in this chart are 

shown for the five leading mechanisms of injury death 

for all ages. 

 Motor vehicle traffic accidents remain the leading 

cause of injury death in the United States (Figure 6). 

The age-adjusted motor vehicle traffic death rate in 

2004 (14.7 per 100,000 population) was 19% lower 

than the rate in 1985. Most of the decline occurred 

from 1988 through 1992, when the rate decreased 

an average of 4.7% per year. Since then, the rate has 

fluctuated, with only modest declines of less than 1% 

per year. 

 The age-adjusted death rate for poisoning, the 

second leading mechanism of injury death as of 2004, 

doubled from 1985 through 2004 to 10.3 deaths per 

100,000 population. Most of the increase occurred 

from 1998 through 2004, when the rate increased an 

average of 8.2% per year. The 2004 rate is higher than 

the rate has been at any time since 1968, when data 

were first categorized by mechanism regardless of 

intent.2 

 From 1985 through 2004, the age-adjusted 

firearm death rate declined 24% to 10.0 deaths per 

100,000 population. From 1985 through 1993, the rate 

increased an average of 1.9% per year, followed by 

a steep decline of 6.1% per year from 1993 through 

1999. Since then, the rate has remained flat. 

 From 1985 through 2004, the age-adjusted death 

rate for falls increased 38%, reaching 6.5 deaths per 

100,000 population in 2004. Most of the increase 

occurred after 1993. During the years 1985–2004, the 

proportion of older adults living with chronic diseases 

in the population increased. People in this group 

are at greater risk for falling and are less likely than 

younger people to survive the injuries resulting from a 

fall (2). 

 Compared with the other leading mechanisms of 

injury, suffocation rates have two distinct periods of 

change from 1985 through 2004; from 1985 through 

1994, the rate declined by an average of 1.7% per 

year, followed by a period of increase of 2.1% per year 

through 2004. 

 Drowning rates declined at an average rate of 

2.6% per year from 1985 through 2004 (see data table

for Figure 6). 

References:

1. Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, 

Warner M. Deaths: Injuries, 2002. National vital statistics 

reports; vol 54 no 10. Hyattsville, MD: National Center for 

Health Statistics. 2006.

2. CDC. Fatalities and injuries from falls among older 

adults—United States, 1993–2003 and 2001–2005. MMWR 

55(45):1221–4. 2006. 1

 All average annual percent changes were calculated by fitting 

regression lines to the data points. See Appendix II, Average

percent change and test of trends. 2

 An unknown portion of the rate increase from 2001 to 2002 

resulted from a change in follow-up procedures put in place by 

NCHS to speed up the process by which certificates are amended 

from “pending investigation” to a known cause (1). 
24 Injury in the United States: 2007 Chartbook

Figure 7. Injury death rates for leading mechanisms of injury, by age:

United States, 2003–2004

Under

1

5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85

and

Age in years over

Deaths per 100,000 population

Motor vehicle traffic

Firearm

Poisoning

Fall

Suffocation

140.3

0

10

20

30

40

50

60

70

80

90

100

NOTES: Death rates by single year of age are unreliable 

for many mechanisms of injury among children and young 

teens under 15 years of age. In this figure, firearm death 

rates are shown for those aged 7 years and over, 

poisoning death rates are shown for those aged 11 years 

and over, fall death rates are shown for those aged 15 

years and over, and suffocation death rates are shown for 

those aged 8 years and over. See data table for specific 

rates that are reliable although not shown in this figure, 

and see Figure 7-1 for the leading mechanisms and 

age-specific rates for children under 5 years of age.

SOURCE: CDC/NCHS, National Vital Statistics System. 
25 Injury in the United States: 2007 Chartbook

Mortality: Mechanism of Injury and Age

Injury death rates for the leading mechanisms of injury—motor vehicles, firearms, poisonings, falls, 

and suffocation—vary by age. 

Determining the mechanism by which a death occurred is the first step toward preventing injury deaths 

because the mechanism provides information on the 

behaviors and events that preceded the injury death 

(1,2). 

 

 Motor vehicle traffic fatalities were the leading 

mechanism of injury death for people 3–33 years 

of age as well as people 54–72 years of age. Motor 

vehicle traffic death rates were highest for young 

people 18–21 years of age with a somewhat lower 

secondary peak for older adults (Figure 7). 

 Poisonings were the leading mechanism of injury 

death for people 34–53 years of age, and falls were 

the leading mechanism for older adults 73 years 

of age and over. Firearms were not the leading 

mechanism of injury death at any single year of age 

despite being the third leading mechanism of injury 

death across all ages combined.

 Suffocation was the leading mechanism of injury 

death for infants less than 1 year of age, and drowning 

was the leading mechanism for 1-year-olds. For 2-yearolds, drowning and motor vehicle traffic fatalities were 

the two leading causes of death, followed by fires and 

burns. For children 3 and 4 years of age, the second 

leading mechanism of injury death following motor 

vehicles was drowning, and the third was fires and 

burns (Figure 7-1). 

 The death rates for males were higher than those 

for females for every mechanism of injury death at 

nearly every single year of age (see data table for

Figure 7).

References:

1. Christoffel T, Gallagher S. (2006). Injury Prevention and Public 

Health. 2d ed. Sudbury, MA: Jones and Bartlett Press. 2006.

2. Bonnie R, Fulco C, et al., editors. Reducing the Burden of 

Injury. Washington, DC: National Academies Press. 1999.

0

2

4

6

8

10

12

14

16

18

20

Under 1 1 2 3 4

Age in years

Motor vehicle traffic

Drowning

Suffocation

Fire and burn

Poisoning

Figure 7-1. Injury death rates for leading

mechanisms of injury, for infants and

children under 5 years of age:

United States, 2003–2004 

Deaths per 100,000 population

NOTES: Poisoning death rates are unreliable for children 3 and 4 

years of age. See Appendix II, Relative Standard Error.

SOURCE: CDC/NCHS, National Vital Statistics System. 
26 Injury in the United States: 2007 Chartbook

Figure 8-1. Percent distribution of injury deaths, by body region of injury:

United States, 2003–2004

0

10

20

30

40

50

Head

and neck

Spine and

upper

back

Torso Hip Other

extremities

Unclassifiable

by body

region

Unspecified

Body region

Percent

Figure 8-2. Percent distribution of injury deaths, by nature of injury:

United States, 2003–2004

0

10

20

30

40

50

Poisoning and

toxic effects

Open

wound

Other effects

of external cause

Fracture Internal

organ

Other

specified

Unspecified

Nature of injury

Percent

NOTE: See Table 8 on page 94 for the total mention of 

injury deaths for each cell of the Injury Mortality Dianosis 

Matrix.

SOURCE: CDC/NCHS, National Vital Statistics System. 
27 Injury in the United States: 2007 Chartbook

Mortality: Body Region and Nature of Injury 

The body region specified most often for injury deaths was the head and neck. Poisoning and open 

wounds were among the leading specified nature of injury categories.

In general, injury diagnoses (i.e., body region and 

nature of injury) from death certificates have not been 

given as much attention in the public health literature 

as have external causes of injury. Diagnosis is important for understanding the patterns of injury and for 

preventing injury. The Injury Mortality Diagnosis (IMD) 

Matrix is useful for this purpose and is described in 

Appendix II.

 In 2003–2004, injury deaths had an average of 1.5 

injury conditions mentioned on the death certificate.1

 

 Over one-quarter of injury deaths involved injuries 

to the head and neck. Nine out of ten head and neck 

injuries were classified as traumatic brain injuries (see 

data table for Figure 8-1).

 About 4 in 10 injuries were not to a specific body 

region but involved either multiple body regions 

(12%) or were system-wide, affecting the entire body 

system (30%). Over 80% of injuries involving multiple 

body regions had no information about the nature of 

the injury and were categorized as unspecified injury. 

About one-half of those injuries involving the entire 

body system had a poison substance mentioned 

(Figure 8-1).

 Poisonings (including toxic effects) and open 

wounds each accounted for almost one-fifth of 

diagnoses in injury deaths (Figure 8-2). Narcotics and 

psychodysleptics were involved in about one-third of 

the poisonings, and psychotropic drugs and carbon 

monoxide were each involved in 7% of the poisonings. 

 The category “other effects of external causes” 

includes primarily asphyxiation (60%) and drowning 

(30%).

 About one-half of the open wounds were in the 

head and neck regions, and one-fifth were in the torso 

(see Table 8 on page 94).

 About one-half of the fractures leading to 

mortality were hip fractures. In total, about 4% of all 

injury deaths involved a hip fracture and nearly all 

were among adults 65 years of age and over (Table 8).

 The nature of injury was unspecified in about 30% 

of the deaths. However, the majority of injuries with 

an unspecified nature did have a specific body region 

mentioned. Of injuries with an unspecified nature of 

injury, over one-third were injuries to the head and 

neck, and one-third involved multiple body regions.

1

 Injury diagnosis data presented in Figures 8-1, 8-2, and 9 adjust for 

deaths mentioning more than one injury condition. See Appendix II, 

Multiple cause-of-death data and injury diagnoses. 
28 Injury in the United States: 2007 Chartbook

Figure 9. Percent distribution of deaths by body region of injury, for motor vehicle

traffic accidents, firearm suicides, and firearm homicides: United States, 2003–2004

0

10

20

30

40

50

60

70

80

90

100

Motor vehicle traffic accidents

(unintentional)

Firearm suicides Firearm homicides

Mechanism and intent of death

Head and neck Torso Other

specified

Unclassifiable

by body region

Unspecified

Percent

SOURCE: CDC/NCHS, National Vital Statistics System. 
29 Injury in the United States: 2007 Chartbook

Mortality: Mechanism and Body Region of Injury

Three-fourths of injuries from firearm suicides, compared with one-third of all injuries from firearm 

homicides and fatal motor vehicle traffic accidents, were injuries to the head and neck. 

The body regions injured in motor vehicle traffic accidents, firearm homicides, and firearm suicides vary by 

mechanism and intent of injury. 

 Injuries involving the head and neck and injuries 

that were not classifiable by body region each 

accounted for one-third of motor vehicle traffic-related 

fatal injuries (Figure 9). Many of the unclassifiable 

injuries were coded as multiple body regions.

 Firearm suicides were most likely to involve the 

head and neck, accounting for about three-fourths of 

the suicides, whereas firearm homicides were equally 

likely to involve either the head and neck or the torso, 

with each of these body regions accounting for about 

one-third of all fatal injuries.

 The majority of firearm suicides resulted from a 

single wound to the head (data not shown). 
30 Injury in the United States: 2007 Chartbook

NOTES: Race and Hispanic origin categories are not 

mutually exclusive. When an asterik (*) is shown in place of a 

bar, the rate is based on fewer than 20 deaths and is 

considered unreliable. See Appendix II, Relative standard 

error.

SOURCE: CDC/NCHS, National Vital Statistics System. 

Figure 10-1. Under 25 years of age

10

20

30

40

50

Motor vehicle traffic Firearm Poisoning Suffocation

Motor vehicle traffic Firearm Poisoning Suffocation

Motor vehicle traffic Firearm Poisoning Suffocation Fall

Figure 10-2. 25–64 years of age 

10

20

30

40

50

Figure 10-3. 65 years of age and over

0

10

20

30

40

50

Hispanic American Indian or

Alaska Native

Asian or

Pacific Islander

Race and Hispanic origin

Figure 10. Injury death rates for leading mechanisms of injury, by race and

Hispanic origin: United States, 2003–2004

Hispanic American Indian or

Alaska Native

Asian or

Pacific Islander

Non-Hispanic

white

Black Hispanic American Indian or

Alaska Native

Asian or

Pacific Islander

0

0

Deaths per 100,000 population Deaths per 100,000 population Deaths per 100,000 population

Non-Hispanic

white

Black

Non-Hispanic

white

Black
31 Injury in the United States: 2007 Chartbook

Mortality: Mechanism by Race, Hispanic Origin, and Age 

For the population under the age of 65 years, the leading causes of injury death differ by race 

and Hispanic origin.

Cultural norms and practices are associated with race 

and Hispanic origin (or ethnicity); therefore, knowledge of how race and ethnicity relate to mechanism 

of injury death may help in addressing aspects of 

prevention programs. Race and ethnic disparities 

reflect factors including socioeconomic status, health 

practices, psychosocial stress and resources, environmental exposures, discrimination, and access to health 

care, all of which can influence levels of mortality (1). 

Inclusion of all of these factors would most likely alter 

the association between mechanism of death and race 

and Hispanic origin, but that is beyond the scope of 

this report. (See Appendix II, Race and Hispanic origin, 

for a discussion of issues regarding validity of race 

specific death rates.)

Under 25 years of age

 Among young people under 25 years of age, the 

American Indian or Alaska Native population had the 

highest injury death rate at 47.6 deaths per 100,000 

population, followed by the young black population at 

a rate of 41.3 deaths per 100,000 population (see data

table for Figure 10-1).

 Motor vehicle traffic accidents were the leading 

cause of injury death in this age group except for the 

black population, for whom firearms were the leading 

cause of injury death (Figure 10-1). Nearly 9 out of 

10 of the firearm deaths among the young black 

population were homicides. 

 Firearms were the second leading cause of death 

for each of the other race and ethnic groups, although 

for the non-Hispanic white population, the poisoning 

death rate was similar to the firearm death rate.

25–64 years of age

 Among adults 25–64 years of age, American 

Indian or Alaska Natives had the highest injury death 

rate at 86.4 deaths per 100,000 population, followed 

by the rate for the black population at 74.9 deaths per 

100,000 population (see data table for Figure 10-2). 

 For Hispanics, American Indian or Alaska Natives, 

and Asian or Pacific Islanders, motor vehicle traffic 

accidents were the leading cause of injury death 

(Figure 10-2). For the black population, firearms 

were the leading cause of injury death, and for the 

non-Hispanic white population, poisonings were the 

leading cause of injury death.

65 years of age and over

 Among older Americans, the injury death rate 

was highest for the non-Hispanic white population, 

at 120.8 deaths per 100,000 population, and the 

rate was lowest for both the Asian or Pacific Islander 

population and the Hispanic population, with 

both rates averaging about 70 deaths per 100,000 

population (see data table for Figure 10-3).

 Falls and motor vehicle traffic accidents were the 

two leading causes of injury death for each of the race 

and ethnic groups (Figure 10-3). The death rate from 

falls was higher than the motor vehicle traffic death 

rate for the non-Hispanic white, Hispanic, and Asian 

or Pacific Islander populations, and the two rates were 

similar for the black population and the American 

Indian or Alaska Native population.

Reference:

1. Williams DR, Rucker TD. Understanding and addressing racial 

disparities in health care. Health Care Financ Rev 21(4):75–90. 

2000.
32 Injury in the United States: 2007 Chartbook

Figure 11. Age-adjusted injury death rates by intent of injury and level

of urbanization: United States, 2003–2004 

0

10

20

30

40

50

60

Unintentional Suicide Homicide

Intent

Large

central

metro

Large

fringe

metro

Medium

metro

Small

metro

Micropolitan

(nonmetro)

Noncore

(nonmetro)

Deaths per 100,000 population

NOTE: See Appendix II, Age adjustment; Urbanization. SOURCE: CDC/NCHS, National Vital Statistics System, 

Compressed Mortality File.
33 Injury in the United States: 2007 Chartbook

Mortality: Intent and Mechanism of Injury and Level of

Urbanization

Death rates from unintentional injuries and suicides are highest in the most rural counties, whereas 

homicide rates are highest in the most urban counties.

Injury death rates vary with the level of urbanization of 

the community (1,2). Communities at different levels 

of urbanization vary in demographic, environmental, 

economic, and social characteristics, factors which 

influence injury mortality rates. Additionally, rural 

communities generally have less access to health care 

than more urban communities, which may potentially 

result in less timely treatment of injuries (3).

 Unintentional injury death rates are similar for 

large central metro and large fringe metro counties, 

and these rates increase as a county becomes 

progressively more rural (Figure 11). 

 Suicide rates, following the same pattern as 

unintentional injury death rates, also increase as a 

county becomes more rural. 

 Homicide rates follow a different pattern. The 

average homicide rate in large central metro counties 

is significantly higher than rates in less urbanized 

counties.

 The relationship between degree of urbanization 

and mechanism of injury must be understood in the 

context of intent. Motor vehicle traffic death rates, 

which are all classified as unintentional, follow the 

same general pattern of all unintentional injury death 

rates (Figure 11-1). That is, they increase as counties 

become more rural, as do firearm suicide rates. Large 

central metro areas, by contrast, have the highest 

average firearm homicide rate—more than twice the 

rate for any other level of urbanization. 

 Motor vehicle traffic death rates ranged from 10.6 

deaths per 100,000 population in the large central 

metro county group to 28.5 deaths per 100,000 

population in the noncore, nonmetropolitan county 

group. The urbanization gradient for all other (not 

motor vehicle traffic) unintentional injuries was not 

nearly as steep, with rates ranging from 19 to 29 

deaths per 100,000 population (data not shown).

References:

1. Eberhardt MS, Pamuk ER. The importance of place of 

residence: Examining health in rural and nonrural areas. Am J 

Public Health 94(10):1682–6. 2004.

2. Baker SP, O’Neill B, Ginsburg MJ, Li G. The Injury Fact Book. 

2d ed. New York, NY: Oxford University Press. 1992.

3. Eberhardt MS, Ingram DD, Makuc DM, et al. Urban and Rural 

Health Chartbook. Health, United States, 2001. Hyattsville, 

MD: National Center for Health Statistics. 2001.

Figure 11-1. Age-adjusted injury death

rates for motor vehicle traffic accidents,

firearm suicides, and firearm homicides,

by level of urbanization:

United States, 2003–2004 

0

10

20

30

40

50

60

Motor vehicle

traffic accidents

(unintentional)

Firearm

suicides

Firearm

homicides

Large

central

metro

Large

fringe

metro

Medium

metro

Small

metro

Micropolitan

(nonmetro)

Noncore

(nonmetro)

Deaths per 100,000 population

Mechanism and intent of death

SOURCE: CDC/NCHS, National Vital Statistics System, 

Compressed Mortality File. 

 
34 Injury in the United States: 2007 Chartbook

Figure 12. Selected occupational injury death rates for employed persons

16 years of age and over, by occupational group: United States, 2004–2005 

0 20 40 60 80 100 120

Fishers and related

fishing workers

Logging workers

Farming, fishing,

and forestry

Installation, maintenance

and repair

Farmers and ranchers

 Management, business

and financial

Sales and related

Construction and

extraction

Aircraft pilots and

flight engineers

Transportation and

material moving

Deaths per 100,000 employed persons

Average number of fatalities

in 2004 and 2005 = 5,749

All worker fatality rate = 4.0 per

100,000 employed persons

NOTES: Totals for major categories may include 

subcategories not shown separately. Categories not in 

bold are subsets of bolded categories above.

SOURCE: U.S. Department of Labor, Bureau of Labor 

Statistics, Census of Fatal Occupational Injuries. 
35 Injury in the United States: 2007 Chartbook

Occupational Injury Mortality

Farming, fishing, and forestry workers had the highest occupational injury fatality rates. However, 

transportation and material moving as well as construction and extraction occupations had the 

highest number of fatal work injuries. 

Targeting injury prevention efforts in occupational 

groups with high fatality rates and with high numbers 

of fatalities can lead to a reduction of injuries in the 

workplace. Although the number of occupationally 

related fatalities is a small subset of overall injury 

fatalities, the injuries occur in a more controlled 

environment with a potentially better opportunity for 

targeted prevention programs.

 In 2004–2005, an average of 5,749 fatalities 

occurred at work, resulting in an occupational injury 

fatality rate of 4.0 deaths per 100,000 employed 

workers 16 years of age and over (see data table for

Figure 12).1

 

 In 2004, approximately 4% of all injury deaths in 

the United States among people 16 years of age and 

over were work-related.

 Workplace deaths among people involved 

in transportation and material moving as well as 

construction and extraction occupations accounted for 

nearly one-half of the occupational injury fatalities (see 

data table for Figure 12).

 Farming, fishing, and forestry occupations, 

including loggers and fishers, had among the highest 

fatality rates of all occupations (Figure 12). 

 Transportation accidents were the leading cause 

of death for occupational injuries, accounting for 43% 

of occupational injury fatalities in 2004–2005 (Figure 

12-1). 

 Contact with objects and equipment was the 

second leading cause of fatal occupational injury, 

accounting for 18% of the deaths, followed by 

assaults and other violent acts (including homicide and 

suicide), which accounted for 14% of the deaths. Falls 

also accounted for 14% of deaths.

 In 2004–2005, homicide accounted for 24% of 

fatal occupational injures for women, compared 

with 9% for men. The homicide rate, however, for 

employed men was four times that for employed 

women (data not shown in figure or table).

Figure 12-1. Percent distribution of

occupational injury fatalities, by type of

event or exposure: United States,

2004–2005 

Transportation

accidents

43%

Contact with

objects and equipment

18%

Assaults and violent

acts

14%

Falls

14%

Exposure to harmful 

substances and 

environments

8%

Fires and

explosions

3%

NOTE: Categories are based on the 1992 Bureau of Labor 

Statistics Occupational Injury and Illness Classification Manual.

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, 

Census of Fatal Occupational Injuries. 

1 An average of 23 occupational fatalities per year occurred for 

those younger than 16 years of age.
36 Injury in the United States: 2007 Chartbook

Figure 13. Percentage of fatally injured drivers of passenger vehicles with blood

alcohol concentration of 0.08 percent or greater, by driver age:

United States, 1982–2004 

0

10

20

30

40

50

60

70

1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004

Year

21–30 years

31 years and over

16–20 years

Percent

NOTE: See Appendix II, Blood alcohol concentration. SOURCE: Insurance Institute for Highway Safety, 

based on data from the National Highway Traffic Safety 

Administration, Fatality Analysis Reporting System. 
37 Injury in the United States: 2007 Chartbook

Motor Vehicle Traffic Deaths: Driver Mortality and Alcohol

The proportion of fatally injured drivers who were legally intoxicated has declined for all age groups 

since 1982; most of the decline occurred by the mid-1990s.

The decrease in motor vehicle traffic death rates over 

the past several decades has been attributed to several factors, including changes in vehicle and highway 

design as well as changes in driver and passenger 

behaviors (1). Alcohol-impaired driving is one of the 

major risk behaviors for motor vehicle traffic accidents. 

The proportion of fatally injured drivers who were legally intoxicated is used as an indicator to track trends 

in impaired driving (see Appendix II, Alcohol-impaired 

driving).

 For all ages combined, legally intoxicated drivers 

(those with a blood alcohol concentration equal to 

or greater than 0.08) accounted for one-half of all 

fatally injured drivers in 1982, compared with onethird in 2004, a decrease of 38%. Significant average 

annual percent declines occurred between 1982 and 

1997, including a 5.2% decrease per year from 1982 

through 1985, a 1.4% decrease per year from 1985 

through 1990, and a 3.2% decrease per year from 

1990 through 1997; since 1997, little progress has 

been made (2). Declines in the percentage of legally 

intoxicated drivers who were involved in fatal crashes 

were greater for young people 16–20 years of age 

(51% decline) than for those 21–30 years of age (25% 

decline) or 30 years of age and over (36% decline) 

(Figure 13). 

 For young people 16–20 years of age, the decline 

in the percentage of fatally injured drivers who were 

legally intoxicated had occurred by 1995. Significant 

declines occurred during two periods, one from 1982 

through 1987 (7.3% annual decline) and the other 

from 1991 through 1995 (7.6% annual decline). Most 

recently, from 1995 through 2004, there has been no 

change.

 In 2004, nearly one-half of fatally injured drivers 

21–30 years of age were legally intoxicated and about 

one-quarter of fatally injured drivers 16–20 years 

of age and 30 years of age and over were legally 

intoxicated.

References:

1. CDC. Achievements in public health, 1900–1999 motor-vehicle 

safety: A 20th century public health achievement. MMWR 

48(18):369–74. 1999.

2. Insurance Institute for Highway Safety. IIHS fatality facts 2005, 

alcohol. Available from: http://www.iihs.org/research/fatality_

facts/alcohol.html. 2007. 
38 Injury in the United States: 2007 Chartbook

Figure 14-1. Injury death rates for teens and young adults 15–24 years of age, by

leading mechanisms of injury: Selected countries, most recent data years available 

0 50 100 150 200 250

Netherlands

England and Wales

Denmark

Northern Ireland

Australia

Austria

Canada

Chile

Eastern Caribbean

Nicaragua

Mexico

New Zealand

Argentina

United States

Puerto Rico

Brazil

South Africa

Colombia

Deaths per 100,000 population

Motor vehicle traffic Firearm All other

Figure 14-2. Injury death rates for persons 65 years of age and over, by leading

mechanisms of injury: Selected countries, most recent data years available 

0 50 100 150 200 250

Puerto Rico

England and Wales

Northern Ireland

New Zealand

Australia

Argentina

Netherlands

Canada

Brazil

South Africa

United States

Chile

Colombia

Austria

Nicaragua

Mexico

Denmark

Deaths per 100,000 population

Falls Motor vehicle

traffic

Unspecified All other

SOURCE: Data provided by participants in the 2005 

meeting of the International Collaborative Effort on Injury 

Statistics. 

 
39 Injury in the United States: 2007 Chartbook

Mortality: International Injury Death Rates

In a group of both developed and less developed countries, motor vehicles and firearms were the leading mechanisms of injury death for teenagers and young adults, and falls and motor vehicles were 

the leading mechanisms of injury death for the elderly population.

Identifying large differences in injury death rates 

among countries can aid in gauging needed improvements in injury prevention programs across countries. 

Figures 14-1 and 14-2 include data from the countries 

that were represented at the June 2005 meeting of 

the International Collaborative Effort on Injury Statistics (see Appendix II, International Collaborative Effort 

on Injury Statistics).

Ages 15–24 years 

 For the countries compared, the lowest injury 

death rates for those 15–24 years of age were 

generally in European countries as well as Australia 

and Canada, and the highest injury death rates were 

generally in Latin American countries as well as South 

Africa and the United States. The injury death rate in 

the United States, 62 deaths per 100,000 population, 

was 2.7 times the rate in the Netherlands and 0.4 

times the rate in Colombia.

 When the data were averaged across all countries 

compared, injuries sustained in motor vehicle traffic 

accidents and by firearms accounted for three out of 

five injury deaths among teenagers and young adults 

15–24 years of age. Motor vehicle traffic accidents 

were the leading mechanism of injury death in most 

countries, with the exceptions of Argentina, Puerto 

Rico, Brazil, South Africa, and Colombia, in which 

firearms were the leading mechanism of injury death 

followed by motor vehicle traffic deaths.

 In Colombia, 70% of injury deaths were caused 

by firearms—a proportion far higher than that in any 

other country. The Colombian firearm death rate was 

about 2.5 times the rates in Brazil, Puerto Rico and 

South Africa, and 6.2 times the rate in Argentina (the 

countries with the next highest firearm death rates).

Ages 65 years and over

 Injury death rates among those 65 years of age 

and over ranged from a low of 61 deaths per 100,000 

population in Puerto Rico to a high of nearly 200 

deaths per 100,000 population in Denmark. The injury 

death rate for the U.S. population 65 years of age 

and over (113 deaths per 100,000 population) was 

1.8 times the injury death rate in Puerto Rico and 0.6 

times the injury death rate in Denmark.

 Among those 65 years of age and over, falls 

accounted for 26% of all injury deaths across all the 

countries compared. Falls were the leading specified 

mechanism of injury death except in Puerto Rico, 

Argentina, South Africa and Colombia, where motor 

vehicle traffic deaths ranked first among injury deaths, 

and in Mexico, where the average annual death rates 

for falls and for motor vehicle traffic accidents were 

similar. 

 For reasons related to quality of death 

certification, injury deaths with an “unspecified” 

mechanism accounted for nearly as high a proportion 

(24%) of injury deaths across all the countries as did 

deaths with falls as the mechanism of injury (26%). 

In the United States, 14% of injury deaths had 

“unspecified” as the mechanism of injury, which was 

a lower percentage than that in most of the other 

countries. If “unspecified” were considered a rankable 

cause of death, it would have been the leading cause 

of injury death in seven of the comparison countries, 

with rates in Mexico and Denmark greatly exceeding 

rates in other countries (see data table for Figure 14-

2).
40 Injury in the United States: 2007 Chartbook

Figure 15-1. Injury hospital discharge rates by age group and year:

United States, 1988–2005

10

100

1,000

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Year

75 years and over

65–74 years

15–24 years

25–64 years

Under 15 years

Discharges per 10,000 population (log scale)

NOTES: Injury discharges are based on the first-listed 

injury diagnosis. See Appendix II, Hospital discharge 

for injury; Logarithmic scale.

SOURCE: CDC/NCHS, National Hospital Discharge 

Survey. 

 
41 Injury in the United States: 2007 Chartbook

Hospital Discharges for Injury: Trends by Age

The rate of injury hospitalizations among adults 75 years of age and over far exceeds that of younger 

age groups. However, in all younger age groups, injury hospitalization rates declined from 1988 

through 2005, whereas the rate for those 75 years of age and over did not change significantly during 

this same period.

Hospitalizations for injury represent a large burden on 

the health care system. For every injury death, there 

are about 11 to 12 injury hospitalizations. Hospitalized 

injuries that occurred in 2000 are estimated to have 

cost $34 billion (1). When examining trends1 in hospital discharge rates for injury, age-specific rates are 

important for gaining a broad understanding of where 

prevention efforts should be targeted, and these rates 

also act as a tool for understanding how health care is 

utilized for injury by age.

 In 2005, injuries were the first-listed diagnosis 

for 6% of hospital discharges and accounted for 1.9 

million hospital discharges at a rate of 65.3 discharges 

per 10,000 population. For an additional 753,000 

hospital discharges, injury was not the first-listed 

diagnosis, but at least one injury diagnosis was 

included on the medical record for the discharge.

 For children under 15 years of age, hospital 

discharge rates for injury declined 7.8% per year on 

average from 1988 through 1996, but the rates did 

not change from 1996 through 2005 (Figure 15-1). The 

rate in 2005 was 50% lower than the rate in 1988.

 For teenagers and young adults 15–24 years of 

age, the injury hospital discharge rate declined from 

1988 through 1999 by an average of 6.8% per year. 

Since then, the rate has fluctuated.

 For adults 25–64 years of age, injury discharge 

rates declined by an average of 5% per year from 

1988 through 2000, followed by a 2.5% increase 

through 2005. The rate in 2005 was 38% lower than 

the rate in 1988.

 The injury hospital discharge rate for older adults 

65–74 years of age declined more slowly than it did 

for younger people, at an average of 1.1% decrease 

per year from 1988 through 2005. 

 The rate for older adults 75 years of age and over 

fluctuated during the years 1988 through 2005 from a 

low of 290 discharges per 10,000 population in 1988 

to a high of 337 discharges per 10,000 population in 

1993.

Reference:

1. Finkelstein EA, Corso PS, Miller TR, et al. The Incidence and 

Economic Burden of Injuries in the United States. New York, 

NY: Oxford University Press. 2006.

1

 Average annual percent changes for each age group were 

calculated by fitting regression lines to the data points. See 

Appendix II, Average percent change and test of trends.
42 Injury in the United States: 2007 Chartbook

Figure 15-2. Injury hospital discharge rates for persons 25–64 years of age, by level

of severity: United States, 1988–2005 

1

10

100

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Discharges per 10,000 population (log scale)

Moderately severe 

Least severe 

Most severe 

Year

NOTES: Injury discharges are based on the first-listed 

injury diagnosis. See Appendix II, Hospital discharge for 

injury; Injury severity for hospital discharges; Logarithmic 

scale.

SOURCE: CDC/NCHS, National Hospital Discharge 

Survey. 

 
43 Injury in the United States: 2007 Chartbook

Hospital Discharges: Trends by Injury Severity 

for Adults 25–64 Years of Age

When 2005 injury hospital discharge rates are compared with 1988 rates, the hospital discharge rates 

for the least severe injuries among adults 25–64 years of age decreased more than hospital discharge 

rates for more severe injuries. 

Injury severity is an important factor to consider when 

examining trends1 in injury hospital discharge rates. 

Prior to 2001, injury hospital discharge rates were 

declining for adults 25–64 years of age. Since then, 

the trend has reversed. Discharge rates can decline 

for many reasons, ones that may have more to do 

with health care practices than with the injury itself. 

The survival risk ratio (SRR), a measure of likelihood of 

survival, is used to assess injury severity (1–3) (see Appendix II, Injury severity for hospital discharges).

 Trends in injury hospital discharge rates among 

those 25–64 years of age varied by severity. The least 

severe injury discharge rate was 55% lower in 2005 

than in 1988. The moderately severe injury discharge 

rate was 21% lower in 2005 than in 1988, and the most 

severe injury discharge rate was 3.5% lower.

 From 1988 through 2000, the injury discharge 

rates declined an average of 6.7% for the least severe 

injuries, whereas the rates declined an average of 

3.7% per year for the moderately severe injuries and 

1.4% per year for the most severe injuries. 

 From 2000 through 2005, the injury discharge 

rates for the least severe injuries did not change, but 

the rates increased for the moderately severe injuries 

(4.4% per year) and most severe injuries (3.9% per 

year). 

 The least severe injury discharges accounted 

for 54% of hospital discharges for injury in 1988 

compared with 39% in 2005, whereas the percentage 

of discharges for moderately severe injuries increased 

from 41% in 1988 to 52% in 2005, and the percentage 

of discharges for the most severe injuries increased 

from 5% in 1988 to 9% in 2005.

References:

1. Wayne MJ, Kilgo PD, Osler TM. Independently derived survival 

risk ratios yield better estimates of survival than traditional 

survival risk ratios when using the ICISS. J Trauma 55(5):933–8. 

2003.

2. Kilgo PD, Osler TM, Meredith W. The worst injury predicts 

mortality outcome the best: Rethinking the role of multiple 

injuries in trauma outcome scoring. J Trauma 55(4):599–606. 

2003. 

3. Cryer C, Langley J, Stephenson S. Developing valid injury 

outcome indicators: A report for the New Zealand Injury 

Prevention Strategy. Dunedin, New Zealand: Injury Prevention 

Research Unit, Department of Preventive and Social Medicine. 

Available from: http://www.nzips.govt.nz/documents/seriousinjury-indicators-2004-09.pdf. 2004.

1

 Average annual percent changes for each age group were 

calculated by fitting regression lines to the data points. See 

Appendix II, Average percent change and test of trends.
44 Injury in the United States: 2007 Chartbook

Figure 16. Injury hospital discharge rates by sex and age group:

United States, 2004–2005

50

0

100

150

200

250

300

350

400

Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over

Age group

Male Female

Discharges per 10,000 population

NOTES: Injury discharges are based on the first-listed 

injury diagnosis. See Appendix II, Hospital discharge for 

injury.

SOURCE: CDC/NCHS, National Hospital Discharge 

Survey. 

 
45 Injury in the United States: 2007 Chartbook

Hospital Discharges for Injury: Sex and Age

Hospital discharge rates are higher for males than for females for all age groups under 65 years of 

age.

Assessing age- and sex-specific hospital discharge 

rates for injury is necessary for identifying at-risk 

populations for injuries that require more than minimal 

medical attention. Prevention of nonfatal injuries is 

the goal; attaining the goal requires an understanding 

of who is likely to be injured seriously enough to be 

hospitalized.

 When all ages are combined, hospital discharge 

rates for injury for males and females were statistically 

similar at 67.6 hospital discharges per 10,000 

population for men compared with 64.1 hospital 

discharges per 10,000 population for women (see data 

table for Figure 16). However, the discharge rates 

vary by sex and age.

 Men had higher injury hospital discharge rates 

than women did for all age groups up to 65 years of 

age and over. The disparity was most pronounced 

for young people 15–24 years of age, with the rate 

for young men 2.1 times the rate for young women 

(Figure 16). 

 For those 65–74 years of age and 75 years of age 

and over, hospital discharge rates for injury among 

women were 1.4 and 1.7 times the rates for men. 

Compared with all other age-sex groups, women 

75 years of age and over had the highest injury 

hospital discharge rate, at 363 discharges per 10,000 

population.

 The higher discharge rate among women 75 years 

of age and over can be explained primarily by their 

higher rate of hip fractures compared with the rate for 

men—156.3 hip fractures for women compared with 

82.9 for men per 10,000 population. (Additional data 

on hip fractures are also shown in Figure 18.)
46 Injury in the United States: 2007 Chartbook

NOTES: When an asterisk (*) is shown with a bar, the 

relative standard error is between 20% and 30%. Injury 

discharges are based on the first-listed injury diagnosis. See 

Appendix II, Hospital discharge for injury; Relative standard 

error

SOURCE: CDC/NCHS, National Hospital Discharge Survey. 

Figure 17-1. Percent distribution of hospital discharges for injury, by nature

of injury: United States, 2004–2005

0

10

20

30

40

50

60

Fractures System-wide

injuries

Internal

 organ

injuries

Open

wounds

Burns Contusions

and superficial

Sprains

and

strains

All other

Nature of injury

Figure 17-2. Percent distribution of hospital discharges for injury, by body

region of injury: United States, 2004–2005

0

10

20

30

40

50

60

Lower

 extremity

Upper

 extremity

Torso Traumatic

brain

injury

Other head,

face, or neck 

Vertebral

column

injury

Other and

unspecified

Spinal cord

injury

Body region of injury

Percent Percent

*

.
47 Injury in the United States: 2007 Chartbook

Hospital Discharges: Nature and Body Region of Injury

Fractures accounted for more than one-half of all hospital discharges for injury in 2004 and 2005.

Knowing the nature of injury and the body region of 

injury are useful for injury prevention. In particular, 

knowledge of the body region or regions impacted 

by injury can lead to devices and engineering designs 

that can prevent injury.

 Fractures were the leading diagnosis for hospital 

discharges for injury, accounting for 53% of all injury 

discharges, and were followed by system-wide injuries 

(16%) and internal organ injuries (12%) (Figure 17-1).

 Fractures were the leading diagnosis for injury for 

each age group. For people under 65 years of age, 

fractures accounted for 41% of all injury discharges, 

whereas fractures accounted for 72% of all hospital 

discharges for injury for adults 65 years of age and 

over (see data table for Figure 17-1). 

 System-wide injuries are those that affect the 

entire body rather than a single region of the body. 

Poisoning and toxic effects accounted for the majority 

of system-wide injuries for all age groups, ranging 

from a high of 91% for young people 15–24 years of 

age to 62% for adults 75 years of age and over (data 

not shown). 

 For all age groups combined, lower extremities 

were the primary body region injured, accounting 

for 35% of all injury discharges. Injuries to the upper 

extremities accounted for 13% of injury discharges, 

the torso for 12%, and traumatic brain injury for 10% 

(Figure 17-2).

 For children under 15 years of age, upper and 

lower extremity injuries accounted for nearly 40% 

of injury hospitalizations, and traumatic brain injury 

accounted for an additional 14%. Among young 

people 15–24 years of age, lower extremity injuries 

accounted for about one out of every five injury 

discharges (similar to system-wide injuries). As age 

increased, lower extremity injuries were responsible 

for a larger proportion of injury discharges, accounting 

for more than one-half of the injury discharges among 

adults 75 years of age and over (see data table for 

Figure 17-2).
48 Injury in the United States: 2007 Chartbook

Figure 18. Hospital discharge rates for fractures, by age and body region of injury:

United States, 2004–2005 

0

50

100

150

200

250

Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years

and over Age group

Other lower extremities

Hip

Upper extremities

Torso

Spine and back

Head and neck

Discharges per 10,000 population

NOTES: Injury discharges are based on the first-listed 

injury diagnosis. See Appendix II, Hospital discharge for 

injury.

SOURCE: CDC/NCHS, National Hospital Discharge 

Survey. 

 
49 Injury in the United States: 2007 Chartbook

Hospital Discharges: Fractures by Body Region of Injury and 

Age

Fractures to the hip account for nearly three out of every five fractures that require hospitalization 

for adults 75 years of age and over. 

Fractures continue to be the leading cause of injury 

hospitalization in the United States, accounting for 

more than one-half of all injury hospitalizations in 

2004–2005. For the older population 75 years of age 

and over, almost three-fourths of injury hospitalizations 

were for fractures. Measures to prevent fractures are 

often related to fall prevention initiatives, although 

programs will be different for children, for example, 

who may fall from playground equipment, as compared with programs for the elderly, who often fall in 

the home (1,2,3).

 Fracture discharge rates were highest for the 

elderly. For people younger than 65 years of age, 

rates for males exceeded those for females, whereas, 

for those 65 years of age and over, rates for females 

were higher than those for males (see data table for 

Figure 18).

 For adults 75 years of age and over, 57% of 

fractures were hip fractures and 21% were other 

extremity fractures, whereas, for people under 75 

years of age, other extremity fractures accounted for 

56% of fractures. Nearly three out of four hip fractures 

were among the elderly; the discharge rate for those 

75 years of age and over was 5.2 times the rate for 

adults 65–74 years of age and 31.4 times the rate for 

adults 45–64 years of age (Figure 18).

 Head and neck fracture rates were highest for 

teens and young adults 15–24 years of age, rates that 

were about two to three times those for other age 

groups. For those under 15 years of age and 15–24 

years of age, head and neck fractures accounted for 

about one-quarter of all fractures. For those under 15 

years of age, 83% of head and neck fractures were 

classified as traumatic brain injury, compared with 

about 50% in each of the other age groups (data not 

shown).

References:

1. Stevens JA, Ryan G, Kresnow MS. Fatalities and injuries from 

falls among older adults—United States, 1993–2003 and 2001–

2005. MMWR 55(45):1221–4. 2006. 

2. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of 

fatal and non-fatal falls among older adults. Inj Prev 12(5):290–

5. 2006.

3. National Center for Injury Prevention and Control. Preventing 

falls among older adults [online]. Available from: http://www.

cdc.gov/ncipc/duip/preventadultfalls.htm. 2006.
50 Injury in the United States: 2007 Chartbook

Figure 19. Initial emergency department injury visit rates by sex and age

group: United States, 2004–2005 

Age group

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and

over

Male Female

Visits per 10,000 population

NOTE: See Appendix II, Initial injury emergency 

department visit.

SOURCE: CDC/NCHS, National Hospital Ambulatory 

Medical Care Survey. 

 
51 Injury in the United States: 2007 Chartbook

Emergency Department Initial Injury Visits: Age and Sex

Young people 15–24 years of age had the highest rate of initial emergency department (ED) visits 

for injury in 2004–2005.

ED utilization for initial visits for an injury varies by age 

and sex. Because injuries seen in the ED differ from 

those seen in the hospital inpatient setting, examining 

both types is important for determining where prevention and treatment programs can best be directed. In 

2004–2005, EDs in the United States had an annual 

average of 31 million initial visits for injuries.

 In 2004–2005, initial visits accounted for 91% of 

all ED injury visits, with a slightly higher proportion for 

children under 15 years of age than the proportions 

for all other ages (data not shown).

 Young people 15–24 years of age had the highest 

initial ED visit rate for injury, at 1,484.8 visits per 

10,000 population, which was more than twice the 

rate for adults 65–74 years of age, who had the lowest 

rate (see data table for Figure 19).

 Initial injury visit rates for males in age groups 

under 45 years were 1.2 to 1.3 times the rates for 

females (Figure 19). Beginning with ages 45–64 years, 

no statistically significant differences existed between 

the rates for men and women.
52 Injury in the United States: 2007 Chartbook

Figure 20. Initial emergency department injury visit rates by leading mechanisms

of injury and age group: United States, 2004–2005 

0

100

200

300

400

500

600

700

800

Fall Cut or pierce

Mechanism of injury

Under 15

years

15–24 years 25–44 years 45–64 years 65–74 years 75 years and over

Visits per 10,000 population

Struck by or against Motor vehicle traffic

NOTE: See Appendix II, Initial injury emergency 

department visit.

SOURCE: CDC/NCHS, National Hospital Ambulatory 

Medical Care Survey. 

 
53 Injury in the United States: 2007 Chartbook

Emergency Department Initial Visits: Mechanism of Injury 

and Age

Falls were the leading mechanism for initial emergency department (ED) visits for injury in 2004–

2005.

Injury prevention depends largely on knowing the circumstances of injuries, most of which are nonfatal, that 

present in EDs. Knowledge of injury mortality patterns 

is not sufficient for prevention because the leading 

mechanisms of injury for ED visits differ from those for 

injury deaths. 

 In 2004–2005, falls accounted for 26% of initial ED 

visits for injuries, whereas injuries resulting from being 

struck by or against an object or person accounted 

for 13% and motor vehicle traffic accidents accounted 

for 12% of initial ED visits for injury (see data table for 

Figure 25).

 Falls were the leading mechanism of initial ED 

visits for injuries among children under 15 years of age 

and among adults 45 years of age and over (Figure 

20). For young people 15–24 years of age, the three 

leading mechanisms of injury were falls, being struck 

by or against, and motor vehicle traffic accidents. For 

adults 25–44 years of age, rates for falls and motor 

vehicle traffic accidents were similar.

 Initial ED visit rates for falls for adults 75 years of 

age and over were, at a minimum, twice the rate for 

any other mechanism of injury and age combination. 

 The age patterns for initial ED visit rates from 

motor vehicle traffic accidents and being struck by or 

against were somewhat similar, with rates generally 

higher for young people 15–24 years of age than rates 

for younger or older ages. However, for motor vehicle 

traffic accidents, visit rates were higher for adults 25–

44 years of age than for children under the age of 15 

years, whereas visit rates resulting from being struck 

by or against were higher for children under 15 years 

of age than for adults 25–44 years of age. 

 Among males under 45 years of age, initial ED visit 

rates for being struck by or against and for being cut 

or pierced were 1.6 to 2.0 times the respective rates 

for females. However, the visit rate for falls among 

women 75 years of age and over was 1.3 times the 

rate for men in that same age group (see data table 

for Figure 20).

NOTE: Mechanism refers to the first-listed external cause of injury 

code on the patient record form.
54 Injury in the United States: 2007 Chartbook

Figure 21. Percent distribution of initial emergency department injury visits, by

nature of injury and leading mechanisms of injury: United States, 2004–2005 

0

5

10

15

20

25

30

35

40

Fall Struck by or against Motor vehicle traffic

Fractures Contusions and

superficial

Sprains and

strains

Open wounds Other injuries

Percent

Mechanism of injury

NOTES: Other injuries include other injury diagnoses and 

include noninjury diagnoses if the initial visit has a 

first-listed external cause of injury code. See Appendix II, 

Initial injury emergency department visit.

SOURCE: CDC/NCHS, National Hospital Ambulatory 

Medical Care Survey. 

 
55 Injury in the United States: 2007 Chartbook

Emergency Department Initial Visits: Mechanism and 

Nature of Injury

Contusions and superficial injuries, open wounds, sprains and strains, and fractures are the leading 

first-listed diagnoses for initial emergency department (ED) visits for the leading mechanisms of 

injury. 

Knowledge of both the mechanism and nature of injuries can be used in designing protective equipment, 

developing interventions for prevention of injury, and 

planning for rehabilitation when a specific event (e.g., 

fall, motor vehicle traffic accident) occurs.

 For all initial ED visits for injury, regardless of 

mechanism, contusions and superficial injuries, open 

wounds, and sprains and strains each accounted 

for 18% to 19% of initial visits for injuries (see data

table for Figure 21). Fractures were the fourth most 

common injury diagnosis, accounting for 11% of injury 

visits. An additional 19% of injury visits had an external 

cause, but an injury was not the fist-listed diagnosis. 

 For initial ED visits for falls, the leading diagnoses 

were fractures and contusions and superficial injuries 

(Figure 21). Of the first-listed diagnoses for visits 

related to a fall, 19% were not injury diagnoses; 32% 

of these noninjury diagnoses were musculoskeletal 

conditions (e.g., pain in joint, backache, or lumbago), 

and another 24% were symptoms and ill-defined 

conditions (e.g., fainting). 

 For initial ED visits for injury that were due to 

being struck by or against an object or person, 

superficial injuries accounted for 30% of first-listed 

diagnoses, followed by open wounds at 23%, whereas 

13% of first-listed diagnoses for being struck by or 

against were not injuries.

 Motor vehicle traffic-related initial ED visits for 

injury were slightly more likely to be sprains and 

strains than contusions and superficial injuries. Also, 

24% of first-listed diagnoses for these visits were not 

injuries—38% were musculoskeletal conditions and 

17% were for observation following a motor vehicle 

accident.
56 Injury in the United States: 2007 Chartbook

Figure 22-1. Injury episode rates by sex and age group: United States, 2004–2005

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Under 15 years 15–24 years 25–44 years 45–64 years 65–74 years 75 years

and over

Age group

Male Female

Figure 22-2. Injury episode rates by leading mechanisms of injury and age

group: United States, 2004–2005

0

100

200

300

400

500

600

700

800

Fall Struck by or against Overexertion Motor vehicle trafficCut or pierce

Under 15 years 15–24 years 25–64 years 65 years and over

* * * * * * * *

Mechanism of injury

Episodes per 10,000 population Episodes per 10,000 population

NOTES: When an asterisk (*) is shown with a bar, the 

relative standard error (RSE) is between 20% and 30%; 

when the asterisk is shown alone, the RSE is greater than 

30% and does not meet the standards of reliability or 

precision. See Appendix II, Injury or poisoning episode; 

Relative standard error.

SOURCE: CDC/NCHS, National Health Interview Survey. 

 
57 Injury in the United States: 2007 Chartbook

Episodes of Injury: Sex, Age, and Mechanism of Injury

In 2004–2005, injury episode rates were highest among young people 15–24 years of age and adults 

75 years of age and over.

The National Health Interview Survey provides more 

detail on episodes of injury than any other NCHS 

survey. Data are available concerning the circumstances of the episode and the diagnosis. Detailed 

demographic data are also available and are considered more reliable than medical records because 

they are based on information from knowledgeable 

respondents. The ability to determine high risk groups 

for mechanisms of injury is an important step towards 

prevention.

 Injury episode rates varied by age and by sex, and 

the biggest differences by sex were for young people 

15–24 years of age and adults 75 years of age and 

over (Figure 22-1). For people 15–24 years of age, the 

rate ratio of episodes for men to women was 1.7 to 1, 

and the rate ratio for women to men was 1.6 to 1 for 

those 75 years of age and over.

 Injury episode rates peaked for males at 15–24 

years of age and for females at 75 years of age and 

over. Although the high injury rate for young men 

15–24 years of age resulted from several different 

mechanisms of injury, the high injury rate for women 

75 years of age and over primarily resulted from 

injuries caused by falls (data not shown).

 Falls were the leading cause of injury episodes for 

all age groups (Figure 22-2). Fall rates for adults 65 

years of age and over were higher than rates for other 

age groups and were followed by fall rates for children 

under 15 years of age. 

 Injuries caused by being struck by or against an 

object or a person, overexertion, and motor vehicle 

traffic accidents were more likely to be reported by 

younger people than older people. 
58 Injury in the United States: 2007 Chartbook

Figure 23-1. Injury episode rates by race and Hispanic origin and age:

United States, 2004–2005 

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

Under 15 years 15–24 years 25–64 years 65 years and over

Age group

Hispanic

Non-Hispanic white

Non-Hispanic black

Figure 23-2. Injury episode rates by race and Hispanic origin and

education, among people 25–64 years of age: United States, 2004–2005 

0

200

400

600

800

1000

1200

1400

1600

Hispanic Non-Hispanic white Non-Hispanic black 

Less than 12

years of education 12 years of education More than 12

years of education

Episodes per 10,000 population Episodes per 10,000 population

Race and Hispanic origin

NOTES: When an asterisk (*) is shown with a bar, the 

relative standard error (RSE) is between 20% and 30%; 

when the asterisk is shown alone, the RSE is greater 

than 30% and does not meet the standards of reliability 

or precision. See Appendix II, Injury or poisoning 

episode; Relative standard error.

SOURCE: CDC/NCHS, National Health Interview 

Survey. 
59 Injury in the United States: 2007 Chartbook

Episodes of Injury: Race, Hispanic Origin, Age, and 

Education

Among those under 25 years of age, the non-Hispanic white population had higher injury episode 

rates than the Hispanic or non-Hispanic black population.

Injury data from the National Health Interview Survey (NHIS), by race and Hispanic origin, as well as 

by education, should have less bias resulting from 

misclassification than medical records-based national 

surveys because of the NHIS design (both the numerator and denominator of the rates are from the same 

source—the respondent, by either self or proxy). The 

information can be helpful for prevention planning 

because socioeconomic and cultural differences may 

exist among racial and ethnic groups that result in differences in injury rates. 

 For children under 15 years of age, the nonHispanic white population had the highest injury 

episode rate, followed by the non-Hispanic black and 

Hispanic population (Figure 23-1). For those 15–24 

years of age, injury episode rates for the non-Hispanic 

white population were also higher than rates for either 

the non-Hispanic black or Hispanic population. Among 

adults aged 25–64 years, injury episode rates for nonHispanic white and non-Hispanic black adults were 

similar and were higher than rates for Hispanic adults. 

 When examining injury episode rates by sex, ageadjusted rates were higher for non-Hispanic white 

males and females than for the other groups (see data

tables for Figures 23-1 and 23-2). 

 Falls were the leading cause of injury episodes 

reported; the age-adjusted rate among the nonHispanic white population was twice the rate for either 

the Hispanic or non-Hispanic black population, for 

whom the rates were similar.

 Injury episode rates were similar and did not 

vary by education for non-Hispanic white and nonHispanic black adults 25–64 years of age, but the 

pattern for Hispanic adults was different (Figure 23-

2). For Hispanic adults who had completed more 

than 12 years of education, injury episode rates were 

significantly higher than rates for those with less 

education. This might be due to Hispanic adults with 

fewer years of education being less likely to report 

medically attended injuries or less likely to seek 

medical attention for injury episodes than are those 

with more than 12 years of education.
60 Injury in the United States: 2007 Chartbook

Figure 24-1: Percent distribution of injury episodes, by activity at time of injury:

United States, 2004–2005 

0 5 10 15 20 25 30 35 40

Other

Attending

school

Working at

paid job

Working around

 house or yard

Sports and

exercise

Percent

Driving or riding

in a motor vehicle

Leisure activities

(excluding sports)

Figure 24-2. Percent distribution of injury episodes, by place of occurrence:

United States, 2004–2005 

0 5 10 15 20 25 30 35 40

Other

School or child

care center

Commercial area

Recreation area

Street

Home (outside)

Home (inside)

Percent

NOTE: Other in Figure 24-2 includes hospital or 

residential institution, other public building, and other 

but not specified. See Appendix II, Injury or poisoning 

episode.

SOURCE: CDC/NCHS, National Health Interview 

Survey. 
61 Injury in the United States: 2007 Chartbook

Episodes of Injury: Activity at Time of Injury and Place of 

Occurrence

About one-quarter of all injury episodes were reported as occurring during leisure activities (excluding sports), and one-half of all injury episodes were reported as occurring in or around the home.

Knowing what an injured person was doing and where 

his or her injuries occurred is important for designing 

prevention programs. The National Health Interview 

Survey is the only source of national injury morbidity 

data with this type of information.

 About one in four injury episodes occurred while 

a person was engaged in leisure (excluding sports) 

activities (Figure 24-1), whereas sports, working 

around the house or yard, and working at a paid job 

each accounted for about 15% of the activities people 

were doing when they were injured. 

 The leading activity when injured varied by 

age. For children under 15 years of age, the leading 

activities were leisure-related (e.g., playing), excluding 

sports. However, sports were the leading activity 

when injured for young people 15–24 years of age. 

The leading activities when injured for adults 25–64 

years of age were working at a paid job, working 

around the house or yard, and engagement in leisure 

activities (excluding sports). However, working around 

the house or yard and leisure activities (excluding 

sports) were what older adults aged 65 years and 

over reported doing when injured. (See data table for

Figure 24-1.) 

 The home, whether inside or outside, was the 

leading place of injury occurrence (Figure 24-2). Onehalf of the injury episodes occurred at home (either 

inside or outside) for all ages combined. Streets, 

highways, and parking lots (indicated as “Street” in 

Figure 24-2), as well as recreation areas, were each 

responsible for 13% of injury episodes. 

 Inside the home was the leading place of injury 

for all age groups except for young people 15–24 

years of age. For adults aged 65 years and over, more 

than one-half of all injury episodes occurred inside the 

home, and one-quarter of injury episodes occurred at 

home but were outside rather than inside (see data 

table for Figure 24-2). 

 Young people 15–24 years of age were equally 

likely to be injured inside the home, at school, on 

streets, and at recreation areas.
62 Injury in the United States: 2007 Chartbook

Hospital discharges for injury,

2004–2005

Poisoning

10%

Fall 26%

All other

18%

No

mechanism

stated

37% 9%

Initial emergency department

injury visits, 2004–2005

All other

30%

Struck by

or against

13%

Fall 26%

No

mechanism

stated 

10%

Cut or pierce

8%

Motor vehicle

traffic 

12%

Episodes of injury,

2004–2005

Motor

vehicle

traffic 

8%

Cut or

pierce 8%

Fall

36%

Overexertion

14%

All other

22%

Injury deaths, 2003–2004

Firearm

18%

Motor

vehicle

traffic 

Suffocation 8% 26%

Fall

11%

18%

Poisoning

Figure 25. Percent distributions by leading mechanisms of injury for deaths,

hospital discharges, initial emergency department visits, and

episodes of injury: United States, 2003–2005 

All other

18%

12%

Struck by

or against

Motor vehicle

traffic 

NOTE: See Appendix II, Hospital discharge for injury; 

Initial injury emergency department visit; Injury or 

poisoning episode.

SOURCES: CDC/NCHS, National Vital Statistics 

System, National Hospital Discharge Survey, National 

Hospital Ambulatory Medical Care Survey, National 

Health Interview Survey. 
63 Injury in the United States: 2007 Chartbook

Mortality and Morbidity: Mechanisms of Injury

Motor vehicle traffic accidents are the leading mechanism of injury deaths, whereas falls are the 

leading mechanism of nonfatal injury. 

Injuries cause relatively a small number of deaths 

compared with the number of injuries seen in hospitals and emergency departments (EDs). Knowing the 

leading mechanisms of injury death is not enough 

because the leading mechanisms differ depending on 

where medical care was sought, either as an inpatient 

in a hospital or during a visit to the ED, or whether an 

injury episode that required medical care was reported 

by a household respondent.

 Motor vehicle traffic accidents continue to 

be the leading mechanism of injury death, but 

this mechanism is only the third or fourth leading 

mechanism of nonfatal injury depending on whether 

hospitalizations, ED visits, or household survey data 

are examined (Figure 25). 

 Falls, regardless of the setting, were the leading 

mechanism of nonfatal injury but were the fourth 

leading mechanism for mortality. 

 Firearms were one of the leading mechanisms 

for injury death but were not among the leading 

mechanisms of nonfatal injury, likely because injuries 

from assaults by firearms and from self-inflicted firearm 

wounds are more likely to be lethal, and a patient may 

not reach a health care facility before dying. 

 Overexertion was the second leading mechanism 

of injury reported in a household survey that 

asked about medically-attended injuries; however, 

overexertion was not a leading mechanism for deaths, 

hospitalizations, or ED visits. 

 Hospital discharges for injuries are often missing 

a valid external cause of injury code; 37% were 

missing a code in 2004–2005, thus making it difficult 

to determine mechanism rankings for hospitalizations 

using the National Hospital Discharge Survey. Based 

on the current definition of an initial injury visit to 

an ED, 10% of visits did not have a valid first-listed 

external cause code.
64 Injury in the United States: 2007 Chartbook

Hospital discharges for injuries, 2004–2005

Systemwide

and other

16%

Torso

12%

Spine and back 6%

Upper and

lower

extremities

48%

Head

and neck

17%

Unspecified 1%

Initial emergency department

injury visits, 2004–2005

Unspecified

9%

Spine

and back 7%

Torso

7%

6%

Episodes of injury, 2004–2005

Unspecified

2%

Spine

and back

2%

Torso

15%

Figure 26. Percent distributions of injuries by body region of injury, for hospital

discharges, initial emergency department visits, and episodes

of injury: United States, 2004–2005

Upper and

lower

extremities

50%

Upper and

lower

extremities

62%

Head

and neck

15%

Head

and neck

20%

NOTES: See Appendix II, Hospital discharge for 

injury; Initial injury emergency department visit; 

Injury or poisoning episode. See Table 26 on page 

130 for the average annual counts and percent 

distributions of first-listed injury hospital discharges, 

initial emergency department visits for injury, and 

episodes of injury by nature of injury.

SOURCES: CDC/NCHS, National Hospital Discharge 

Survey, National Hospital Ambulatory Medical Care 

Survey, National Health Interview Survey.

 

 

System-wide

and other

System-wide

and other 3%
65 Injury in the United States: 2007 Chartbook

Morbidity: Body Region and Nature of Injury

Extremity injuries account for the majority of nonfatal injuries that are classified by body region.

Injury diagnosis data provide important information 

on health care utilization as well as some indication as 

to where to target prevention strategies. The distributions of injuries according to body region across treatment settings are more similar to each other than are 

the distributions according to nature of injury.

 Extremity injuries accounted for the greatest 

proportion of injuries classified by body region, 

ranging from 48% in hospitals and 50% in emergency 

departments (EDs) to 62% reported in a household 

survey that asked about medically-attended injuries 

(Figure 26).

 Head and neck injuries accounted for 17% of 

hospitalized injuries, 20% of initial visits to EDs, and 

15% of injuries reported in the household survey.

 Injuries to the torso were more likely to be 

reported in hospital data (12%) and in the household 

survey (15%) than in EDs (7%).

 The category “System-wide and other” is 

predominantly system-wide injuries, regardless of the 

setting. In hospitalization data, poisoning, including 

toxic effects, accounted for 83% of system-wide 

injuries, ranging from 91% among young people 

15–24 years of age to 55% for children under 15 years 

of age. 

 Fractures accounted for far more hospitalized 

injuries than for visits for injuries to the ED or for 

injuries reported in the household survey (see Table 

26 on page 130). Conversely, open wounds and 

contusions and superficial injuries were more likely 

to be seen in the ED and reported in the household 

survey than to be seen in the hospital. Sprains and 

strains accounted for the largest proportion of injuries 

reported in a household survey (Table 26).
Tables
69 Injury in the United States: 2007 Chartbook

Data table for Figure 1. Injuries in the United States, 2004

Event Injury events Number of total events

Injury events as a 

percent of total 

events

Number SE1 Number SE

Deaths 167,184 409 2,397,615 1,548 7.0

Hospital discharges in thousands 1,939 93 34,864 1,187 5.6

Initial emergency department visits in 

thousands

31,314 1,594 98,166 4,798 31.9

Initial outpatient hospital department and 

physician office visits in thousands

34,848 2,153 295,735 11,649 11.8

Injury episodes from household interviews 

in thousands

33,149 1,216 ... ... ...

...Category not applicable.

1

SE is standard error.

NOTES: See Appendix I for description of data sources; NVSS, Mortality Statistics for identifying injury deaths. See Appendix II for definitions of injury 

in other settings: Hospital discharge for injury; Initial injury emergency department visit; Outpatient visit; Injury or poisoning episode; Standard error.

SOURCE: CDC/NCHS, National Vital Statistics System, National Hospital Discharge Survey, National Hospital Ambulatory Medical Care Survey, 

National Ambulatory Medical Care Survey, National Health Interview Survey.
70 Injury in the United States: 2007 Chartbook

Data table for Figure 2. Injury rates by age: United States, 2003–2005

Age in years Injury deaths, 2003–2004 Hospital discharges, 2004–2005 Initial emergency department 

visits, 2004–2005

Average annual 

rate1 SE2 Average annual 

rate3 SE Average annual rate3 SE

Under 1 3.5 0.1 38.8 7.7 918.4 103.1

1 1.7 0.0 53.6 12.0 1,672.6 133.4

2 1.5 0.0 43.1 8.3 1,676.9 140.7

3 1.2 0.0 29.5 5.7 1,463.6 134.4

4 0.9 0.0 29.7 5.2 1,196.8 102.3

5 0.8 0.0 19.7 3.3 1,089.2 105.7

6 0.6 0.0 30.4 5.0 1,035.5 97.6

7 0.6 0.0 30.4 5.5 1,001.4 110.1

8 0.6 0.0 24.1 3.6 1,076.5 88.4

9 0.6 0.0 17.1 2.9 963.9 84.9

10 0.6 0.0 20.7 3.6 973.3 87.4

11 0.6 0.0 16.8 3.1 1,208.5 97.8

12 0.9 0.0 22.7 3.3 1,414.9 123.1

13 1.1 0.0 39.9 5.1 1,288.2 108.2

14 1.6 0.0 41.1 5.4 1,407.8 107.1

15 2.3 0.1 52.3 6.3 1,377.4 94.6

16 4.0 0.1 48.6 5.7 1,590.2 122.1

17 5.1 0.1 56.2 5.4 1,439.4 113.8

18 6.8 0.1 54.6 5.3 1,626.9 115.2

19 7.3 0.1 60.4 5.6 1,507.0 121.5

20 7.3 0.1 55.2 6.0 1,526.1 113.7

21 7.5 0.1 61.4 6.0 1,574.7 114.7

22 7.3 0.1 61.3 5.2 1,363.8 89.0

23 6.8 0.1 42.0 4.1 1,484.0 111.4

24 6.7 0.1 46.4 5.9 1,367.3 98.7

25 6.5 0.1 56.6 5.7 1,490.8 103.5

26 6.4 0.1 45.2 6.9 1,410.3 110.0

27 6.1 0.1 54.3 5.6 1,143.4 92.6

28 5.8 0.1 47.4 5.2 1,313.7 112.4

29 5.8 0.1 45.0 5.8 1,159.8 95.7

30 5.5 0.1 54.7 5.7 1,091.7 88.2

31 5.6 0.1 46.9 4.8 1,014.0 89.0

32 5.7 0.1 50.6 5.8 1,019.1 80.1

33 5.4 0.1 46.8 5.0 1,181.8 96.3

34 5.5 0.1 49.1 5.3 982.0 94.4

35 5.8 0.1 47.6 4.6 1,152.5 94.4

36 5.7 0.1 40.1 3.4 868.3 72.3

37 6.1 0.1 57.9 7.2 1,061.2 89.0

38 6.1 0.1 36.5 3.9 994.0 79.6

39 6.0 0.1 44.8 5.4 1,071.3 89.1

40 6.3 0.1 47.0 4.8 1,065.9 80.0

41 6.7 0.1 48.7 5.2 1,042.4 75.3

42 6.7 0.1 55.0 7.0 1,012.4 87.9

43 6.8 0.1 53.9 5.7 1,066.3 93.2

44 6.6 0.1 52.6 4.7 917.1 88.1

45 6.9 0.1 50.7 5.2 1,064.4 91.0

See footnotes at end of table.
71 Injury in the United States: 2007 Chartbook

Data table for Figure 2. Injury rates by age: United States, 2003–2005—Con.

Age in years Injury deaths, 2003–2004 Hospital discharges, 2004–2005 Initial emergency department 

visits, 2004–2005

Average annual 

rate1 SE2 Average annual 

rate3 SE Average annual rate3 SE

46 6.9 0.1 52.5 5.3 899.1 75.3

47 6.8 0.1 42.4 4.4 970.8 82.6

48 6.7 0.1 49.0 5.0 861.2 72.2

49 6.4 0.1 50.8 5.4 768.4 68.2

50 6.4 0.1 54.8 6.9 811.7 77.2

51 6.3 0.1 53.6 5.3 741.4 70.1

52 6.0 0.1 55.1 5.0 790.5 81.4

53 5.7 0.1 52.7 5.5 784.3 76.2

54 5.8 0.1 46.9 5.1 692.8 69.4

55 5.3 0.1 50.8 5.2 707.9 74.6

56 5.3 0.1 59.6 5.2 681.8 73.8

57 5.1 0.1 48.2 5.6 667.4 67.9

58 5.3 0.1 61.3 5.8 654.1 85.3

59 5.1 0.1 61.9 7.0 563.3 68.2

60 5.2 0.1 64.5 7.1 538.3 65.1

61 5.0 0.1 55.8 6.8 648.9 76.9

62 5.0 0.1 57.5 5.9 570.5 69.9

63 4.9 0.1 64.5 8.8 492.5 64.0

64 4.9 0.1 57.9 7.3 620.8 95.7

65 5.2 0.1 71.6 9.3 579.7 75.1

66 5.1 0.1 67.0 7.0 597.1 91.2

67 5.4 0.1 78.5 10.2 554.8 82.8

68 5.5 0.1 84.5 10.8 707.7 100.1

69 5.5 0.1 87.7 8.6 556.0 86.8

70 6.1 0.1 110.6 10.2 649.8 87.9

71 6.3 0.1 114.8 12.7 674.2 108.5

72 6.7 0.1 102.7 10.2 673.3 110.9

73 6.9 0.1 122.5 14.9 878.6 123.8

74 7.7 0.2 147.3 19.4 730.3 95.4

75 8.4 0.2 134.8 14.1 741.9 116.9

76 9.1 0.2 182.8 15.5 888.5 134.7

77 9.8 0.2 166.3 16.2 968.1 132.5

78 10.4 0.2 204.2 20.5 732.8 101.3

79 11.7 0.2 201.7 18.0 936.1 122.5

80 12.8 0.2 260.1 20.6 1,214.1 165.7

81 14.1 0.2 271.3 25.1 896.4 125.2

82 15.9 0.3 300.5 23.8 1,313.4 173.2

83 17.8 0.3 303.1 24.9 1,257.9 169.8

84 18.3 0.3 341.0 33.4 824.6 137.6

85 and over 29.8 0.2 517.4 28.9 1,451.5 97.3

0.0 Quantity more than zero but less than 0.05.

1

Rate per 10,000 resident population.

2

SE is standard error.

3

Rate per 10,000 civilian population.

NOTES: See Appendix I for description of data sources; NVSS, Mortality Statistics for identifying injury deaths. See Appendix II, Hospital discharge for 

injury; Initial injury emergency department visit; Standard error.

SOURCE: CDC/NCHS, National Vital Statistics System, National Hospital Discharge Survey, and National Hospital Ambulatory Medical Care Survey.
72 Injury in the United States: 2007 Chartbook

Data table for Figure 3. Injury deaths as a percentage of total deaths, injury death rates by age and sex, and ratio 

of male-to-female death rates: United States, average annual 2003–2004

Both sexes Male Female

Age in years Percent of 

total deaths SE1 Rate SE Rate SE Rate SE Male-female 

rate ratio

Under 1 5.1 0.1 35.2 0.7 39.5 1.0 30.7 0.9 1.3

1 36.4 0.8 17.3 0.5 19.6 0.7 15.0 0.6 1.3

2 46.5 1.0 14.6 0.4 16.8 0.6 12.4 0.6 1.4

3 48.3 1.1 11.5 0.4 13.9 0.6 9.0 0.5 1.5

4 47.0 1.3 9.1 0.3 10.2 0.5 7.9 0.5 1.3

5 44.8 1.4 7.6 0.3 8.9 0.5 6.1 0.4 1.5

6 42.2 1.4 6.5 0.3 7.8 0.4 5.1 0.4 1.5

7 43.6 1.5 6.1 0.3 6.9 0.4 5.3 0.4 1.3

8 42.4 1.5 5.7 0.3 6.9 0.4 4.5 0.3 1.5

9 44.2 1.5 6.1 0.3 6.7 0.4 5.4 0.4 1.2

10 41.3 1.4 6.3 0.3 7.7 0.4 5.0 0.4 1.5

11 44.0 1.4 6.3 0.3 7.7 0.4 4.9 0.3 1.6

12 49.1 1.3 8.6 0.3 11.6 0.5 5.4 0.4 2.1

13 52.1 1.2 10.8 0.4 14.0 0.6 7.5 0.4 1.9

14 60.3 1.0 15.8 0.4 21.2 0.7 10.2 0.5 2.1

15 65.9 0.9 23.1 0.5 30.3 0.8 15.6 0.6 1.9

16 74.4 0.7 39.7 0.7 54.0 1.1 24.7 0.8 2.2

17 77.7 0.6 51.4 0.8 73.1 1.3 28.5 0.8 2.6

18 79.9 0.5 68.3 0.9 100.4 1.5 34.4 0.9 2.9

19 79.4 0.5 72.7 0.9 111.4 1.6 31.6 0.9 3.5

20 77.7 0.5 72.9 0.9 113.2 1.6 29.7 0.9 3.8

21 77.1 0.5 75.1 0.9 116.9 1.6 30.3 0.9 3.9

22 74.7 0.5 72.5 0.9 114.2 1.6 28.3 0.8 4.0

23 73.3 0.5 68.5 0.9 109.1 1.6 25.7 0.8 4.2

24 71.6 0.5 67.4 0.9 106.7 1.6 26.1 0.8 4.1

25 69.1 0.5 64.7 0.9 103.3 1.6 24.0 0.8 4.3

26 66.9 0.5 64.4 0.9 100.5 1.6 26.5 0.8 3.8

27 63.8 0.6 61.4 0.9 96.4 1.6 24.9 0.8 3.9

28 61.8 0.6 57.8 0.9 89.5 1.5 24.8 0.8 3.6

29 58.9 0.6 58.1 0.9 90.4 1.5 24.8 0.8 3.6

30 56.3 0.6 55.2 0.8 85.1 1.5 24.6 0.8 3.5

31 53.8 0.5 55.6 0.8 85.8 1.5 24.9 0.8 3.4

32 51.4 0.5 57.0 0.8 87.9 1.4 25.7 0.8 3.4

33 47.9 0.5 54.4 0.8 82.5 1.4 25.8 0.8 3.2

34 46.0 0.5 55.4 0.8 81.8 1.4 28.5 0.8 2.9

35 43.6 0.5 58.4 0.8 87.3 1.5 29.2 0.8 3.0

36 40.6 0.5 57.5 0.8 85.7 1.4 29.0 0.8 3.0

37 39.1 0.4 60.6 0.9 88.8 1.5 32.2 0.9 2.8

38 37.0 0.4 60.9 0.8 89.0 1.4 32.7 0.9 2.7

39 33.8 0.4 60.4 0.8 87.5 1.4 33.3 0.9 2.6

40 32.0 0.3 63.3 0.8 90.2 1.4 36.7 0.9 2.5

41 30.8 0.3 66.7 0.9 96.2 1.5 37.5 0.9 2.6

42 28.1 0.3 67.0 0.9 97.1 1.5 37.2 0.9 2.6

43 26.6 0.3 67.6 0.9 97.7 1.5 37.9 0.9 2.6

44 24.2 0.3 66.3 0.8 96.3 1.4 36.8 0.9 2.6

45 22.8 0.3 68.5 0.9 99.3 1.5 38.5 0.9 2.6

See footnotes at end of table.
73 Injury in the United States: 2007 Chartbook

Data table for Figure 3. Injury deaths as a percentage of total deaths, injury death rates by age and sex, and ratio 

of male-to-female death rates: United States, average annual 2003–2004—Con.

Both sexes Male Female

Age in years Percent of 

total deaths SE1 Rate SE Rate SE Rate SE Male-female 

rate ratio

46 20.6 0.2 68.5 0.9 98.6 1.5 39.1 0.9 2.5

47 19.1 0.2 68.0 0.9 98.8 1.5 38.1 0.9 2.6

48 17.5 0.2 67.0 0.9 97.1 1.5 37.8 0.9 2.6

49 15.7 0.2 64.4 0.9 92.7 1.5 36.9 0.9 2.5

50 14.3 0.2 64.0 0.9 94.0 1.5 35.3 0.9 2.7

51 13.1 0.2 62.8 0.9 91.3 1.5 35.6 0.9 2.6

52 11.6 0.2 60.2 0.9 90.0 1.6 31.6 0.9 2.8

53 10.5 0.2 57.3 0.9 85.0 1.5 30.8 0.9 2.8

54 9.8 0.1 57.8 0.9 84.0 1.5 32.8 0.9 2.6

55 8.3 0.1 52.7 0.9 76.6 1.5 30.0 0.9 2.6

56 7.6 0.1 53.3 0.9 79.4 1.5 28.5 0.9 2.8

57 7.1 0.1 50.5 0.9 74.4 1.5 28.0 0.9 2.7

58 6.4 0.1 53.1 1.0 76.1 1.7 31.5 1.0 2.4

59 5.7 0.1 50.8 1.0 76.6 1.7 26.7 1.0 2.9

60 5.2 0.1 51.5 1.0 75.0 1.7 29.8 1.0 2.5

61 4.8 0.1 50.0 1.0 75.1 1.7 27.0 1.0 2.8

62 4.3 0.1 50.3 1.0 74.2 1.8 28.6 1.1 2.6

63 3.8 0.1 48.7 1.0 71.7 1.8 28.0 1.1 2.6

64 3.5 0.1 48.8 1.1 71.0 1.8 28.8 1.1 2.5

65 3.5 0.1 51.6 1.1 75.2 1.9 30.6 1.2 2.5

66 3.2 0.1 50.8 1.1 72.8 2.0 31.5 1.2 2.3

67 3.0 0.1 53.9 1.2 80.1 2.1 31.2 1.2 2.6

68 2.9 0.1 55.4 1.2 81.3 2.1 33.2 1.3 2.5

69 2.7 0.1 54.7 1.2 81.2 2.2 32.4 1.3 2.5

70 2.7 0.1 61.4 1.3 89.1 2.4 38.3 1.4 2.3

71 2.5 0.1 62.6 1.3 89.1 2.4 40.9 1.5 2.2

72 2.4 0.1 66.6 1.4 96.7 2.5 42.4 1.5 2.3

73 2.3 0.0 69.4 1.4 101.4 2.6 44.1 1.5 2.3

74 2.4 0.0 76.9 1.5 109.5 2.8 51.6 1.7 2.1

75 2.3 0.0 84.0 1.6 120.5 3.0 56.3 1.8 2.1

76 2.3 0.0 91.4 1.7 132.1 3.2 61.4 1.9 2.2

77 2.3 0.0 97.5 1.8 137.4 3.3 69.0 2.0 2.0

78 2.2 0.0 103.7 1.9 152.3 3.6 70.1 2.0 2.2

79 2.3 0.0 116.9 2.1 167.3 3.9 83.1 2.2 2.0

80 2.3 0.0 128.4 2.2 180.2 4.2 94.6 2.5 1.9

81 2.3 0.0 141.5 2.4 203.5 4.7 102.2 2.6 2.0

82 2.3 0.0 159.1 2.7 233.6 5.2 113.4 2.9 2.1

83 2.3 0.0 177.8 3.0 252.2 5.8 134.0 3.3 1.9

84 2.2 0.0 182.7 3.2 256.2 6.2 141.0 3.5 1.8

85 and over 2.1 0.0 298.0 1.8 399.9 3.7 252.6 2.0 1.6

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. See Appendix I, NVSS, Mortality Statistics for description of data sources and for identifying injury 

deaths. See Appendix II, Standard error.

SOURCE: CDC/NCHS, National Vital Statistics System.
74 Injury in the United States: 2007 Chartbook

Data table for Figure 4. Age-adjusted injury death rates by intent of injury and year: United States, 1985–2004

Year All Unintentional Suicide Homicide Undetermined Legal or war1

Rate SE2 Rate SE Rate SE Rate SE Rate SE Rate SE

1985 60.3 0.2 38.6 0.1 12.5 0.1 7.9 0.1 1.2 0.0 0.1 0.0

1986 61.5 0.2 38.6 0.1 13.0 0.1 8.5 0.1 1.3 0.0 0.1 0.0

1987 60.6 0.2 38.2 0.1 12.8 0.1 8.2 0.1 1.2 0.0 0.1 0.0

1988 61.1 0.2 38.9 0.1 12.5 0.1 8.4 0.1 1.2 0.0 0.1 0.0

1989 59.9 0.2 37.7 0.1 12.3 0.1 8.7 0.1 1.1 0.0 0.1 0.0

1990 59.2 0.2 36.3 0.1 12.5 0.1 9.4 0.1 0.9 0.0 0.1 0.0

1991 58.0 0.2 34.7 0.1 12.3 0.1 9.9 0.1 1.0 0.0 0.1 0.0

1992 55.9 0.1 33.2 0.1 12.0 0.1 9.4 0.1 1.1 0.0 0.1 0.0

1993 57.2 0.1 34.2 0.1 12.1 0.1 9.6 0.1 1.3 0.0 0.1 0.0

1994 56.6 0.1 34.2 0.1 11.9 0.1 9.1 0.1 1.3 0.0 0.1 0.0

1995 55.8 0.1 34.4 0.1 11.8 0.1 8.3 0.1 1.2 0.0 0.1 0.0

1996 54.9 0.1 34.5 0.1 11.5 0.1 7.5 0.1 1.3 0.0 0.1 0.0

1997 54.0 0.1 34.2 0.1 11.2 0.1 7.0 0.1 1.3 0.0 0.1 0.0

1998 53.5 0.1 34.5 0.1 11.1 0.1 6.4 0.0 1.3 0.0 0.1 0.0

1999 53.3 0.1 35.3 0.1 10.5 0.1 6.0 0.0 1.4 0.0 0.1 0.0

2000 52.8 0.1 34.9 0.1 10.4 0.1 5.9 0.0 1.4 0.0 0.1 0.0

2001 55.1 0.1 35.6 0.1 10.7 0.1 7.1 0.0 1.5 0.0 0.1 0.0

2002 55.7 0.1 36.9 0.1 10.9 0.1 6.1 0.0 1.7 0.0 0.1 0.0

2003 56.0 0.1 37.3 0.1 10.8 0.1 6.1 0.0 1.7 0.0 0.2 0.0

2004 56.4 0.1 37.7 0.1 10.9 0.1 5.9 0.0 1.7 0.0 0.1 0.0

 0.0 Quantity more than zero but less than 0.05.

1

Includes legal intervention and operations of war. The catgory was referred to as “Other” before 1998.

2

SE is standard error.

NOTES: Rates are per 100,000 resident population. Rates are age adjusted to the 2000 U.S. standard population. Age-adjusted rates may not agree 

with rates published by the Division of Vital Statistics because of the methodology. See Appendix I, NVSS, Mortality Statistics for description of data 

source and for identifying injury deaths. See Appendix II, Age adjustment, for difference in methods; Standard error. See Table VI for classification 

codes for intent of injury.

SOURCE: CDC/NCHS, National Vital Statistics System.
76 Injury in the United States: 2007 Chartbook

Data table A for Figure 5-1. Average annual injury death rates for total population by intent of injury and age: 

United States, 2003–2004

Intent of injury

Age in years Unintentional Suicide Homicide Undetermined

Rate SE1 Rate SE Rate SE Rate SE

Under 1 24.7 0.6 ... ... 8.2 0.3 2.2 0.2

1 13.2 0.4 ... ... 3.7 0.2 0.5 0.1

2 11.8 0.4 ... ... 2.6 0.2 0.3 0.1

3 9.5 0.3 ... ... 1.9 0.2 * *

4 7.7 0.3 ... ... 1.3 0.1 * *

5 6.7 0.3 * * 0.7 0.1 * *

6 5.8 0.3 * * 0.6 0.1 * *

7 5.4 0.3 * * 0.6 0.1 * *

8 5.0 0.3 * * 0.7 0.1 * *

9 5.3 0.3 * * 0.6 0.1 * *

10 5.4 0.3 0.3 0.1 0.6 0.1 * *

11 5.3 0.3 0.4 0.1 0.5 0.1 * *

12 6.8 0.3 0.9 0.1 0.8 0.1 * *

13 7.7 0.3 1.8 0.1 1.1 0.1 0.2 0.1

14 10.9 0.4 2.8 0.2 1.9 0.1 0.3 0.1

15 15.0 0.4 4.1 0.2 3.6 0.2 0.4 0.1

16 27.4 0.6 6.1 0.3 5.7 0.3 0.4 0.1

17 34.9 0.7 7.0 0.3 8.8 0.3 0.6 0.1

18 43.8 0.7 9.8 0.3 13.5 0.4 1.0 0.1

19 43.9 0.7 11.7 0.4 15.5 0.4 1.4 0.1

20 43.6 0.7 11.4 0.4 16.2 0.4 1.4 0.1

21 44.8 0.7 13.0 0.4 15.2 0.4 1.6 0.1

22 42.2 0.7 12.2 0.4 16.0 0.4 1.8 0.1

23 38.2 0.7 12.6 0.4 15.5 0.4 2.0 0.2

24 36.8 0.7 12.1 0.4 16.1 0.4 2.0 0.2

25 35.6 0.7 12.0 0.4 15.0 0.4 1.8 0.1

26 35.5 0.7 12.1 0.4 14.6 0.4 1.7 0.1

27 34.0 0.7 11.9 0.4 13.5 0.4 1.7 0.1

28 31.7 0.6 12.1 0.4 11.8 0.4 1.9 0.2

29 31.7 0.6 12.4 0.4 11.6 0.4 2.2 0.2

30 29.5 0.6 12.6 0.4 10.5 0.4 2.3 0.2

31 29.7 0.6 13.0 0.4 10.5 0.4 2.3 0.2

32 31.4 0.6 13.7 0.4 9.5 0.3 2.1 0.2

33 30.5 0.6 13.2 0.4 8.3 0.3 2.1 0.2

34 30.8 0.6 13.7 0.4 8.2 0.3 2.5 0.2

35 33.6 0.6 13.4 0.4 8.4 0.3 2.7 0.2

36 33.9 0.6 12.9 0.4 7.4 0.3 3.0 0.2

37 35.2 0.7 14.5 0.4 7.6 0.3 3.0 0.2

38 35.8 0.6 14.1 0.4 7.5 0.3 3.2 0.2

39 35.7 0.6 14.5 0.4 6.5 0.3 3.4 0.2

40 37.3 0.6 15.4 0.4 6.9 0.3 3.5 0.2

41 40.3 0.7 15.8 0.4 6.6 0.3 3.8 0.2

42 40.4 0.7 16.2 0.4 6.6 0.3 3.6 0.2

43 42.0 0.7 15.8 0.4 6.2 0.3 3.5 0.2

44 40.2 0.7 16.4 0.4 5.5 0.2 3.9 0.2

See footnotes at end of table.
77 Injury in the United States: 2007 Chartbook

Data table A for Figure 5-1. Average annual injury death rates for total population by intent of injury and age: 

United States, 2003–2004—Con.

Intent of injury

Age in years Unintentional Suicide Homicide Undetermined

Rate SE1 Rate SE Rate SE Rate SE

45 42.1 0.7 16.3 0.4 6.5 0.3 3.5 0.2

46 42.9 0.7 16.3 0.4 5.7 0.3 3.4 0.2

47 42.3 0.7 16.6 0.4 5.3 0.2 3.8 0.2

48 41.4 0.7 16.4 0.4 5.2 0.2 3.8 0.2

49 39.5 0.7 16.8 0.4 4.6 0.2 3.3 0.2

50 39.8 0.7 16.7 0.5 4.5 0.2 2.9 0.2

51 39.2 0.7 16.2 0.5 4.5 0.2 2.8 0.2

52 37.3 0.7 15.9 0.5 4.4 0.2 2.3 0.2

53 35.5 0.7 15.3 0.5 3.8 0.2 2.7 0.2

54 35.8 0.7 15.8 0.5 3.9 0.2 2.2 0.2

55 33.3 0.7 14.0 0.4 3.3 0.2 2.1 0.2

56 33.5 0.7 14.7 0.5 3.2 0.2 1.8 0.2

57 31.6 0.7 13.9 0.5 3.2 0.2 1.8 0.2

58 33.1 0.8 15.5 0.5 3.1 0.2 1.2 0.1

59 32.4 0.8 14.4 0.5 2.9 0.2 1.0 0.1

60 33.3 0.8 14.3 0.5 2.9 0.2 1.1 0.1

61 32.3 0.8 13.7 0.5 2.9 0.2 1.1 0.1

62 34.2 0.8 12.4 0.5 2.4 0.2 1.1 0.2

63 33.1 0.9 12.2 0.5 2.5 0.2 0.9 0.1

64 33.9 0.9 11.6 0.5 2.5 0.2 0.8 0.1

65 36.1 0.9 12.0 0.5 2.6 0.2 0.9 0.1

66 36.5 0.9 11.4 0.5 2.2 0.2 0.7 0.1

67 37.7 1.0 12.1 0.6 2.9 0.3 1.2 0.2

68 41.0 1.0 11.2 0.5 2.1 0.2 0.9 0.2

69 40.2 1.0 11.6 0.6 2.5 0.3 * *

70 45.6 1.1 12.6 0.6 2.3 0.3 0.9 0.2

71 46.9 1.2 13.0 0.6 2.2 0.3 * *

72 50.3 1.2 13.1 0.6 2.6 0.3 0.6 0.1

73 52.4 1.2 14.3 0.6 1.9 0.2 0.8 0.1

74 58.6 1.3 14.8 0.7 2.5 0.3 0.9 0.2

75 64.0 1.4 16.7 0.7 2.6 0.3 0.7 0.1

76 73.7 1.5 15.0 0.7 2.0 0.3 0.7 0.1

77 79.8 1.6 14.9 0.7 2.2 0.3 * *

78 84.8 1.7 16.1 0.8 2.0 0.3 * *

79 96.7 1.9 16.4 0.8 3.1 0.3 * *

80 108.8 2.1 15.8 0.8 2.7 0.3 0.9 0.2

81 120.4 2.2 17.6 0.9 2.3 0.3 1.0 0.2

82 136.3 2.5 19.3 0.9 2.5 0.3 1.0 0.2

83 157.9 2.8 16.9 0.9 1.8 0.3 1.1 0.2

84 162.4 3.0 16.4 0.9 2.3 0.4 1.6 0.3

85 years and over 277.8 1.7 16.7 0.4 2.2 0.2 1.4 0.1

...Category not applicable.

*Figure does not meet standards of reliability or precision; rates based on fewer than 20 deaths are considered unreliable.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. Suicide rates are not calculated for children under 5 years of age. See Appendix I, NVSS, Mortality 

Statistics for description of data source. See Appendix II, Standard error. See Table III for classification codes for intent.

SOURCE: CDC/NCHS, National Vital Statistics System.
78 Injury in the United States: 2007 Chartbook

Data table B for Figure 5-1. Average annual injury death rates for males by intent of injury and age: United States, 

2003–2004

Intent of injury

Age in years Unintentional Suicide Homicide Undetermined

Rate SE1 Rate SE Rate SE Rate SE

Under 1 27.7 0.8 ... ... 9.0 0.5 2.8 0.3

1 14.9 0.6 ... ... 4.1 0.3 0.6 0.1

2 13.9 0.6 ... ... 2.6 0.3 * *

3 11.9 0.5 ... ... 1.9 0.2 * *

4 8.8 0.5 ... ... 1.4 0.2 * *

5 8.1 0.5 * * 0.7 0.1 * *

6 7.0 0.4 * * 0.7 0.1 * *

7 6.3 0.4 * * * * * *

8 6.0 0.4 * * 0.7 0.1 * *

9 5.7 0.4 * * 0.7 0.1 * *

10 6.3 0.4 * * 0.6 0.1 * *

11 6.5 0.4 0.6 0.1 0.5 0.1 * *

12 9.0 0.5 1.3 0.2 1.1 0.2 * *

13 9.7 0.5 2.4 0.2 1.5 0.2 * *

14 14.1 0.6 3.7 0.3 2.9 0.3 * *

15 18.5 0.7 5.6 0.4 5.5 0.4 0.7 0.1

16 35.1 0.9 8.9 0.5 9.4 0.5 0.7 0.1

17 46.3 1.0 11.1 0.5 14.6 0.6 1.0 0.2

18 60.2 1.2 15.8 0.6 22.6 0.7 1.5 0.2

19 63.6 1.2 19.4 0.7 26.1 0.8 1.8 0.2

20 64.1 1.2 19.3 0.7 27.3 0.8 1.9 0.2

21 67.1 1.2 21.9 0.7 24.8 0.8 2.3 0.2

22 63.9 1.2 20.2 0.7 26.9 0.8 2.7 0.2

23 58.2 1.2 21.0 0.7 26.4 0.8 3.1 0.3

24 55.6 1.1 20.3 0.7 27.3 0.8 2.8 0.3

25 54.5 1.2 20.0 0.7 25.7 0.8 2.5 0.2

26 53.1 1.2 20.0 0.7 24.3 0.8 2.4 0.2

27 51.2 1.1 19.4 0.7 22.8 0.8 2.6 0.3

28 47.4 1.1 19.5 0.7 19.6 0.7 2.5 0.3

29 47.7 1.1 20.1 0.7 19.1 0.7 3.0 0.3

30 44.5 1.1 19.7 0.7 16.9 0.7 3.3 0.3

31 44.5 1.1 20.8 0.7 16.9 0.6 3.1 0.3

32 47.2 1.1 22.2 0.7 15.2 0.6 2.7 0.3

33 44.7 1.0 21.0 0.7 13.4 0.6 2.8 0.3

34 44.1 1.0 21.7 0.7 12.3 0.5 3.2 0.3

35 48.7 1.1 21.2 0.7 13.1 0.6 3.6 0.3

36 49.3 1.1 20.1 0.7 11.9 0.5 3.8 0.3

37 50.2 1.1 23.0 0.7 11.2 0.5 3.8 0.3

38 51.0 1.1 22.3 0.7 10.9 0.5 4.1 0.3

39 50.6 1.1 22.1 0.7 9.7 0.5 4.5 0.3

40 52.2 1.1 23.5 0.7 9.5 0.5 4.5 0.3

41 56.9 1.1 24.3 0.7 9.9 0.5 4.6 0.3

42 57.7 1.1 24.7 0.7 9.7 0.5 4.6 0.3

43 59.9 1.1 24.5 0.7 9.0 0.4 4.0 0.3

44 58.1 1.1 24.6 0.7 8.3 0.4 4.9 0.3

See footnotes at end of table.
79 Injury in the United States: 2007 Chartbook

Data table B for Figure 5-1. Average annual injury death rates for males by intent of injury and age: United States, 

2003–2004—Con.

Intent of injury

Age in years Unintentional Suicide Homicide Undetermined

Rate SE1 Rate SE Rate SE Rate SE

45 60.3 1.2 24.6 0.7 9.5 0.5 4.6 0.3

46 61.2 1.2 24.4 0.7 8.2 0.4 4.6 0.3

47 61.2 1.2 25.0 0.8 7.9 0.4 4.5 0.3

48 59.2 1.2 24.6 0.8 7.9 0.4 5.1 0.3

49 56.4 1.2 25.3 0.8 6.7 0.4 4.0 0.3

50 57.7 1.2 25.0 0.8 7.0 0.4 4.0 0.3

51 56.4 1.2 24.3 0.8 6.7 0.4 3.6 0.3

52 55.2 1.2 24.9 0.8 6.9 0.4 2.6 0.3

53 51.5 1.2 23.6 0.8 6.0 0.4 3.7 0.3

54 51.0 1.2 24.2 0.8 6.0 0.4 2.8 0.3

55 47.7 1.2 21.2 0.8 4.9 0.4 2.7 0.3

56 49.0 1.2 23.1 0.8 4.8 0.4 2.3 0.3

57 45.4 1.2 22.0 0.8 4.7 0.4 2.1 0.3

58 45.5 1.3 24.2 0.9 4.7 0.4 1.4 0.2

59 47.2 1.3 23.5 0.9 4.6 0.4 1.1 0.2

60 47.2 1.3 22.1 0.9 4.3 0.4 1.3 0.2

61 45.8 1.3 23.4 0.9 4.5 0.4 1.3 0.2

62 48.5 1.5 20.7 1.0 3.6 0.4 1.2 0.2

63 46.9 1.5 20.2 1.0 3.5 0.4 1.1 0.2

64 46.4 1.5 20.0 1.0 3.6 0.4 * *

65 49.2 1.6 21.1 1.0 4.0 0.4 1.0 0.2

66 49.9 1.6 19.2 1.0 3.0 0.4 * *

67 53.2 1.7 21.2 1.1 4.4 0.5 1.4 0.3

68 56.0 1.8 20.5 1.1 3.1 0.4 1.5 0.3

69 55.2 1.8 21.6 1.1 3.7 0.5 * *

70 61.3 2.0 23.2 1.2 3.8 0.5 * *

71 60.6 2.0 24.0 1.2 3.6 0.5 * *

72 68.1 2.1 24.7 1.3 3.2 0.5 * *

73 69.5 2.2 28.4 1.4 2.6 0.4 * *

74 76.0 2.3 28.7 1.4 3.4 0.5 * *

75 82.9 2.5 32.9 1.5 3.7 0.5 * *

76 99.2 2.7 29.3 1.5 2.8 0.5 * *

77 103.7 2.9 30.3 1.6 2.7 0.5 * *

78 114.8 3.1 33.6 1.7 2.3 0.4 * *

79 127.5 3.4 34.9 1.8 3.8 0.6 * *

80 141.6 3.8 34.3 1.9 3.3 0.6 * *

81 159.7 4.2 39.4 2.1 2.7 0.5 * *

82 184.5 4.7 44.3 2.3 3.1 0.6 * *

83 209.8 5.3 38.8 2.3 * * * *

84 211.4 5.7 40.3 2.5 * * * *

85 and over 348.9 3.4 46.4 1.3 2.9 0.3 1.7 0.2

...Category not applicable.

*Figure does not meet standards of reliability or precision; rates based on fewer than 20 deaths are considered unreliable.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. Suicide rates are not calculated for children under 5 years of age. See Appendix I, NVSS, Mortality 

Statistics for description of data source. See Appendix II, Standard error. See Table III for classification codes for intent.

SOURCE: CDC/NCHS, National Vital Statistics System.
80 Injury in the United States: 2007 Chartbook

Data table C for Figure 5. Average annual injury death rates for females by intent of injury and age: United 

States, 2003–2004

Intent of injury

Age in years Unintentional Suicide Homicide Undetermined

Rate SE Rate SE Rate SE Rate SE

Under 1 21.6 0.7 ... ... 7.4 0.4 1.6 0.2

1 11.4 0.5 ... ... 3.3 0.3 * *

2 9.6 0.5 ... ... 2.5 0.3 * *

3 7.0 0.4 ... ... 1.9 0.2 * *

4 6.5 0.4 ... ... 1.3 0.2 * *

5 5.3 0.4 ... 0.6 0.1 * *

6 4.5 0.3 * * * * * *

7 4.5 0.3 * * 0.7 0.1 * *

8 3.9 0.3 * * 0.6 0.1 * *

9 4.9 0.4 * * 0.6 0.1 * *

10 4.3 0.3 * * 0.5 0.1 * *

11 4.0 0.3 * * 0.5 0.1 * *

12 4.5 0.3 * * 0.6 0.1 * *

13 5.6 0.4 1.1 0.2 0.7 0.1 * *

14 7.4 0.4 1.8 0.2 0.8 0.1 * *

15 11.3 0.5 2.5 0.2 1.6 0.2 * *

16 19.4 0.7 3.1 0.3 1.9 0.2 * *

17 23.0 0.8 2.7 0.3 2.6 0.3 * *

18 26.5 0.8 3.6 0.3 3.8 0.3 0.6 0.1

19 23.0 0.8 3.6 0.3 4.2 0.3 0.8 0.1

20 21.6 0.7 3.1 0.3 4.2 0.3 0.7 0.1

21 21.0 0.7 3.5 0.3 4.9 0.3 0.9 0.2

22 19.1 0.7 3.6 0.3 4.5 0.3 1.0 0.2

23 17.1 0.6 3.7 0.3 4.0 0.3 0.8 0.1

24 17.0 0.6 3.5 0.3 4.3 0.3 1.3 0.2

25 15.7 0.6 3.4 0.3 3.8 0.3 1.0 0.2

26 17.1 0.7 3.9 0.3 4.4 0.3 1.0 0.2

27 16.0 0.7 4.1 0.3 3.9 0.3 0.8 0.1

28 15.4 0.6 4.5 0.3 3.6 0.3 1.3 0.2

29 15.1 0.6 4.4 0.3 3.9 0.3 1.4 0.2

30 14.1 0.6 5.4 0.4 3.8 0.3 1.3 0.2

31 14.6 0.6 5.0 0.4 3.9 0.3 1.4 0.2

32 15.4 0.6 5.0 0.3 3.8 0.3 1.5 0.2

33 16.0 0.6 5.3 0.4 3.2 0.3 1.4 0.2

34 17.3 0.6 5.5 0.4 4.0 0.3 1.7 0.2

35 18.4 0.7 5.4 0.4 3.6 0.3 1.7 0.2

36 18.4 0.7 5.6 0.4 2.8 0.3 2.1 0.2

37 20.2 0.7 6.0 0.4 4.0 0.3 2.1 0.2

38 20.5 0.7 5.8 0.4 4.1 0.3 2.2 0.2

39 20.8 0.7 6.9 0.4 3.4 0.3 2.2 0.2

40 22.5 0.7 7.4 0.4 4.2 0.3 2.5 0.2

41 23.9 0.7 7.4 0.4 3.3 0.3 3.0 0.3

42 23.2 0.7 7.9 0.4 3.6 0.3 2.5 0.2

43 24.3 0.7 7.1 0.4 3.5 0.3 3.0 0.3

44 22.6 0.7 8.3 0.4 2.8 0.2 3.0 0.3

See footnotes at end of table.
81 Injury in the United States: 2007 Chartbook

Data table C for Figure 5. Average annual injury death rates for females by intent of injury and age: United 

States, 2003–2004—Con.

Intent of injury

Age in single years Unintentional Suicide Homicide Undetermined

Rate SE1 Rate SE Rate SE Rate SE

45 24.4 0.7 8.1 0.4 3.5 0.3 2.4 0.2

46 25.1 0.7 8.4 0.4 3.3 0.3 2.4 0.2

47 24.0 0.7 8.4 0.4 2.8 0.2 3.0 0.3

48 24.1 0.7 8.6 0.4 2.6 0.2 2.5 0.2

49 23.1 0.7 8.5 0.4 2.6 0.2 2.7 0.3

50 22.6 0.7 8.6 0.5 2.1 0.2 1.9 0.2

51 22.8 0.8 8.4 0.5 2.4 0.2 2.1 0.2

52 20.3 0.7 7.2 0.4 2.0 0.2 2.2 0.2

53 20.2 0.7 7.4 0.4 1.6 0.2 1.7 0.2

54 21.5 0.8 7.9 0.5 1.8 0.2 1.6 0.2

55 19.7 0.7 7.1 0.4 1.7 0.2 1.4 0.2

56 18.8 0.7 6.6 0.4 1.7 0.2 1.4 0.2

57 18.6 0.7 6.2 0.4 1.7 0.2 1.4 0.2

58 21.6 0.9 7.4 0.5 1.6 0.2 0.9 0.2

59 18.6 0.8 5.9 0.5 1.4 0.2 0.9 0.2

60 20.4 0.8 7.0 0.5 1.5 0.2 0.9 0.2

61 20.0 0.8 4.7 0.4 1.3 0.2 1.0 0.2

62 21.3 0.9 4.9 0.4 1.4 0.2 1.0 0.2

63 20.7 0.9 5.0 0.5 1.6 0.3 * *

64 22.6 1.0 4.1 0.4 1.4 0.2 * *

65 24.4 1.0 4.0 0.4 1.3 0.2 * *

66 24.8 1.1 4.4 0.5 1.5 0.3 * *

67 24.3 1.1 4.3 0.5 1.7 0.3 1.0 0.2

68 28.0 1.2 3.3 0.4 1.3 0.3 * *

69 27.5 1.2 3.1 0.4 1.5 0.3 * *

70 32.5 1.3 3.8 0.4 * * * *

71 35.7 1.4 3.9 0.5 1.0 0.2 * *

72 36.0 1.4 3.7 0.4 2.1 0.3 * *

73 38.9 1.4 3.2 0.4 1.4 0.3 * *

74 45.2 1.6 4.0 0.5 1.8 0.3 * *

75 49.7 1.7 4.4 0.5 1.7 0.3 * *

76 54.9 1.8 4.4 0.5 1.3 0.3 * *

77 62.7 1.9 3.9 0.5 1.8 0.3 * *

78 64.0 1.9 4.0 0.5 1.7 0.3 * *

79 76.1 2.2 4.0 0.5 2.7 0.4 * *

80 87.6 2.4 3.8 0.5 2.3 0.4 * *

81 95.5 2.6 3.8 0.5 2.0 0.4 * *

82 106.7 2.8 3.9 0.5 2.2 0.4 * *

83 127.3 3.2 4.0 0.6 * * * *

84 134.5 3.4 2.8 0.5 2.1 0.4 * *

85 and over 246.1 1.9 3.4 0.2 1.8 0.2 1.3 0.1

...Category not applicable.

*Figure does not meet standards of reliability or precision; rates based on fewer than 20 deaths are considered unreliable.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. Suicide rates are not calculated for children under 5 years of age. See Appendix I, NVSS, Mortality 

Statistics for description of data source. See Appendix II, Standard error. See Table III for classification codes for intent.

SOURCE: CDC/NCHS, National Vital Statistics System.
82 Injury in the United States: 2007 Chartbook

Data table for Figure 5-2. Injury deaths and percent distribution, by intent: United States, 2003–2004

Intent Deaths Percent distribution

Unintentional 221,289 66.8

Suicide 63,923 19.3

Homicide 35,089 10.6

Undetermined 10,048 3.0

Legal intervention or operations of war 837 0.3

All injury deaths 331,186 100.0

NOTE: Deaths are 2-year totals.

SOURCE: CDC/NCHS, National Vital Statistics System. 
83 Injury in the United States: 2007 Chartbook

Data table for Figure 6. Age-adjusted injury death rates for leading mechanisms of injury, by year: United States, 

1985–2004 

Year Motor vehicle 

traffic Firearm Poisoning Fall Suffocation Drowning

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

1985 18.1 0.1 13.1 0.1 5.1 0.0 4.7 0.0 4.2 0.0 2.1 0.0

1986 18.7 0.1 13.6 0.1 5.5 0.0 4.5 0.0 4.4 0.0 2.3 0.0

1987 18.8 0.1 13.3 0.1 5.4 0.0 4.5 0.0 4.3 0.0 2.1 0.0

1988 19.0 0.1 13.5 0.1 5.5 0.0 4.5 0.0 4.2 0.0 2.0 0.0

1989 18.4 0.1 13.8 0.1 5.5 0.0 4.5 0.0 4.1 0.0 1.9 0.0

1990 18.1 0.1 14.6 0.1 5.0 0.0 4.5 0.0 3.9 0.0 1.8 0.0

1991 16.6 0.1 14.9 0.1 5.3 0.0 4.5 0.0 3.9 0.0 1.8 0.0

1992 15.5 0.1 14.5 0.1 5.6 0.0 4.3 0.0 3.8 0.0 1.6 0.0

1993 15.7 0.1 15.0 0.1 6.1 0.0 4.3 0.0 3.8 0.0 1.7 0.0

1994 15.7 0.1 14.5 0.1 6.2 0.0 4.4 0.0 3.8 0.0 1.5 0.0

1995 15.9 0.1 13.4 0.1 6.1 0.0 4.5 0.0 3.9 0.0 1.7 0.0

1996 15.8 0.1 12.6 0.1 6.2 0.0 4.7 0.0 3.9 0.0 1.5 0.0

1997 15.5 0.1 11.8 0.1 6.5 0.0 4.8 0.0 3.9 0.0 1.5 0.0

1998 15.3 0.1 11.1 0.1 6.7 0.0 5.0 0.0 4.0 0.0 1.7 0.0

1999 14.7 0.1 10.3 0.1 7.1 0.1 5.1 0.0 4.2 0.0 1.5 0.0

2000 14.9 0.1 10.2 0.1 7.2 0.1 5.1 0.0 4.3 0.0 1.4 0.0

2001 14.9 0.1 10.3 0.1 7.8 0.1 5.6 0.0 4.4 0.0 1.4 0.0

2002 15.2 0.1 10.4 0.1 9.2 0.1 5.9 0.0 4.4 0.0 1.4 0.0

2003 14.8 0.1 10.3 0.1 9.9 0.1 6.1 0.0 4.4 0.0 1.3 0.0

2004 14.7 0.1 10.0 0.1 10.3 0.1 6.5 0.0 4.7 0.0 1.3 0.0

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. Rates are age adjusted to the 2000 U.S. standard population. See Appendix I, NVSS, Mortality 

Statistics for description of data source, and Appendix II, Age adjustment. Age-adjusted rates may not agree with rates published by the Division of 

Vital Statistics because of the methodology. See Appendix II, Age adjustment, for difference in methods. For years 1985–1998, when the International 

Classification of Diseases, Ninth Revision (ICD–9) was in effect in the United States, ICD–9 external cause of injury codes for motor vehicle trafficrelated deaths and for drowning were modified from the external cause of injury mortality matrix to be comparable to the way the categories are 

coded using ICD–10. E958.5 and E988.5 were removed from motor vehicle traffic codes, and E830–E832 were removed from drowning codes for 

1985–1998. This provides trend data comparable to data year 1999 and beyond. See Table VI for classification codes for mechanisms of injury. See 

Appendix II, Comparability ratio; Standard error.

SOURCE: CDC/NCHS, National Vital Statistics System.
84 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: 

United States, 2003–2004

Motor vehicle traffic Firearm

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

Under 1 3.5 0.2 3.8 0.3 3.2 0.3 * * * * * *

1 3.0 0.2 3.8 0.3 2.7 0.3 * * * * * *

2 3.4 0.2 3.4 0.3 3.3 0.3 0.3 0.1 * * * *

3 3.4 0.2 3.4 0.3 3.3 0.3 0.4 0.1 * * * *

4 3.1 0.2 3.4 0.3 2.9 0.3 0.4 0.1 * * * *

5 3.2 0.2 3.4 0.3 2.7 0.3 0.3 0.1 * * * *

6 3.2 0.2 3.7 0.3 2.6 0.3 * * * * * *

7 2.9 0.2 3.1 0.3 2.7 0.3 0.4 0.1 * * * *

8 2.7 0.2 3.1 0.3 2.4 0.2 0.3 0.1 * * * *

9 3.0 0.2 3.1 0.3 3.0 0.3 0.3 0.1 * * * *

10 3.1 0.2 3.1 0.3 3.1 0.3 0.4 0.1 0.5 0.1 * *

11 3.1 0.2 3.4 0.3 2.7 0.3 0.4 0.1 0.6 0.1 * *

12 3.6 0.2 4.7 0.3 2.5 0.2 0.8 0.1 1.4 0.2 * *

13 4.7 0.2 5.5 0.4 3.8 0.3 1.4 0.1 2.3 0.2 0.6 0.1

14 7.1 0.3 8.5 0.4 5.5 0.4 2.8 0.2 4.7 0.3 0.9 0.1

15 10.7 0.4 12.3 0.5 9.0 0.5 4.9 0.2 8.0 0.4 1.6 0.2

16 21.5 0.5 25.8 0.8 17.1 0.7 7.8 0.3 13.3 0.6 2.0 0.2

17 27.4 0.6 34.6 0.9 19.8 0.7 11.2 0.4 19.2 0.7 2.8 0.3

18 33.5 0.6 43.7 1.0 22.7 0.8 16.6 0.4 29.1 0.8 3.3 0.3

19 31.9 0.6 44.2 1.0 18.8 0.7 19.9 0.5 35.3 0.9 3.6 0.3

20 30.6 0.6 43.0 1.0 17.3 0.7 20.1 0.5 35.6 0.9 3.6 0.3

21 30.6 0.6 44.7 1.0 15.5 0.6 20.1 0.5 35.0 0.9 4.1 0.3

22 27.7 0.6 40.6 1.0 13.9 0.6 20.6 0.5 36.2 0.9 4.0 0.3

23 23.7 0.5 35.4 0.9 11.4 0.5 19.9 0.5 35.3 0.9 3.6 0.3

24 21.9 0.5 32.8 0.9 10.5 0.5 20.3 0.5 36.1 0.9 3.8 0.3

25 20.7 0.5 31.0 0.9 9.9 0.5 18.9 0.5 33.8 0.9 3.3 0.3

26 20.2 0.5 29.8 0.9 10.2 0.5 18.5 0.5 32.4 0.9 3.9 0.3

27 18.9 0.5 28.2 0.8 9.3 0.5 17.4 0.5 30.7 0.9 3.5 0.3

28 17.3 0.5 25.3 0.8 9.0 0.5 15.5 0.5 27.3 0.8 3.3 0.3

29 17.1 0.5 25.2 0.8 8.7 0.5 15.3 0.4 26.7 0.8 3.5 0.3

30 15.8 0.5 23.6 0.8 7.7 0.5 14.8 0.4 25.0 0.8 4.3 0.3

31 14.7 0.4 21.1 0.7 8.3 0.5 14.3 0.4 24.8 0.8 3.7 0.3

32 15.5 0.4 22.9 0.7 8.1 0.4 13.9 0.4 23.7 0.8 3.9 0.3

33 14.9 0.4 22.1 0.7 7.6 0.4 12.8 0.4 22.1 0.7 3.3 0.3

34 14.4 0.4 20.5 0.7 8.2 0.4 12.0 0.4 20.2 0.7 3.7 0.3

35 15.2 0.4 21.8 0.7 8.4 0.5 11.9 0.4 20.3 0.7 3.4 0.3

36 15.0 0.4 21.4 0.7 8.4 0.5 10.9 0.4 18.9 0.7 2.9 0.3

37 15.2 0.4 21.3 0.7 9.1 0.5 11.7 0.4 19.5 0.7 3.8 0.3

38 14.7 0.4 21.3 0.7 8.0 0.4 11.4 0.4 19.1 0.7 3.6 0.3

39 14.3 0.4 20.6 0.7 8.1 0.4 11.2 0.4 18.0 0.6 4.3 0.3

40 14.6 0.4 20.3 0.7 8.9 0.4 11.6 0.4 18.6 0.6 4.6 0.3

41 15.3 0.4 22.1 0.7 8.5 0.4 11.3 0.4 18.6 0.6 4.2 0.3

42 15.7 0.4 22.7 0.7 8.8 0.4 11.6 0.4 19.0 0.6 4.3 0.3

43 15.2 0.4 21.9 0.7 8.6 0.4 11.4 0.3 18.7 0.6 4.3 0.3

44 14.5 0.4 21.3 0.7 7.7 0.4 11.2 0.3 18.5 0.6 4.0 0.3

See footnotes at end of table.
85 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: 

United States, 2003–2004—Con.

Motor vehicle traffic Firearm

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

45 15.6 0.4 22.6 0.7 8.7 0.4 11.9 0.4 19.4 0.7 4.5 0.3

46 15.1 0.4 21.7 0.7 8.7 0.4 11.5 0.4 18.6 0.6 4.6 0.3

47 14.8 0.4 21.3 0.7 8.5 0.4 11.3 0.4 18.6 0.7 4.2 0.3

48 14.7 0.4 21.0 0.7 8.7 0.4 11.0 0.4 18.4 0.7 3.8 0.3

49 13.6 0.4 20.0 0.7 7.5 0.4 11.0 0.4 18.2 0.7 4.0 0.3

50 14.6 0.4 21.6 0.7 7.8 0.4 11.6 0.4 19.4 0.7 4.1 0.3

51 14.8 0.4 21.1 0.7 8.7 0.5 10.9 0.4 18.1 0.7 4.0 0.3

52 13.2 0.4 19.4 0.7 7.3 0.4 10.6 0.4 18.6 0.7 2.9 0.3

53 13.5 0.4 18.9 0.7 8.4 0.5 10.2 0.4 17.5 0.7 3.2 0.3

54 14.9 0.5 21.3 0.8 8.9 0.5 10.6 0.4 17.9 0.7 3.7 0.3

55 14.0 0.4 20.2 0.8 8.2 0.5 9.2 0.4 15.2 0.7 3.6 0.3

56 13.3 0.4 19.5 0.8 7.6 0.5 10.4 0.4 18.3 0.7 2.9 0.3

57 13.0 0.4 18.6 0.7 7.7 0.5 9.4 0.4 16.1 0.7 3.0 0.3

58 13.6 0.5 18.2 0.8 9.4 0.6 11.1 0.4 19.0 0.8 3.6 0.4

59 13.7 0.5 19.8 0.9 8.0 0.5 10.4 0.4 18.6 0.8 2.7 0.3

60 14.4 0.5 20.2 0.9 9.1 0.6 10.0 0.4 16.9 0.8 3.6 0.4

61 13.7 0.5 18.0 0.8 9.8 0.6 10.7 0.4 19.4 0.9 2.8 0.3

62 14.2 0.5 19.4 0.9 9.4 0.6 9.0 0.4 16.5 0.8 2.2 0.3

63 12.9 0.5 18.1 0.9 8.2 0.6 9.8 0.5 17.1 0.9 3.2 0.4

64 13.3 0.6 17.3 0.9 9.8 0.6 9.4 0.5 17.4 0.9 2.2 0.3

65 15.4 0.6 20.1 1.0 11.1 0.7 9.4 0.5 17.6 0.9 2.0 0.3

66 15.0 0.6 20.1 1.0 10.5 0.7 9.0 0.5 16.2 0.9 2.7 0.4

67 13.8 0.6 19.2 1.0 9.1 0.7 10.8 0.5 20.1 1.1 2.7 0.4

68 15.3 0.6 19.3 1.0 11.8 0.8 9.1 0.5 17.7 1.0 1.7 0.3

69 13.5 0.6 18.2 1.0 9.5 0.7 9.9 0.5 19.4 1.1 2.0 0.3

70 16.4 0.7 20.3 1.1 13.1 0.8 10.4 0.5 20.1 1.1 2.3 0.3

71 15.3 0.7 20.3 1.1 11.2 0.8 10.5 0.6 21.1 1.2 1.9 0.3

72 16.6 0.7 21.0 1.2 13.1 0.8 10.5 0.6 20.6 1.2 2.3 0.3

73 17.1 0.7 22.3 1.2 13.0 0.8 11.6 0.6 24.0 1.3 1.9 0.3

74 18.5 0.7 23.8 1.3 14.4 0.9 12.7 0.6 25.8 1.3 2.5 0.4

75 19.3 0.8 25.3 1.4 14.7 0.9 13.8 0.7 28.8 1.4 2.4 0.4

76 21.2 0.8 28.8 1.5 15.6 0.9 12.0 0.6 25.1 1.4 2.4 0.4

77 21.6 0.9 27.8 1.5 17.1 1.0 12.3 0.6 26.4 1.5 2.3 0.4

78 23.4 0.9 32.3 1.7 17.3 1.0 13.2 0.7 29.4 1.6 2.0 0.3

79 23.9 0.9 33.5 1.7 17.5 1.0 14.3 0.7 31.1 1.7 3.0 0.4

80 25.6 1.0 35.5 1.9 19.1 1.1 13.0 0.7 29.1 1.7 2.6 0.4

81 25.0 1.0 35.1 1.9 18.5 1.1 14.1 0.8 33.1 1.9 2.1 0.4

82 28.4 1.1 40.9 2.2 20.7 1.2 15.4 0.8 36.9 2.1 2.2 0.4

83 29.5 1.2 44.0 2.4 21.0 1.3 13.5 0.8 33.3 2.1 1.8 0.4

84 26.1 1.2 41.6 2.5 17.3 1.2 12.7 0.8 32.8 2.2 * *

85 and over 26.4 0.5 45.0 1.2 18.1 0.5 12.2 0.4 36.8 1.1 1.2 0.1

See footnotes at end of table.
86 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: United 

States, 2003–2004—Con.

Poisoning Fall

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

Under 1 0.9 0.1 0.8 0.1 0.9 0.2 0.5 0.1 0.6 0.1 * *

1 0.5 0.1 0.6 0.1 * * 0.5 0.1 0.7 0.1 * *

2 0.3 0.1 * * * * 0.4 0.1 0.5 0.1 * *

3 * * * * * * * * * * * *

4 * * * * * * * * * * * *

5 * * * * * * * * * * * *

6 * * * * * * * * * * * *

7 * * * * * * * * * * * *

8 * * * * * * * * * * * *

9 * * * * * * * * * * * *

10 * * * * * * * * * * * *

11 0.3 0.1 * * * * * * * * * *

12 0.3 0.1 * * * * * * * * * *

13 0.3 0.1 * * * * * * * * * *

14 0.6 0.1 0.5 0.1 0.8 0.1 * * * * * *

15 1.2 0.1 1.6 0.2 0.9 0.1 0.2 0.1 * * * *

16 1.9 0.2 2.6 0.2 1.3 0.2 0.4 0.1 0.5 0.1 * *

17 3.2 0.2 4.6 0.3 1.8 0.2 0.7 0.1 1.1 0.2 * *

18 5.6 0.3 7.9 0.4 3.1 0.3 0.8 0.1 1.3 0.2 * *

19 7.3 0.3 10.9 0.5 3.5 0.3 1.0 0.1 1.5 0.2 0.5 0.1

20 7.7 0.3 11.7 0.5 3.3 0.3 1.2 0.1 2.0 0.2 * *

21 9.5 0.3 13.7 0.6 5.0 0.4 1.3 0.1 2.1 0.2 * *

22 10.1 0.3 15.3 0.6 4.7 0.3 1.1 0.1 1.8 0.2 * *

23 10.4 0.4 15.7 0.6 4.9 0.3 0.8 0.1 1.2 0.2 * *

24 11.3 0.4 16.1 0.6 6.2 0.4 1.0 0.1 1.7 0.2 * *

25 11.2 0.4 16.6 0.6 5.4 0.4 0.9 0.1 1.6 0.2 * *

26 11.1 0.4 16.1 0.6 5.9 0.4 1.1 0.1 1.7 0.2 * *

27 11.7 0.4 16.6 0.7 6.6 0.4 1.0 0.1 1.7 0.2 * *

28 11.8 0.4 16.3 0.6 7.1 0.4 1.1 0.1 1.8 0.2 * *

29 11.7 0.4 16.4 0.6 6.8 0.4 1.3 0.1 2.1 0.2 0.5 0.1

30 11.8 0.4 16.5 0.7 7.0 0.4 0.9 0.1 1.3 0.2 * *

31 13.1 0.4 18.4 0.7 7.6 0.4 1.0 0.1 1.6 0.2 * *

32 13.8 0.4 18.9 0.7 8.6 0.5 1.2 0.1 2.0 0.2 * *

33 13.4 0.4 17.6 0.6 9.1 0.5 1.2 0.1 1.9 0.2 0.5 0.1

34 14.8 0.4 19.5 0.7 10.0 0.5 1.4 0.1 2.0 0.2 0.7 0.1

35 16.2 0.4 21.7 0.7 10.7 0.5 1.5 0.1 2.4 0.2 0.7 0.1

36 17.2 0.5 22.4 0.7 11.9 0.5 1.3 0.1 2.2 0.2 0.5 0.1

37 18.5 0.5 24.4 0.8 12.5 0.5 1.6 0.1 2.6 0.3 0.6 0.1

38 19.2 0.5 24.7 0.8 13.7 0.6 1.6 0.1 2.5 0.2 0.6 0.1

39 20.0 0.5 25.6 0.8 14.4 0.6 1.7 0.1 2.6 0.2 0.8 0.1

40 21.2 0.5 26.6 0.8 15.9 0.6 1.6 0.1 2.6 0.2 0.6 0.1

41 22.5 0.5 28.1 0.8 17.0 0.6 2.0 0.1 3.2 0.3 0.9 0.1

42 22.6 0.5 29.2 0.8 16.1 0.6 2.0 0.1 3.2 0.3 0.8 0.1

43 23.6 0.5 29.9 0.8 17.4 0.6 2.3 0.2 3.7 0.3 0.9 0.1

44 23.5 0.5 29.6 0.8 17.5 0.6 2.7 0.2 4.2 0.3 1.3 0.2

See footnotes at end of table.
87 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: 

United States, 2003–2004—Con.

Poisoning Fall

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

45 23.1 0.5 29.3 0.8 17.0 0.6 2.4 0.2 3.5 0.3 1.3 0.2

46 23.6 0.5 29.7 0.8 17.7 0.6 2.7 0.2 4.3 0.3 1.2 0.2

47 23.5 0.5 30.0 0.8 17.2 0.6 2.9 0.2 4.7 0.3 1.2 0.2

48 22.8 0.5 29.7 0.8 16.1 0.6 3.0 0.2 4.6 0.3 1.5 0.2

49 22.0 0.5 27.0 0.8 17.2 0.6 2.9 0.2 4.7 0.3 1.1 0.2

50 19.8 0.5 24.9 0.8 14.8 0.6 3.3 0.2 5.1 0.4 1.6 0.2

51 18.7 0.5 23.5 0.8 14.0 0.6 3.2 0.2 4.8 0.4 1.8 0.2

52 17.5 0.5 22.5 0.8 12.8 0.6 3.6 0.2 5.7 0.4 1.5 0.2

53 16.2 0.5 21.0 0.8 11.7 0.6 3.1 0.2 5.0 0.4 1.3 0.2

54 14.5 0.4 18.2 0.7 10.9 0.5 3.4 0.2 5.0 0.4 2.0 0.2

55 12.5 0.4 15.3 0.7 9.8 0.5 3.6 0.2 5.5 0.4 1.9 0.2

56 11.7 0.4 14.5 0.6 9.1 0.5 4.1 0.2 6.0 0.4 2.3 0.3

57 10.2 0.4 11.3 0.6 9.1 0.5 4.2 0.2 6.4 0.4 2.1 0.2

58 9.6 0.4 10.8 0.6 8.5 0.5 4.8 0.3 7.0 0.5 2.6 0.3

59 8.0 0.4 9.5 0.6 6.7 0.5 4.5 0.3 6.7 0.5 2.4 0.3

60 7.8 0.4 8.6 0.6 7.0 0.5 4.8 0.3 7.2 0.5 2.6 0.3

61 6.4 0.3 7.6 0.5 5.2 0.4 5.5 0.3 8.0 0.6 3.2 0.3

62 6.2 0.4 7.5 0.6 5.1 0.4 6.3 0.4 8.3 0.6 4.4 0.4

63 5.8 0.4 6.8 0.6 4.9 0.5 6.2 0.4 8.5 0.6 4.2 0.4

64 5.0 0.3 6.0 0.5 4.1 0.4 6.5 0.4 8.8 0.6 4.5 0.4

65 4.4 0.3 4.8 0.5 4.1 0.4 6.9 0.4 9.7 0.7 4.4 0.4

66 4.0 0.3 4.1 0.5 3.9 0.4 8.1 0.4 10.9 0.8 5.7 0.5

67 4.6 0.3 5.2 0.5 4.0 0.4 8.7 0.5 12.0 0.8 5.8 0.5

68 3.7 0.3 4.6 0.5 3.0 0.4 9.7 0.5 13.3 0.9 6.7 0.6

69 3.8 0.3 4.3 0.5 3.3 0.4 10.5 0.5 14.3 0.9 7.3 0.6

70 3.5 0.3 4.1 0.5 3.1 0.4 11.9 0.6 16.8 1.0 7.8 0.6

71 3.9 0.3 4.3 0.5 3.5 0.4 13.9 0.6 16.8 1.0 11.6 0.8

72 3.6 0.3 4.2 0.5 3.2 0.4 15.2 0.7 21.6 1.2 10.0 0.7

73 3.8 0.3 4.8 0.6 3.0 0.4 17.8 0.7 23.7 1.3 13.1 0.8

74 3.6 0.3 3.9 0.5 3.4 0.4 20.0 0.8 25.4 1.3 15.8 0.9

75 3.8 0.3 4.0 0.5 3.6 0.4 21.7 0.8 27.3 1.4 17.5 1.0

76 4.1 0.4 4.5 0.6 3.8 0.5 27.4 0.9 36.5 1.7 20.6 1.1

77 4.0 0.4 4.5 0.6 3.7 0.5 30.1 1.0 38.6 1.8 24.0 1.2

78 3.4 0.3 3.5 0.5 3.4 0.4 32.2 1.1 41.3 1.9 25.8 1.2

79 4.0 0.4 5.2 0.7 3.2 0.4 38.8 1.2 49.0 2.1 32.0 1.4

80 3.7 0.4 4.9 0.7 2.9 0.4 45.0 1.3 58.0 2.4 36.2 1.5

81 4.6 0.4 5.9 0.8 3.7 0.5 53.4 1.5 68.7 2.7 43.7 1.7

82 4.2 0.4 5.1 0.8 3.7 0.5 59.7 1.6 77.9 3.0 48.5 1.9

83 4.2 0.5 4.1 0.7 4.3 0.6 72.6 1.9 94.2 3.6 59.9 2.1

84 4.8 0.5 7.4 1.1 3.3 0.5 76.4 2.0 96.4 3.8 65.1 2.4

85 and over 5.4 0.2 7.5 0.5 4.5 0.3 140.3 1.2 171.0 2.4 126.6 1.4

See footnotes at end of table.
88 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: United 

States, 2003–2004—Con.

Suffocation Drowning

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

Under 1 18.8 0.5 21.4 0.7 16.0 0.6 2.0 0.2 2.2 0.2 1.7 0.2

1 2.1 0.2 2.5 0.2 1.7 0.2 4.4 0.2 5.1 0.4 3.7 0.3

2 1.0 0.1 1.2 0.2 0.8 0.1 3.7 0.2 4.7 0.3 2.5 0.3

3 0.6 0.1 0.8 0.1 * * 2.1 0.2 2.9 0.3 1.3 0.2

4 0.5 0.1 0.5 0.1 * * 1.3 0.1 1.5 0.2 1.1 0.2

5 * * * * * * 1.0 0.1 1.5 0.2 0.6 0.1

6 0.3 0.1 * * * * 0.7 0.1 0.9 0.1 0.6 0.1

7 * * * * * * 0.7 0.1 1.0 0.2 * *

8 0.3 0.1 * * * * 0.5 0.1 0.7 0.1 * *

9 0.5 0.1 0.6 0.1 * * 0.5 0.1 0.6 0.1 * *

10 0.6 0.1 1.0 0.2 * * 0.5 0.1 0.6 0.1 * *

11 0.6 0.1 0.9 0.1 * * 0.5 0.1 0.7 0.1 * *

12 1.2 0.1 1.9 0.2 0.5 0.1 0.7 0.1 1.0 0.2 0.5 0.1

13 1.6 0.1 2.3 0.2 1.0 0.2 0.7 0.1 1.1 0.2 * *

14 2.0 0.2 2.7 0.2 1.3 0.2 1.0 0.1 1.6 0.2 * *

15 2.7 0.2 3.3 0.3 2.1 0.2 0.9 0.1 1.6 0.2 * *

16 3.1 0.2 4.4 0.3 1.8 0.2 1.4 0.1 2.4 0.2 * *

17 3.1 0.2 4.7 0.3 1.5 0.2 1.7 0.1 3.0 0.3 * *

18 4.3 0.2 6.2 0.4 2.3 0.2 1.8 0.1 3.1 0.3 * *

19 4.5 0.2 6.9 0.4 1.9 0.2 1.8 0.1 3.2 0.3 * *

20 4.4 0.2 7.0 0.4 1.7 0.2 1.8 0.1 3.1 0.3 * *

21 5.2 0.3 8.0 0.4 2.2 0.2 1.4 0.1 2.5 0.2 * *

22 4.6 0.2 7.1 0.4 1.9 0.2 1.6 0.1 2.9 0.3 * *

23 4.6 0.2 7.2 0.4 1.8 0.2 1.5 0.1 2.6 0.2 * *

24 4.4 0.2 7.0 0.4 1.7 0.2 1.3 0.1 2.2 0.2 * *

25 4.2 0.2 6.6 0.4 1.7 0.2 1.9 0.2 3.3 0.3 * *

26 4.7 0.2 7.4 0.4 2.0 0.2 1.4 0.1 2.3 0.2 * *

27 4.7 0.2 7.2 0.4 2.0 0.2 1.2 0.1 2.0 0.2 * *

28 4.5 0.2 6.8 0.4 2.0 0.2 1.0 0.1 1.8 0.2 * *

29 4.8 0.2 7.5 0.4 1.9 0.2 1.3 0.1 2.0 0.2 0.5 0.1

30 4.5 0.2 7.2 0.4 1.7 0.2 1.2 0.1 1.9 0.2 * *

31 5.0 0.3 8.0 0.4 2.0 0.2 0.9 0.1 1.4 0.2 * *

32 4.9 0.2 7.9 0.4 1.7 0.2 1.1 0.1 1.8 0.2 * *

33 4.5 0.2 7.2 0.4 1.9 0.2 1.1 0.1 1.8 0.2 * *

34 4.9 0.2 7.5 0.4 2.2 0.2 1.1 0.1 1.8 0.2 * *

35 4.7 0.2 7.3 0.4 2.1 0.2 1.3 0.1 2.1 0.2 0.5 0.1

36 4.6 0.2 7.4 0.4 1.9 0.2 1.2 0.1 2.1 0.2 * *

37 4.7 0.2 7.6 0.4 1.8 0.2 1.1 0.1 1.7 0.2 0.5 0.1

38 4.8 0.2 7.6 0.4 2.0 0.2 1.3 0.1 2.3 0.2 * *

39 4.5 0.2 7.4 0.4 1.6 0.2 1.3 0.1 2.1 0.2 0.5 0.1

40 4.8 0.2 7.8 0.4 1.9 0.2 1.3 0.1 2.1 0.2 0.6 0.1

41 5.0 0.2 7.8 0.4 2.2 0.2 1.4 0.1 2.4 0.2 0.4 0.1

42 4.8 0.2 7.4 0.4 2.3 0.2 1.4 0.1 2.0 0.2 0.7 0.1

43 4.8 0.2 7.5 0.4 2.1 0.2 1.4 0.1 2.3 0.2 0.6 0.1

44 4.3 0.2 6.8 0.4 1.9 0.2 1.4 0.1 2.1 0.2 0.6 0.1

See footnotes at end of table.
89 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: 

United States, 2003–2004—Con.

Suffocation Drowning

Age in years Both sexes Male Female Both sexes Male Female

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

45 4.4 0.2 6.7 0.4 2.1 0.2 1.6 0.1 2.6 0.2 0.6 0.1

46 4.5 0.2 7.0 0.4 2.1 0.2 1.3 0.1 2.1 0.2 0.6 0.1

47 4.3 0.2 6.6 0.4 2.0 0.2 1.2 0.1 1.9 0.2 0.5 0.1

48 4.2 0.2 6.3 0.4 2.2 0.2 1.4 0.1 1.9 0.2 0.8 0.1

49 4.3 0.2 6.7 0.4 2.1 0.2 1.1 0.1 1.8 0.2 * *

50 4.2 0.2 6.2 0.4 2.3 0.2 1.5 0.1 2.4 0.2 0.6 0.1

51 3.7 0.2 5.2 0.4 2.2 0.2 1.3 0.1 2.1 0.2 0.5 0.1

52 4.1 0.2 6.3 0.4 2.0 0.2 1.2 0.1 1.8 0.2 0.6 0.1

53 3.7 0.2 5.6 0.4 2.0 0.2 1.2 0.1 1.9 0.2 0.6 0.1

54 3.8 0.2 5.3 0.4 2.3 0.2 1.3 0.1 1.9 0.2 0.7 0.1

55 3.8 0.2 5.7 0.4 2.0 0.2 1.1 0.1 1.8 0.2 0.6 0.1

56 3.4 0.2 5.2 0.4 1.7 0.2 1.2 0.1 1.9 0.2 0.6 0.1

57 3.7 0.2 5.6 0.4 1.8 0.2 1.3 0.1 2.1 0.3 0.6 0.1

58 3.8 0.3 5.4 0.4 2.2 0.3 1.3 0.2 2.1 0.3 * *

59 3.8 0.3 5.5 0.5 2.3 0.3 0.8 0.1 1.3 0.2 * *

60 3.7 0.3 5.0 0.4 2.4 0.3 1.3 0.2 1.7 0.3 0.9 0.2

61 3.3 0.2 5.3 0.5 1.5 0.2 1.1 0.1 1.7 0.3 * *

62 3.9 0.3 5.8 0.5 2.1 0.3 1.2 0.2 1.9 0.3 * *

63 3.5 0.3 5.0 0.5 2.2 0.3 1.2 0.2 1.8 0.3 * *

64 3.1 0.3 4.0 0.4 2.2 0.3 1.1 0.2 1.6 0.3 * *

65 4.1 0.3 5.7 0.5 2.6 0.3 1.3 0.2 1.8 0.3 0.9 0.2

66 3.6 0.3 4.7 0.5 2.6 0.3 1.1 0.2 1.8 0.3 * *

67 3.4 0.3 4.7 0.5 2.3 0.3 1.2 0.2 1.7 0.3 * *

68 4.3 0.3 6.0 0.6 2.8 0.4 1.5 0.2 2.5 0.4 * *

69 4.0 0.3 5.4 0.6 2.9 0.4 1.3 0.2 2.1 0.3 * *

70 5.0 0.4 6.9 0.7 3.4 0.4 1.4 0.2 1.8 0.3 1.1 0.2

71 5.6 0.4 6.6 0.7 4.8 0.5 1.2 0.2 1.7 0.3 * *

72 5.8 0.4 8.1 0.7 3.9 0.5 1.4 0.2 2.4 0.4 * *

73 5.6 0.4 7.8 0.7 3.9 0.5 1.2 0.2 2.0 0.4 * *

74 5.8 0.4 7.3 0.7 4.6 0.5 1.5 0.2 2.3 0.4 * *

75 6.6 0.5 9.0 0.8 4.7 0.5 1.4 0.2 1.7 0.4 1.1 0.2

76 7.8 0.5 10.7 0.9 5.6 0.6 1.3 0.2 1.7 0.4 * *

77 9.3 0.6 13.2 1.0 6.6 0.6 1.2 0.2 2.1 0.4 * *

78 10.0 0.6 15.6 1.2 6.2 0.6 1.3 0.2 2.2 0.4 * *

79 10.5 0.6 14.0 1.1 8.1 0.7 1.4 0.2 2.2 0.4 * *

80 12.4 0.7 16.6 1.3 9.7 0.8 1.5 0.2 2.5 0.5 * *

81 14.7 0.8 21.6 1.5 10.4 0.8 1.6 0.3 2.8 0.6 * *

82 15.8 0.8 22.5 1.6 11.7 0.9 1.9 0.3 4.0 0.7 * *

83 17.7 0.9 23.9 1.8 14.1 1.1 1.7 0.3 3.1 0.6 * *

84 19.3 1.0 26.3 2.0 15.3 1.1 1.8 0.3 2.9 0.7 * *

85 and over 31.7 0.6 43.9 1.2 26.2 0.6 2.1 0.1 3.9 0.4 1.3 0.1

See footnotes at end of table.
90 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: United 

States, 2003–2004—Con.

Fire and burn

Age in years Both sexes Male Female

Rate SE1 Rate SE Rate SE

Under 1 0.9 0.1 0.8 0.1 1.1 0.2

1 1.5 0.1 1.5 0.2 1.4 0.2

2 1.6 0.1 1.8 0.2 1.4 0.2

3 1.6 0.1 2.0 0.2 1.2 0.2

4 1.5 0.1 1.6 0.2 1.5 0.2

5 1.3 0.1 1.5 0.2 1.1 0.2

6 0.7 0.1 0.9 0.1 * *

7 0.9 0.1 0.9 0.1 0.9 0.1

8 0.6 0.1 0.7 0.1 0.5 0.1

9 0.7 0.1 0.9 0.1 * *

10 0.4 0.1 * * * *

11 0.5 0.1 0.6 0.1 * *

12 0.6 0.1 0.5 0.1 0.7 0.1

13 0.5 0.1 * * 0.6 0.1

14 0.3 0.1 * * * *

15 0.4 0.1 * * 0.5 0.1

16 0.3 0.1 * * * *

17 0.4 0.1 * * * *

18 0.4 0.1 0.6 0.1 * *

19 0.6 0.1 0.7 0.1 0.5 0.1

20 0.7 0.1 0.7 0.1 0.6 0.1

21 0.8 0.1 1.0 0.1 0.6 0.1

22 0.9 0.1 1.1 0.2 0.6 0.1

23 0.6 0.1 0.8 0.1 0.5 0.1

24 0.7 0.1 0.8 0.1 0.7 0.1

25 0.9 0.1 1.2 0.2 0.5 0.1

26 0.8 0.1 1.0 0.2 0.6 0.1

27 0.8 0.1 0.9 0.2 0.6 0.1

28 0.8 0.1 1.0 0.2 * *

29 0.6 0.1 0.8 0.1 * *

30 0.6 0.1 0.7 0.1 * *

31 0.6 0.1 0.8 0.1 * *

32 0.8 0.1 1.1 0.2 * *

33 0.7 0.1 1.0 0.1 0.5 0.1

34 0.8 0.1 0.9 0.1 0.8 0.1

35 1.0 0.1 1.4 0.2 0.6 0.1

36 0.8 0.1 1.1 0.2 0.6 0.1

37 0.9 0.1 1.0 0.2 0.7 0.1

38 0.9 0.1 1.1 0.2 0.6 0.1

39 1.0 0.1 1.4 0.2 0.6 0.1

40 0.9 0.1 1.3 0.2 0.5 0.1

41 1.3 0.1 1.5 0.2 1.1 0.2

42 1.0 0.1 1.2 0.2 0.8 0.1

43 1.1 0.1 1.6 0.2 0.7 0.1

44 1.1 0.1 1.4 0.2 0.8 0.1

See footnotes at end of table.
91 Injury in the United States: 2007 Chartbook

Data table for Figures 7 and 7-1. Average annual injury death rates by leading mechanisms, age, and sex: 

United States, 2003–2004—Con.

Fire and burn

Age in years Both sexes Male Female

Rate SE1 Rate SE Rate SE

45 1.4 0.1 1.8 0.2 1.0 0.1

46 1.5 0.1 2.0 0.2 0.9 0.1

47 1.6 0.1 2.1 0.2 1.0 0.2

48 1.3 0.1 1.7 0.2 1.0 0.1

49 1.4 0.1 1.8 0.2 1.0 0.2

50 1.6 0.1 2.0 0.2 1.2 0.2

51 1.7 0.1 2.2 0.2 1.3 0.2

52 1.5 0.1 2.0 0.2 1.1 0.2

53 1.3 0.1 2.0 0.2 0.7 0.1

54 1.5 0.1 2.0 0.2 1.1 0.2

55 1.3 0.1 1.9 0.2 0.6 0.1

56 1.5 0.1 2.1 0.2 0.9 0.2

57 1.5 0.1 2.0 0.2 1.0 0.2

58 1.4 0.2 1.6 0.2 1.3 0.2

59 1.8 0.2 2.5 0.3 1.2 0.2

60 1.5 0.2 1.9 0.3 1.1 0.2

61 1.7 0.2 2.3 0.3 1.1 0.2

62 2.0 0.2 2.5 0.3 1.5 0.2

63 1.9 0.2 2.4 0.3 1.5 0.2

64 2.0 0.2 2.4 0.3 1.7 0.3

65 1.7 0.2 2.2 0.3 1.3 0.2

66 2.2 0.2 2.8 0.4 1.6 0.3

67 1.9 0.2 2.9 0.4 1.0 0.2

68 2.5 0.3 3.1 0.4 1.9 0.3

69 2.3 0.3 3.0 0.4 1.8 0.3

70 2.5 0.3 3.2 0.4 1.9 0.3

71 2.0 0.2 2.8 0.4 1.3 0.3

72 2.5 0.3 3.1 0.5 2.1 0.3

73 2.7 0.3 3.6 0.5 2.0 0.3

74 2.6 0.3 3.1 0.5 2.2 0.3

75 3.1 0.3 3.9 0.5 2.5 0.4

76 3.4 0.3 4.2 0.6 2.9 0.4

77 3.3 0.3 4.0 0.6 2.8 0.4

78 3.2 0.3 4.4 0.6 2.4 0.4

79 2.9 0.3 3.7 0.6 2.3 0.4

80 4.7 0.4 5.9 0.8 4.0 0.5

81 4.2 0.4 5.2 0.7 3.5 0.5

82 4.7 0.5 6.1 0.8 3.9 0.5

83 4.7 0.5 6.6 0.9 3.6 0.5

84 5.3 0.5 6.4 1.0 4.7 0.6

85 and over 6.1 0.3 8.0 0.5 5.2 0.3

*Figure does not meet standards of reliability or precision. Rates based on fewer than 20 deaths are considered unreliable.

1

SE is standard error. 

NOTES: Rates are per 100,000 resident population. See Appendix I, NVSS, Mortality Statistics for description of data source. See 

Appendix II, Standard error. See Table III for classification codes for mechanisms of injury.

SOURCE: CDC/NCHS, National Vital Statistics System.
92 Injury in the United States: 2007 Chartbook

Data table for Figure 8-1. Average annual number of injury deaths and percent distribution of injury deaths, by 

body region: United States 2003–2004

Body region Annual weighted number of 

deaths Percent distribution SE1

 (percent)

Total 165,593 100.0 - 

Head and neck 46,970 28.4 0.1 

Traumatic brain injury 42,755 25.8 0.1 

Other head 126 0.1 0.0 

Neck 4,065 2.5 0.0 

Head and neck, other 24 0.0 0.0 

Spine and upper back 1,691 1.0 0.0 

Spinal cord 884 0.5 0.0 

Verterbral column 807 0.5 0.0 

Torso 23,110 14.0 0.1 

Thorax 11,807 7.1 0.0 

Abdomen 1,949 1.2 0.0 

Pelvis and lower back 770 0.5 0.0 

Abdomen, lower back, and 

pelvis

 1,607 1.0 0.0 

Trunk, other 6,977 4.2 0.0 

Hip 6,091 3.7 0.0 

Other extremities 3,404 2.1 0.0 

Upper extremity 1,028 0.6 0.0 

Other lower extremity 2,376 1.4 0.0 

Unclassifiable by body region 68,623 41.4 0.1 

Multiple body regions 19,700 11.9 0.1 

System-wide 48,923 29.5 0.1 

Unspecified region 15,704 9.5 0.1 

- Quantity zero.

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error. 

NOTE: See Appendix I, NVSS Mortality Statistics for description of data source and Appendix II, Multiple-cause-of-death data and injury diagnoses, 

for method to calculate annual weighted number of deaths; Standard error. See Table IV for classification codes for body region of injury.

SOURCE: CDC/NCHS, National Vital Statistics System.
93 Injury in the United States: 2007 Chartbook

Data table for Figure 8-2. Average annual number of injury deaths and percent distribution of injury deaths, by 

nature of injury: United States 2003–2004

Nature of injury Average weighted number 

of deaths Percent distribution SE1

 (percent)

Total 165,593 100.0 -

Poisoning and toxic effects 32,149 19.4 0.1 

Poisoning 25,995 15.7 0.1 

Toxic effects 6,154 3.7 0.0 

Open wounds 29,682 17.9 0.1 

Other effects of external cause 16,253 9.8 0.1 

Fracture 13,190 8.0 0.0 

Internal organ 12,975 7.8 0.0 

Other specified 10,532 6.4 0.0 

Dislocation 214 0.1 0.0 

Amputation 89 0.1 0.0 

Blood vessel 927 0.6 0.0 

Contusions or superficial 261 0.2 0.0 

Crush 549 0.3 0.0 

Burn 2,044 1.2 0.0 

Effects of foreign body 4,526 2.7 0.0 

Multiple injuries 975 0.6 0.0 

Other specified injuries 948 0.6 0.0 

Unspecified 50,812 30.7 0.1 

- Quantity zero.

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error. 

NOTE: See Appendix I, NVSS Mortality Statistics for description of data source and Appendix II, Multiple-cause-of-death data and injury diagnoses, 

for method to calculate annual weighted number of deaths; Standard error. See Table IV for classification codes for nature of injury.

SOURCE: CDC/NCHS, National Vital Statistics System.
94 Injury in the United States: 2007 Chartbook

Table 8. Average annual number of injury deaths and percentage of deaths classified by the ICD–10 Injury 

Mortality Diagnosis Matrix among all deaths with an underlying cause of injury: United States, 2003–2004

Body region of 

injury All Fracture Dislocation

Internal 

organ 

injury

Open 

wounds Amputation Blood vessel

Contusion 

or 

superficial 

Crush

Annual weighted number of deaths

All injuries 

mentioned 165,593 13,190 214 12,975 29,682 89 927 261 549

Head and neck 46,970 2,697 2 9,675 15,657 51 74 65 170

Traumatic brain 

injury 42,755 1,315 ... 9,675 14,738 ... ... ... 153

Other head 126 29 2 ... 6 6 2 50 ...

Neck 4,065 1,353 1 ... 913 45 73 15 17

Head and neck, 

other 24 ... ... ... ... ... ... ... ...

Spine and 

upper back 1,691 605 184 884 ... ... 11 ... ...

Spinal cord 884 ... ... 884 ... ... ... ... ...

Vertebral 

column 807 605 184 1 ... ... 11 ... ...

Torso 23,110 1,397 - 2,416 6,478 1 694 59 331

Thorax 11,807 762 - 961 4,754 - 600 32 261

Abdomen 1,949 ... ... 917 959 ... 65 3 ...

Pelvis and lower 

back 770 609 - 60 74 - 23 1 -

Abdomen, 

lower back and 

pelvis

1,607 8 ... 477 10 1 7 16 45

Other trunk 6,977 17 ... ... 682 1 ... 6 25

Extremities 9,495 8,085 27 ... 692 32 71 41 17

Upper extremity 1,028 405 8 ... 433 11 34 11 4

Hip 6,091 6,050 14 ... 21 - ... 5 -

Other lower 

extremity 2,376 1,630 5 ... 238 20 36 25 13

Unclassifiable 

by body region 68,623 190 ... ... 3,209 5 3 16 32

Multiple body 

regions 19,700 190 ... ... 3,209 5 3 16 32

System-wide 48,923 ... ... ... ... ... ... ... ...

Unspecified 15,704 217 ... ... 3,647 ... 73 80 ...

See footnotes at end of table.
95 Injury in the United States: 2007 Chartbook

Table 8. Average annual number of injury deaths and percentage of deaths classified by the ICD–10 Injury 

Mortality Diagnosis Matrix among all deaths with an underlying cause of injury: United States, 2003–2004—Con.

Body region of 

injury Burn

Effect of foreign 

bodies entering 

orifice

Other 

effects of 

external 

causes

Poisoning Toxic 

effects

Multiple 

injuries

Other 

specified 

injury

Unspecified 

injury

Annual weighted number of deaths

All injuries 

mentioned 2,044 4,526 16,253 25,995 6,154 975 948 50,812

Head and neck 24 37 - ... ... 482 55 17,980

Traumatic brain 

injury ... ... ... ... ... 434 22 16,417

Other head - 7 - ... ... ... 10 16

Neck 1 30 - ... ... 48 24 1,547

Head and neck, 

other 23 ... - ... ... ... ... ...

Spine and 

upper back ... ... ... ... ... ... 6 ...

Spinal cord ... ... ... ... ... ... ... ...

Vertebral 

column ... ... ... ... ... ... 6 ...

Torso 206 4,488 - ... ... 193 248 6,599

Thorax 0 12 - ... ... 189 238 3,997

Abdomen ... 5 ... ... ... ... ... ...

Pelvis and lower 

back - 3 ... ... ... ... - ...

Abdomen, 

lower back and 

pelvis

... ... - ... ... - 9 1,034

Other trunk 206 4,468 ... ... ... 4 1 1,568

Extremities 37 ... - ... ... 9 41 444

Upper extremity 13 ... - ... ... 2 5 103

Hip ... ... ... ... ... ... 1 ...

Other lower 

extremity 24 ... - ... ... 7 36 342

Unclassifiable 

by body region 4 - 16,248 25,995 6,154 75 551 16,138

Multiple body 

regions 4 ... - ... ... 75 26 16,138

System-wide ... ... 16,248 25,995 6,154 ... 526 ...

Unspecified 1,772 1 4 ... ... 215 47 9,650

See footnotes at end of table.
96 Injury in the United States: 2007 Chartbook

Table 8. Average annual number of injury deaths and percentage of deaths classified by the ICD–10 Injury 

Mortality Diagnosis Matrix among all deaths with an underlying cause of injury: United States, 2003–2004—Con.

Body region of 

injury All Fracture Dislocation

Internal 

organ 

injury

Open 

wound Amputation Blood vessel

Contusion 

or 

superficial 

Crushing

Percent of all injuries mentioned

All injuries 

mentioned 100.0 8.0 0.1 7.8 17.9 0.1 0.6 0.2 0.3

Head and neck 28.4 1.6 0.0 5.8 9.5 0.0 0.0 0.0 0.1

Traumatic brain 

injury 25.8 0.8 ... 5.8 8.9 ... ... ... 0.1

Other head 0.1 0.0 0.0 ... 0.0 0.0 0.0 0.0 ...

Neck 2.5 0.8 - ... 0.6 0.0 0.0 0.0 0.0

Head and neck, 

other 0.0 ... ... ... ... ... ... ... ...

Spine and 

upper back 1.0 0.4 0.1 0.5 ... ... 0.0 ... ...

Spinal cord 0.5 ... ... 0.5 ... ... ... ... ...

Vertebral 

column 0.5 0.4 0.1 0.0 ... ... 0.0 ... ...

Torso 14.0 0.8 - 1.5 3.9 0.0 0.4 0.0 0.2

Thorax 7.1 0.5 - 0.6 2.9 - 0.4 0.0 0.2

Abdomen 1.2 ... ... 0.6 0.6 ... 0.0 0.0 ...

Pelvis and lower 

back 0.5 0.4 - 0.0 0.0 - 0.0 0.0 -

Abdomen, 

lower back and 

pelvis

1.0 0.0 ... 0.3 0.0 0.0 0.0 0.0 0.0

Other trunk 4.2 0.0 ... ... 0.4 ... ... 0.0 -

Extremities 5.7 4.9 0.0 ... 0.4 0.0 0.0 0.0 0.0

Upper extremity 0.6 0.2 0.0 ... 0.3 0.0 0.0 0.0 0.0

Hip 3.7 3.7 0.0 ... 0.0 ... ... 0.0 -

Other lower 

extremity 1.4 1.0 0.0 ... 0.1 0.0 0.0 0.0 0.0

Unclassifiable 

by body region 41.4 0.1 ... ... 1.9 0.0 0.0 0.0 0.0

Multiple body 

regions 11.9 0.1 ... ... 1.9 0.0 0.0 0.0 0.0

System-wide 29.5 ... ... ... ... ... ... ... ...

Unspecified 9.5 0.1 ... ... 2.2 ... 0.0 0.0 ...

See footnotes at end of table.
97 Injury in the United States: 2007 Chartbook

Table 8. Average annual number of injury deaths and percentage of deaths classified by the ICD–10 Injury 

Mortality Diagnosis Matrix among all deaths with an underlying cause of injury: United States, 2003–2004—Con.

Body region of 

injury Burn

Effect of foreign 

bodies entering 

orifice

Other 

effects of 

external 

causes

Poisoning Toxic 

effects

Multiple 

injuries

Other 

specified 

injury

Unspecified 

injury

Percent of all injuries mentioned

All injuries 

mentioned 1.2 2.7 9.8 15.7 3.7 0.6 0.6 30.7

Head and neck 0.0 0.0 - ... ... 0.3 0.0 10.9

Traumatic brain 

injury ... ... ... ... ... 0.3 0.0 9.9

Other head - 0.0 - ... ... ... 0.0 0.0

Neck 0.0 0.0 - ... ... 0.0 0.0 0.9

Head and neck, 

other 0.0 ... - ... ... ... ... ...

Spine and 

upper back ... ... ... ... ... ... 0.0 ...

Spinal cord ... ... ... ... ... ... ... ...

Vertebral 

column ... ... ... ... ... ... 0.0 ...

Torso 0.1 2.7 - ... ... 0.1 0.1 4.0

Thorax - 0.0 - ... ... 0.1 0.1 2.4

Abdomen ... 0.0 ... ... ... ... ... ...

Pelvis and lower 

back - 0.0 ... ... ... ... - ...

Abdomen, 

lower back and 

pelvis

... ... - ... ... - 0.0 0.6

Other trunk 0.1 2.7 ... ... ... 0.0 0.0 0.9

Extremities 0.0 ... - ... ... 0.0 0.0 0.3

Upper extremity 0.0 ... - ... ... 0.0 0.0 0.1

Hip ... ... ... ... ... ... 0.0 ...

Other lower 

extremity 0.0 ... - ... ... 0.0 0.0 0.2

Unclassifiable 

by body region 0.0 ... 9.8 15.7 3.7 0.0 0.3 9.7

Multiple body 

regions 0.0 ... - ... ... 0.0 0.0 9.7

System-wide ... ... 9.8 15.7 3.7 ... ... ...

Unspecified 1.1 0.0 0.0 ... ... 0.1 0.0 5.8

... Category not applicable (no codes in cell).

0.0 Quantity more than zero but less than 0.05.

- Quantity zero.

 NOTES: Other specified includes injuries to nerves, muscles and tendons, sprains and strains, and early complications of trauma, as well as other 

specified injuries. Other head includes injuries to face, eye, and other head injuries. Numbers may not sum to totals because of rounding. See 

Appendix II, Multiple cause-of-death data and injury diagnoses for method to calculate weighted number of deaths.

SOURCE: CDC/NCHS, National Vital Statistics System.
98 Injury in the United States: 2007 Chartbook

Data table for Figure 9. Average annual weighted number of deaths and percent distribution of deaths by body 

region of injury, for motor vehicle traffic accidents, firearm suicides, and firearm homicides: United States 2003–

2004

Motor vehicle traffic Firearm suicide Firearm homicide

Body region Number 

of deaths

Percent 

distribution

SE1

(percent)

Number 

of deaths

Percent

distribution

SE

(percent)

Number 

of deaths

Percent

distribution

SE

(percent)

Total 43,386 100.0 - 16,829 100.0 - 11,772 100.0 - 

Head and neck 13,862 32.0 0.3 12,428 73.9 0.3 3,714 31.5 0.5 

Torso 7,382 17.0 0.3 2,211 13.1 0.5 4,005 34.0 0.5 

Other specified 911 2.1 0.3 28 0.2 0.5 397 3.4 0.6 

Spine and 

upper back 492 1.1 0.3 13 0.1 0.5 33 0.3 0.7 

Extremities 418 1.0 0.3 14 0.1 0.5 363 3.1 0.6 

Unclassifiable 

by body region 14,691 33.9 0.3 67 0.4 0.5 2,685 22.8 0.6 

Unspecified 6,540 15.1 0.3 2,094 12.4 0.5 972 8.3 0.6 

- Quantity zero.

1

SE is standard error.

NOTE: See Appendix I, NVSS, Mortality Statistics for description of data sources and Appendix II, Multiple-cause-of-death data and injury diagnoses, 

for method to calculate annual weighted number of deaths; Standard error. See Tables III and IV for classification codes.

SOURCE: CDC/NCHS, National Vital Statistics System.
99 Injury in the United States: 2007 Chartbook

Data table for Figure 10. Average annual injury death rates for leading mechanisms of injury, by race and Hispanic 

origin: United States, 2003–2004

10-1. Under 25 years of age

Race and Hispanic 

origin1

Motor vehicle 

traffic Firearm Poisoning Suffocation Fall All injury deaths2

Rate SE3 Rate SE Rate SE Rate SE Rate SE Rate SE

Non-Hispanic white 13.7 0.1 3.9 0.1 4.0 0.1 2.9 0.0 0.5 0.0 30.1 0.2

Black 9.7 0.2 18.7 0.2 1.2 0.1 3.3 0.1 0.3 0.0 41.3 0.4

Hispanic 11.7 0.2 7.4 0.1 1.5 0.1 2.2 0.1 0.4 0.0 28.5 0.3

American Indian or 

Alaska Native

20.7 0.9 7.5 0.5 2.8 0.3 6.5 0.5 * * 47.6 1.3

Asian or Pacific 

Islander

6.6 0.3 2.5 0.2 0.7 0.1 1.7 0.1 0.6 0.1 15.7 0.4

10-2. 25–64 years of age

Race and Hispanic 

origin1

Motor vehicle 

traffic Firearm Poisoning Suffocation Fall All injury deaths2

Rate SE3 Rate SE Rate SE Rate SE Rate SE Rate SE

Non-Hispanic white 14.9 0.1 11.2 0.1 18.4 0.1 4.7 0.0 2.7 0.0 61.1 0.2

Black 17.2 0.2 22.7 0.2 14.8 0.2 3.3 0.1 2.5 0.1 74.9 0.4

Hispanic 15.4 0.2 9.2 0.2 9.3 0.2 3.3 0.1 2.2 0.1 47.5 0.3

American Indian or 

Alaska Native

29.2 1.0 10.4 0.6 18.1 0.8 6.7 0.5 4.2 0.4 86.4 1.7

Asian or Pacific

Islander

6.8 0.2 3.7 0.2 2.7 0.1 3.1 0.1 1.2 0.1 21.7 0.4

10-3. 65 years of age and over

Race and Hispanic 

origin1

Motor vehicle 

traffic Firearm Poisoning Suffocation Fall All injury deaths2

Rate SE3 Rate SE Rate SE Rate SE Rate SE Rate SE

Non-Hispanic white 20.3 0.2 13.1 0.1 4.3 0.1 11.0 0.1 43.9 0.3 120.8 0.5

Black 17.4 0.5 5.9 0.3 4.2 0.3 10.9 0.4 17.1 0.5 84.8 1.2

Hispanic 18.4 0.7 4.8 0.3 3.1 0.3 6.7 0.4 23.1 0.7 71.3 1.3

American Indian or 

Alaska Native

31.6 2.8 * * 5.1 1.1 7.9 1.4 26.3 2.6 109.0 5.3

Asian or Pacific 

Islander

16.4 0.9 2.2 0.3 1.8 0.3 10.1 0.7 24.4 1.1 68.7 1.8

0.0 Quantity more than zero but less than 0.05.

*Figure does not meet standards of reliability or precision. Rates are considered unreliable when based on fewer than 20 deaths.

1

Categories are not mutually exclusive.

2

Includes other mechanisms not shown.

3

SE is standard error.

NOTES: Rate is per 100,000 resident population. See Appendix I, NVSS, Mortality Statistics for description of data source. See Appendix II, Race and 

Hispanic origin; Standard error. See Table III for classification codes for mechanisms of injury.

SOURCE: CDC/NCHS, National Vital Statistics System.
100 Injury in the United States: 2007 Chartbook

Data table for Figure 11. Average annual age-adjusted injury death rates by intent of injury and level of 

urbanization: United States, 2003–2004

Level of urbanization All injury Unintentional Suicide Homicide Undetermined Legal or war1

Rate SE2 Rate SE Rate SE Rate SE Rate SE Rate SE

Large central metro 52.5 0.2 31.6 0.1 9.5 0.1 9.6 0.1 1.6 0.0 0.2 0.0

Large fringe metro 47.4 0.2 31.5 0.2 9.6 0.1 4.0 0.1 2.1 0.0 0.1 0.0

Medium metro 57.1 0.2 39.1 0.2 11.4 0.1 5.0 0.1 1.5 0.0 0.1 0.0

Small metro 60.2 0.3 41.7 0.3 12.3 0.1 4.2 0.1 1.8 0.1 0.1 0.0

Micropolitan 

(nonmetro)

67.2 0.3 48.4 0.3 13.0 0.1 4.3 0.1 1.4 0.0 0.1 0.0

Noncore (nonmetro) 78.7 0.4 58.0 0.4 14.4 0.2 4.6 0.1 1.5 0.1 0.3 0.0

0.0 Quantity more than zero but less than 0.05.

1

Includes legal intervention and operations of war.

2

SE is standard error.

NOTES: Rates are per 100,000 resident population and are age adjusted to the 2000 U.S. standard population. See Appendix I, NVSS, Mortality 

Statistics for description of data source. See Appendix II, Age adjustment; Standard error; Urbanization. See Table III for classification codes for intent 

of injury.

SOURCE: CDC/NCHS, National Vital Statistics System, Compressed Mortality File.

Data table for Figure 11-1. Average annual age-adjusted death rates for motor vehicle traffic accidents, firearm 

suicides, and firearm homicides, by level of urbanization: United States, 2003–2004 

Level of urbanization Motor vehicle traffic 

(unintentional)

Firearm suicide Firearm homicide

Rate SE1 Rate SE Rate SE

Large central metro 10.6 0.1 4.2 0.0 6.9 0.1

Large fringe metro 12.2 0.1 4.8 0.1 2.6 0.0

Medium metro 14.9 0.1 6.0 0.1 3.2 0.1

Small metro 17.2 0.2 7.0 0.1 2.5 0.1

Micropolitan 

(nonmetro)

21.3 0.2 7.9 0.1 2.5 0.1

Noncore (nonmetro) 28.5 0.3 9.4 0.2 2.8 0.1

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population and are age adjusted to the 2000 U.S. standard population. See Appendix I, NVSS, Mortality 

Statistics for description of data source. See Appendix II, Age adjustment; Standard error; Urbanization. See Table III for classification codes for 

mechanism and intent of injury.

SOURCE: CDC/NCHS, National Vital Statistics System, Compressed Mortality File.
101 Injury in the United States: 2007 Chartbook

Data table for Figure 12. Average annual occupational injury death rates and deaths and percent distribution of 

deaths for selected occupations: United States, 2004–2005

Average number 2004–2005

Death rate SE1 Deaths Employed population 

in thousands

Percent distribution 

of deaths

Total 4.0 0.0 5,749 141,653 100.0 

Sales and related 2.1 0.1 340 16,208 5.9 

Production 3.0 0.1 281 9,420 4.9 

Professional and related 0.9 0.0 268 28,546 4.7 

Office and administrative 

support

0.6 0.0 101 19,505 1.7 

Farming, fishing and 

forestry

29.8 1.2 305 984 5.3 

Fishers and related 

fishing workers 

103.6 11.0 44 41 0.8 

Logging workers 93.2 7.2 83 89 1.4 

Installation, management 

and repair

7.6 0.3 391 5,148 6.8 

Management, business 

and financial

3.1 0.1 635 20,343 11.0 

Farmers and ranchers 39.5 1.5 326 822 5.7 

Construction and 

extraction

13.1 0.3 1,161 8,834 20.2 

Transportation and 

material moving

17.9 0.3 1,531 8,578 26.6 

Aircraft pilots and 

flight engineers 

80.4 5.8 96 120 1.7 

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error.

NOTES: Totals for major categories include subcategories not shown separately. Figures may not add to totals because of rounding. For workers 

under the age of 16 years, there were 29 fatal injuries in 2005 and 17 in 2004 that were not included in the rate calculations to maintain consistency 

with the Current Population Survey (CPS). The employed population is an annual average estimate of employed civilians, 16 years of age and over, 

from the CPS, 2004 and 2005. See Appendix I for description of data source and Appendix II, Occupational injury fatality rates, for how rates were 

derived for persons 16 years of age and over. The rate is the number of fatal occupational injuries per 100,000 employed workers.

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries, 2004 and 2005. 
102 Injury in the United States: 2007 Chartbook

Data table for Figure 12-1. Percent distribution of occupational injury deaths, by type of event or exposure: United 

States, 2004–2005

Event or exposure1 Deaths2 SE3 Percent distribution SE (percent)

All 11,498 107.2 100.0 -

Transportation accidents 4,983 70.6 43.3 0.5 

Contact with objects and 

equipment

 2,014 44.9 17.5 0.4 

Assaults and violent acts 1,601 40.0 13.9 0.3 

Falls 1,592 39.9 13.8 0.3 

Exposure to harmful substances and 

environments

 965 31.1 8.4 0.3 

Fires and explosions 318 17.8 2.8 0.2 

Other 25 5.0 0.2 0.0 

- Quantity zero.

0.0 Quantity more than zero but less than 0.05.

1

Based on the 1992 Bureau of Labor Statistics Occupational Injury and Illness Classification Manual. 2

Deaths are 2-year totals.

3

SE is standard error.

SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injures, 2004 and 2005.
103 Injury in the United States: 2007 Chartbook

Data table for Figure 13. Fatally injured drivers of passenger vehicles with blood alcohol concentration of 0.08 

percent or greater as a percentage of total fatally injured drivers, by driver age and year: United States, 1982–

2004

16–20 years of age 21–30 years of age 31 years of age and over All ages

Year Percent 

of fatally 

injured 

drivers with 

BAC ≥ 0.08

SE1

(percent)

Percent 

of fatally 

injured 

drivers with 

BAC ≥ 0.08

SE

(percent)

Percent 

of fatally 

injured 

drivers with 

BAC ≥ 0.08

SE

(percent)

Percent 

of fatally 

injured 

drivers with 

BAC ≥ 0.08

SE

(percent)

1982 52.8 0.6 63.2 0.5 42.7 0.3 51.0 0.3

1983 50.5 0.6 63.8 0.5 40.1 0.3 49.3 0.3

1984 46.4 0.6 60.6 0.5 37.3 0.3 46.3 0.2

1985 39.0 0.5 58.4 0.5 35.6 0.3 43.3 0.2

1986 41.1 0.5 59.4 0.5 35.2 0.3 43.8 0.2

1987 36.2 0.5 58.4 0.5 34.7 0.3 42.3 0.2

1988 35.9 0.5 58.5 0.5 34.6 0.3 42.0 0.2

1989 34.6 0.5 56.8 0.5 34.4 0.3 40.9 0.2

1990 35.3 0.5 57.1 0.5 34.5 0.3 41.0 0.2

1991 34.6 0.5 56.6 0.5 33.8 0.3 40.2 0.2

1992 30.7 0.5 53.9 0.5 32.8 0.2 38.1 0.2

1993 28.3 0.5 52.5 0.5 32.0 0.2 36.7 0.2

1994 26.8 0.4 49.9 0.5 30.1 0.2 34.4 0.2

1995 24.3 0.4 50.9 0.5 31.4 0.2 35.0 0.2

1996 25.4 0.4 49.6 0.5 30.2 0.2 34.0 0.2

1997 25.5 0.4 47.6 0.5 29.0 0.2 32.7 0.2

1998 24.8 0.4 48.5 0.5 28.4 0.2 32.2 0.2

1999 26.0 0.4 48.6 0.5 27.9 0.2 32.0 0.2

2000 26.0 0.4 48.2 0.5 29.1 0.2 32.8 0.2

2001 25.3 0.4 49.8 0.5 29.0 0.2 33.0 0.2

2002 25.3 0.4 49.9 0.5 28.7 0.2 32.8 0.2

2003 26.3 0.4 47.6 0.5 28.2 0.2 32.2 0.2

2004 25.8 0.4 47.7 0.5 27.3 0.2 31.8 0.2

1

SE is standard error.

NOTES: BAC is blood alcohol concentration. Multiple imputation was used for estimating BACs for drivers with missing values using the U.S. 

Department of Transportation’s multiple imputation model. See Appendix I for description of data source and Appendix II, Blood alcohol 

concentration; Standard error.

SOURCE: Insurance Institute for Highway Safety, based on data from the National Highway Traffic Safety Administration, Fatality Analysis Reporting 

System. 
104 Injury in the United States: 2007 Chartbook

Data table for Figure 14-1. Average annual injury death rates for selected mechanisms of injury among teens and 

young adults 15–24 years of age: Selected countries, most recent data years available, 2000–2004

All injury Motor vehicle 

traffic Firearm Poisoning Suffocation

Country Data years Rate SE1 Rate SE Rate SE Rate SE Rate SE

Netherlands 2002 22.8 1.1 12.8 0.8 * * * * 2.7 0.4

England and 

Wales

2002 23.5 0.6 10.2 0.4 * * 3.2 0.2 4.1 0.3

Denmark 2001 29.9 2.2 14.5 1.6 * * 3.7 0.8 3.3 0.7

Northern 

Ireland

2002–2003 33.9 2.6 17.0 1.9 * * * * 8.2 1.3

Australia 2002 37.8 1.2 16.4 0.8 1.7 0.3 4.2 0.4 7.4 0.5

Austria 2004 38.5 2.0 19.6 1.4 * * 2.6 0.5 5.0 0.7

Canada 2000–2002 38.9 0.6 15.1 0.3 3.0 0.2 3.4 0.2 7.9 0.3

Chile 2002 42.1 1.3 10.6 0.6 5.5 0.5 1.4 0.2 8.4 0.6

Eastern 

Caribbean

2000–2002 43.5 6.4 20.8 4.4 * * * * * *

Nicaragua 2002 49.2 2.1 8.8 0.9 6.5 0.8 4.9 0.7 2.1 0.4

Mexico 2002 49.4 0.5 10.6 0.2 8.0 0.2 1.7 0.1 6.4 0.2

New Zealand 2000–2001 55.2 2.3 15.8 1.2 3.0 0.5 9.7 1.0 12.2 1.1

Argentina 2002–2003 56.7 0.7 9.5 0.3 19.3 0.4 0.9 0.1 7.5 0.2

United States 2002 62.1 0.4 27.7 0.3 16.7 0.2 5.7 0.1 3.9 0.1

Puerto Rico 2002 84.3 3.7 23.3 2.0 44.1 2.7 7.9 1.1 * *

Brazil 2003 96.8 0.5 16.0 0.2 46.9 0.4 1.2 0.1 3.1 0.1

South Africa 2003 139.1 1.2 27.4 0.6 43.1 0.7 4.1 0.2 10.8 0.3

Colombia 2002 171.3 1.4 14.5 0.4 119.2 1.2 5.9 0.3 4.3 0.2

See footnotes at end of table.
105 Injury in the United States: 2007 Chartbook

Data table for Figure 14-1. Average annual injury death rates for selected mechanisms of injury among teens and 

young adults 15–24 years of age: Selected countries, most recent data years available, 2000–2004—Con.

Drowning Cut or pierce Unspecified All other causes 

of injury

Country Data years Rate SE1 Rate SE Rate SE Rate SE

Netherlands 2002 * * * * * * 4.3 0.5

England and 

Wales

2002 0.6 0.1 0.5 0.1 2.0 0.2 2.8 0.2

Denmark 2001 * * * * * * 4.3 0.9

Northern 

Ireland

2002–2003 * * * * * * * *

Australia 2002 1.0 0.2 0.9 0.2 * * 5.9 0.5

Austria 2004 * * * * * * 7.4 0.9

Canada 2000–2002 1.6 0.1 0.8 0.1 0.6 0.1 6.5 0.2

Chile 2002 4.1 0.4 4.3 0.4 4.2 0.4 3.5 0.4

Eastern 

Caribbean

2000–2002 * * * * * * * *

Nicaragua 2002 6.0 0.7 6.8 0.8 * * 13.6 1.1

Mexico 2002 3.7 0.1 2.4 0.1 7.6 0.2 8.9 0.2

New Zealand 2000–2001 2.2 0.5 * * * * 10.7 1.0

Argentina 2002–2003 3.1 0.2 3.2 0.2 8.9 0.3 4.3 0.2

United States 2002 1.7 0.1 1.2 0.1 0.9 0.0 4.4 0.1

Puerto Rico 2002 * * * * * * * *

Brazil 2003 5.0 0.1 6.1 0.1 8.5 0.2 10.1 0.2

South Africa 2003 2.4 0.2 27.6 0.6 3.8 0.2 19.8 0.5

Colombia 2002 4.0 0.2 11.1 0.4 2.3 0.2 10.2 0.4

*Figure does not meet standards of reliability or precision. Rates are considered unreliable when based on fewer than 20 deaths.

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error. 

NOTES: Rates are per 100,000 resident population. See Appendix I, International Collaborative Effort on Injury Statistics. See Appendix II, Standard 

error. See Table III for classification codes for mechanism of injury.

SOURCE: Data provided by participants in the 2005 meeting of the International Collaborative Effort on Injury Statistics.
106 Injury in the United States: 2007 Chartbook

Data table for Figure 14-2. Average annual injury death rates for selected mechanisms of injury among persons 65 

years of age and over: Selected countries, most recent data years available, 2000–2004

All Injury Falls Motor vehicle 

traffic Suffocation

Country Data years Rate SE1 Rate SE Rate SE Rate SE

Puerto Rico 2002 61.2 3.7 10.5 1.5 20.3 2.1 9.6 1.5

England and Wales 2002 77.0 1.0 22.7 0.5 6.4 0.3 5.2 0.2

Northern Ireland 2002–2003 82.0 4.2 10.7 1.5 7.7 1.3 4.8 1.0

New Zealand 2000–01 94.7 3.2 51.4 2.4 14.3 1.3 5.4 0.8

Australia 2002 95.7 2.0 18.7 0.9 10.1 0.6 8.4 0.6

Argentina 2002–2003 102.8 1.2 4.9 0.3 12.6 0.4 12.8 0.4

Netherlands 2002 107.8 2.2 34.1 1.2 10.4 0.7 6.9 0.6

Canada 2000–2002 112.0 1.0 35.7 0.6 12.3 0.3 8.8 0.3

Brazil 2003 112.2 1.0 27.1 0.5 16.1 0.4 9.0 0.3

South Africa 2003 112.8 2.2 9.5 0.6 35.4 1.3 6.7 0.5

United States 2002 113.3 0.6 36.4 0.3 20.8 0.2 10.7 0.2

Chile 2002 127.1 3.3 31.0 1.6 26.7 1.5 14.9 1.1

Colombia 2002 128.6 2.5 17.4 0.9 32.4 1.2 12.3 0.8

Austria 2004 135.7 3.2 62.5 2.2 14.9 1.1 21.1 1.3

Nicaragua 2002 149.3 9.5 * * 29.0 4.2 * *

Mexico 2002 159.7 1.8 16.5 0.6 17.1 0.6 12.1 0.5

Denmark 2001 197.9 5.0 33.5 2.1 12.0 1.2 15.2 1.4

See footnotes at end of table.
107 Injury in the United States: 2007 Chartbook

Data table for Figure 14-2. Average annual injury death rates for selected mechanisms of injury among persons 65 

years of age and over: Selected countries, most recent data years available, 2000–2004—Con.

Firearm Poisoning Unspecified All other causes 

of injury

Country Data years Rate SE1 Rate SE Rate SE Rate SE

Puerto Rico 2002 * * * * 6.5 1.2 7.6 1.3

England and Wales 2002 0.3 0.1 3.7 0.2 31.5 0.6 7.2 0.3

Northern Ireland 2002–2003 * * * * 47.0 3.2 8.7 1.4

New Zealand 2000–01 * * 5.4 0.8 2.8 0.6 14.3 1.3

Australia 2002 2.3 0.3 4.8 0.4 37.1 1.2 9.9 0.6

Argentina 2002–2003 12.2 0.4 2.7 0.2 42.8 0.8 14.9 0.4

Netherlands 2002 * * 3.8 0.4 42.0 1.4 10.5 0.7

Canada 2000–2002 3.3 0.2 4.8 0.2 35.2 0.5 12.0 0.3

Brazil 2003 5.8 0.2 1.6 0.1 25.4 0.5 27.2 0.5

South Africa 2003 13.9 0.8 1.7 0.3 8.2 0.6 37.6 1.3

United States 2002 12.4 0.2 4.3 0.1 15.6 0.2 13.0 0.2

Chile 2002 1.9 0.4 3.3 0.5 23.5 1.4 25.8 1.5

Colombia 2002 22.8 1.0 2.6 0.4 11.3 0.7 29.8 1.2

Austria 2004 6.8 0.7 4.0 0.6 12.3 1.0 14.2 1.1

Nicaragua 2002 * * * * * * 95.5 7.6

Mexico 2002 5.8 0.3 3.1 0.2 61.2 1.1 43.9 0.9

Denmark 2001 2.6 0.6 10.0 1.1 102.8 3.6 21.8 1.7

*Figure does not meet standards of reliability or precision. Rates are considered unreliable when based on fewer than 20 deaths.

1

SE is standard error.

NOTES: Rates are per 100,000 resident population. See Appendix I, International Collaborative Effort on Injury Statistics. See Appendix II, Standard 

error. See Table III for classification codes for mechanism of injury.

SOURCE: Data provided by participants in the 2005 meeting of the International Collaborative Effort on Injury Statistics.
108 Injury in the United States: 2007 Chartbook

Data table for Figure 15-1. Injury hospital discharge rates by age group and year: United States, 1988–2005

Year Under 15 years 15–24 years 25–64 years 65–74 years 75 years and 

over

Total

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE

1988 58.9 4.5 115.8 6.5 83.1 4.0 110.0 5.9 290.5 16.6 95.5 4.0

1989 57.9 5.5 107.8 5.5 81.3 4.1 111.1 6.3 308.1 17.9 94.2 4.1

1990 41.0 3.7 100.2 4.7 78.0 3.3 107.7 6.0 324.9 17.5 87.9 3.4

1991 43.1 3.7 94.1 4.5 73.0 3.4 107.3 6.9 326.9 20.0 85.1 3.5

1992 43.2 3.9 87.2 4.1 67.4 2.9 108.8 7.5 312.0 17.8 80.7 3.2

1993 34.5 3.0 84.2 5.6 66.2 3.4 115.9 7.3 337.2 21.0 79.7 3.7

1994 36.3 3.3 75.0 4.6 61.8 2.8 106.1 6.4 313.2 18.5 74.7 3.1

1995 33.8 3.3 74.2 4.0 58.6 3.0 94.8 6.1 331.7 20.3 72.8 3.2

1996 30.2 3.0 64.7 4.5 55.2 2.8 108.9 7.1 334.0 16.7 70.4 3.1

1997 28.5 3.0 63.2 3.8 51.7 2.4 96.2 4.7 334.7 18.3 67.3 2.8

1998 31.0 4.0 56.3 3.7 51.2 2.6 94.2 4.8 313.6 15.3 65.6 2.8

1999 30.7 4.7 53.9 3.7 50.4 2.9 99.7 6.8 325.8 19.2 66.0 3.3

2000 30.2 4.3 52.4 3.6 45.4 2.4 101.5 7.6 310.4 18.6 62.5 3.1

2001 30.9 4.4 52.8 3.6 47.2 2.4 96.8 6.0 316.4 18.3 63.8 2.9

2002 30.4 4.6 50.9 3.4 48.6 2.5 91.3 6.0 315.9 17.9 63.9 3.0

2003 33.4 5.7 62.7 4.5 48.8 2.8 97.4 5.7 314.9 17.0 66.7 3.2

2004 31.8 5.0 56.4 4.1 51.1 2.7 98.9 6.6 305.3 16.9 66.3 3.2

2005 29.4 4.6 51.2 3.7 51.3 2.7 94.5 6.2 308.5 17.2 65.3 3.2

1

SE is standard error.

NOTES: Rates are per 10,000 civilian population. See Appendix I for description of data source. See Appendix II, Hospital discharge for injury; 

Standard error. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
109 Injury in the United States: 2007 Chartbook

Data table for Figure 15-2. Injury hospital discharge rates for persons 25–64 years of age, by severity of injury 

measured by the survival risk ratio and as a percentage of all injury: United States, 1988–2005

Year Least severe injury discharges Moderately severe injury 

discharges Most severe injury discharges

Rate SE1 Percent of 

all injuries Rate SE Percent of all injuries Rate SE Percent of all injuries

1988 44.6 2.6 53.6 34.0 1.9 40.9 4.5 0.4 5.5

1989 44.0 2.4 54.2 32.8 1.8 40.3 4.4 0.5 5.5

1990 39.7 1.8 50.9 33.7 1.7 43.2 4.6 0.4 5.9

1991 38.4 1.9 52.6 30.3 1.7 41.5 4.3 0.4 5.9

1992 35.9 1.6 53.2 27.9 1.4 41.3 3.7 0.4 5.4

1993 35.6 2.1 53.8 26.4 1.4 39.9 4.2 0.4 6.3

1994 31.0 1.7 50.1 26.9 1.3 43.5 4.0 0.3 6.4

1995 27.9 1.5 47.6 26.5 1.6 45.2 4.2 0.5 7.1

1996 26.2 1.6 47.5 25.4 1.3 45.9 3.6 0.4 6.6

1997 24.3 1.2 47.0 23.6 1.3 45.7 3.8 0.3 7.3

1998 22.4 1.1 43.8 24.6 1.6 48.0 4.2 0.5 8.2

1999 23.2 1.5 46.0 23.0 1.4 45.6 4.3 0.5 8.4

2000 20.4 1.4 45.0 21.4 1.2 47.2 3.5 0.4 7.8

2001 20.6 1.2 43.7 22.7 1.3 48.2 3.8 0.3 8.1

2002 20.4 1.2 41.9 24.0 1.5 49.4 4.2 0.3 8.7

2003 20.5 1.2 42.0 23.9 1.5 49.1 4.3 0.5 8.9

2004 20.7 1.2 40.5 26.0 1.6 50.9 4.4 0.4 8.6

2005 20.2 1.3 39.3 26.8 1.4 52.2 4.4 0.4 8.6

1

SE is standard error.

NOTES: Least severe includes injury discharges where all injury diagnoses have a survival risk ratio (SRR) of less than 0.995 (i.e., probability of survival 

of more than 99.5%). Moderately severe includes injury discharges where the lowest SRR among the injury diagnoses is between 0.995 and 0.95. 

Most severe includes injury discharges where the lowest SRR among the injury diagnoses is 0.95 or smaller. See Appendix II, Hospital discharge for 

injury; Injury severity for hospital discharges; Standard error.

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
110 Injury in the United States: 2007 Chartbook

Data table for Figure 16. Average annual hospital discharge rates for injury, by sex and age group: United States, 

2004–2005

Age group Both sexes Male Female

Rate SE1 Rate SE Rate SE

All ages 65.8 2.9 67.6 3.3 64.1 2.8

Under 15 years 30.6 4.0 38.3 5.2 22.5 3.0

15–24 years 53.8 3.4 72.8 4.8 33.9 2.6

25–44 years 49.1 2.5 64.1 3.5 34.0 1.7

45–64 years 53.7 2.4 62.9 3.2 44.8 2.3

65–74 years 96.7 5.1 80.0 5.5 110.7 7.1

75 years and over 306.9 15.3 215.2 12.9 362.7 18.3

1

SE is standard error.

NOTES: Rates are per 10,000 civilian population. See Appendix I for description of data source. See Appendix II, Hospital discharge for injury; 

Standard error.

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
112 Injury in the United States: 2007 Chartbook

Data table for Figure 17-1. Number and percent distribution of hospital discharges for injury, by nature of injury 

and age group: United States, 2004–2005

All ages Under 15 years of age 15–24 years of age

Nature of 

injury

Number in 

thousands

SE1

(number)

Percent

distribution

SE

(percent)

Number in 

thousands

SE

(number)

Percent

distribution 

SE

(percent)

Number in 

thousands

SE

(number)

Percent

distribution 

SE

(percent)

Total 3,868 168 100.0 - 372 49 100.0 - 445 28 100.0 -

Fractures 2,048 96 52.9 1.3 140 17 37.7 3.3 172 12 38.6 1.8

Dislocation 33 3 0.8 0.1 * * * * *4 1 1.0 0.3

Sprains and 

strains 102 8 2.6 0.2 * * * * *5 1 1.1 0.3

Internal 

organ 

injuries

 467 27 12.1 0.4 42 7 11.4 1.4 76 6 17.0 1.0

Open 

wounds 185 12 4.8 0.3 24 5 6.3 0.9 35 4 7.9 0.7

Amputations 19 3 0.5 0.1 *3 1 0.7 0.2 * * * *

Blood vessel 

injuries 15 3 0.4 0.1 * * * * *6 2 1.2 0.3

Contusions 

or superficial 

injuries

 130 11 3.4 0.2 14 2 3.8 0.6 *13 3 2.9 0.6

Crush 

injuries *8 2 0.2 0.0 * * * * * * * *

Burns * * * * * * * * * * * *

Nerve 

injuries *5 1 0.1 0.0 * * * * * * * *

Unspecified 

injuries 68 8 1.8 0.2 *8 2 2.3 0.5 *9 2 2.0 0.4

System-wide 

injuries 616 27 15.9 0.5 62 10 16.7 1.6 97 8 21.8 1.5

See footnotes at end of table.
113 Injury in the United States: 2007 Chartbook

Data table for Figure 17-1. Number and percent distribution of hospital discharges for injury, by nature of injury 

and age group: United States, 2004–2005—Con.

25–64 years of age 65–74 years of age 75 years of age and over

Nature of 

injury

Number in 

thousands

SE1

(number)

Percent 

distribution 

SE

(percent)

Number in 

thousands

SE

(number)

Percent

distribution 

SE

(percent)

Number in 

thousands

SE

(number)

Percent 

distribution 

SE

(percent)

Total 1,588 73 100.0 - 359 19 100.0 - 1,104 55 100.0 -

Fractures 677 37 42.6 1.5 242 14 67.5 1.5 817 44 74.0 0.9

Dislocation 18 2 1.2 0.1 *4 1 1.2 0.3 * * * *

Sprains and 

strains

52 5 3.3 0.3 17 3 4.7 0.7 25 3 2.3 0.2

Internal 

organ 

injuries

203 14 12.8 0.6 37 4 10.4 1.0 109 8 9.9 0.6

Open 

wounds

98 7 6.2 0.4 *7 1 2.0 0.4 21 2 1.9 0.2

Amputations 12 2 0.7 0.1 * * * * * * * *

Blood vessel 

injuries

*9 2 0.6 0.1 * * * * * * * *

Contusions 

or superficial 

injuries

36 4 2.3 0.2 11 2 3.1 0.5 56 7 5.1 0.5

Crush 

injuries

*4 1 0.3 0.1 * * * * * * * *

Burns * * * * * * * * * * * *

Nerve 

injuries

* * * * * * * * * * * *

Unspecified 

injuries

28 4 1.7 0.3 *3 1 0.8 0.2 20 3 1.8 0.3

System-wide 

injuries

384 17 24.2 0.9 30 4 8.4 0.9 42 4 3.8 0.3

- Quantity zero.

*Figure does not meet standards of reliability or precision. Relative standard error (RSE) is greater than 30%. Numbers shown with an asterisk indicate 

that the RSE is between 20% and 30%. 

0.0 Quantity more than zero but less than 0.05.

1

SE is standard error.

NOTES: Numbers are 2-year totals. See Appendix I for description of data source; See Appendix II, Hospital discharge for injury; Relative Standard 

error; Standard error.

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
114 Injury in the United States: 2007 Chartbook

Data table for Figure 17-2. Number and percent distribution of hospital discharges for injury, by body region of 

injury and age group: United States, 2004–2005

All ages Under 15 years of age 15–24 years of age

Number in 

thousands

SE1

(number)

Percent 

distribution

SE

(percent)

Number in 

thousands

SE

(number)

Percent 

distribution

SE

(percent)

Number in 

thousands

SE

(number)

Percent 

distribution

SE

(percent)

All 3,868 168 100.0 - 372 49 100.0 - 445 28 100.0 -

Traumatic 

brain injury 393 26 10.2 0.43 53 9 14.4 1.52 59 6 13.3 0.99

Other 

head, face 

and neck

249 20 6.4 0.38 44 9 11.9 1.25 47 7 10.7 1.25

Spinal cord 22 3 0.6 0.08 * * * * * * * *

Vertebral 

column 200 16 5.2 0.29 *5 1 1.3 0.34 22 4 5.0 0.77

Torso 473 26 12.2 0.36 *40 9 10.7 1.47 60 6 13.6 0.95

Upper 

extremity 495 23 12.8 0.35 66 7 17.9 1.37 58 5 12.9 0.88

Lower 

extremity 1,368 65 35.4 0.81 77 9 20.8 1.39 91 8 20.5 1.11

Other and 

unspecified *53 15 1.4 0.37 * * * * * * * *

Systemwide 616 27 15.9 0.49 62 10 16.7 1.62 97 8 21.8 1.49

See footnotes at end of table.
115 Injury in the United States: 2007 Chartbook

Data table for Figure 17-2. Number and percent distribution of hospital discharges for injury, by body region of 

injury and age group: United States, 2004–2005—Con

25–64 years of age 65–74 years of age 75 years of age and over

Number in 

thousands

SE1

(number)

Percent

distribution

SE

(percent)

Number in 

thousands

SE

(number)

Percent

distribution

SE

(percent)

Number in 

thousands

SE

(number)

Percent 

distribution

SE

(percent)

All 1,588 73 100.0 - 359 19 100.0 - 1,104 55 100.0 -

Traumatic 

brain injury 151 12 9.5 0.54 29 3 8.0 0.84 101 8 9.1 0.62

Other 

head, face 

and neck

104 9 6.6 0.41 *10 2 2.8 0.51 43 4 3.9 0.36

Spinal cord 14 2 0.9 0.15 * * * * *2 - 0.2 0.04

Vertebral 

column 74 7 4.7 0.34 22 3 6.2 0.8 77 7 7.0 0.53

Torso 197 13 12.4 0.52 42 5 11.6 1.08 134 8 12.1 0.54

Upper 

extremity 212 13 13.4 0.62 58 6 16.2 1.35 100 8 9.1 0.53

Lower 

extremity 438 23 27.6 0.79 163 10 45.5 1.83 597 36 54.1 1.03

Other and 

unspecified *13 3 0.8 0.15 * * * * * * * *

Systemwide 384 17 24.2 0.85 30 4 8.4 0.88 42 4 3.8 0.33

- Quantity zero.

*Figure does not meet standards of reliability or precision. Relative standard error (RSE) is greater than 30%. Numbers shown with an asterisk indicate 

that the RSE is between 20% and 30%.

1

SE is standard error.

NOTES: Numbers are 2-year totals. See Appendix I for description of data source. See Appendix II, Hospital discharge for injury; Relative Standard 

Error; Standard error.

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
116 Injury in the United States: 2007 Chartbook

Data table for Figure 18. Average annual hospital discharge rates for fractures by body region, age, and sex: 

United States, 2004–2005

Body region Both sexes Male Female

Rate SE1 Rate SE Rate SE

All ages 34.9 1.6 31.0 1.6 38.6 1.9

Head and neck 2.9 0.2 4.5 0.3 1.4 0.2

Spine and back 3.2 0.3 2.9 0.3 3.6 0.3

Torso 3.3 0.2 2.8 0.2 3.7 0.2

Upper extremities 5.4 0.3 5.0 0.3 5.8 0.3

Hip 10.7 0.6 6.2 0.4 15.1 0.9

Other lower extremities 9.3 0.5 9.6 0.6 8.9 0.6

Under 15 years 11.5 1.4 14.8 1.9 8.1 1.1

Head and neck 2.8 0.5 *3.5 0.7 2.0 0.4

Spine and back * * * * * *

Torso * * * * * *

Upper extremities 3.9 0.4 4.8 0.6 3.1 0.5

Hip *0.3 0.1 * * * *

Other lower extremities 4.1 0.5 5.7 0.9 2.3 0.4

15–24 years 20.7 1.5 30.3 2.1 10.8 1.3

Head and neck 5.2 0.6 8.5 1.0 *1.8 0.4

Spine and back 2.8 0.5 *3.3 0.7 *2.2 0.5

Torso *1.0 0.2 *1.4 0.3 * 0.2

Upper extremities 3.6 0.4 5.6 0.7 *1.4 0.3

Hip * * * * * *

Other lower extremities 7.7 0.6 10.6 1.0 4.7 0.7

25–44 years 18.3 1.2 25.8 1.8 10.6 0.9

Head and neck 2.9 0.3 4.8 0.5 *1.1 0.3

Spine and back 2.0 0.3 2.7 0.4 1.2 0.2

Torso 1.4 0.2 2.0 0.3 *0.9 0.2

Upper extremities 2.9 0.3 4.1 0.4 1.7 0.3

Hip 0.6 0.1 *0.9 0.2 *0.3 0.1

Other lower extremities 8.4 0.7 11.2 1.0 5.5 0.6

45–64 years 25.9 1.4 28.0 1.7 24.0 1.5

Head and neck 1.8 0.2 3.1 0.4 *0.6 0.1

Spine and back 2.5 0.3 2.6 0.4 2.3 0.3

Torso 2.6 0.3 3.5 0.5 1.7 0.2

Upper extremities 4.5 0.4 4.4 0.5 4.6 0.5

Hip 4.1 0.4 3.6 0.4 4.5 0.5

Other lower extremities 10.4 0.7 10.6 0.8 10.3 0.9

See footnotes at end of table.
117 Injury in the United States: 2007 Chartbook

Data table for Figure 18. Average annual hospital discharge rates for fractures by body region, age, and sex: 

United States, 2004–2005—Con.

Body region Both sexes Male Female

Rate SE1 Rate SE Rate SE

65–74 years 65.3 3.9 43.3 4.0 83.8 5.9

Head and neck *1.7 0.3 *2.2 0.5 * *

Spine and back 5.6 0.8 *6.0 1.3 5.3 0.8

Torso 6.4 0.9 6.2 1.2 6.5 1.0

Upper extremities 11.6 1.3 *5.7 1.1 16.6 2.2

Hip 24.9 2.0 16.7 2.2 31.8 3.2

Other lower extremities 15.0 1.6 6.5 1.1 22.2 2.8

75 years and over 227.2 12.3 138.7 9.7 281.0 15.4

Head and neck 3.7 0.6 *4.4 1.0 *3.2 0.7

Spine and back 20.8 1.9 12.2 1.7 26.0 2.5

Torso 26.8 1.8 14.9 1.9 34.0 2.6

Upper extremities 23.1 1.9 10.7 1.8 30.6 2.5

Hip 128.6 7.9 82.9 6.7 156.3 10.0

Other lower extremities 24.3 1.8 13.5 2.2 30.9 2.3

*Figure does not meet standards of reliability or precision. Rates based on a relative standard error (RSE) between 20% and 30% are shown with an 

asterisk. If the RSE is greater than 30%, the rate is replaced with an asterisk. 1

SE is standard error. 

NOTES: Rates are per 10,000 civilian population. See Appendix I for description of data source. See Appendix II, Hospital discharge for injury; 

Relative standard error; Standard error.

SOURCE: CDC/NCHS, National Hospital Discharge Survey.
118 Injury in the United States: 2007 Chartbook

Data table for Figure 19. Average annual emergency department initial injury visit rates by sex and age group: 

United States, 2004–2005

Both sexes Male Female

Age group Rate SE1 Rate SE Rate SE

All ages 1,067.6 36.5 1,171.0 42.2 967.9 34.8

Under 15 years 1,229.0 61.9 1,400.9 74.2 1,048.9 58.2

15–24 years 1,484.8 57.3 1,666.4 69.8 1,295.6 59.0

25–44 years 1,099.1 42.6 1,215.1 51.1 982.6 43.9

45–64 years 752.9 28.6 775.3 33.9 731.6 32.1

65–74 years 653.9 37.3 624.5 47.6 678.7 48.6

75 years and over 1,097.5 52.8 1,024.7 68.6 1,141.8 65.6

1

SE is standard error.

NOTES: Rates are per 10,000 civilian population. See Appendix I for description of data source and Appendix II, Initial injury emergency department 

visit; Standard error.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
119 Injury in the United States: 2007 Chartbook

Data table for Figure 20. Average annual emergency department initial visit rates for leading mechanisms of injury, 

by sex and age group: United States, 2004–2005

Both sexes

Mechanism All ages Under 15 

years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE Rate SE

Fall 273.0 10.5 371.9 22.0 223.5 14.0 194.4 10.2 197.1 10.3 300.3 21.2 691.8 38.0 

Struck by or 

against 141.0 6.6 199.1 13.1 256.4 16.3 139.5 9.0 73.3 5.9 *41.6 10.0 58.7 9.1 

Motor 

vehicle traffic 132.8 6.1 86.6 8.3 254.3 17.8 167.1 10.4 97.8 6.7 72.5 10.0 52.1 7.7 

Cut or pierce 83.6 3.9 66.5 6.1 138.6 11.0 107.3 6.3 66.3 5.4 *31.3 *6.5 27.8 5.6 

Female

Mechanism All ages Under 15 

years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over

Rate SE1 Rate SE Rate SE Rate SE Rate SE Rate SE Rate SE

Fall 288.8 12.3 335.4 23.8 195.0 17.1 209.3 14.5 233.7 15.1 339.2 30.2 766.9 50.1 

Struck by or 

against 103.2 6.3 139.9 13.6 168.6 16.0 107.9 9.4 59.4 7.1 * * 61.1 11.2 

Motor 

vehicle traffic 138.6 7.7 89.4 11.5 282.0 24.5 176.0 13.3 105.0 9.6 *67.5 13.3 *45.1 *9.0 

Cut or pierce 57.9 3.7 47.7 7.1 99.3 13.1 75.3 7.0 44.0 5.7 * * *25.0 *6.8 

 Male 

Mechanism All ages Under 15 

years 15–24 years 25–44 years 45–64 years 65–74 years 75 years and over

Rate SE Rate SE Rate SE Rate SE Rate SE Rate SE Rate SE

Fall 256.6 11.4 406.6 26.2 250.7 21.1 179.6 11.8 158.5 12.3 254.1 28.2 568.4 46.6 

Struck by or 

against 180.2 9.1 255.5 19.2 340.7 24.6 171.0 13.1 87.9 8.4 *30.9 *8.1 *54.8 *13.2 

Motor 

vehicle traffic 126.8 6.6 83.9 10.5 227.8 20.1 158.3 12.1 90.1 8.5 78.6 14.2 *63.6 *14.2 

Cut or pierce 110.3 5.9 84.5 9.1 176.4 16.1 139.3 9.7 89.8 9.1 *45.0 *11.6 *32.5 *9.6 

*Figure does not meet standards of reliability or precision. Rates based on a relative standard error (RSE) between 20% and 30% are shown with an 

asterisk. If the RSE is greater than 30%, the rate is replaced with an asterisk. 1

SE is standard error. 

NOTES: Rates are per 10,000 civilian population. See Appendix I for description of data source. See Appendix II, Initial injury emergency department 

visit; Relative standard error; Standard error. 

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
120 Injury in the United States: 2007 Chartbook

Data table for Figure 21. Average annual number and percent distribution of initial injury emergency department 

visits by nature of injury for selected mechanisms of injury: United States, 2004–2005

Fall Struck by or against

Nature of

injury

Number in 

thousands

SE1

(number) Percent SE (percent)

Number in 

thousands

SE 

(number) Percent SE (percent)

Fractures 1,652 85 20.6 0.7 592 49 14.3 0.9

Contusions or 

superficial

 1,741 99 21.7 0.9 1,251 75 30.2 1.3

Sprains or 

strains

 1,212 72 15.1 0.7 332 35 8.0 0.7

Open wounds 996 64 12.4 0.6 945 62 22.8 1.1

Other injuries 2,420 122 30.2 1.0 1,023 66 24.7 1.1

Other initial 

injuries

 869 62 10.8 0.6 496 43 12.0 0.9

Other 

diagnoses2

 1,551 86 19.3 0.8 526 46 12.7 0.9

Total 8,021 309 100.0 - 4,143 193 100.0 -

Motor vehicle traffic All initial visits

Nature of

injury

Number in 

thousands

SE 

(number) Percent SE (percent)

Number in 

thousands

SE 

(number) Percent SE (percent)

Fractures 240 26 6.2 0.6 3,420 152 10.9 0.3

Contusions or 

superficial

 962 61 24.7 1.2 6,053 242 19.3 0.4

Sprains or 

strains

 1,165 77 29.9 1.3 5,560 245 17.7 0.5

Open wounds 176 21 4.5 0.5 5,620 222 17.9 0.4

Other injuries 1,358 86 34.8 1.4 10,713 413 34.2 0.6

Other initial 

injuries

 441 41 11.3 1.0 4,826 207 15.4 0.4

Other 

diagnoses2

 917 65 23.5 1.2 5,886 258 18.8 0.5

Total 3,902 181 100.0 - 31,366 1,073 100.0 -

- Quantity zero.

1

SE is standard error.

2

These include first-listed diagnoses that were not injuries but that had a valid external cause of injury code.

NOTES: See Appendix I for description of data source. Other injuries include other initial injuries and other diagnoses that had an external cause of 

injury code. See Table V for classification codes for mechanisms of injury.

SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey.
121 Injury in the United States: 2007 Chartbook

Data table for Figure 22-1. Average annual injury episode rates by sex and age: United States, 2004–2005

Age group Both sexes Male Female

Rate SE1 Rate SE Rate SE

All, age adjusted 1,145.9 29.0 1,228.8 42.2 1,055.9 39.1

Under 15 years 1,152.0 63.2 1,301.4 93.7 995.7 77.6

15–24 years 1,430.6 95.2 1,786.3 145.9 1,067.8 112.4

25–64 years 1,049.7 37.1 1,092.9 52.9 1,008.1 50.8

25–44 years 1,035.4 50.6 1,183.6 76.6 890.4 64.8

45–64 years 1,066.1 54.8 986.4 70.0 1,141.3 79.2

65 years and over 1,219.2 84.5 1,053.2 115.1 1,341.9 118.0

65–74 years 975.8 105.1 1,033.0 163.9 927.5 133.0

75 years and over 1,490.3 137.3 1,079.5 170.8 1,752.2 193.1

1

SE is standard error.

NOTES: Rate per 10,000 civilian noninstitutionalized population. Rates are age adjusted to the 2000 standard population. See Appendix I for 

description of data source. See Appendix II, Injury or poisoning episode; Standard error.

SOURCE: CDC/NCHS, National Health Interview Survey.

Data table for Figure 22-2. Average annual injury episode rates by age group and leading mechanisms of injury: 

United States, 2004–2005

Mechanism All, age adjusted Under 15 years 15–24 years 25–64 years 65 years and over

Rate SE1 Rate SE Rate SE Rate SE Rate SE

Fall 414.4 17.3 442.2 38.8 335.6 41.6 340.7 20.9 756.7 69.6 

Struck by or 

against

138.9 9.4 215.3 26.3 231.0 33.2 97.9 11.0 *77.0 19.5 

Overexertion 158.1 10.1 *66.2 14.9 246.3 33.5 189.9 15.5 *86.7 20.9 

Motor vehicle 

traffic

95.1 9.6 * * 192.7 33.8 95.8 11.3 * * 

Cut or pierce 87.9 7.9 *56.9 12.9 *71.0 19.8 110.8 12.3 * * 

*Figure does not meet standards of reliability or precision. Rates based on a relative standard error (RSE) between 20% and 30% are shown with an 

asterisk. If the RSE is greater than 30%, the rate is replaced with an asterisk.

1

SE is standard error.

NOTES: Rates are per 10,000 civilian noninstitutionalized population. Rates are age adjusted to the 2000 standard population. See Appendix I for 

description of data source. See Appendix II, Injury or poisoning episode; Relative standard error; Standard error. 

SOURCE: CDC/NCHS, National Health Interview Survey.
122 Injury in the United States: 2007 Chartbook

Data table for Figures 23-1 and 23-2. Average annual injury episode rates, by race and Hispanic origin, age, 

education, sex, and mechanism of injury: United States, 2004–2005

All persons Hispanic Non-Hispanic, white Non-Hispanic black

Age group Rate SE1 Rate SE Rate SE Rate SE

Under 15 years 1,152.0 63.2 520.5 66.3 1,434.7 96.5 959.0 157.2

15–24 years 1,430.6 95.2 699.2 106.8 1,785.0 131.7 *991.8 219.3

25–64 years 1,049.7 37.1 602.1 59.3 1,163.2 48.0 989.0 107.0

65 years and over 1,219.2 84.5 *1,215.3 285.7 1,299.1 96.2 * *

Education

(ages 25–64 years)

Less than 12 years of 

education 927.3 91.5 407.9 73.4 1,397.5 186.0 *1,113.6 262.7

12 years of education 1,067.8 71.1 *408.5 87.4 1,220.0 89.8 *931.6 201.4

More than 12 years of 

education 1,109.7 50.7 1,027.2 150.4 1,155.5 61.2 983.9 142.9

Sex (age adjusted)

Male 1,228.8 42.2 752.0 79.1 1,411.3 54.3 1,051.3 128.0

Female 1,055.9 39.1 602.0 67.6 1,229.8 53.3 808.5 86.0

Mechanism

(age adjusted)

Fall 414.4 17.3 275.1 36.7 493.7 23.6 225.6 31.0

Struck by or against 138.9 9.4 *50.8 12.8 168.6 13.3 123.8 24.5

Overexertion 158.1 10.1 *93.8 19.6 183.6 13.4 *134.1 27.6

Motor vehicle traffic 95.1 9.6 82.7 15.1 85.2 9.4 *180.9 51.2

Cut or pierce 87.9 7.9 *68.7 16.9 100.5 10.3 *48.0 13.9

Other 251.5 12.9 104.5 14.9 293.3 18.2 216.7 32.3

*Figure does not meet standards of reliability or precision. Rates based on a relative standard error (RSE) between 20% and 30% are shown with an 

asterisk. If the RSE is greater than 30%, the rate is replaced with an asterisk.

1

SE is standard error.

NOTES: Rates are per 10,000 civilian noninstitutionalized population. Age-adjusted rates for sex and mechanism are calculated for all ages. See 

Appendix I for description of data source. See Appendix II, Age adjustment; Injury or poisoning episode; Relative standard error; Standard error. 

SOURCE: CDC/NCHS, National Health Interview Survey.
123 Injury in the United States: 2007 Chartbook

Data table for Figure 24-1. Average annual number of injury episodes and percent distribution, by activity at time 

of injury by age group: United States, 2004–2005

All ages Under 15 years 15–24 years

Activity

Number

(in 

thousands)

Percent

distribution

SE1 

(percent)

Number

(in 

thousands)

Percent

distribution

SE 

(percent)

Number

(in 

thousands)

Percent

distribution

SE 

(percent)

Driving or riding in 

a motor vehicle 2,668 8.2 0.8 * * * 790 13.8 2.1

Working at paid 

job 4,617 14.2 0.9 * * * 691 12.1 2.2

Working around 

house or yard 4,897 15.0 0.9 * * * *255 *4.5 *1.1

Attending school 912 2.8 0.4 651 9.5 1.6 *239 *4.2 *1.2

Sports and 

exercise 5,120 15.7 1.0 1,981 29.0 2.6 1,756 30.7 2.8

Leisure activities 

(excluding sports) 8,603 26.4 1.1 2,887 42.3 2.7 1,375 24.0 2.4

Other2 5,750 17.7 1.0 968 14.2 1.8 617 10.8 1.9

25–64 years 65 years and over

Activity

Number

(in 

thousands)

Percent

distribution

SE 

(percent)

Number

(in 

thousands)

Percent

distribution

SE 

(percent)

Driving or riding in 

a motor vehicle 1,458 9.2 1.1 * * *

Working at paid 

job 3,808 24.0 1.6 * * *

Working around 

house or yard 3,312 20.8 1.5 1,274 30.8 3.5

Attending school * * * * * *

Sports and 

exercise 1,317 8.3 1.0 * * *

Leisure activities 

(excluding sports) 3,108 19.6 1.4 1,232 29.8 3.2

Other2 2,874 18.1 1.4 1,291 31.2 3.1

*Figure does not meet standards of reliability or precision. Numbers and percentages based on a relative standard error (RSE) between 20% and 30% 

are shown with an asterisk. If the RSE is greater than 30%, the number or percentage is replaced with an asterisk. 1

SE is standard error. 2

Other includes unpaid work such as housework, shopping, volunteer work, sleeping, resting, eating, drinking, cooking, hands-on care from another 

person, and unspecified activities.

NOTES: See Appendix I for description of data source. See Appendix II, Injury or poisoning episode; Relative standard error; Standard error.

SOURCE: CDC/NCHS, National Health Interview Survey.
124 Injury in the United States: 2007 Chartbook

Data table for Figure 24-2. Average annual number and percent distribution of injury episodes, by location at time 

of injury and age group: United States, 2004–2005

Age group

All ages Under 15 years 15–24 years

Location Number

(in thousands) Percent SE1(percent)

Number

(in thousands) Percent SE (percent)

Number

(in thousands) Percent SE (percent)

Home (inside) 9,104 27.9 1.1 1,839 27.0 2.4 914 16.0 2.2

Home (outside) 6,192 19.0 1.0 1,319 19.3 2.1 638 11.2 1.8

School, child care 

center, or preschool 2,490 7.6 0.7 1,203 17.6 2.3 956 16.8 2.2

Hospital or 

residential 

institution

566 1.7 0.3 * * * * * *

Street including 

highway, sidewalk, 

or parking lot

4,320 13.2 0.9 *540 *7.9 *1.7 1,154 20.2 2.6

Recreation—sport 

facility, recreation 

area, lake, river, or 

pool

4,263 13.1 0.9 1,257 18.4 2.1 1,269 22.2 2.4

Commercial 

area—industrial, 

construction area, 

or farm

1,531 4.7 0.5 * * * * * *

Commercial—trade 

or service area 1,340 4.1 0.5 * * * * * *

Other public 

building 689 2.1 0.4 * * * * * *

Other places, not 

specified 2,143 6.6 0.6 *399 *5.9 *1.3 *221 *3.9 *1.1

See footnotes at end of table.
125 Injury in the United States: 2007 Chartbook

Data table for Figure 24-2. Average annual number and percent distribution of injury episodes, by location at time 

of injury and age group: United States, 2004–2005—Con.

Age group

25–64 years 65 years and over

Location Number

(in thousands) Percent SE1(percent)

Number

(in thousands) Percent SE (percent)

Home (inside) 4,185 26.3 1.5 2,166 51.5 3.4

Home (outside) 3,170 19.9 1.5 1,066 25.3 3.3

School, child care 

center, or preschool *279 *1.8 *0.4 * * *

Hospital or 

residential 

institution

*397 *2.5 *0.5 * * *

Street including 

highway, sidewalk, 

or parking lot

2,159 13.6 1.2 *467 *11.1 *2.1

Recreation—sport 

facility, recreation 

area, lake, river, or 

pool

1,639 10.3 1.2 * * *

Commercial 

area—industrial, 

construction area, 

or farm

1,273 8.0 1.0 * * *

Commercial—trade 

or service area 1,006 6.3 0.9 * * *

Other public 

building *404 *2.5 *0.5 * * *

Other places, not 

specified 1,392 8.8 0.9 * * *

*Figure does not meet standards of reliability or precision. Numbers and percentages based on a RSE between 20% and 30% are shown with an 

asterisk. If the RSE is greater than 30%, the number or percentage is replaced with an asterisk.

1

SE is standard error.

NOTES: See Appendix I for description of data source. See Appendix II, Injury or poisoning episode; Relative standard error; Standard error. 

SOURCE: CDC/NCHS, National Health Interview Survey.
126 Injury in the United States: 2007 Chartbook

Data table for Figure 25. Average annual numbers of injury deaths, hospital discharges for injury, initial emergency 

department visits for injury, and episodes of injury, by mechanism of injury: United States, 2003–2005

Mechanism Injury deaths, 2003–2004 Injury hospital discharges, 2004–2005

Number Percent 

distribution

SE1

(percent)

Number in 

thousands

Percent 

distribution

SE 

(percent)

Total, average annual 165,593 100.0 - 1,934 100.0 -

Cut or pierce 2,771 1.7 0.0 32 1.7 0.1

Drowning 3,936 2.4 0.0 * * * 

Fall 18,808 11.4 0.1 493 25.5 1.0

Fire or hot object 3,802 2.3 0.0 * * * 

Firearm 29,853 18.0 0.1 22 1.1 0.1

Machinery 718 0.4 0.0 11 0.6 0.1

Motor vehicle traffic 43,386 26.2 0.1 180 9.3 0.6

Other pedal cyclist 198 0.1 0.0 12 0.6 0.1

Other pedestrian 1,089 0.7 0.0 *2 0.1 0.0

Other land transport 1,627 1.0 0.0 37 1.9 0.2

Other transportation 1,285 0.8 0.0 4 0.2 0.0

Natural or environmental 1,390 0.8 0.0 25 1.3 0.2

Overexertion 13 0.0 0.0 23 1.2 0.1

Poisoning 29,504 17.8 0.1 197 10.2 0.4

Struck by or against 1,045 0.6 0.0 64 3.3 0.2

Suffocation 13,518 8.2 0.0 *5 0.3 0.1

Other specified 2,042 1.2 0.0 33 1.7 0.2

Other, not elsewhere classified 1,967 1.2 0.0 11 0.6 0.1

Not specified 8,647 5.2 0.0 24 1.2 0.1

Missing external cause code ... ... ... 713 36.9 1.7

See footnotes at end of table.
127 Injury in the United States: 2007 Chartbook

Data table for Figure 25. Average annual numbers of injury deaths, hospital discharges for injury, initial emergency 

department visits for injury, and episodes of injury, by mechanism of injury: United States, 2003–2005—Con.

Mechanism Initial emergency department visits, 

2004–2005 Injury episodes, 2004–2005

Number in 

thousands

Percent 

distribution

SE1

(percent)

Number in 

thousands

Percent 

distribution

SE 

(percent)

Total, average annual 31,366 100.0 - 33,175 100.0 - 

Cut or pierce 2,457 7.8 0.3 2,559 7.7 0.7

Drowning * * * * * * 

Fall 8,021 25.6 0.6 11,914 35.9 1.2

Fire or hot object 503 1.6 0.1 442 1.3 0.3

Firearm *79 0.3 *0.1 * * * 

Machinery 281 0.9 0.1 *364 1.1 0.2

Motor vehicle traffic 3,900 12.4 0.4 2,775 8.4 0.8

Other pedal cyclist 398 1.3 0.1 553 1.7 0.3

Other pedestrian * * * * * * 

Other land transport 395 1.3 0.1 *376 1.1 0.3

Other transportation 89 0.3 0.1 * * * 

Natural or environmental 1,757 5.6 0.3 1,427 4.3 0.6

Overexertion 1,670 5.3 0.3 4,621 13.9 0.8

Poisoning 1,167 3.7 0.2 *456 1.4 0.3

Struck by or against 4,143 13.2 0.4 4,020 12.1 0.8

Suffocation 97 0.3 0.1 * * * 

Other specified 1,541 4.9 0.2 901 2.7 0.4

Other, not elsewhere classified 1,132 3.6 0.2 887 2.7 0.5

Not specified 412 1.3 0.1 1,775 5.3 0.5

Missing external cause code 3,282 10.5 0.6 ... ... ...

- Quantity zero.

0.0 Quantity more than zero but less than 0.05. 

*Figure does not meet standards of reliability or precision. Numbers based on a relative standard error (RSE) between 20% and 30% are shown with 

an asterisk. If the RSE is greater than 30%, the rate is replaced with an asterisk.

... Category not applicable.

1

SE is standard error. 

NOTES: See Appendix I for description of data sources; NVSS, Mortality Statistics for identifying injury deaths. See Appendix II, Hospital discharge for 

injury; Initial injury emergency department visit; Injury or poisoning episode; Relative standard error; Standard error. External cause codes for hospital 

discharge data and emergency department data are compatible with International Classification of Diseases, Tenth Revision external cause matrix as 

shown in Table VI.

SOURCE: CDC/NCHS, National Vital Statistics System, National Hospital Discharge Survey, National Hospital Ambulatory Medical Care Survey, 

National Health Interview Survey.
128 Injury in the United States: 2007 Chartbook

Data table for Figure 26. Average annual estimates and percent distribution of injuries by body region of injury 

for injury hospital discharges, initial emergency department visits for injury, and episodes of injury: United States, 

2004–2005

Body region Hospital discharges, 2004–2005

Number in 

thousands

SE1

(number)

Percent SE (percent)

Total 1,934 84 100.0 -

Head and neck 321 21 16.6 0.6

Spine and back 111 9 5.7 0.3

Torso 236 13 12.2 0.4

Extremities 931 41 48.1 0.9

System-wide and other 309 13 16.0 0.5

Unspecified *25 7 *1.3 0.4

Body region Initial emergency department visits, 2004–2005

Number in 

thousands

SE1

(number)

Percent SE (percent)

Total2 25,479 876 100.0 - 

Head and neck 5,210 211 20.5 0.5 

Spine and back 1,834 99 7.2 0.3 

Torso 1,858 107 7.3 0.3 

Extremities 12,665 437 49.7 0.6 

System-wide and other 1,622 86 6.4 0.3 

Unspecified 2,289 166 9.0 0.5 

Body region Episodes of injury, 2004–2005

Number in 

thousands

SE1

(number)

Percent SE (percent)

Total 33,175 897 100.0 - 

Head and neck 5,039 322 15.2 0.9 

Spine and back 798 119 2.4 0.4 

Torso 5,052 337 15.2 0.9 

Extremities 20,718 690 62.5 1.2 

System-wide and other 922 131 2.8 0.4 

Unspecified 646 118 1.9 0.4 

*Figure does not meet standards of reliability or precision. Numbers based on a relative standard error (RSE) between 20% and 30% are shown with 

an asterisk.

- Quantity zero.

1

SE is standard error.

2

An additional 5.9 million initial emergency department visits have an external cause of injury code but no valid injury diagnosis code.

NOTES: See Appendix I for description of data sources. See Appendix II, Hospital discharge for injury; Initial injury emergency department visit; Injury 

or poisoning episode; Relative standard error; Standard error. See Table I for classification codes for body region of injury.

SOURCE: CDC/NCHS, National Hospital Discharge Survey, National Hospital Ambulatory Medical Care Survey, National Health Interview Survey.
130 Injury in the United States: 2007 Chartbook

Table 26. Average annual estimates and percent distributions of injury hospital discharges, initial emergency 

department visits for injury, and episodes of injury by nature of injury: United States, 2004–2005

Nature of injury Hospital discharges for injuries, 2004–2005 Emergency department initial visits for injuries, 

2004–2005

Discharges 

in 

thousands

SE1

(discharges)

Percent 

distribution

SE 

(percent)

Visits in 

thousands

SE 

(visits)

Percent 

distribution

SE 

(percent)

Total 1,934 84 100.0 - 31,366 1,073 100.0 -

Fractures 1,024 48 52.9 1.3 3,420 152 10.9 0.3

Dislocation 16 2 0.8 0.1 435 38 1.4 0.1

Sprains and 

strains

 51 4 2.6 0.2 5,560 245 17.7 0.5

Internal organ 

injuries

 234 13 12.1 0.4 353 38 1.1 0.1

Open wounds 93 6 4.8 0.3 5,620 222 17.9 0.4

Amputations 9 1 0.5 0.1 *52 11 *0.2 0.0

Blood vessel 

injuries

 8 1 0.4 0.1 * * * *

Contusions or 

superficial injuries 

 65 6 3.4 0.2 6,053 242 19.3 0.4

Crush injuries *4 1 *0.2 *0.0 103 17 0.3 0.1

Burns * * * * 459 38 1.5 0.1

Nerve injuries * * * * * * * * 

System-wide and 

late effects

 308 13 15.9 0.5 1,621 86 5.2 0.2

Unspecified 

injuries

 34 4 1.8 0.2 1,789 120 5.7 0.3

Diagnosis not an 

injury

 ... ... ... ... 5,886 258 18.8 0.5

See footnotes at end of table.
131 Injury in the United States: 2007 Chartbook

Table 26. Average annual estimates and percent distributions of injury hospital discharges, initial emergency 

department visits for injury, and episodes of injury by nature of injury: United States, 2004–2005—Con.

Nature of injury Episodes of injury, 2004–2005

Episodes 

in 

thousands

SE 

(episodes)

Percent 

distribution

SE 

(percent)

Total 33,175 897 100.0 -

Fractures 5,721 328 17.2 0.9

Dislocation *358 92 *1.1 0.3

Sprains and 

strains

 10,802 470 32.6 1.1

Internal organ 

injuries

*305 82 0.9 0.2

Open wounds 6,041 348 18.2 0.9

Amputations * * * *

Blood vessel 

injuries

* * * *

Contusions or 

superficial injuries 

6,230 373 18.8 1.0

Crush injuries * * * *

Burns *458 93 *1.4 0.3

Nerve injuries * * * *

System-wide and 

late effects

906 130 2.7 0.4

Unspecified 

injuries

2,143 225 6.5 0.7

Diagnosis not an 

injury

... ... ... ...

- Quantity zero.

*Figure does not meet standards of reliability or precision. Numbers based on a relative standard error (RSE) between 20% and 30% are shown with 

an asterisk. If the RSE is greater than 30%, the number is replaced with an asterisk.

... Category not applicable.

1

SE is standard error.

NOTES: See Appendix I for description of data sources. See Appendix II, Hospital discharge for injury; Initial injury emergency department visit; Injury 

or poisoning episode; Relative standard error; Standard error. Mortality data were not included in this comparison because classification by body 

region and nature of injury for mortality is not comparable to classification for nonfatal data. See Table I for classification codes for each nature of 

injury category. 

SOURCE: CDC/NCHS, National Hospital Discharge Survey, National Hospital Ambulatory Medical Care Survey, National Health Interview Survey.
Appendixes
135 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

This report consolidates current data on injury 

mortality and morbidity in the United States. 

Information was obtained from data systems and 

surveys from the Centers for Disease Control and 

Prevention’s National Center for Health Statistics 

(NCHS) as well as several other federal government 

agencies. 

Much of the material in this section was taken from 

Appendix I, Data Sources, in Health, United States, 

2007. For more detailed information than provided 

here, see http://www.cdc.gov/nchs/hus.htm.

Although a detailed description and comprehensive 

evaluation of each data source are beyond the scope 

of this appendix, users should be aware of the general 

strengths and weaknesses of the different data 

collection systems. For example, medical record-based 

surveys, which collect data from physician and hospital 

records, usually have precise diagnostic information 

but little or no information about the socioeconomic 

characteristics of individuals or the circumstances 

of the injury. In contrast, population-based surveys 

provide socioeconomic data and detailed data on 

what was happening at the time the person was 

injured, such as the place the injury occurred and the 

activity at the time of injury. These data are limited by 

the amount of information a respondent remembers 

or is willing to report. A respondent may not know 

detailed medical information, such as precise 

diagnoses, and therefore cannot report that level of 

detail. 

All data collection systems are subject to error, and 

records may be incomplete or contain inaccurate 

information. Respondents may not remember essential 

information, a question may not mean the same thing 

to different respondents, and some institutions or 

individuals may not respond at all. Measuring the 

magnitude of these errors or their effect on the data 

is not always feasible. Where possible, this section, 

as well as Appendix II, Definitions and Methods, 

describes the universe and method of data collection 

to assist users in evaluating data quality. 

To the extent possible, government data systems 

are described using a standard format. “Overview” 

is a brief, general statement about the purpose or 

objectives of the data system. “Selected content” 

lists only the components that are reflected in this 

chartbook. “Data years” gives the years that the 

survey or data system has existed or been fielded. 

“Coverage” describes the population that the data 

system represents; for example, residents of the 

United States, the noninstitutionalized population, 

persons in specific population groups, or other entities 

that comprise the survey. The “Methodology” section 

presents a short description of methods used to 

collect data. The “Identifying injury-related records” 

section describes how injury-related records were 

identified in this source. “Sample size and response 

rates” are given for surveys. For more information 

about the methodology, data files, and history of 

a data source, consult the references and websites 

at the end of each summary, as well as Appendix II, 

Definitions and Methods.

Census of Fatal Occupational 

Injuries (CFOI)

Bureau of Labor Statistics

Overview: The Census of Fatal Occupational 

Injuries (CFOI) compiles comprehensive and timely 

information on fatal work injuries occurring in the 50 

states and the District of Columbia (D.C.) to monitor 

workplace safety and to inform private and public 

health efforts to improve workplace safety. 

Selected content: Information is collected about 

each workplace fatality, including occupation and 

other worker characteristics, equipment involved, and 

circumstances of the event. 

Coverage: The data cover all 50 states and D.C. 

Methodology: CFOI is administered by the Bureau 

of Labor Statistics in conjunction with participating 

state agencies to compile counts that are as complete 
136 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

as possible to identify, verify, and profile fatal work 

injuries. Key information about each workplace 

fatality (occupation and other worker characteristics, 

equipment or machinery involved, and circumstances 

of the event) is obtained by cross referencing source 

records. For a fatality to be included in the census, the 

decedent must have been employed (that is, working 

for pay, compensation, or profit) at the time of the 

event, engaged in a legal work activity, or present at 

the site of the incident as a requirement of his or her 

job. These criteria are generally broader than those 

used by federal and state agencies administering 

specific laws and regulations. Fatalities that occur 

during a person’s commute to or from work are 

excluded from the census counts.

Data for the CFOI are compiled from various federal, 

state, and local administrative sources including 

death certificates, workers’ compensation reports 

and claims, reports to various regulatory agencies, 

medical examiner reports, police reports, and news 

reports. Diverse sources are used because studies 

have shown that no single source captures all jobrelated fatalities. Source documents are matched so 

that each fatality is counted only once. To ensure that 

a fatality occurred while the decedent was at work, 

information is verified from two or more independent 

source documents or from a source document and a 

follow-up questionnaire.

Denominators of occupational injury fatality rates 

come from the Current Population Survey (CPS) from 

the U.S. Census Bureau (see Appendix I, Current 

Population Survey). One should remember that 

because it is a survey, the population estimates are 

subject to sampling error. For an explanation of CPS 

sampling and estimation methodology, as well as 

standard error computations, see the explanatory 

notes in the press release “The Employment Situation: 

February 2004” from the Bureau of Labor Statistics, 

available from http://www.bls.gov/news.release/

archives/empsit_03052004.pdf. The relative standard 

errors of the CPS employment estimates can be used 

to approximate confidence ranges for the fatality 

rates.

Identifying injury records: For the purposes of the 

Census of Fatal Occupational Injuries, according to 

the Bureau of Labor Statistics Report 965, “an injury 

is defined as any intentional or unintentional wound 

or bodily damage resulting from acute exposure to 

kinetic energy, or the absence of such essentials as 

oxygen or heat caused by a specific event, incident, 

or series of events within a single workday or shift.” 

For more information, see the CFOI website at http://

www.bls.gov/iif/oshcfoi1.htm.

References:

Bureau of Labor Statistics. Fatal Occupational Injuries in the United 

States, 1995–1999: A Chartbook. Washington, DC: U.S. Department of Labor; Bureau of Labor Statistics Report 965. Available 

from: http://www.bls.gov/opub/cfoichartbook/pdf/entirereport.pdf. 

2003.

Bureau of Labor Statistics. National census of fatal occupational 

injuries in 2005 [press release]. Washington, DC: U.S. Department 

of Labor. Available from: http://www.bls.gov/news.release/pdf/cfoi.

pdf. 10 Aug 2006.

Revised and final 2005 data can be found at: http://www.bls.gov/iif/

oshcfoi1.htm#2005.

Bureau of Labor Statistics. The employment situation: February 

2004 [press release]. Washington, DC: United States Department of 

Labor. Available from: http://www.bls.gov/news.release/archives/

empsit_03052004.pdf. March 2004.

Current Population Survey 

(CPS)

Bureau of Labor Statistics and U.S. Census 

Bureau

Overview: The Current Population Survey (CPS) 

is a monthly survey of about 50,000 households 

conducted by the U.S. Census Bureau for the Bureau 

of Labor Statistics. The survey has been conducted for 

more than 50 years.

The CPS is the primary source of information on the 

labor force characteristics of the U.S. population. 

The sample is scientifically selected to represent the 
137 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

civilian noninstitutionalized population 15 years of 

age and over. Respondents are interviewed to obtain 

information about the employment status of each 

member of the household 15 years of age and over. 

However, published labor force data focus on those 

ages 16 and over. The sample provides estimates for 

the nation as a whole and serves as part of modelbased estimates for individual states and other 

geographic areas. 

For more information, visit the U.S. Census Bureau 

home page available from: http://www.census.gov/

cps.

Fatality Analysis Reporting 

System (FARS)

National Highway Traffic Safety 

Administration

Overview: The Fatality Analysis Reporting System 

(FARS) contains data on motor vehicle traffic crashes 

that involved a motor vehicle traveling on a traffic way 

customarily open to the public and that resulted in the 

death of either a vehicle occupant or a nonmotorist 

within 30 days of the crash. 

Selected content: Information is collected about 

each fatality including time and location of crash, first 

harmful event, number of vehicles, number of people, 

vehicle information, demographics of people involved, 

injury severity, restraint use, and blood alcohol 

estimates.

Coverage: The data cover all 50 states, the District of 

Columbia, and Puerto Rico.

Methodology: Trained state employees, called FARS 

analysts, extract information on fatal motor vehicle 

traffic crashes from source documents in the state. 

Typical source documents include police accident 

reports, state vehicle registration files, state driver 

licensing files, state highway department data, vital 

statistics, death certificates, coroner or medical 

examiner reports, hospital medical records, and 

emergency medical service reports. The analysts 

use these records to code more than 100 FARS data 

elements. These data are transmitted daily to the 

National Highway Traffic Safety Administration’s 

central computer database, where the data are 

checked for consistency, completeness, and accuracy. 

For more information, see the FARS website at http://

www-fars.nhtsa.dot.gov.

Reference:

National Highway Traffic Safety Administration. Traffic safety facts 

2004: A compilation of motor vehicle crash data from the Fatality 

Analysis Reporting System and the General Estimates System. 

Washington, DC: National Center for Statistics and Analysis. 2006.

International Collaborative 

Effort on Injury Statistics

Centers for Disease Control and Prevention

National Center for Health Statistics

Overview: The International Collaborative Effort 

(ICE) on Injury Statistics is one of several international 

activities sponsored by NCHS. The goal is to provide 

a forum for international exchange and collaboration 

among injury researchers who develop and promote 

international standards in injury data collection and 

analysis. A secondary goal is to produce products of 

the highest quality to facilitate the comparability and 

improve the quality of injury data.

Coverage: Countries currently involved in the ICE 

on Injury Statistics include Argentina, Australia, 

Austria, Brazil, Canada, Chile, Colombia, Denmark, 

Dominica, England, Israel, Mexico, Netherlands, 

New Zealand, Nicaragua, Norway, Puerto Rico, St. 

Lucia, South Africa, Spain, Thailand, and the United 

States. Organizations involved include the Pan 

American Health Organization and the World Health 

Organization.

Methodology: Researchers from the different 
138 Injury in the United States: 2007 Chartbook

countries provided data on injuries in their country by 

age group and by external cause of injury.

For more information, see the ICE on Injury Statistics 

website at http://www.cdc.gov/nchs/advice.htm. 

National Health Interview 

Survey (NHIS)

Centers for Disease Control and Prevention

National Center for Health Statistics

Overview: The National Health Interview Survey 

(NHIS) monitors the health of the U.S. population 

through the collection and analysis of data on a broad 

range of health topics. A major strength of this survey 

is that it allows for the analysis of health measures by 

many demographic and socioeconomic characteristics, 

and its detailed questions allow for the description of 

episodes of injury and poisoning (referred to as injury). 

Selected content: The NHIS obtains information 

during household interviews for all family 

members regarding household composition and 

sociodemographic characteristics, along with basic 

indicators of health status, limitation in activities, 

utilization of health care services, and injury. 

Demographic data including gender, age, education, 

and race and ethnicity (reported by respondent or 

proxy) were obtained.

Coverage: The NHIS samples the civilian 

noninstitutionalized population of the United States, 

and the numerator and denominator of estimated 

rates are based on that population (unlike in other 

surveys, where the numerator is from a survey of 

medical records and the denominator is from the U.S. 

Census Bureau). Excluded from the survey are patients 

in long-term care facilities, persons on active duty with 

the Armed Forces (although their dependents are 

included), and U.S. nationals living in foreign countries. 

Methodology: The NHIS is a cross-sectional 

household interview survey. Sampling and interviewing 

are continuous throughout each year. The sampling 

plan follows a multistage area probability design that 

permits the representative sampling of households. 

Details on sample design can be found in “Design 

and Estimation for the National Health Interview 

Survey, 1995–2004.” Trained interviewers from the 

U.S. Census Bureau visit each selected household and 

administer NHIS in person. 

The Basic module of the NHIS is a core questionnaire 

that remains largely unchanged from year to year and 

allows for trend analysis and for data from more than 1 

year to be pooled to increase sample size for analytic 

purposes. The Basic module consists of three main 

components: the Family Core, the Sample Adult Core, 

and the Sample Child Core. The Family Core, the 

source of data for this chartbook, collects information 

for all family members. 

Identifying injury-related records: The injury section is 

in the Family Core; thus, the questions on medically 

attended or consulted injuries and poisonings that 

occurred within a three-month reference period were 

asked about each member of the family. Data on 

injuries and poisonings are collected at the episode 

or event level. Therefore, there may be more than 

one episode per person. These questions may 

be answered by a family respondent for all family 

members.

Injury and poisoning episodes are based on the 

questions ‘‘Of the [number] times that [person] was 

injured, how many of those times was the injury 

serious enough that a medical professional was 

consulted?’’ and ‘‘Of the [number] times that [person] 

was poisoned, how many of those times was the 

poisoning serious enough that a medical professional 

was consulted?’’ Examples of valid medically consulted 

episodes include a call to a poison control center, the 

use of an emergency vehicle or emergency room, a 

visit to a doctor’s office or other health clinic, or a 

phone call to a doctor, nurse, or other health care 

Appendix I–Data Sources
139 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

professional. Counts and rates of episodes have been 

annualized based only on episodes that occurred 5 

weeks or less before the date the injury or poisoning 

questions were asked. 

An injury episode refers to the traumatic event in 

which the person was injured one or more times from 

an external cause (e.g., a fall or a motor vehicle traffic 

accident). An injury condition is the acute condition or 

the physical harm caused by the traumatic event. The 

Verbatim Injury/Poisoning Episode File contains the 

respondent’s description of what happened. 

In 2004, to be considered an injury, each episode 

had to have at least one injury condition classified 

according to the International Classification of 

Diseases, Ninth Revision, Clinical Modification (ICD–

9–CM) diagnosis codes 800–909.2, 909.4, 909.9, 910–

994.9, 995.5–995.59, and 995.80–995.85. Beginning 

with data year 2005, the episode was also required to 

have one external cause of injury code (E800–E848, 

E850–E869.9, E880–E929.9, or E950–E999). 

Sample size and response rates: In both 2004 and 

2005, more than 35,000 households completed the 

interview, and the response rates of households 

were more than 86%. In 2005, household interviews 

were completed for 98,649 persons living in 38,509 

households.

Detailed interviewer instructions can be found in 

the NHIS Field Representative’s Manual, available 

from ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/

Survey_Questionnaires/NHIS/2005/frmanual.pdf and 

ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Survey_

Questionnaires/NHIS/2004/frmanual.pdf.

For more information, see the Survey Description 

Documents for 2004 and 2005 at the NHIS website at 

http://www.cdc.gov/nchs/nhis.htm and http://www.

cdc.gov/nchs/about/otheract/injury/injury_interview.

htm.

References:

NCHS. National Health Interview Survey: Research for the 1995–

2004 redesign. National Center for Health Statistics. Vital Health 

Stat 2(126). 1999.

Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and 

estimation for the National Health Interview Survey, 1995–2004. 

National Center for Health Statistics. Vital Health Stat 2(130). 2000.

Warner M, Barnes PM, Fingerhut LA. Injury and poisoning episodes 

and conditions; National Health Interview Survey, 1997. Vital Health 

Stat 10(202). 2000.

Warner M, Schenker N, Heinen MA, Fingerhut LA. The effects of 

recall on reporting injury and poisoning episodes in the National 

Health Interview Survey. Inj Prev 11(5):282–7. 2005.

National Hospital 

Ambulatory Medical Care 

Survey (NHAMCS)

Centers for Disease Control and Prevention

National Center for Health Statistics

Overview: The National Hospital Ambulatory Medical 

Care Survey (NHAMCS) collects data on the utilization 

and provision of medical care services provided in 

hospital emergency departments (EDs) and outpatient 

departments (OPDs). 

Selected content: Data are collected from medical 

records on types of providers seen, reasons for visits, 

diagnoses, drugs ordered or provided, and selected 

procedures and tests performed during visits. Patient 

data include age, sex, race, and expected source 

of payment. Data are also collected on selected 

characteristics of the hospitals included in the survey.

Coverage: The survey is a representative sample of 

visits to EDs and OPDs of nonfederal, short-stay, or 

general hospitals. Telephone contacts are excluded. 

In this chartbook, analyses that present visit rates 

per population use the civilian population as the 

denominator because persons who visit nonfederal 

hospital EDs or OPDs can include civilians who reside 
140 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

inside or outside institutional settings. See Appendix 

II, Population.

Methodology: A four-stage probability sample 

design is used in NHAMCS, involving samples of 

primary sampling units (PSUs), hospitals within PSUs, 

clinics within OPDs, and patient visits within clinics 

and EDs. Detail on the sampling methods can be 

found at http://www.cdc.gov/nchs/about/major/ahcd/

sampham.htm.

Sample data are weighted to produce national 

estimates. The estimation procedure used in the 

NHAMCS has three basic components: inflation by the 

reciprocal of the probability of selection, adjustment 

for nonresponse, and ratio adjustment to fixed totals.

Identifying an injury-related record: An injury OPD 

or injury ED visit is defined as an initial visit that has 

either a first-listed injury diagnosis code or a first-listed 

valid external cause of injury code. Visits with a firstlisted diagnosis or with a first-listed external cause 

code describing a complication or adverse effect of 

medical care are excluded. The relevant codes from 

the ICD–9–CM for injury diagnoses are the codes from 

the Barell Injury Diagnosis Matrix: 800–909.2, 909.4, 

909.9–994.9, 995.50–995.59, and 995.80–995.85. 

The relevant codes from the ICD–9–CM for external 

causes of injury are E800–E869, E880–E929, and 

E950–E999. See Appendix II, Initial injury emergency 

department visit. This is not the same definition used 

in reports prepared by the Ambulatory Care Branch 

in the Division of Health Care Statistics, which has a 

definition that is much broader. See http://www.cdc.

gov/nchs/data/ad/ad372.pdf. 

Sample size and response rates: In any given year, 

the hospital sample consists of approximately 500 

hospitals, of which 80% have EDs and about one-half 

have eligible OPDs. Typically, about 1,000 clinics are 

selected from participating hospital OPDs. In 2004, 

the number of patient record forms (PRFs) completed 

for EDs was 36,589 and for OPDs was 31,783. In 2005, 

the number of PRFs completed for EDs was 33,605 

and for OPDs was 29,975. In 2004, the hospital 

response rate was 89% for EDs and 75% for OPDs. In 

2005, the hospital response rate was 86% for EDs and 

74% for OPDs.

For more information, see the NHCS websites, 

available from http://www.cdc.gov/nchs/nhcs.htm, and 

the injury data and resource websites, available from

http://www.cdc.gov/nchs/about/otheract/injury/injury_

emergency.htm and http://www.cdc.gov/nchs/about/

otheract/injury/injury_outpatient.htm.

References: 

McCaig LF, McLemore T. Plan and operation of the National 

Hospital Ambulatory Medical Care Survey. National Center for 

Health Statistics. Vital Health Stat 1(34). 1994.

Fingerhut L. Recommended definition of initial injury visits to 

EDs for use with the NHAMCS—ED Data. Health E-Stats. 2007. 

Available from: http://www.cdc.gov/nchs/products/pubs/pubd/

hestats/injury/injury.htm.

National Hospital Discharge 

Survey (NHDS)

Centers for Disease Control and Prevention

National Center for Health Statistics

Overview: The National Hospital Discharge Survey 

(NHDS) collects and produces national estimates on 

characteristics of inpatient stays in nonfederal shortstay hospitals in the United States. 

Selected content: Patient information collected 

includes demographics, length of stay, diagnoses, and 

procedures. Hospital characteristics collected include 

region, ownership, and bedsize.

Coverage: The survey design covers the 50 states 

and the District of Columbia. Included in the survey 

are general and children’s general hospitals with 

an average length of stay of less than 30 days for 

all inpatients. Excluded are federal, military, and 

Department of Veterans Affairs hospitals, as well as 
141 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

hospital units of institutions (such as prison hospitals) 

and hospitals with fewer than six beds staffed for 

patient use. All discharged patients from in-scope 

hospitals are included in the survey; however, 

newborns are not included in this chartbook. The 

civilian population is used as the denominator of 

hospital discharge rates. See Appendix II, Population.

Methodology: 

Hospitals are selected using a modified three-stage 

stratified design. Units selected at the first stage 

consisted of either hospitals or geographic areas. The 

geographic areas were primary sample units (PSUs) 

used for the 1985–1994 National Health Interview 

Survey, which are geographic areas such as counties 

or townships. Hospitals within PSUs were then 

selected at the second stage. Strata at this stage were 

defined by geographic region, PSU size, abstracting 

service status, and hospital specialty-size groups. 

Within these strata, hospitals were selected with 

probabilities proportional to their annual number of 

discharges. At the third stage, a sample of discharges 

was selected by a systematic random sampling 

technique. The sampling rate was determined by 

the hospital’s sampling stratum and the type of 

data collection system (manual or automated) used. 

Discharge records from hospitals submitting data via 

commercial abstracting services and selected state 

data systems (approximately 41% of sample hospitals) 

were stratified before sampling by primary diagnoses, 

patient sex and age group, and date of discharge. 

The NHDS hospital sample is updated every 3 years by 

continuing the sampling process among hospitals that 

become eligible for the survey during the intervening 

years and by deleting hospitals that are no longer 

eligible. 

The basic unit of estimation for NHDS is a sampled 

discharge. The basic estimation procedure involves 

inflation by the reciprocal of the probability of 

selection. There are adjustments for nonresponding 

hospitals and discharges; a postratio adjustment to 

fixed totals is employed.

Identifying injury-related records: There are up to 

seven diagnosis codes on each hospital record. The 

principal diagnosis is the diagnosis that was chiefly 

responsible for admission to the hospital. Some 

medical records do not have a principal diagnosis 

indicated. If a principal diagnosis is present on a 

record, then it is the first-listed diagnosis in NHDS; 

otherwise, the first diagnosis on the record is used as 

the first-listed NHDS diagnosis. 

Injury hospital discharges are identified by examining 

the first-listed diagnosis on the record. If the firstlisted diagnosis is identified by any of the codes in 

the Barell Injury Diagnosis Matrix (see Appendix II, 

Barell Injury Diagnosis Matrix), then the record is 

considered to be an injury hospital discharge; valid 

nature of injury codes, as defined in the ICD–9–CM are 

800–909.2, 909.4, 909.9, 910–994.9, 995.50–995.59, 

or 995.80–995.85. Adverse effects of therapeutic use 

of drugs or medical or surgical care, as well as the late 

effects of those adverse effects, are not included in 

this definition of injury. 

The external cause for an injury is determined by 

examining the codes entered in diagnosis fields 2 

through 7. The first valid external cause code (E code) 

found is used to derive the external cause. Thirtyseven percent of injury-related hospital discharge 

records in 2004–2005 did not have a valid E code. 

Valid E codes include E800–E999, except E849, E967, 

E869.4, E870–E879, and E930–E949. 

Sample size and response rate: In 2004, 501 hospitals 

were selected for NHDS: 476 of these hospitals were 

within scope and 439 participated (92%). From the 

hospitals that participated, data were collected from 

medical records for approximately 371,000 discharges. 

In 2005, 501 hospitals were selected, 473 of the 

hospitals were within scope, 444 participated (94%), 

and data were collected from medical records for 

approximately 375,000 discharges. 

For more information, see http://www.cdc.gov/nchs/

about/major/hdasd/nhds.htm and http://www.cdc.
142 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

gov/nchs/about/otheract/injury/injury_hospital.htm.

References: 

DeFrances CJ, Hall MJ, Podgornik MN. 2004 National Hospital 

Discharge Survey. Advance data from vital and health statistics; no 

371. Hyattsville, MD: National Center for Health Statistics. 2006.

Dennison C, Pokras R. Design and operation of the National 

Hospital Discharge Survey: 1988 redesign. National Center for 

Health Statistics. Vital Health Stat 1(39). 2000.

Heinen M, Hall MJ, Boudreault MA, Fingerhut LA. National trends in 

injury hospitalizations, 1979–2001. Hyattsville, MD: National Center 

for Health Statistics. March 2005.

National Vital Statistics 

System (NVSS)

Centers for Disease Control and Prevention

National Center for Health Statistics

Mortality Statistics

Overview: Mortality statistics are collected through the 

National Vital Statistics System (NVSS) based on U.S. 

standard death certificates. Vital statistics mortality 

data are a fundamental source of demographic, 

geographic, and cause-of-death information. This is 

one of the few sources of comparable health-related 

data for small geographic areas over an extended 

time period. The data are used to present the 

characteristics of those dying in the United States and 

compare mortality trends with other countries. 

Selected content: The mortality file includes medical 

information on cause of death and demographic 

information on age, sex, race, Hispanic origin, state of 

residence, and educational attainment.

Data years: The death registration area for all states 

and the District of Columbia (D.C.) has been in 

existence since 1932.

Coverage: NVSS collects and presents U.S. resident 

data for the aggregate of 50 states, New York City, 

and D.C., as well as for each individual state. Vital 

events occurring in the United States to non-U.S. 

residents and vital events occurring abroad to U.S. 

residents are excluded. Death rates for 2001 through 

2004 were calculated using estimates of the resident 

population based on the 2000 census. See Appendix 

II, Table IX.

Methodology: The Division of Vital Statistics obtains 

information on deaths from the registration offices 

of each of the 50 states, New York City, D.C., Puerto 

Rico, the U.S. Virgin Islands, Guam, American Samoa, 

and the Northern Mariana Islands. Data are sent 

to NCHS through the Vital Statistics Cooperative 

Program (VSCP). 

By law, the registration of deaths is the responsibility 

of the funeral director. The funeral director obtains 

demographic data for the death certificate from an 

informant. The physician in attendance at the death is 

required to certify the cause of death. When a death 

is from other than natural causes, a coroner or medical 

examiner may be required to examine the body and 

certify the cause of death. Data for the entire United 

States refer to events occurring within the United 

States; data for geographic areas are by place of 

residence. 

Identifying injury deaths: All NVSS mortality files 

have an underlying cause of death for each record. 

The underlying cause of death is defined as “(a) 

the disease or injury which initiated the train of 

morbid events leading directly to death, or (b) the 

circumstances of the accident or violence which 

produced the fatal injury.” Beginning with data year 

1999, if the underlying cause of death is coded to 

one of the following International Classification of 

Diseases, Tenth Revision, (ICD–10) codes, *U01–

*U03, V01–Y36, Y85–Y87, or Y89, then the death 

is considered to be due to an injury. The U codes 

are preceded by an asterisk (*), which indicates that 

the codes were introduced in the United States, 

but are not officially part of the ICD. For data years 

1979–1998, ICD–9 codes E800–E869, E880–E929, 

and E950–E999 identify an injury death. For an injury 
143 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

record, the underlying cause of death is always an 

external cause. 

In addition to the underlying cause of death, the 

mortality file has data on multiple causes of death 

that reflect all medical information reported on death 

certificates and complement traditional underlying 

cause-of-death data. See Appendix II, International 

Classification of Diseases (ICD) Multiple-cause-ofdeath data and injury diagnoses, and Injury Mortality 

Diagnosis (IMD) Matrix.

For more information, see the mortality data website, 

available from http://www.cdc.gov/nchs/deaths.htm, 

and the injury data and resources website, available 

from http://www.cdc.gov/nchs/about/otheract/injury/

injury_mortality.htm. Injury deaths and rates can also 

be found at http://www.cdc.gov/NCIPC/wisqars/

default.htm.

References: 

Grove RD, Hetzel AM. Vital statistics rates in the United States, 

1940–60. Washington DC: U.S. Government Printing Office. 1968.

National Center for Health Statistics, Vital statistics of the United 

States, Vol II, Mortality, part A. Technical Appendix. Available from: 

http://www.cdc.gov/nchs/datawh/statab/pubd/ta.htm. 2007.

Anderson RN, Miniño AM, Fingerhut LA, Warner M, Heinen MA. 

Deaths: Injuries, 2001. National vital statistics reports; vol 52 no 21. 

Hyattsville, MD: National Center for Health Statistics. 2004.

Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. 

Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. 

Hyattsville, MD: National Center for Health Statistics. 2006. 

Compressed Mortality File 

Overview: The Compressed Mortality File (CMF) 

is a county-level national mortality and population 

database. 

Selected content: The compressed mortality database 

contains mortality data derived from the detailed 

mortality files of the NVSS and population estimates 

from the U.S. Census Bureau estimates of U.S. 

national, state, and county resident populations. 

Number of deaths, crude death rates, and ageadjusted death rates for all underlying causes of 

death can be obtained by place of residence (level 

of urbanization and total United States, state, and 

county), age group, race (white, black, and other), 

sex, year of death, and any individual or group of 

underlying cause(s) of death. The primary difference 

between the population data from the CMF 

compared with data from the U.S. Census Bureau is 

the population under 1 year of age. The CMF uses 

births, and the data from the U.S. Census Bureau uses 

the population. Although the differences are small 

and may make no difference to the resulting ageadjusted rates, the user should know that the rate 

denominators are different.

Data years: The CMF spans the years 1968–2004. On 

the CDC WONDER website at wonder.cdc.gov, data 

are available starting with 1979.

Methodology: In this chartbook, the CMF was 

used to compute injury death rates by urbanization 

level of decedent’s county of residence. Counties 

are categorized according to level of urbanization 

based on an NCHS‐modified version of the 1993 

rural-urban continuum codes for metropolitan and 

nonmetropolitan counties, which was developed by 

the Economic Research Service, U.S. Department of 

Agriculture. See Appendix II, Urbanization.

For more information, see the CMF website at http://

www.cdc.gov/nchs/products/elec_prods/subject/

mcompres.htm, or see the CDC Wonder website at 

http://wonder.cdc.gov/mortSQL.html.

Population Census and 

Population Estimates

U.S. Census Bureau

Decennial Census

The census of population (decennial census) has been 

held in the United States every 10 years since 1790. 

The decennial census has enumerated the resident 
144 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

population as of April 1 of the census year since 

1930. Data on sex, race, age, and marital status are 

collected from 100% of the enumerated population. 

More detailed information such as income, education, 

housing, occupation, and industry have been collected 

from a representative sample of the population. 

Intercensal Population Estimates

The further from the census year on which the 

postcensal estimates are based, the less accurate 

the estimates are. With the completion of the 

decennial census at the end of the decade, intercensal 

estimates for the preceding decade were prepared 

to replace the less accurate postcensal estimates. 

Intercensal population estimates take into account 

the census of population at the beginning and end 

of the decade. Thus, intercensal estimates are more 

accurate than postcensal estimates as they correct 

for the error of closure or difference between the 

estimated population at the end of the decade and 

the census count for that date. The error of closure 

at the national level was 1.5 million for the 1980s 

and 6 million for the 1990s. The error of closure 

differentially affects age, race, sex, and Hispanic origin 

subgroup populations as well as the rates based on 

these populations. Vital rates that were calculated 

using postcensal population estimates are routinely 

revised when intercensal estimates become available 

because the intercensal estimates correct for the error 

of closure.

Intercensal estimates for the 1990s with race data 

comparable to the 1977 standards have been derived 

so that vital rates for the 1990s could be revised to 

reflect the 2000 census. Calculation of the intercensal 

population estimates for the 1990s was complicated 

by the incomparability of the race data on the 1990 

and 2000 censuses. The U.S. Census Bureau, in 

collaboration with the National Cancer Institute and 

NCHS, derived race-specific intercensal population 

estimates for the 1990s using the 1990 Modified Age 

Race Sex (MARS) file as the beginning population base 

and the bridged-race population estimates for April 

1, 2000, as the ending population base. Bridged-race 

intercensal population estimates are available from 

http://www.cdc.gov/nchs/about/major/dvs/popbridge/

popbridge.htm.

Postcensal Population Estimates 

Postcensal population estimates are estimates made 

for the years following a census before the next 

census is taken. National postcensal population 

estimates are derived by updating the resident 

population enumerated in the decennial census using 

components of population change approach. 

Bridged-Race Population Estimates for Census 

2000

Race data on the 2000 census are not comparable with 

race data on other data systems that are continuing 

to collect data using the 1977 standards on race and 

ethnicity during the transition to full implementation 

of the 1997 standards. For example, most of the 

states in the Vital Statistics Cooperative Program 

revised their birth and death certificates to conform 

to the 1997 standards after 2000. Thus, population 

estimates for 2000 and beyond with race categories 

comparable to the 1977 categories are needed so that 

race-specific birth and death rates can be calculated. 

To meet this need, NCHS, in collaboration with the 

U.S. Census Bureau, developed methodology to 

bridge the 31 race groups in the 2000 census to the 

four single-race categories specified under the 1977 

standards. 

The bridging methodology was developed using 

information from the 1997–2000 National Health 

Interview Survey (NHIS). The NHIS provides a 

unique opportunity to investigate multiple-race 

groups because, since 1982, the NHIS has allowed 

respondents to choose more than one race but has 

also asked respondents reporting multiple races to 

choose a primary race. The bridging methodology 

developed by NCHS involved the application of 

regression models relating person-level and countylevel covariates to the selection of a particular primary 

race by the multiple-race respondents. Bridging 
145 Injury in the United States: 2007 Chartbook

Appendix I–Data Sources

proportions derived from these models were applied 

by the U.S. Census Bureau to the Census 2000 

Modified Race Data Summary File. This application 

resulted in bridged counts of the April 1, 2000, 

resident single-race populations for four racial groups: 

American Indian or Alaska Native, Asian or Pacific 

Islander, black, and white. As bridged-race population 

estimates continue to be needed for the calculation of 

vital rates, the U.S. Census Bureau annually produces 

postcensal bridged-race estimates of the July 1 

resident single-race populations.

For more information about bridged-race population 

estimates, see: Ingram DD, Parker JD, Schenker N, 

et al. United States Census 2000 population with 

bridged race categories. National Center for Health 

Statistics. Vital Health Stat 2(135). 2003. Also see the 

NCHS website, “U.S. Census Populations with Bridged 

Race Categories,” at http://www.cdc.gov/nchs/about/

major/dvs/popbridge/popbridge.htm. See Appendix 

II, Population for estimates used in this chartbook.
Appendix Tables I–VI
148 Injury in the United States: 2007 Chartbook

Table I. The Barell Injury Diagnosis Matrix based on ICD–9–CM codes for classification by body region and nature of 

the injury

Body region of injury International Classification of Diseases, Ninth Revision, Clinical 

Modification (ICD–9–CM) codes

 Fracture

800–829

Dislocation

830–839

Sprains

and strains

840–848

Head and neck

Traumatic 

brain injuryType 1 TBI [800,801,803,804](.1–.4,.6–.9,.03–.05,.53–.55),

850(.2–.4), 851–854, 950(.1–.3), 995.55

[800,801,803,804](.1–.4,.6–.9,

.03–.05,.53–.55) ... ...

Type 2 TBI [800,801,803,804](.00,.02,.06,.09,.50,.52,.56,.59), 850(.0–.1,.5,.9) [800,801,803,804](.00,.02,.06,.09,

.50,.52,.56,.59) ... ...

Type 3 TBI [800,801,803,804](.01, .51) [800,801,803,804](.01,.51) ... ...

Other head, face, and neck

Other head 873(.0–.1,.8–.9), 941.x6, 951, 959.01 ... ... ...

Face 802, 830, 848(.0–.1), 872, 873(.2–.7), 941(.x1,.x3–.x5,.x7) 802 830 848(.0–.1)

Eye 870–871, 918, 921, 940, 941.x2, 950(.0,.9) ... ... ...

Neck 807(.5–.6), 848.2, 874, 925.2, 941.x8, 953.0, 954.0 807(.5–.6) ... 848.2

 Head, face, and

 neck unspecified 900, 910, 920, 925.1, 941(.x0, .x9), 947.0, 957.0, 959.09 ... ... ...

Spine and back

Spinal cord (SCI)

Cervical SCI 806(.0–.1), 952.0 806(.0–.1) ... ...

Thoracic or dorsal 

SCI 806(.2–.3), 952.1 806(.2–.3) ... ...

Lumbar SCI 806(.4–.5), 952.2 806(.4–.5) ... ...

Sacrum coccyx 

SCI 806(.6–.7), 952(.3–.4) 806(.6–.7) ... ...

Spine and back 

unspecified SCI 806(.8–.9), 952(.8–.9) 806(.8–.9) ... ...

Vertebral column (VCI)

Cervical VCI 805(.0–.1), 839(.0–.1), 847.0 805(.0–.1) 839(.0–.1) 847.0

Thoracic or dorsal

VCI 805(.2–.3), 839(.21,.31), 847.1 805(.2–.3) 839(.21,.31) 847.1

Lumbar VCI 805(.4–.5), 839(.20,.30), 847.2 805(.4–.5) 839(.20,.30) 847.2

Sacrum Coccyx

VCI 805(.6–.7), 839(.41–.42,.51–.52), 847(.3–.4) 805(.6–.7) 839(.41–.42, .51–.52) 847(.3–.4)

Spine and back 

unspecified VCI 805(.8–.9), 839(.40,.49,.50,.59) 805(.8–.9) 839(.40,.49,.50,.59) ...

TorsoTorso

Chest (thorax) 807(.0–.4), 839(.61,.71), 848(.3–.4), 860–862, 875, 879(.0–.1),

 901, 922(.0–.1,.33), 926.19, 942(.x1–.x2), 953.1 807(.0–.4) 839(.61,.71) 848(.3–.4)

Abdomen 863–866, 868, 879(.2–.5), 902(.0–.4), 922.2,942.x3, 947.3, 953(.2,.5) ... ... ...

Pelvis 

and urogenital

808, 839(.69,.79), 846, 848.5, 867,877–878

902(.5,.81–.82), 922.4, 926(.0,.12), 942.x5,947.4, 953.3 808 839(.69,.79) 846, 848.5

Trunk 809, 879(.6–.7), 911, 922(.8–.9),

926(.8–.9), 942(.x0,.x9), 954(.1,.8–.9), 959.1 809 ... ...

Back and buttock 847.9, 876, 922(.31–.32), 926.11, 942.x4 ... ... 847.9

Extremities

Upper

Shoulder and

upper arm 810–812, 831, 840, 880, 887(.2–.3), 912,923.0, 927.0, 943(.x3–.x6) ,959.2 810–812 831 840

Forearm and elbow 813, 832, 841, 881(.x0–.x1), 887(.0–.1), 923.1, 927.1, 943(.x1–.x2) 813 832 841

Wrist, hand, 

and fingers

814–817, 833–834, 842,881.x2, 882, 883, 885–886, 914–915,

923(.2–.3) ,927(.2–.3), 944 ,959(.4–.5) 814–817 833, 834 842

Other and 

unspecified 818, 884, 887(.4–.7), 903, 913, 923(.8–.9), 927(.8–.9), 

943(.x0,.x9), 953.4, 955, 959.3 818 ... ...

Lower

Hip 820, 835, 843, 924.01, 928.01 820 835 843

Upper leg and thigh 821, 897(.2–.3), 924.00, 928.00, 945.x6 821 ... ...

Knee 822, 836, 844(.0–.3), 924.11, 928.11, 945.x5 822 836 844(.0–.3)

Lower leg and ankle 823–824, 837, 845.0, 897(.0–.1), 924(.10,.21), 928(.10,.21), 945(.x3–.x4) 823–824 837 845.0

Foot and toes 825–826, 838, 845.1, 892–893, 895–896, 917, 924(.3,.20), 

928 (.3,.20), 945 (.x1–.x2) 825–826 838 845.1

Other and

unspecified 827,844(.8–.9), 890–891, 894, 897(.4–.7), 904(.0–.8), 916, 924(.4–.5),

 928(.8–.9), 945(.x0,.x9), 959(.6–.7) 827 ... 844(.8–.9)

Unclassifiable by site

Other and 

unspecifiedOther or multiple 819, 828, 902(.87,.89), 947(.1–.2), 953.8, 956 819, 828 ... ...

Unspecified 

site 829, 839(.8–.9), 848(.8–.9), 869, 879(.8–.9), 902.9, 904.9, 919, 924(.8–.9), 

 929, 946, 947(.8–.9), 948, 949, 953.9, 957(.1,.8–.9), 959(.8–.9) 829 839(.8–.9) 848(.8–.9)

System- wideSystem-wide and

late effects

 905–908, 909 (.0–.2,.4,.9), 930–939,958, 960–994,

 995(.50–.54,.59,.80–.85)

See footnotes at end of table.
149 Injury in the United States: 2007 Chartbook

Table I. The Barell Injury Diagnosis Matrix based on ICD–9–CM codes for classification by body region and nature of 

the injury—Con.

Body region of injury

Internal

850–854,860–869,

952, 995.55

Open Wound

870–884, 

890–894

Amputations

885–887,

895–897

Blood

vessels

900–904

Contusion or

 superficial

910–924

Crush

925–929

Burns

940–949

Nerves

950–951,

953–957

Unspecified

959

Head and neck

Traumatic 

brain injuryType 1 TBI 850(.2–.4),

851–854†, 995.55 ... ... ... ... ... ... 950(.1–.3) ...

Type 2 TBI 850(.0–.1,.5,.9) ... ... ... ... ... ... ... ...

Type 3 TBI ... ... ... ... ... ... ... ... ...

Other head, face, and neck

Other head ... 873(.0–.1,.8–.9) ... ... ... ... 941.x6 951 959.01†

Face ... 872, 873(.2–.7) ... ... ... ... 941(.x1,.x3–.x5,.x7) ... ...

Eye ... 870–871 ... ... 918, 921 ... 940, 941.x2 950(.0,.9) ...

Neck ... 874 ... ... ... 925.2 941.x8 953.0, 954.0 ...

 Head, face, and

 neck unspecified ... ... ... 900 910, 920 925.1 941(.x0,.x9), 947.0 957.0 959.09

Spine and back

Spinal cord (SCI)

Cervical SCI 952.0 ... ... ... ... ... ... ... ...

Thoracic or dorsal 

SCI 952.1 ... ... ... ... ... ... ... ...

Lumbar SCI 952.2 ... ... ... ... ... ... ... ...

Sacrum coccyx 

SCI 952(.3–.4) ... ... ... ... ... ... ... ...

Spine and back 

unspecified SCI 952(.8–.9) ... ... ... ... ... ... ... ...

Vertebral column (VCI)

Cervical VCI ... ... ... ... ... ... ... ... ...

Thoracic or dorsal

VCI ... ... ... ... ... ... ... ... ...

Lumbar VCI ... ... ... ... ... ... ... ... ...

Sacrum Coccyx

VCI ... ... ... ... ... ... ... ... ...

Spine and back 

unspecified VCI ... ... ... ... ... ... ... ... ...

TorsoTorso

Chest (thorax) 860–862 875, 879(.0–.1) ... 901 922(.0–.1,.33) 926.19 942(.x1–.x2) 953.1 ...

Abdomen 863–866, 868 879(.2–.5) ... 902(.0–.4) 922.2 ... 942.x3, 947.3 953(.2,.5) ...

Pelvis 

and urogenital 867 877–878 ... 902(.5, .81–.82) 922.4 926(.0, .12) 942.x5, 947.4 953.3 ...

Trunk ... 879(.6–.7) ... ... 911, 922(.8–.9) 926(.8–.9) 942.x0, 942.x9 954(.1, .8–.9) 959.1

Back and buttock ... 876 ... ... 922(.31–.32) 926.11 942.x4 ... ...

Extremities

Upper

Shoulder and

upper arm ... 880 887(.2–.3) ... 912, 923.0 927.0 943(.x3–.x6) ... 959.2

Forearm and elbow ... 881(.x0–x1) 887(.0–.1) ... 923.1 927.1 943(.x1–.x2) ... ...

Wrist, hand, 

and fingers ... 881.x2,882, 883 885–886 ... 914–915,

 923(.2–.3) 927(.2–.3) 944 ... 959(.4–.5)

Other and 

unspecified ... 884 887(.4–.7) 903 913,923(.8–.9) 927(.8–.9) 943(.x0,.x9) 953.4, 955 959.3

Lower

Hip ... ... ... ... 924.01 928.01 ... ... ...

Upper leg and thigh ... ... 897(.2–.3) ... 924.00 928.00 945.x6 ... ...

Knee ... ... ... ... 924.11 928.11 945.x5 ... ...

Lower leg and ankle ... ... 897(.0–.1) ... 924(.10,.21) 928(.10,.21) 945(.x3–.x4) ... ...

Foot and toes ... 892–893 895–896 ... 917, 924(.3,.20) 928(.3,.20) 945(.x1–.x2) ... ...

Other and

unspecified ... 890–891,894 897(.4–.7) 904(.0–.8) 916, 924(.4–.5) 928(.8–.9) 945(.x0,.x9) ... 959(.6–.7)

Unclassifiable by site

Other and 

unspecifiedOther or multiple ... ... ... 902(.87,.89) ... ... 947(.1–.2) 953.8, 956 ...

Unspecified 

site 869 879(.8–.9) ... 902.9, 904.9 919, 924(.8–.9) 929 946, 947(.8–.9)

948, 949 953.9, 957(.1,.8–.9) 959(.8–.9)

System- wideSystem-wide and

late effects Foreign body (930–939), Early complications of trauma (958), Poisoning (960–979), Toxic Effects (980–989), Other and unspecified effects of external cause (990–994), 

Child and adult maltreatment (995(.50–.54, .59, .80–.85)). Late effects of injuries, poisonings, toxic effects and other external causes (905–909) excluding 909(.3, .5)

... Category not applicable (no code in cell). 

†According to the CDC, 959.01 (added to ICD–9–CM in 1997) is not intended to be assigned to TBI cases; however, in the United States, it has been assigned incorrectly to a substantial proportion of cases previously coded 854.

 

NOTES: When a set of additional digits are required for International Classification of Diseases codes, the additional digits are in parentheses ( ) and apply to the preceding code or preceding range of codes in brackets [ ]. Special diagnostic codes for trauma are Flail Chest (807.4) and Pneumothorax (860). For purposes of classification, head injuries are labeled as “Type 1 TBI” if there is recorded evidence of an intracranial injury or a moderate or prolonged loss of consciousness 

(LOC), Shaken Infant Syndrome (SIS), or injuries to the optic nerve pathways. Type 2 TBI includes injuries with no recorded evidence of intracranial injury, and LOC of less than one hour, or LOC of unknown duration, or unspecified level of 

consciousness. Type 3 TBI includes patients with no evidence of intracranial injury and no LOC. 

SOURCE: Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, et al. An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev 8(2):91–6. 2002.
150 Injury in the United States: 2007 Chartbook

Table II. External cause-of-injury mortality matrix based on ICD–9 external cause of injury codes

Manner or intent 

Mechanism of death 

(based on ICD–9) Unintentional Suicide

All injury E800–E869, E880–E929 E950–E959 

Cut or pierce E920(.0–.9) E956 

Drowning or

submersion E830(.0–.9), E832(.0–.9), E910(.0–.9) E954 

Fall E880.0–E886.9, E888 E957(.0–.9) 

Fire or burn E890.0–E899, E924(.0–.9) E958(.1–.2, .7) 

Fire or flame E890.0–E899 E958.1 

Hot object or 

substance E924(.0–.9) E958(.2, .7) 

Firearm E922(.0–.9) E955(.0–.4) 

Machinery E919(.0–.9) ...

MV traffic1 [E810–E819] (.0–.9) E958.5 

Occupant [E810–E819] (.0–.1) ...

Motorcyclist [E810–E819] (.2,.3) ...

Pedal cyclist [E810–E819] (.6) ...

Pedestrian [E810–E819] (.7) ...

Unspecified [E810–E819] (.9) ...

Pedal cyclist, other [E800–E807](.3),[E820–E825] (.6); E826(.1, .9); [E827–E829] (.1) ... 

Pedestrian, other [E800–E807](.2), [E820–E825] (.7), [E826–E829](.0) ...

Transport, other [E800–E807](.0,.1,.8–.9), [E820–E825](.0–.5,.8–.9), E826(.2–.8),

[E827–E829](.2–.9), E831(.0–.9), E833.0–E845.9 E958.6 

Natural or

environmental

E900.0–E909, E928(.0–.2) E958.3 

Bites and stings E905(.0–.6,.9); E906(.0–.4,.9) ...

Overexertion E927 ...

Poisoning E850.0–E869.9 E950.0–E952.9 

Struck by or against E916–E917.9 ...

Suffocation E911–E913.9 E953(.0–.9) 

Other specified, 

classifiable

E846–E848, E914–E915, E918, E921(.0–.9), E923(.0–.9), E925.0–E926.9, 

E929(.0–.5) 

E955(.5,.9) 

E958.(0,.4 )

Other specified, not 

elsewhere classifiable E928.8, E929.8 E958.8, E959 

Unspecified E887, E928.9, E929.9 E958.9 

See footnotes at end of table.
151 Injury in the United States: 2007 Chartbook

Table II. External cause-of-injury mortality matrix based on ICD–9 external cause of injury codes—Con.

Manner or intent

Mechanism of death 

(based on ICD–9) Homicide Undetermined Legal intervention or war 

All injury E960–E969 E980–E989 E970–E978, E990–E999

Cut or pierce E966 E986 E974 

Drowning or

submersion E964 E984 ...

Fall E968.1 E987(.0–.9) ...

Fire or burn E961, E968(.0, .3) E988(.1–.2, .7) ...

Fire or flame E968.0 E988.1 ...

Hot object or 

substance E961, E968.3 E988(.2, .7) ...

Firearm E965(.0–.4) E985(.0–.4) E970 

Machinery ... ... ...

MV traffic1 ... E988.5 ...

Occupant ... ... ...

Motorcyclist ... ... ...

Pedal cyclist ... ... ...

Pedestrian ... ... ...

Unspecified ... ... ...

Pedal cyclist, other ... ... ... 

Pedestrian, other ... ... ...

Transport, other ... E988.6 ...

Natural or

environmental ... E988.3 ...

Bites and stings ... ... ...

Overexertion ... ... ...

Poisoning E962(.0–.9) E980.0–E982.9 E972 

Struck by or against E960.0, E968.2 ... E973, E975 

Suffocation E963 E983(.0–.9) ...

Other specified, 

classifiable

E960.1, E965(.5–.9), E967(.0–

.9), E968.4 E985.5, E988(.0,.4) E971, E978, E990–E994, E996, E997(.0–.2)

Other specified, not 

elsewhere classifiable E968.8, E969 E988.8, E989 E977, E995, E997.8, E998, E999

Unspecified E968.9 E988.9 E976, E997.9 

... Category not applicable (no code in cell). 1

Three fourth-digit codes (.4 [occupant of streetcar], .5 [rider of animal], and .8 [other specified person]) are not separated because of the minimal 

number of deaths in these categories. However, because they are included in the overall motor vehicle traffic category, the sum of these categories 

can be derived by subtraction. 

NOTES: ICD–9 is International Classification of Diseases, Ninth Revision. When a set of additional digits are required for ICD codes, the additional 

digits are in parentheses ( ) and apply to the preceding code or preceding range of codes in brackets [ ]. MV is motor vehicle. 

SOURCE: CDC. Recommended framework for presenting injury mortality data. MMWR 46 (RR-14). Available from: http://www.cdc.gov/mmwr/PDF/rr/

rr4614.pdf. 1997.
152 Injury in the United States: 2007 Chartbook

Table III. External cause-of-injury mortality matrix based on ICD–10 external cause-of-injury codes

Manner or intent

Mechanism of death 

(based on ICD–10) All injury Unintentional

All injury *U01–*U03, V01–Y36, Y85–Y87, Y89 V01–X59, Y85–Y86

# Cut or pierce W25–W29, W45, X78, X99, Y28, Y35.4 W25–W29, W45

# Drowning W65–W74, X71, X92, Y21 W65–W74

# Fall W00–W19, X80, Y01, Y30 W00–W19

# Fire or hot object or 

substance

*U01.3, X00–X19, X76–X77, X97–X98, Y26–Y27, 

Y36.3

X00–X19

Fire or flame X00–X09, X76, X97, Y26 X00–X09

Hot object or substance X10–X19, X77, X98, Y27 X10–X19

# Firearm *U01.4,W32–W34,X72–X74,X93–X95,Y22–Y24, 

Y35.0

W32–W34

# Machinery W24, W30–W31 W24, W30–W31

All transport *U01.1, V01–V99, X82, Y03, Y32, Y36.1 V01–V99

# Motor vehicle traffic [V02–V04](.1,.9), V09.2, [V12–V14](.3–.9), V19(.4–

.6), [V20–V28](.3–.9),[ V29–V79](.4–.9), V80(.3–.5), 

V81.1, V82.1, [V83–V86](.0–.3), V87(.0–.8), V89.2

[V02–V04](.1,.9), V09.2, [V12–V14](.3–.9), V19(.4–

.6), [V20–V28](.3–.9), [V29–V79](.4–.9), V80(.3–.5), 

V81.1, V82.1, [V83–V86](.0–.3), V87(.0–.8), V89.2

Occupant [V30–V79](.4–.9), [V83–V86](.0–.3) [V30–V79](.4–.9), [V83–V86](.0–.3)

Motorcyclist [V20–V28](.3–.9), V29(.4–.9) [V20–V28](.3–.9), V29(.4–.9)

Pedal cyclist [V12–V14](.3–.9), V19(.4–.6) [V12–V14](.3–.9), V19(.4–.6)

Pedestrian [V02–V04](.1,.9), V09.2 [V02–V04](.1,.9), V09.2

Other V80(.3–.5), V81.1, V82.1 V80(.3–.5), V81.1, V82.1

Unspecified V87(.0–.8), V89.2 V87(.0–.8), V89.2

# Pedal cyclist, other V10–V11, [V12–V14](.0–.2), V15–V18, V19(.0–

.3,.8,.9)

V10–V11, [V12–V14](.0–.2), V15–V18, V19(.0–

.3,.8,.9)

# Pedestrian, other V01, [V02–V04](.0), V05, V06, V09(.0–.1,.3,.9) V01, [V02–V04](.0), V05, V06, V09(.0–.1,.3,.9)

Other land transport [V20–V28](.0–.2), [V29–V79](.0–.3), V80(.0–.2,.6–

.9), [V81–V82](.0,.2–.9), [V83–V86](.4–.9), V87.9, 

V88(.0–.9), V89(.0,.1,.3,.9), X82, Y03, Y32

[V20–V28](.0–.2), [V29–V79](.0–.3), V80(.0–.2,.6–

.9), [V81–V82](.0,.2–.9), [V83–V86](.4–.9), V87.9, 

V88(.0–.9), V89(.0,.1,.3,.9)

Other transport *U01.1,V90–V99,Y36.1 V90–V99

# Natural or environmental W42–W43, W53–W64, W92–W99, X20–X39, 

X51–X57

W42–W43, W53–W64, W92–W99, X20–X39, 

X51–X57

# Overexertion X50 X50

# Poisoning *U01(.6–.7), X40–X49, X60–X69, X85–X90, Y10–

Y19, Y35.2

X40–X49

# Struck by or against W20–W22,W50–W52,X79,Y00,Y04,Y29,Y35.3 W20–W22, W50–W52

# Suffocation W75–W84,X70,X91,Y20 W75–W84

Other specified, 

classifiable

*U01(.0,.2,.5), *U03.0, W23, W35–W41, W44, 

W49, W85–W91, X75, X81, X96, Y02, Y05–Y07, 

Y25, Y31, Y35(.1,.5), Y36(.0,.2,.4–.8), Y85

W23, W35–W41, W44, W49, W85–W91, Y85

Other specified, not 

elsewhere classified

*U01.8,*U02,X58,X83,Y08,Y33,Y35.6,Y86–

Y87,Y89(.0–.1)

X58,Y86

Unspecified *U01.9, *U03.9, X59, X84,Y09, Y34, Y35.7, Y36.9, 

Y89.9

X59

See footnotes at end of table.
153 Injury in the United States: 2007 Chartbook

Table III. External cause-of-injury mortality matrix based on ICD–10 external cause-of-injury codes—Con.

Manner or intent

Mechanism of death 

(based on ICD–10) Suicide Homicide Undetermined Legal intervention or war

All injury *U03, X60–X84, Y87.0 *U01–*U02, X85–Y09, Y87.1 Y10–Y34, Y87.2, Y89.9 Y35–Y36, Y89(.0.–1)

# Cut or pierce X78 X99 Y28 Y35.4

# Drowning X71 X92 Y21 ...

# Fall X80 Y01 Y30 ...

# Fire or hot object or 

substance

X76–X77 *U01.3, X97–X98 Y26–Y27 Y36.3

Fire or flame X76 X97 Y26 ...

Hot object or 

substance

X77 X98 Y27 ...

# Firearm X72–X74 *U01.4, X93–X95 Y22–Y24 Y35.0

# Machinery ... ... ... ...

All transport X82 *U01.1, Y03 Y32 Y36.1

# Motor vehicle traffic ... ... ... ...

Occupant ... ... ... ...

Motorcyclist ... ... ... ...

Pedal cyclist ... ... ... ...

Pedestrian ... ... ... ...

Other ... ... ... ...

Unspecified ... ... ... ...

# Pedal cyclist, other ... ... ... ...

# Pedestrian, other ... ... ... ...

Other land transport X82 Y03 Y32 ...

Other transport ... *U01.1 ... Y36.1

# Natural or environmental ... ... ... ...

# Overexertion ... ... ... ...

# Poisoning X60–X69 *U01(.6–.7), X85–X90 Y10–Y19 Y35.2

# Struck by or against X79 Y00,Y04 Y29 Y35.3

# Suffocation X70 X91 Y20 ...

Other specified, 

classifiable

*U03.0, X75, X81 *U01(.0,.2,.5), X96, Y02, 

Y05–Y07

Y25,Y31 Y35(.1,.5), 

Y36(.0,.2,.4–.8)

Other specified, not 

elsewhere classified

X83, Y87.0 *U01.8, *U02, Y08, Y87.1 Y33, Y87.2 Y35.6, Y89(.0–.1)

Unspecified *U03.9, X84 *U01.9, Y09 Y34, Y89.9 Y35.7, Y36.9

... Category not applicable.

NOTES: ICD–10 is the International Classification of Diseases, Tenth Revision. The causes designated by # are ranked to determine leading mechanisms of injury.

When a set of additional digits are required for International Classification of Diseases codes, the additional digits are in parentheses ( ) and apply to the preceding code or 

preceding range of codes in brackets [ ]. For explanation of asterisks (*) preceding cause-of-death codes, see Appendix I, Mortality, identifying injury deaths.

SOURCE: Fingerhut L. ICD Framework: External cause of injury mortality matrix [online]. Hyattsville, MD: National Center for Health Statistics. Available from: http://www.

cdc.gov/nchs/about/otheract/ice/matrix10.htm.
154 Injury in the United States: 2007 Chartbook

Table IV. Injury Mortality Diagnosis Matrix based on ICD–10 codes used for multiple cause-of-death coding

Body region of injury

Nature of injury

Fracture Dislocation Internal organ 

injury Open wound Amputation Blood vessel Contusion or superficial Crushing

Head and neck 

Traumatic brain 

injury (TBI)

S02(.0–.1, .3, 

.7–.9), T90.2 ... S06, T90.5 S01, T90.1 ... ... ... S07

Other head S02(.2, .4–.6) S03(.0–.3) ... S05(.2–.7), 

S08.0, S09.2 S08(.1–.9) S09.0

S00, 

S05(.0–.1), 

T90.0

...

Neck S12(.8–.9) S13(.2–.3) ... S11 S18 S15(.0, .2–.9) S10 S17

Head and neck, 

other ... ... ... ... ... ... ... ...

Spine and upper 

back

Spinal cord ... ...

S14(.0–.1),

S24(.0–.1),

 S34(.0–.1, .3), 

T09.3, T91.3

... ... ... ... ...

Vertebral column

S12(.0–.7), S22

(.0–.1), S32(.0–.2), 

T08, T91.1

S13(.0–.1), 

S23(.0–.1), 

S33(.0–.2)

S14.2 ... ... S15.1 ... ...

Torso

Thorax S22(.2–.9) S23.2 S26.0, S27

(.0–.6, .8–.9), T91.4 S21 S28.1 S25 S20 S28.0

Abdomen ... ... S36 S31(.1,.8) ... S35(.0–.4) S30.1 ...

Pelvis and lower 

back S32(.3–.8) S33(.3–.4) S37 S31(.0, .2–.5) S38.2 S35.5 S30(.0, .2) S38.0

Abdomen, lower 

back & pelvis T02.1 ... S39(.6–.7), T06.5, T91.5 S31.7 S38.3 S35(.7–.9) S30(.7–.9) S38.1

Other trunk T91.2 ... ... T09.1 T09.6 ... T09.0 T04.1

Extremities

Upper extremity

S42, S52, S62, 

T02(.2, .4), T10, 

T92(.1–.2)

S43(.0–.3), 

S53(.0–.1), 

S63(.0–.2)

...

S41, S51, S61, 

T01.2, T11.1, 

T92.0

S48, S58, 

S68, T05(.0, 

.2), T11.6

S45, S55, S65, 

T11.4

S40, S50, S60, 

T00.2, T11.0

S47, S57, 

S67, T04.2

Hip S72(.0–.2) S73.0 ... S71.0 S78.0 ... S70.0 S77.0

Other lower 

extremity

S72(.3–.9), S82, 

S92, T02(.3, .5), 

T12, T93(.1–.2)

S83(.0–.1), 

S93(.0–.1, .3) ...

S71(.1–.8), S81, 

S91, T01.3, 

T13.1, T93.0

S78(.1–.9), 

S88, S98, 

T05(.3, .5), 

T13.6

S75, S85, S95, 

T13.4

S70(.1–.9), S80, 

S90, T00.3, 

T13.0

S77(.1–.2), 

S87, S97, 

T04.3

Unclassifiable by 

body region

Multiple body 

regions T02(.8–.9) ... ... T01.9 T05(.8–.9) T06.3 T00(.8–.9) T04(.8–.9)

System wide ... ... ... ... ... ... ... ...

Unspecified T14.2 ... ... T14.1 ... T14.5 T14.0 ...

See footnotes at end of table.
155 Injury in the United States: 2007 Chartbook

Table IV. Injury Mortality Diagnosis Matrix based on ICD–10 codes used for multiple cause-of-death coding—Con.

Body region of injury

Nature of injury

Burn

Effect of foreign 

bodies entering orifice

Other effects 

of external 

causes

Poisoning Toxic 

effects

Multiple 

injuries Other specified injury Unspecified injury

Head and neck 

Traumatic brain 

injury (TBI) ... ... ... ... ... S09.7 S04.0, S09.8,T90(.4, .8) S09.9, T90.9

Other head T26 T15–T16, 

T17(.0–.1), T18.0 T33.0, T34.0 ... ... ... S03(.4–.5), S04(.1–.9), S05.8, S09.1, T90.3 S05.9

Neck T27.0, T27.4 T17(.2–.4) T33.1, T34.1 ... ... S19.7 S13(.5–.6), S14(.3–.6), S16, 

S19.8 S19.9

Head and neck, 

other

T20, T28.0, 

T28.5, T95.0 ... T35.2 ... ... ... ... ...

Spine and upper 

back

Spinal cord ... ... ... ... ... ... ... ...

Vertebral column ... ... ... ... ... ...

S13.4, S23.3, S24.2, 

S33(.5–.7), S34(.2, .4), 

T09.4

...

Torso

Thorax T28(.1, .6) T17.5 T33.2, T34.2 ... ... S27.7, S29.7 S23(.4–.5), S24(.3–.6), 

S26.8, S29(.0, .8) S26.9, S29.9

Abdomen ... T18(.2–.4) ... ... ... ... ... ...

Pelvis and lower 

back T28(.3, .8) T18.5, T19 ... ... ... ... S34.5 ...

Abdomen, lower 

back & pelvis ... ... T33.3, T34.3, T35.3 ... ... T03.1 S34(.6, .8), S39(.0, .8) S39.9

Other trunk

T21, T27(.2–.3, 

.6–.7), T28(.2, 

.7), T95.1 

T17(.8–.9), 

T18(.1, .8–.9) ... ... ... T09.2 T09(.5, .8) T09.9

Extremities

Upper extremity T22–T23, T95.2 ...

T33(.4–.5), 

T34(.4–.5), 

T35.4

... ...

S49.7, S59.7, 

S69.7, T03.2, 

T11.2, 

T92(.3, .6)

S43(.4–.7), S44, S46, S49.8, 

S53(.2–.4), S54, S56, S59.8, 

S63(.3–.7), S64, S66, S69.8, 

T11(.3, .5, .8), T92(.4–.5, .8)

S49.9, S59.9, 

S69.9, T11.9, 

T92.9

Hip ... ... ... ... ... ... S73.1, S76.0 ...

Other lower 

extremity T24–T25, T95.3 ...

T33(.6–.8), 

T34(.6–.8), 

T35.5

... ...

S79.7, S89.7, 

S99.7, T03.3, 

T13.2, 

T93(.3, .6)

S74, S76(.1–.7), S79.8, 

S83(.2–.6), S84, S86, S89.8, 

S93(.2, .4–.6), S94, S96, 

S99.8,

T13(.3, .5, .8), T93(.4–.5, .8)

S79.9, S83.7, 

S89.9, S99.9, 

T13.9, T93.9

Unclassifiable by 

body region

Multiple body 

regions

T27.1, T27.5, 

T28.9 ... T35(.0–.1, .6) ... ... T03(.8–.9), T91.0 T06(.2, .4), T91.8 T07, T91.9, T94.0

System wide ... ... T66–T75 T36–T50, 

T96

T51–T65, 

T97 ... T79(.0–.9), T98.2 ...

Unspecified

T28.4, T30–

T32, T95(.4, 

.8–.9)

T98.0 T33.9, T34.9, 

T35.7 ... ... T14.3, T14.7 T14(.4, .6) T14(.8–.9), T94.1, T98.1

... Category not applicable (no code in cell).

NOTES: ICD–10 is the International Classification of Diseases, Tenth Revision. When a set of additional digits are required for ICD codes, the additional 

digits are in parentheses ( ) and apply to the preceding code or preceding range of codes in brackets [ ]. The matrix excludes the following codes that 

are not valid in the United States: T00(.0–.1, .6), T01(.0–.1, .6, .8), T02(.0, .6–.7), T03(.0, .4), T04(.0, .4, .7), T05(.1, .4, .6), T06(.0–.1, .8), and T29. Also 

excluded are codes T78, T80–T88, T98.3 for adverse effects, not elsewhere classified and complications of surgical and medical, not elsewhere classified, 

and their sequelae. 

SOURCE: Fingerhut LA, Warner M. The ICD–10 Injury Mortality Diagnosis Matrix. Inj Prev 12(1):24–9. 2006.
156 Injury in the United States: 2007 Chartbook

Table V. External cause-of-injury morbidity matrix based on ICD–9–CM external cause-of-injury codes

Mechanism or cause

Manner or intent

Unintentional Self-inflicted

All injury E800–E869, E880–E929 E950–E959

Cut or pierce E920(.0–.9) E956

Drowning or submersion E830(.0–.9), E832(.0–.9), E910(.0–.9) E954

Fall E880.0–E886.9, E888 E957(.0–.9)

Fire or burn E890.0–E899, E924(.0–.9) E958(.1–.2,.7)

Fire or flame E890.0–E899 E958.1

 Hot object or substance E924(.0–.9) E958(.2,.7)

Firearm E922(.0–.3,.8–.9) E955(.0–.4)

Machinery E919 (.0–.9) ...

Motor vehicle traffic1 [E810–E819](.0–.9) E958.5

 Occupant [E810–E819](.0–.1) ...

 Motorcyclist [E810–E819](.2–.3) ...

 Pedal cyclist [E810–E819](.6) ...

 Pedestrian [E810–E819](.7) ...

Unspecified [E810–E819](.9) ...

Pedal cyclist, other [E800–E807](.3),

[E820–E825](.6), E826(.1,.9),

[E827–E829](.1)

...

Pedestrian, other [E800–807](.2)

[E820–E825](.7),

[E826–E829](.0)

...

Transport, other [E800–E807](.0–.1,.8–.9),

[E820–E825](.0–.5,.8–.9),

E826(.2–.8),

[E827–E829](.2–.9),

E831(.0–.9), [E833.0–E845](.9)

E958.6

Natural or environmental E900.0–E909, E928(.0–.2) E958.3

 Bites and stings E905(.0–.6,.9), E906(.0–.5,.9) ...

Overexertion E927 ...

Poisoning E850.0–E869.9 E950.0–E952.9

Struck by or against E916–E917.9 ...

Suffocation E911–E913.9 E953(.0–.9)

Other specified and classifiable E846–E848, E914–E915, E918, E921(.0–.9), E922(.4–.5), 

E923(.0–.9), E925.0–E926.9

E955(.5–.7,.9), E958(.0,.4)

Other specified, not

elsewhere classifiable

E928.8, E929.8 E958.8, E959

Unspecified E887, E928.9, E929.9 E958.9

See footnotes at end of table.
157 Injury in the United States: 2007 Chartbook

Table V. External cause-of-injury morbidity matrix based on ICD–9–CM external cause-of-injury codes—Con.

Mechanism or cause

Manner or intent

Assault Undetermined Legal intervention or war

All injury E960–E969, E979, E999.1 E980–E989 E970–E978, E990–E999.0

Cut or pierce E966 E986 E974

Drowning or submersion E964 E984 ...

Fall E968.1 E987(.0–.9) ...

Fire or burn E961, E968(.0,.3), E979.3 E988(.1–.2,.7) ...

Fire or flame E968.0, E979.3 E988.1 ...

 Hot object or substance E961, E968.3 E988(.2,.7) ...

Firearm E965(.0–4), E979.4 E985(.0–.4) E970

Machinery ... ... ...

Motor vehicle traffic1 E968.5 E988.5 ...

 Occupant ... ... ...

 Motorcyclist ... ... ...

 Pedal cyclist ... ... ...

 Pedestrian ... ... ...

Unspecified ... ... ...

Pedal cyclist, other ... ... ...

Pedestrian, other ... ... ...

Transport, other ... E988.6 ...

Natural or environmental ... E988.3 ...

 Bites and stings ... ... ...

Overexertion ... ... ...

Poisoning E962(.0–.9), E979(.6–.7) E980.0–E982.9 E972

Struck by or against E960.0, E968.2 ... E973, E975

Suffocation E963 E983(.0–.9) ...

Other specified and classifiable E960.1, E965(.5–.9), E967(.0–.9), 

E968(.4,.6–.7), E979(.0–.2, .5, .8–.9) 

E985(.5–.7) E988(.0,.4) E971, E978, E990–E994, 

E996, E997(.0–.2)

Other specified, not

elsewhere classifiable

E968.8, E969, E999.1 E988.8, E989 E977, E995, E997.8, E998, 

E999.0 

Unspecified E968.9 E988.9 E976, E997.9

... Category not applicable (no code in cell). 1

Three fourth-digit codes (.4 [occupant of streetcar], .5 [rider of animal], .8 [other specified person]) are not presented separately because of small 

numbers. However, because they are included in the overall motor vehicle traffic category, the sum of these categories can be derived by subtraction.

NOTES: ICD–9–CM is International Classification of Diseases, Ninth Revision, Clinical Modification. When a set of additional digits are required for ICD 

codes, the additional digits are in parentheses ( ) and apply to the preceding code or preceding range of codes in brackets [ ]. Codes were in effect as 

of February 2007.

SOURCE: Centers for Disease Control and Prevention’s National Center for Health Statistics and National Center for Injury Prevention and Control. 

Available from: http://www.cdc.gov/ncipc/whatsnew/matrix2.htm.
158 Injury in the United States: 2007 Chartbook

Table VI. ICD–10 and ICD–9 comparability ratios according to mechanism of injury and intent of death

Mechanism and intent of death ICD–10 codes ICD–9 codes1 Comparability ratio

All injury *U01–*U03,V01–Y36,

Y85–Y87,Y89

E800–E869,E880–E929,E950–E999 1.0159

Unintentional V01–X59,Y85–Y86 E800–E869,E880–E929 1.0251

Suicide *U03,X60–X84,Y87.0 E950–E959 1.0022

Homicide *U01–*U02,X85–Y09,Y87.1 E960–E969 1.0020

Undetermined Y10–Y34,Y87.2,Y89.9 E980–E989 0.9867

Legal intervention or war Y35–Y36,Y89(.0,.1) E970–E978,E990–E999 0.9235

Cut or pierce W25–W29,W45,X78,X99,

Y28,Y35.4

E920,E956,E966,E974,E986 0.9428

Unintentional W25–W29,W45 E920 0.8049

Suicide X78 E956 0.8708

Homicide X99 E966 0.9587

Undetermined Y28 E986 *

Legal intervention or war Y35.4 E974 *

Drowning W65–W74,X71,X92,Y21 E910,E954,E964,E984 1.0269

Unintentional W65–W74 E910 1.0297

Suicide X71 E954 1.0149

Homicide X92 E964 1.0159

Undetermined Y21 E984 1.0047

Fall W00–W19,X80,Y01,Y30 E880–E886,E888,E957,E968.1,E987 1.0015

Unintentional W00–W19 E880–E886,E888 0.9991

Suicide X80 E957 1.0409

Homicide Y01 E968.1 1.0833

Undetermined Y30 E987 0.9857

Fire or hot object or substance *U01.3,X00–X19,X76–X77, 

X97–X98,Y26–Y27,Y36.3

E890–E899,E924,E958(.1–.2,.7), 

E961,E968(.0,.3), E988(.1–.2,.7),E990

0.9969

Unintentional X00–X19 E890–E899,E924 0.9987

Suicide X76–X77 E958(.1,.2,.7) 0.9675

Homicide *U01.3,X97–X98 E961,E968(.0,.3) 1.0048

Undetermined Y26–Y27 E988(.1,.2,.7) 0.9420

Legal intervention or war Y36.3 E990 *

Fire or flame X00–X09,X76,X97,Y26 E890–E899,E958.1,E968.0,E988.1 0.9975

Unintentional X00–X09 E890–E899 0.9995

Suicide X76 E958.1 0.9675

Homicide X97 E968.0 0.9951

Undetermined Y26 E988.1 0.9692

Hot object or substance X10–X19,X77,X98,Y27 E924,E958(.2,.7),E961,E968.3, 

E988(.2,.7)

0.9720

Unintentional X10–X19 E924 0.9694

Suicide X77 E958(.2,.7) *

Homicide X98 E961,E968.3 *

Undetermined Y27 E988(.2,.7) *

See footnotes at end of table.
159 Injury in the United States: 2007 Chartbook

Table VI. ICD–10 and ICD–9 comparability ratios according to mechanism of injury and intent of death—Con.

Mechanism and intent of death ICD–10 codes ICD–9 codes1 Comparability ratio

Firearm *U01.4,W32–W34,X72–X74,X93–X95, 

Y22–Y24,Y35.0

E922,E955(.0–.4),

E965(.0–.4),E985(.0–.4),E970 

1.0012

Unintentional W32–W34 E922 1.0165

Suicide X72–X74 E955(.0–.4) 1.0012

Homicide *U01.4,X93–X95 E965(.0–.4) 1.0019

Undetermined Y22–Y24 E985(.0–.4) 1.0000

Legal intervention or war Y35.0 E970 0.9196

Machinery2 W24,W30–W31 E919 0.8813

All transport *U01.1,V01–V99,X82,Y03,Y32,Y36.1 E800–848,E958.5,E988.5,E994 0.9930

Unintentional V01–V99 E800–E848 0.9929

Suicide X82 E958.5 0.9437

Homicide *U01.1,Y03 ... *

Undetermined Y32 E988.5 *

Legal intervention or war Y36.1 E994 *

Motor vehicle traffic (MVT)2 [V02–V04](.1,.9),V09.2,[V12–V14](.3–.9), 

V19(.4–.6),[V20–V28](.3–.9),[V29–V79]

(.4–.9),V80(.3–.5),V81.1,V82.1,[V83–V86] 

(.0–.3),V87(.0–.8),V89.2

E810–E819 0.9545

Occupant2 [V30–V79](.4–.9),[V83–V86](.0–.3) [E810–E819](.0-.1) 0.6191

Motorcyclist2 [V20–V28](.3–.9),V29(.4–.9) [E810–E819](.2-.3) 1.1520

Pedal cyclist2 [V12–V14](.3–.9),V19(.4–.6) [E810–E819](.6) 0.8038

Pedestrian2 [V02–V04](.1,.9),V09.2 [E810–E819](.7) 0.9535

Other specified2 V80(.3–.5),V81.1,V82.1 [E810–E819](.4,.5,.8) *

Unspecified2 V87(.0–.8),V89.2 [E810–E819](.9) 1.8753

Pedal cyclist, other2 V10–V11,[V12–V14](.0–.2),V15–

V18,V19(.0–.3,.8–.9)

[E800–E807](.3),[E820–E825] 

(.6),E826(.1,.9)

1.7477

Pedestrian, other2 V01,[V02–V04](.0),V05,V06,

V09(.0–.1,.3,.9)

[E800–E807](.2),[E820–E825] 

(.7),[E826–E829](.0) 

1.2057

Other land transport [‘V20–V28](.0–.2),[V29–V79](.0–.3),

V80 (.0–.2,.6–.9),[V81–V82](.0,.2–.9),

[V83–V86](.4–.9),V87.9,V88(.0–.9),V89 

(.0–.1,.3,.9),X82,Y03,Y32

[E800–E807](.0–.1,.8–.9), 

[E820–E825](.0–.5,.8–.9),E826 

(.2–.8),[E827–E829](.2–.9), 

E846,E958.5,E988.5

2.6292

Unintentional [V20–V28](.0–.2),[V29–V79](.0–.3),V80

(.0–.2,.6–.9),[V81–V82](.0,.2–.9),[V83–V86] 

(.4–.9),V87.9,V88(.0–.9),V89(.0–.1,.3,.9)

[E800–E807](.0–.1,.8–.9), 

[E820–E825](.0–.5,.8–.9),E826 

(.2–.8),[E827–E829](.2–.9),E846

2.7630

Suicide X82 E958.5 0.9437

Homicide Y03 ... *

Undetermined Y32 E988.5 *

Other transport *U01.1,V90–V99,Y36.1 E830–E845, E847–E848, E994 0.9098

Unintentional V90–V99 E830–E845, E847–E848 0.9098

Homicide *U01.1 ... *

Legal intervention or war Y36.1 E994 *

Natural or environmental2 W42–W43,W53–W64,W92–W99,

X20–X39,X51–X57

E900–E909,E928(.0–.2) 1.0390

Overexertion2 X50 E927 *

See footnotes at end of table.
160 Injury in the United States: 2007 Chartbook

Table VI. ICD–10 and ICD–9 comparability ratios according to mechanism of injury and intent of death—Con.

Mechanism and intent of death ICD–10 codes ICD–9 codes1 Comparability ratio

Poisoning *U01(.6–.7),X40–X49, X60–X69, 

X85–X90,Y10–19,Y35.2

E850–E869,E950–952,E962,E972,

E980–E982

1.0192

Unintentional X40–X49 E850–E869 1.0365

Suicide X60–X69 E950–E952 1.0013

Homicide *U01(.6–.7),X85–X90 E962 1.0417

Undetermined Y10–Y19 E980–E982 0.9870

Legal intervention or war Y35.2 E972 *

Struck by or against W20–W22,W50–W52,X79,Y00, 

Y04,Y29,Y35.3

E916–E917,E960.0,E968.2,E973,E975 1.0852

Unintentional W20–W22,W50–W52 E916–E917 1.0549

Suicide X79 ... *

Homicide Y00,Y04 E960.0,E968.2 1.1765

Undetermined Y29 ... *

Legal intervention or war Y35.3 E973,E975 *

Suffocation W75–W84,X70,X91,Y20 E911–E913,E953,E963,E983 1.0974

Unintentional W75–W84 E911–E913 1.2320

Suicide X70 E953 1.0025

Homicide X91 E963 1.0840

Undetermined Y20 E983 0.9016

Other specified, classifiable *U01(.0,.2,.5),*U03.0,W23,

W35–W41,W44,W49,W85–W91, 

X75,X81,X96,Y02,Y05–Y07,Y25, 

Y31,Y35(.1,.5),Y36(.0,.2,.4–.8), 

Y85

E914–E915,E918,E921,E923,E925–E926, 

E929(.0–.5),E955(.5,.9),E958(.0,.3–.4), 

E960.1, E965(.5–.9),E967,E968.4,E971, 

E978,E985.5, E988(.0,.3–.4),E991–E993, 

E996,E997(.0–.2)

0.8956

Unintentional W23,W35–W41,W44,W49, 

W85–W91,Y85

E914–E915,E918,E921,E923,E925–E926, 

E929(.0–.5) 

0.8789

Suicide *U03.0,X75,X81 E955(.5,.9),E958(.0,.3–.4) 0.9010

Homicide *U01(.0,.2,.5),X96,Y02,Y05–Y07 E960.1,E965(.5–.9),E967,E968.4 0.9730

Undetermined Y25,Y31 E985.5,E988(.0,.3–.4) *

Legal intervention or war Y35(.1,.5),Y36(.0,.2,.4–.8) E971,E978,E991–E993,E996,E997(.0–.2) 1.2000

Other specified, not elsewhere 

classified 

*U01.8,*U02,X58,X83,Y08,Y33, 

Y35.6,Y86–Y87,Y89(.0–.1)

E928.8,E929.8,E958(.6,.8),E959,E968.8,

E969,E977, E988(.6,.8),E989,E995,E997.

8,E998,E999

1.5667

Unintentional X58,Y86 E928.8,E929.8 9.0920

Suicide X83,Y87.0 E958(.6,.8),E959 1.1878

Homicide *U01.8,*U02,Y08,Y87.1 E968.8,E969 0.9605

Undetermined Y33,Y87.2 E988(.6,.8),E989 1.0800

Legal intervention or war Y35.6,Y89(.0,.1) E977,E995,E997.8,E998,E999 *

See footnotes at end of table.
161 Injury in the United States: 2007 Chartbook

Table VI. ICD–10 and ICD–9 comparability ratios according to mechanism of injury and intent of death—Con.

Mechanism and intent of death ICD–10 codes ICD–9 codes1 Comparability ratio

Unspecified *U01.9,*U03.9,X59,X84,Y09, 

Y34,Y35.7,Y36.9,Y89.9

E887,E928.9,E929.9,E958.9,E968.9,

E976,E988.9,E997.9

1.1124

Unintentional X59 E887,E928.9,E929.9 1.1293

Suicide *U03.9,X84 E958.9 1.7368

Homicide *U01.9,Y09 E968.9 1.0177

Undetermined Y34,Y89.9 E988.9 0.9960

Legal intervention or war Y35.7,Y36.9 E976,E997.9 *

* Figure does not meet standards of reliability or precision.

... Category not applicable (no code in cell). 1

ICD–9 categories in this table are not all consistent with the ICD–9 external cause of injury death matrix. The following ICD–9 codes have been 

allocated to different categories of the injury matrix so that the ICD–9 definition conforms more closely to that dictated by the ICD–10 version of this 

instrument. See list of codes below.

ICD–9 codes In the ICD–9 external cause mortality matrix, 

codes came from the following categories:

To be made compatible with ICD–10 codes, 

codes were moved to the following categories:

E990 Other specified and classifiable, legal 

intervention

Fire or hot object or substance, legal 

intervention

[E800–E807](.0,–.1,.8,–.9),[E820–E825]

(.0–.5,.8,.–9),E826(.2–.8),[E827–E829](.2–.9)

Transport, other, unintentional Other land transport, unintentional

E846 Other specified and classifiable, unintentional Other land transport, unintentional

E958.5 MVT, suicide Other land transport, suicide

E988.5 MVT, undetermined Other land transport, undetermined

E830–E832 Drowning, unintentional Other transport, unintentional

E847–E848 Other specified and classifiable, unintentional Other transport, unintentional

E994 Other specified and classifiable, legal 

intervention

Other transport, legal intervention

E958.3 Natural or environmental, suicide Other specified classifiable, suicide

E958.6 Transport, other, suicide Other specified, not elsewhere classified, 

suicide

E988.3 Natural or environmental, undetermined Other specified classifiable, undetermined

E988.6 Transport, other, undetermined Other specified, not elsewhere classified, 

undetermined

2

 Intent of death is unintentional. 

NOTES: ICD is International Classification of Diseases. When a set of additional digits are required for ICD codes, the additional digits are in 

parentheses ( ) and apply to the preceding code or preceding range of codes in brackets [ ]. The notes for footnote 1 are an expanded version 

of what is in the report cited as the source. When a set of additional digits are required for ICD codes, the additional digits are in parentheses ( ) 

and apply to the preceding code or preceding range of codes in brackets [ ]. For explanation of asterisks (*) preceding cause-of-death codes, see 

Appendix I, Mortality Statistics. 

SOURCE: Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. 

Hyattsville, MD: National Center for Health Statistics. 2006.
163 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

Following is an alphabetical listing of the definitions of 

key terms and methods used in this chartbook. 

Accident—The term accident is used in this 

chartbook to mean an unintentional injury death or 

an unintentional nonfatal event. The word is used 

sparingly because of its history of being considered by 

some to be inappropriate to describe events that are 

preventable. See the introduction for the chartbook. 

Activity—An activity is used to describe what the 

injured person was doing when the injury occurred. 

The data source is the National Health Interview 

Survey. Categories include driving, working at paid 

job, working around house or yard, attending school, 

sports, leisure activities (excluding sports), and other. 

More than one activity can be checked for the same 

episode (Figure 24).

Age—A person’s age is reported as age at last 

birthday, that is, age in completed years. Presenting 

the data by single year of age rather than 

predetermined age groups provides a level of detail 

that traditional 5- or 10-year age groupings of fatal 

and nonfatal injuries can obscure. For example, the 

commonly used age group, 15–19 years, is a poor 

choice for motor vehicle traffic death rates and other 

causes of injury; the rate at 19 years of age is three 

times the rate at 15 years of age. Combining the ages 

makes this higher rate less obvious.

Age adjustment—Age adjustment is used to compare 

risks of two or more populations at one point in time 

or one population at two or more points in time. Ageadjusted rates are computed by the direct method 

of applying age‐specific rates in a population of 

interest to a standardized age distribution to eliminate 

differences in observed rates that result from age 

differences in population composition. Age-adjusted 

rates should be viewed as relative indexes rather than 

actual measures of risk. Age-adjusted rates for two 

different outcome measures at the same point in time 

should not be compared (Figures 4, 6, and 11).

Age-adjusted rates (R’) are calculated by the direct 

method by applying unrounded age-specific rates (Ri)

to the U.S. standard population (wi

). 

The application of unrounded age-specific rates to 

the standard population differs from the current 

method used to calculate death rates in other reports 

published by the National Center for Health Statistics. 

In very few instances do the final age-adjusted rates 

differ, but when they do, they differ by no more than 

0.1 per 100,000. For example, in comparing homicide 

rates from 1984 through 2004 shown in Figure 4, 

only data year 2003 differs from what is published in 

National Vital Statistics Reports (6.1 compared with 

6.0 per 100,000 population).

Mortality

Beginning with 2003 data, the traditional standard 

million population, along with corresponding 

standard weights to six decimal places based on 

the projected year 2000 population, were replaced 

by the unrounded projected year 2000 population 

age distribution (see Table VII). The effect of the 

change is negligible and does not significantly affect 

comparability with age-adjusted rates calculated using 

the previous method (Figures 4, 6, and 11).
164 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

Table VII. United States standard population and age 

groups used to age adjust mortality data 

Age group Population

Total 274,633,642

Under 1 year 3,794,901

1–4 years 15,191,619

5–14 years 39,976,619

15–24 years 38,076,743

25–34 years 37,233,437

35–44 years 44,659,185

45–54 years 37,030,152

55–64 years 23,961,506

65–74 years 18,135,514

75–84 years 12,314,793

85 years and over 4,259,173

SOURCE: National Institutes of Health, National Cancer Institute. 

Surveillance, Epidemiology, and End Results (SEER), Standard 

population in single year of age. Available from: http://seer.cancer.

gov/stdpopulations/stdpop.singleages.html.

National Health Interview Survey—Estimates based 

on the National Health Interview Survey are age 

adjusted to the same 2000 U.S. standard population. 

Adjustment is based on 4 age groups as shown below 

with their corresponding standard population (see 

data tables for Figures 22 and 23). (See Table VIII.)

Table VIII. United States standard population and age 

groups used to age adjust National Health Interview 

Survey data

Age group Population

Total 274,633,642

Under 15 years 58,963,139

15–24 years 38,076,743

25–64 years 142,884,280

65 years and over 34,709,480

SOURCE: National Institutes of Health, National Cancer Institute. 

Surveillance, Epidemiology, and End Results (SEER), Standard 

population in single year of age. Available from: http://seer.cancer.

gov/stdpopulations/stdpop.singleages.html.

Alcohol-impaired driving—Alcohol-impaired driving 

is defined as operating a motor vehicle when legally 

intoxicated. Legally intoxicated drivers have a 

measurable or estimated blood alcohol concentration 

(BAC) of 0.08 grams per deciliter (g/dl) or above.

Trends in alcohol impaired driving are tracked using 

the proportion of fatally injured drivers who were 

legally intoxicated among all fatally injured drivers.

The Insurance Institute for Highway Safety calculates 

the proportion using the Fatality Analysis Reporting 

System (FARS), which captures the number of fatally 

injured drivers on public roads from all 50 states and 

the District of Columbia. Multiple imputation is used 

for estimating the BACs for those with missing values 

using the U.S. Department of Transportation’s multiple 

imputation model.

References:

Insurance Institute for Highway Safety. IIHS fatality facts 2005, 

alcohol. Available from: http://www.iihs.org/research/fatality_facts/

alcohol.html). 2007. 

Subramanian, R. Transitioning to multiple imputation—A new 

method to impute missing blood alcohol concentration (BAC) values 

in FARS. Technical report no. DOT HS-809-403. Washington, DC: 

U.S. Department of Transportation. 2002.

Average percent change and test of trends—

Joinpoint software, developed by the National Cancer 

Institute, was used to estimate the annual percent 

change in death rates and in hospital discharge rates. 

The software uses trend data and fits the simplest 

joinpoint model that the data allow. The user supplies 

the minimum and maximum number of joinpoints. 

The program starts with the minimum number of 

joinpoints (i.e., 0 joinpoints, which is a straight line) 

and tests whether more joinpoints are statistically 

significant and must be added to the model (up to the 

specified maximum number). This enables the user to 

test that an apparent change in trend is statistically 

significant. The tests of significance use a Monte Carlo 

Permutation method. The models used in these figures 

incorporate estimates of both the data points as well 

as the standard error of each point. Estimates were 

included and calculated using only one decimal place 

unless the standard error was greater than 0.0 but less 

than 0.5; in those cases, two decimal places were used 
165 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

for the standard errors. In addition, the models are 

linear on the log of the response (i.e., for calculating 

annual percentage rate change). Models used for the 

figures were the ones determined by Joinpoint to best 

fit the data (Figures 4, 6, 13, 15-1, and 15-2).

For details see: 

http://srab.cancer.gov/joinpoint/. 

Reference:

Kim HJ, Fay MP, Feuer EJ, Midthune DN. Permutation tests for joinpoint regression with applications to cancer rates [published correction appeared in Stat Med 20(4):655. 2001]. Stat Med 19(3):335–51. 

2000.

Barell Injury Diagnosis Matrix (Barell Matrix)—The 

matrix is a two-dimensional array of International 

Classification of Diseases, Ninth Revision, Clinical 

Modification (ICD–9–CM) diagnosis codes for injury 

(updated as of 2002) grouped by body region of the 

injury and the nature of the injury. This matrix provides 

a standard format for reporting injury data. This injury 

diagnosis matrix is a product of the participants in 

the International Collaborative Effort (ICE) on Injury 

Statistics. For more information about the Barell 

Matrix, refer to http://www.cdc.gov/nchs/about/

otheract/ice/barellmatrix.htm. The matrix was adopted 

for use by the State and Territorial Injury Prevention 

Directors Association and recommended as the basis 

for defining injury hospitalizations. The matrix is 

included in Table I (see Figures 17-1, 17-2, 18, 21, and 

26).

References: 

Barell V, Aharonson-Daniel L, Fingerhut LA, MacKenzie EJ, et al. An 

introduction to the Barell body region by nature of injury diagnosis 

matrix. Inj Prev 8:91–6. 2002.

Injury Surveillance Workgroup. Consensus recommendations for 

using hospital discharge data for injury surveillance. Marietta, GA: 

State and Territorial Injury Prevention Directors Association. 2003.

Blood alcohol concentration (BAC)—A BAC 

describes the amount of alcohol in a person’s blood, 

expressed as weight of alcohol per unit of volume 

of blood. For example, 0.08% BAC indicates 80 

mg of alcohol per 100 ml of blood. For most legal 

purposes, however, a blood sample is not necessary to 

determine a person’s BAC. It can be measured more 

simply by analyzing exhaled breath. All 50 states and 

the District of Columbia (D.C.) have laws defining it as 

a crime to drive with a BAC at or above the proscribed 

level of 0.08%. The data in Figure 13 are based on 

data from all 50 states and D.C. with imputations for 

missing BACs provided by the U.S. Department of 

Transportation’s multiple imputation model.

Reference: 

Subramanian R. Transitioning to multiple imputation—A new 

method to impute missing blood alcohol concentration (BAC) values 

in FARS. Technical report no. DOT HS-809-403. Washington, DC: 

U.S. Department of Transportation. 2002.

Body region—Body region refers to one of the two 

dimensions of the Barell Injury Diagnosis Matrix and 

the Injury Mortality Diagnosis matrix. This dimension 

classifies the part of the body that was injured and is 

based on ICD–9–CM codes in the Barell Matrix and 

ICD–10 codes in the Injury Mortality Diagnosis Matrix. 

For a detailed listing of the body regions see Table I.

Cause of death—For the purpose of national 

mortality statistics, every death is attributed to one 

underlying condition, based on information reported 

on the death certificate and using the international 

rules for selecting the underlying cause of death 

from the conditions stated on the death certificate. 

For injury deaths, the underlying cause is defined 

by the World Health Organization (WHO) as the 

circumstances of the accident or violence that 

produced the fatal injury. Generally more medical 

information is reported on death certificates than is 

directly reflected in the underlying cause of death. The 

conditions that are not selected as underlying cause of 

death constitute the nonunderlying cause(s) of death, 

also known as multiple causes of death.

Cause of death is coded according to the appropriate 

revision of the ICD. Effective with deaths occurring 

in 1999, the United States began using the Tenth 

Revision of the ICD (ICD–10) to code cause of death. 

During 1979–1998, causes of death were coded and 
166 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

classified according to the Ninth Revision (ICD–9). 

Each of these ICD revisions has produced 

discontinuities in cause-of-death trends. These 

discontinuities are measured using comparability 

ratios. These ratios are essential to the interpretation 

of mortality trends. 

For more information, see Comparability ratio.

See also Multiple-cause-of death data and injury 

diagnoses.

Reference:

Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. 

Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. 

Hyattsville, MD: National Center for Health Statistics. 2006.

Cause‐of‐death ranking—Selected causes of death 

of public health and medical importance are ranked 

according to the number of deaths assigned to 

these causes. The top-ranking causes are the leading 

causes of death. For deaths from injuries in 2004, 3 

causes ranked in the top 15 rankable causes based 

on ICD–10. They are accidents (unintentional injuries), 

intentional self-harm (suicide), and assault (homicide). 

Causes that are tied receive the same rank; the next 

cause is assigned the rank it would have received had 

the lower-ranked causes not been tied, that is, it skips 

a rank. See ICD. 

References: 

Heron MP, Smith BL. Deaths: Leading causes for 2003. National vital 

statistics reports; vol 55 no 10. Hyattsville, MD: National Center for 

Health Statistics. 2007.

NCHS. ICD–10 cause-of-death lists for tabulating mortality statistics 

(updated October 2002). NCHS instruction manual; part 9. Hyattsville, MD: National Center for Health Statistics; 2002.

Cause-of-death ranking for leading mechanisms of 

injury death—Leading mechanisms of injury death are 

ranked according to the number of deaths assigned 

to rankable mechanisms in the external cause of injury 

mortality matrix; rankable mechanisms are indicated 

by the number symbol (#) using a procedure consistent with that used to rank leading causes of death. 

Vaguely defined categories are summarily excluded 

from selection as rankable mechanisms. These include 

all categories beginning with the words ‘‘other’’ or 

“unspecified.’’ Among the remaining mechanism 

categories, decisions were made to select as rankable 

the mechanism of injury considered most useful from a 

public health perspective with the following condition: 

the rankable mechanisms must be mutually exclusive. 

If a category representing a subtotal (such as motor vehicle traffic or fire or hot object or substance) 

is selected as a rankable mechanism, its component 

parts are not selected as rankable. The external cause 

of injury mortality matrices for ICD–9 and ICD–10 are 

shown in Tables II and III.

Civilian population, civilian noninstitutionalized 

population—See Population.

Comparability ratio—About every 10 to 20 years, the 

ICD is revised to stay abreast of advances in medical 

science and changes in medical terminology. Each 

of these revisions produces breaks in the continuity 

of cause-of-death statistics. Discontinuities across 

revisions are due to changes in classification and rules 

for selecting underlying cause of death. Classification 

and rule changes affect cause-of-death trend data 

by shifting deaths away from some cause-of-death 

categories and into others. 

Comparability ratios are based on a comparability 

study in which the same deaths were coded by both 

the Ninth and Tenth Revisions. The comparability 

ratio was calculated by dividing the number of 

deaths classified by ICD–10 by the number of deaths 

classified by ICD–9. The resulting ratios represent the 

net effect of the Tenth Revision on cause-of-death 

statistics and can be used to adjust mortality statistics 

for causes of death classified by the Ninth Revision in 

1998 to be comparable with cause‐specific mortality 

statistics classified by the Tenth Revision in 1999.

The application of comparability ratios to mortality 

statistics helps make the analysis of change between 

1998 and 1999 more accurate and complete. The 1998 
167 Injury in the United States: 2007 Chartbook

comparability‐modified death rate is calculated by 

multiplying the comparability ratio by the 1998 death 

rate. Comparability‐modified rates should be used to 

estimate mortality change between 1998 and 1999. 

Comparability ratios measure the effect of changes 

in classification and coding rules. For all external 

causes of injury based on the external cause of injury 

mortality matrix, comparability ratios are shown in 

Table VI. 

For selected causes of death, the ICD–9 codes used 

to calculate death rates for 1985 through 1998 differ 

from the ICD–9 codes most nearly comparable with 

the corresponding ICD–10 cause-of-death category, 

which also affects the ability to compare death 

rates across ICD revisions. In this chartbook, rates 

for unintentional injuries and homicide in Figure 4 

and motor vehicle traffic fatalities and drowning 

in Figure 6 for 1985–1998 were recalculated using 

ICD–9 codes that are more comparable with codes for 

corresponding ICD–10 categories. The codes used can 

be found in Table VI. 

Final and preliminary comparability ratios for 113 

selected causes of death are available from: ftp://

ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/

Comparability/icd9_icd10/.

Reference: 

Anderson RN, Miniño AM, Hoyert DL, Rosenberg HM. 

Comparability of cause of death between ICD–9 and ICD–10: 

Preliminary estimates. National vital statistics reports; vol 49 no 

2. Hyattsville, MD: National Center for Health Statistics. Available 

from: http://www.cdc.gov/nchs/data/nvsr/nvsr49/nvsr49_02.pdf. 

2001.

Death rate: See Rate: Death and related rates.

Diagnosis—Diagnosis is the act or process of 

identifying or determining the nature and cause of a 

disease or injury through evaluation of patient history, 

examination, and review of laboratory data. Diagnoses 

in the National Hospital Discharge Survey, and the 

National Hospital Ambulatory Medical Care Survey 

are abstracted from medical records and coded to 

the ICD–9–CM. For a given medical care encounter, 

the first-listed diagnosis can be used to categorize 

the hospital discharge, or if more than one diagnosis 

is recorded on the survey abstraction form, the 

discharge can be categorized based on all diagnoses 

recorded. The first-listed diagnosis is often, but not 

always, considered the most important or dominant 

condition among all comorbid conditions. For 

example, a hospital discharge would be considered a 

first-listed injury discharge if an ICD–9–CM diagnosis 

code for injury was recorded in the first diagnosis 

field on the NHDS abstract form. Other discharges 

may have an injury diagnosis in one or more of the 

remaining second through seventh diagnosis fields on 

this abstract form.

See related External cause of injury, Initial injury 

emergency department visit, and Multiple cause-ofdeath data and injury diagnoses. 

Education—In survey data, educational categories are 

based on information about educational credentials, 

such as diplomas and degrees. In vital statistics, 

educational attainment is based on years of school 

completed. This chartbook does not include death 

rates by educational attainment because of a change 

in the way the data are collected in states that have 

implemented the 2003 revised death certificate. See 

http://www.cdc.gov/nchs/vital_certs_rev.htm.

National Health Interview Survey (NHIS)—Beginning 

in 1997, the NHIS questionnaire was changed 

to ask “What is the highest level of school _____ 

has completed or the highest degree received?” 

Responses were used to categorize adults according 

to educational credentials (i.e., no high school diploma 

or general educational development [GED] high 

school equivalency diploma; high school diploma 

or GED; some college, no bachelor’s degree; or 

bachelor’s degree or higher).

Emergency department—According to the National 

Hospital Ambulatory Medical Care Survey, an 

emergency department is a hospital facility that is 

Appendix II–Definitions and Methods
168 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

staffed 24 hours a day and provides unscheduled 

outpatient services to patients whose conditions 

require immediate care. Offsite emergency 

departments that are open less than 24 hours are 

included if staffed by the hospital’s emergency 

department. 

Emergency department visit—In the National 

Hospital Ambulatory Medical Care Survey, an 

emergency department visit is a direct personal 

exchange between a patient and a physician or other 

health care providers working under the physician’s 

supervision, for the purpose of seeking care and 

receiving personal health services. See related Initial 

injury emergency department visit.

Episode of injury—See Injury or poisoning episode.

Ethnicity—See Race and Hispanic origin.

External cause of injury—The external cause of 

injury is used for classifying the circumstances in which 

injuries occur. The external cause is comprised of two 

axes, the mechanism or cause (e.g. firearm or motor 

vehicle) and the manner or intent (e.g. homicide or 

suicide).

External cause of injury matrix—The matrix is a twodimensional array describing both the mechanism 

or external cause of the injury (e.g., fall, cut, or 

struck) and the manner or intent of the injury (e.g., 

unintentional or accidental, suicide or self inflicted, 

or homicide or assault). There are three versions of 

the external cause of injury matrix: two matrices for 

injury deaths—one that uses ICD–9 codes and one for 

ICD–10 codes—and one matrix for injury morbidity 

that uses ICD–9–CM codes. Each of the matrices can 

be found in Tables II, III, and V. For more information, 

see http://www.cdc.gov/nchs/about/otheract/injury/

tools.htm. 

The first matrix was developed for the ICD–9 external 

cause codes. It was jointly developed by the Injury 

Control and Emergency Health Services section of 

the American Public Health Association and the 

International Collaborative Effort (ICE) on Injury 

Statistics. The World Health Organization has reviewed 

the external cause matrix for international use and is 

now considering its inclusion as one of its standard 

cause-of-death lists.

The ICD–9 matrix was later modified to be consistent 

with ICD–10 codes. Table VI shows ICD–9 and ICD–10 

codes and the comparability ratios for each cell of the 

external cause matrix. 

The external cause matrix was developed as a 

standard framework specifically to facilitate national 

and international comparability in the presentation of 

injury mortality statistics. The mechanism describes 

the vector that transfers the energy to the body (e.g., 

fall, motor vehicle traffic accident, or poisoning). The 

intent of the injury describes whether or not the injury 

was inflicted purposefully (in some cases, intent cannot 

be determined) and, when purposefully, whether 

the injury was self-inflicted (suicide or self-harm) or 

inflicted upon another person (homicide or assault).

Classification of intent can be more difficult to assign 

than mechanism. That is, for mortality, whether or 

not a person was intentionally harming themselves 

or another is determined by the medical examiner or 

coroner. In the United States, there are instructions 

for classification of intent (http://www.cdc.gov/nchs/

data/dvs/2a-Final.pdf); however, no centralized system 

exists for assuring that these instructions are followed 

uniformly. Guidelines also exist for the classification of 

ICD–9–CM (http://www.cdc.gov/nchs/datawh/ftpserv/

ftpifcd9/icdguide07.pdf). The six categories of intent 

in ICD–9 and ICD–10 are unintentional (i.e., accident), 

homicide, suicide, undetermined, legal intervention 

and operations of war. 

References:

CDC. Recommended framework for presenting injury mortality 

data. MMWR 46 (RR-14) Centers for Disease Control and Prevention. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/00049162.htm. 1997.

Fingerhut LA, editor. Proceedings of the international collaborative 

effort on injury statistics: Volume I. DHHS Pub. No. 95–1252. Hyattsville, MD: National Center for Health Statistics. 1995.
169 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

Fingerhut L, Cox C, Warner M, et al. International comparative 

analysis of injury mortality: Findings from the ICE on injury statistics. 

Advance data from vital and health statistics; no 303. Hyattsville, 

MD: National Center for Health Statistics. 1998.

World Health Organization. Executive summary of the WHO Family 

of International Classifications Network Meeting; Reykjavik, Iceland. 

October 2004. Available from: http://www.who.int/classifications/

network/en/icelandexecutifsummary.pdf. 2004.

NCHS. ICD–10 framework: External cause-of-injury mortality matrix 

[online]. Available from: http://www.cdc.gov/nchs/about/otheract/

ice/matrix10.htm. 2002.

See reference under Cause of death, National Vital 

Statistics Reports, “Deaths: Injuries 2002” for additional references. 

Extremity injury—An injury to one of the following 

body parts: shoulder, upper arm, forearm, elbow, 

wrist, hand, fingers, hip, upper leg, thigh, knees, lower 

leg, foot, ankle, or toes. See Barell Injury Diagnosis 

Matrix and Table I as well as the Injury Mortality 

Diagnosis Matrix and Table IV.

Hospital discharge for injury—The National Hospital 

Discharge Survey defines a discharge as a completed 

inpatient hospitalization. A hospitalization may be 

completed by death or by releasing the patient to the 

customary place of residence, a nursing home, another 

hospital, or other locations. Injury discharges are those 

for which the first-listed diagnosis is defined by the 

ICD–9–CM codes in the Barell Injury Diagnosis Matrix. 

See Table I for the codes; see related Barell Injury 

Diagnosis Matrix

ICD; ICD codes—See Cause of death; International 

Classification of Diseases.

Initial injury emergency department visit—In the 

2001–2005 National Hospital Ambulatory Medical 

Care Surveys, an initial injury visit is the first visit 

to an emergency department for an injury that is 

characterized by either the first-listed diagnosis being 

a valid injury diagnosis or by a valid first-listed external 

cause of injury code regardless of the diagnosis code 

(see Tables I, V). There are visits, for example, that 

could have been associated with another condition, 

such as a mental health disorder or a musculoskeletal 

condition, or that could have been assigned a V code 

that would be included if there was a valid first-listed 

external cause of injury code. Visits for which the 

first-listed diagnosis or the first-listed external cause 

code was for a complication of medical care or for 

an adverse event are not counted as injury visits. For 

data years 2001–2004, the patient record form had a 

specific question on whether or not the visit was the 

initial one for that condition. In 2005 (and again in 

2006), the variable was dropped, and in its place, an 

imputed variable indicating that the visit was or was 

not the initial visit was included on the public use file. 

For an explanation of the methodology used to create 

the initial visit variable, see http://www.cdc.gov/nchs/

data/ahcd/initialvisit.pdf. Also, see http://www.cdc.

gov/nchs/products/pubs/pubd/hestats/injury/injury.

htm.

Advance Data from Vital and Health Statistics reports 

from the National Hospital Ambulatory Medical Care 

Survey—Emergency Department do not use the 

definition described above. For the definition used by 

the Ambulatory Care Statistics branch of NCHS, see 

http://www.cdc.gov/nchs/data/ad/ad386.pdf.

Injury—According to the Injury Surveillance 

Guidelines, an injury is the physical damage that 

results when a human body is suddenly or briefly 

subjected to intolerable levels of energy. Injury can 

be a bodily lesion resulting from acute exposure 

to energy in amounts that exceed the threshold of 

physiological tolerance, or it can be an impairment 

of function resulting from a lack of one or more 

vital elements (i.e., air, water, or warmth), as in 

strangulation, drowning, or freezing. The time 

between exposure to the energy and the appearance 

of an injury is short.

The energy causing an injury may be one of the 

following:

 Mechanical (e.g., an impact with a moving or 

stationary object, such as a surface, knife, or 
170 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

vehicle)

 Radiant (e.g., a blinding light or a shock wave 

from an explosion)

 Thermal (e.g., air or water that is too hot or 

too cold)

 Electrical

 Chemical (e.g., a poison or an intoxicating or 

mind-altering substance such as alcohol or a 

drug)

In other words, injuries are the acute, physical 

conditions listed in Chapter XIX (“Injury, poisoning, 

and certain other consequences of external causes”) 

and the circumstances under which they were 

caused as defined in Chapter XX (“External causes of 

morbidity and mortality”) in ICD–10. 

Whereas the above definition of an injury includes 

drowning (lack of oxygen), hypothermia (lack of 

heat), strangulation (lack of oxygen), decompression 

sickness or “the bends” (excess nitrogen compounds), 

and poisonings (by toxic substances), it does NOT 

include conditions that result from continual stress, 

such as carpal tunnel syndrome, chronic back pain, 

and poisoning due to infections. Mental disorders and 

chronic disability, although these may be eventual 

consequences of physical injury, are also excluded by 

the above definition. Also excluded from the definition 

of injury by international consensus are complications 

of medical or surgical care and adverse events.

Reference:

Holder Y, Peden M, Krug E, et al., editors. Injury surveillance guidelines. Geneva: World Health Organization. 2001.

Injury mortality classification changes from ICD–9 to 

ICD–10—Fundamental changes in the classification 

of injury occurred with the introduction of ICD–10, 

implemented beginning with 1999 mortality data. In 

ICD–9, codes were numeric with external causes of 

injury classified to a supplementary chapter in which 

codes were given the prefix E, hence the use of the 

term E codes to denote those used for external 

causes. Nature of injury codes were often referred to 

as N codes. In ICD–10, the terms E code and N code 

are no longer appropriate to describe injury mortality 

because all ICD–10 codes are alphanumeric, each 

beginning with a letter of the alphabet followed by 

numbers (E codes in ICD–10 would include endocrine, 

nutritional, and metabolic diseases found in Chapter 

IV of the ICD; N codes would refer to diseases of the 

genitourinary system found in Chapter XIV). External 

cause-of-death codes in ICD–10 begin with letters: 

*U, V, W, X or Y. Nature-of injury and poisoning codes 

begin with letters S or T. 

Another important difference in the classification 

of injury mortality introduced with ICD–10 involves 

changes in the way the codes are organized. In 

ICD–10, transport accidents are grouped by the 

characteristics of the injured person (e.g., pedestrian 

[V01–V09], pedal cyclist [V10–V19], or car occupant 

[V40–V49]). In ICD–9, transport accidents were 

grouped by the type of vehicle involved in the 

accident (e.g., railway accidents [E800–E807], motor 

vehicle traffic [E810–E819], and water transport 

accidents [E830–E838]. Nature-of-injury codes are 

also organized differently in ICD–10 and are grouped 

according to the site of the injury (e.g., head [S00–

S09], neck [S10–S19], and ankle and foot [S90–S99]). In 

ICD–9, nature-of-injury codes were grouped according 

to the type of injury, (e.g., fractures [800–829], 

intracranial injury [850–854], and open wound [870–

897]). 

Although ICD–10 is generally more detailed, some 

external cause categories have less specificity in 

ICD–10. ICD–10 codes for unintentional poisonings 

(X40–X49) are substantially less detailed than they 

were in ICD–9 (E850–E869). For example, ICD–10 

code X41 (accidental poisoning by and exposure to 

antiepileptic, sedative-hypnotic, anti-Parkinsonism, 

and psychotropic drugs) would be roughly comparable 

to ICD–9 codes E851 (barbiturates), E852.0–E852.9 

(various other sedatives and hypnotics), E853.0–

E853.9 (various tranquilizers), E854.0 (antidepressants), 

E854.2 (psychostimulants), E854.3 (central nervous 
171 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

system stimulants), and E855.0 (anticonvulsant and 

anti-Parkinsonism drugs). In ICD–10, carbon monoxide 

cannot be uniquely identified using the assigned 

external cause code X47 (accidental poisoning by and 

exposure to other gases and vapors). In ICD–9, codes 

E868.0–E868.9 involve categories of carbon monoxide 

poisoning. Fortunately, much of the poisoning detail 

lost in the external cause codes in ICD–10 can be 

regained by using multiple-cause poisoning codes (in 

Chapter XIX, ‘‘Injury and Poisoning’’) in combination 

with the external cause codes. For example, an 

underlying cause coded to X47 with T58 in the 

multiple cause data would indicate poisoning by 

carbon monoxide. Unintentional firearm categories 

(W32–W34) are also somewhat less detailed in ICD–10 

than in ICD–9 (E922.0–E922.9).

In some cases, comparable ICD–10 codes do not 

exist for categories in ICD–9. For example, E887 

(fracture, cause unspecified) is assigned in ICD–9 

when a fracture is specified on the death certificate 

without specificity regarding the external cause of the 

fracture. This category was often grouped in ICD–9 

with unintentional falls, assuming that the unspecified 

external cause would be, in most instances, a fall. In 

ICD–10, no such category exists and these deaths 

would be classified to X59 (exposure to unspecified 

factor), a much less specific category and one not 

amenable to grouping with unintentional falls.

More detailed analysis of changes in injury mortality 

coding between ICD–9 and ICD–10 is possible using 

the comparability data file published by NCHS and 

available on the NCHS website. This data file contains 

individual 1996 mortality records coded by both ICD–9 

and ICD–10. 

References:

World Health Organization. Manual of the International Statistical 

Classification of Diseases, Injuries, and Causes of Death, Ninth Revision. Geneva: World Health Organization. 1977.

World Health Organization. International Statistical Classification 

of Diseases and Related Health Problems, Tenth Revision. Geneva: 

World Health Organization. 1992.

NCHS. Comparability of cause-of-death between ICD revisions. 

Data Warehouse. Hyattsville, MD: National Center for Health 

Statistics. Available from: http://www.cdc.gov/nchs/datawh/statab/

unpubd/comp.htm#A%20guide%20 to20state%20implementation%

20of%20ICD–10. 2007.

Injury Mortality Diagnosis (IMD) Matrix—The IMD 

matrix categorizes the nearly 1,200 injury diagnosis 

codes from ICD–10’s Chapter XIX (S and T codes, 

excluding adverse effects and complications of medical and surgical care [T79, T80–T88, T98.3]) by body 

region and nature of the injury. At its most detailed 

level, the ICD–10 matrix has 19 nature-of-injury 

categories and 43 body-region categories. For most 

analyses of mortality data, similar categories can be 

aggregated to reduce the categories to those most 

meaningful for mortality. For purposes of this report, 

16 nature-of-injury categories and 17 body-region 

categories are presented. The body regions can be 

further combined into five groups; this is often useful for analyses using additional dimensions, such as 

external cause or age (see Table IV). 

The ICD–10 IMD Matrix is similar in structure to the 

Barell Injury Diagnosis Matrix that categorizes ICD–9–

CM injury morbidity codes by body region and nature 

of injury. However, the ICD–10 matrix is adapted for 

use with mortality data, which tend to be less detailed 

than morbidity data, and also takes into account 

important changes related to the revision of the ICD 

classification scheme. See http://www.cdc.gov/nchs/

about/otheract/ice/injury_matrix10.htm. See also 

Multiple-cause-of-death data and injury diagnoses.

Reference:

Fingerhut LA, Warner M. ICD–10 Injury Mortality Diagnosis Matrix. 

Inj Prev 2006 12(1):24–9.

Injury or poisoning episode—An injury episode in 

the National Health Interview Survey refers to the 

traumatic event in which a person was injured one or 

more times from an external cause (e.g., a fall or a 

motor vehicle traffic accident). A poisoning episode 

refers to the event resulting from ingestion of or 

contact with harmful substances, as well as overdoses 

or wrong use of any drug or medication. 
172 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

Injury severity for hospital discharges—The injury 

severity measure used in Figure 15-2 was empirically 

derived based on threat to life. Survival risk ratios 

(SRRs) were calculated for Figure 15-2 by dividing the 

number of alive discharges with a given ICD–9–CM 

injury diagnosis code by the number of discharges 

with that diagnosis code. Discharges from the National 

Hospital Discharge Survey for 1988–2005 with a 

first-listed diagnosis of injury and no other injury 

diagnoses (i.e., isolated injury diagnoses) were used in 

the calculations. The resulting SRRs are referred to as 

independent SRRs. The reason for using independent 

SRRs instead of traditional SRRs (i.e., both isolated and 

multiple injury diagnoses) is to avoid the problem that 

patients with multiple injuries could have more serious 

injuries contributing to the calculation of the SRRs 

of minor injuries. This would cause minor injuries to 

appear more serious than if they occurred alone. For 

diagnoses that were never isolated (i.e., only occurred 

with other diagnoses), SRRs could not be calculated.

For discharges with multiple injury diagnoses, the 

diagnosis with the lowest SRR (i.e., lowest probability 

of survival) was used to determine severity. The 

choice of the lowest SRR as the indicator of severity 

is based on the work of Kilgo et al., which compared 

summary measures of severity and found that the 

worst injury (i.e., lowest SRR) best predicted mortality. 

The categorization of injury severity shown in Figure 

15-2 was developed for this figure. Least severe 

include injury discharges where all injury diagnoses 

have a SRR of less than 0.995 (i.e. probability of 

survival of more than 99.5%). Moderately severe 

include injury discharges where the lowest SRR 

among the injury diagnoses is between 0.995 and 

0.95. Most severe include injury discharges where 

the lowest SRR among the injury diagnoses is 0.95 

or lower. In addition to the likelihood of survival, the 

proportions of hospitalized patients in each group 

were considered. Currently no standard set of SRRs for 

injury severity levels has been developed. 

References:

Meredith JW, Kilgo PD, Osler TM. Independently derived survival 

risk ratios yield better estimates of survival than traditional survival 

risk ratios when using the ICISS. J Trauma. 55(5):933–8. 2003.

Kilgo PD, Osler TM, Meredith JW. The worst injury predicts mortality outcome the best: Rethinking the role of multiple injuries in 

trauma outcome scoring. J Trauma. 55(4):599–607. 2003.

Intent of injury—Intent refers to one of the two 

dimensions of the external cause of injury matrix. 

This dimension classifies manner of the injury (e.g., 

unintentional or accidental, suicide or self inflicted, 

homicide or assault, or undetermined) in three 

versions of the external cause of injury matrix: two for 

injury deaths—one that uses ICD–9 codes and one 

that uses ICD–10 codes—and one matrix for injury 

morbidity that uses ICD–9–CM codes. For a detailed 

listing of the intent ICD codes, see Tables II, III, and V.

International Classification of Diseases (ICD)—The 

ICD provides the ground rules for coding and 

classifying cause-of-death data. The ICD is developed 

collaboratively by the World Health Organization 

and 10 international centers, one of which is housed 

at NCHS. The purpose of the ICD is to promote 

international comparability in the collection, 

classification, processing, and presentation of health 

statistics. Since 1900, the ICD has been modified 

about once every 10 years, except for the 20-year 

interval between ICD–9 and ICD–10. The purpose 

of the revisions is to stay abreast with advances in 

medical science. New revisions can introduce major 

disruptions in time series of mortality statistics, but in 

general, this has not been the case for injury deaths. 

For more information, see http://www.cdc.gov/nchs/

about/major/dvs/icd10des.htm. See related Cause of 

death; Comparability ratio; ICD–9–CM.

ICD–9–CM—The ICD–9–CM is based on and is 

compatible with the World Health Organization’s 

ICD–9. The United States currently uses ICD–9–CM to 

code morbidity diagnoses and inpatient procedures. 

ICD–9–CM consists of three volumes. Volumes 1 and 

2 contain the diagnosis tabular list and index. Volume 

3 contains the procedure classification (tabular and 

index combined).
173 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

ICD–9–CM is divided into 17 chapters and 2 

supplemental classifications. The chapters are 

arranged primarily by body system. There is a chapter 

for injuries that is arranged by nature of injury 

rather than by body region of injury. One of the two 

supplemental classifications is external causes of injury 

and poisoning (E Codes). 

ICD–9–CM is used for coding of patient diagnoses 

in the National Ambulatory Medical Care Survey, the 

National Hospital Ambulatory Medical Care Survey, 

the National Hospital Discharge Survey, and for coding 

the respondent’s verbatim responses in the National 

Health Interview Survey.

International Collaborative Effort (ICE) on Injury 

Statistics—This is one of several international 

activities sponsored by NCHS. The goal is to provide 

a forum for international exchange and collaboration 

among injury researchers who develop and promote 

international standards in injury data collection and 

analysis. A secondary goal is to produce products of 

the highest quality to facilitate the comparability and 

improved quality of injury data. The mission of the 

Injury ICE is to improve international comparability 

and quality of injury data. The ultimate aim is to 

provide the data needed to better assess the causes 

and consequences of injury, differences in injury 

occurrence over time and place, and the most 

effective means of prevention and control. See http://

www.cdc.gov/nchs/advice.htm.

Lifetime medical treatment costs— Medical 

treatment costs are calculated differently for fatalities, 

hospitalized injuries, and nonhospitalized injuries. 

Fatality costs take into account where the death 

occurred and can include costs for the coroner or 

medical examiner, transport of the victim, emergency 

department treatment, hospital treatment, and 

nursing home care. Hospitalized injury costs can 

include inpatient facility charges, nonfacility costs of 

an inpatient stay, hospital readmission costs, hospital 

rehabilitation costs, nursing home costs, short-tomedium term noninpatient costs, costs beyond 18 

months, and transport costs. Nonhospitalized injury 

costs are based on primary treatment location and 

include medical and transport costs. Estimates for 

mental health and psychological treatment due to 

injury are not available and are therefore not included 

in this cost. 

Reference:

Finkelstein E, Corso P, Miller T. The Incidence and Economic Burden 

of Injuries in the United States. New York, NY: Oxford University 

Press. 2006. 

Lifetime productivity costs—These costs include 

lost wages, lost fringe benefits, and the lost ability to 

perform household responsibilities. Calculations differ 

for nonfatal and fatal injuries. For nonfatal injuries, 

there are two categories of productivity losses: shortterm, which are losses during the first six months after 

injury, and long-term, which are the losses occurring 

after the first six months. Fatal productivity costs are 

estimated by calculating expected lifetime earnings by 

age and sex. This cost also includes an imputed value 

for lost household services.

Reference:

Finkelstein E, Corso P, Miller, T. The Incidence and Economic Burden 

of Injuries in the United States. New York, NY: Oxford University 

Press. 2006. 

Logarithmic scale—A logarithmic scale is a scale used 

to emphasize relative changes in numbers. The choice 

of a linear or logarithmic (log) scale depends on what 

the analyst or author wants to emphasize about the 

graph for the audience—either the absolute or the relative changes in numbers. The absolute change is the 

arithmetic difference between two values. The relative 

change is the percent difference between two values. 

The linear scale is the scale most frequently used and 

recognized, and it emphasizes the absolute changes 

between data points over time. Logarithmic scales, on 

the other hand, emphasize the relative or percentage 

change between data points. Equal distances on a 

log scale represent an equal percentage change. This 
174 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

feature makes a log graph particularly useful for showing rates of change in data. In addition, trends can be 

shown on a log scale to enable measures with large 

differences in magnitude to be shown on the same 

chart. One potential disadvantage to using the log 

scale is that the absolute magnitude of changes may 

appear less dramatic.

To properly interpret data on a log scale, the following 

points should be kept in mind:

1. A sloping straight line indicates a constant rate (not 

amount) of increase or decrease in the values.

2. A horizontal line indicates no change.

3. The slope of the line indicates the rate of increase 

or decrease.

4. Parallel lines, regardless of their magnitude, depict 

similar rates of change.

References:

Page RM, Cole GE, Timmreck TC. Basic Epidemiological Methods 

and Biostatistics: A Practical Guidebook. Sudbury, Massachusetts: 

Jones and Bartlett Publishers. 1995.

Jekel JF, Elmore JG, Katz DL. Epidemiology biostatistics and preventive medicine. Philadelphia, PA: W.B. Saunders Company. 1996.

Mechanism of injury—This refers to one of the two 

dimensions of the external cause of injury matrix. This 

dimension classifies external cause of the injury (e.g., 

fall, cut, or struck) in three versions of the external 

cause of injury matrix: two for injury deaths—one that 

uses ICD–9 codes and one that uses ICD–10 codes—

and one matrix for injury morbidity that uses ICD–9–

CM codes. For a detailed listing of the codes used to 

classify mechanism see Tables II, III, and V.

Multiple-cause-of-death data and injury diagnosesInjury mortality diagnosis data that are found in the 

multiple-cause fields of each record are presented 

using the ICD–10 Injury Mortality Diagnosis Matrix. 

Multiple-cause-of-death data allow for more than 

one injury diagnosis code per death. Multiple-causeof-death data can be summarized in several ways; in 

this report, multiple-cause-of-death data are shown 

as weighted total mentions. Using this method, each 

injury diagnosis is given equal weight within a death 

and each death is counted equally. For example, if 

the death includes mention of a superficial injury and 

a traumatic brain injury, each is given a weight of onehalf.

References:

Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. 

Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. 

Hyattsville, MD: National Center for Health Statistics. 2006.

Fingerhut LA, Warner M. ICD–10 Injury Mortality Diagnosis Matrix. 

Inj Prev 12(1):24–9. 2006.

Finkelstein E, Corso P, Miller T. The Incidence and Economic Burden 

of Injuries in the United States. New York, NY: Oxford University 

Press. 2006. 

Nature of injury—Nature of injury refers to one of the 

two dimensions of the Barell Injury Diagnosis Matrix 

and of the Injury Mortality Diagnosis (IMD) Matrix. This 

dimension classifies the nature of injury and is based 

on ICD–9–CM codes in the Barell matrix and ICD–10 

codes in the IMD Matrix. For a detailed listing of the 

codes used in both matrices, see Tables I and IV.

Occupational injury fatality rates—The Census of 

Fatal Occupational Injuries (CFOI) publishes annual 

fatality rates for persons 16 years of age and over 

to be consistent with the employment data (the 

denominator of the rates) from the Current Population 

Survey. However, the number of deaths is published 

for all persons regardless of age because of CFOI 

disclosure rules. Thus, in order to calculate a 2-year 

average annual rate for the population 16 years of age 

and over (as shown in Figure 12), deaths for persons 

16 years of age and over for the 2-year period had to 

be derived by weighting the published annual rates by 

the population of employed workers.

Outpatient visit—In the National Hospital 

Ambulatory Medical Care Survey (NHAMCS), an 

outpatient department visit is a direct personal 

exchange between a patient and a physician or other 

health care provider working under the physician’s 

supervision for the purpose of seeking care and 

receiving personal health services. Beginning with data 

year 2005, the outpatient department component 
175 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

of the NHAMCS no longer collects information on 

the external cause of injury. See related Emergency 

department visit.

Place of occurrence—In the National Health Interview 

Survey, place of occurrence refers to the place where 

the injury occurred. Categories include home (inside), 

home (outside), school/child care center/preschool, 

hospital/residential institution, street/highway/parking 

lot, sport facility/recreation area/lake/river/ocean, 

industrial/construction area, trade/service area, other 

public building, and other (Figure 24).

Population—The U.S. Census Bureau collects and 

publishes data on populations in the United States 

according to several different definitions. Various 

statistical systems then use the appropriate population 

for calculating rates. 

Resident population—This population is used as 

the denominator for death rates. It includes persons 

whose usual place of residence (i.e., the place where 

one usually lives and sleeps) is in one of the 50 states 

or the District of Columbia. It includes members of 

the Armed Forces stationed in the United States and 

their families. It excludes international military, naval, 

and diplomatic personnel and their families located 

in this country and residing in embassies or similar 

quarters. Also excluded are international workers and 

international students in this country and U.S. citizens 

living abroad. Populations for 2003 and 2004, used for 

many of the figures, are shown in Table IX. 

Civilian population—The civilian population is the 

resident population excluding members of the 

Armed Forces. However, families of members of 

the Armed Forces are included. This population 

is the denominator in rates calculated for the 

National Hospital Discharge Survey as used in this 

chartbook. Emergency department (ED) visit rates 

are also based on this population rather than the 

civilian noninstitutionalized population because 

institutionalized populations (such as those in nursing 

homes or in prisons) use EDs. Populations for 2004 

and 2005, used for many of the figures, are shown in 

Table X.

Civilian noninstitutionalized population—This is the 

civilian population not residing in institutions such 

as correctional institutions, detention homes, and 

training schools for juvenile delinquents; homes for 

aged and dependent persons (e.g., nursing homes 

and convalescent homes); homes for dependent and 

neglected children; homes and schools for mentally 

or physically handicapped persons; homes for unwed 

mothers; psychiatric, tuberculosis, and chronic 

disease hospitals; and residential treatment centers. 

The National Health Interview Survey samples this 

population. Populations for 2004 and 2005, used for 

many of the figures, are shown in Table XI.

For additional detail on populations as denominators, 

see Appendix I, Population Census and Population 

Estimates and Health, United States, Appendix at 

http://www.cdc.gov/nchs/hus.htm.

Table IX. United States resident population by age group, 

2003–2004

Age group 2003–2004 combined 

populations

Total 584,466,193

Under 1 year 8,080,793

1–4 years 31,759,754

5–14 years 81,719,365

15–24 years 82,907,268

25–34 years 79,904,535

35–44 years 88,479,246

45–54 years 82,423,404

55–64 years 56,978,659

65–74 years 36,800,517

75–84 years 25,839,554

85 years and 

over

9,573,098

SOURCE: National Center for Health Statistics. Bridged-race 

vintage 2004 postcensal population estimates of the resident 

population of the United States for July 1, 2000, through July 1, 

2004, by year, county, single-year of age, bridged-race, Hispanic 

origin, and sex (pcen_v2004.txt), prepared under a collaborative 

agreement with the U.S. Census Bureau. Available from: http://www.

cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm. 2005.
176 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

National Center for Health Statistics. Bridged-race vintage 2003 

postcensal estimates of the resident population of the United 

States for July 1, 2000–July 1, 2003, by year, county, single year 

of age, bridged-race, Hispanic origin and sex (pcen_v2003.txt), 

prepared under a collaborative arrangement with the U.S. Census 

Bureau. Available from: http://www.cdc.gov/nchs/about/major/dvs/

popbridge/popbridge.htm. 2004.

Table X. United States civilian population by age group, 

2004–2005

Age group 2004–2005 combined populations

Total 587,608,640

Less than 15 years 121,522,256

15–24 years 82,769,245

25–44 years 166,784,057

45–64 years 143,448,984

65–74 years 37,103,285

75 years and over 35,980,813

SOURCE: Population data are from unpublished tabulations of the 

U.S. Census Bureau, which can be found on CD-ROMs released by 

CDC/NCHS, National Hospital Discharge Survey.

Table XI. United States civilian, noninstitutionalized 

population by age group, 2004–2005

Age group 2004–2005 combined 

populations

Total 579,395,708

Less than 15 years 121,423,927

15–24 years 81,626,002

25–44 years 164,233,264

45–64 years 142,475,064

65–74 years 36,696,535

75 years and over 32,940,916

SOURCE: Population data are derived from the National Health 

Interview Survey. See Appendix I.

Race and Hispanic origin—Federal data systems have 

different methods for assigning race and Hispanic 

origin. In this chartbook, two figures include these 

variables, one from the National Vital Statistics System 

and one from the National Health Interview Survey.

National Vital Statistics System—Mortality data

Most states are in the process of revising their 

death certificates to conform to the most recent 

standards on race and ethnicity. These 1997 Office 

of Management and Budget (OMB) standards for 

classification of individuals by race within the federal 

government’s data systems have five racial groups: 

American Indian or Alaska Native, Asian, Black or 

African American, Native Hawaiian or Other Pacific 

Islander, and White (Revisions to the Standards for the 

Classification of Federal Data on Race and Ethnicity. 

Federal Register 62:58781-90. 30 Oct 1997). During 

the transition to full implementation of the 1997 

standards, vital statistics data will continue to be 

presented for the four major race groups—white, 

black or African American, American Indian or Alaska 

Native, and Asian or Pacific Islander—in accordance 

with the original 1977 standards. 

Data in Figure 10 and the accompanying data table 

are reported as Hispanic, non-Hispanic white, black, 

American Indian or Alaska Native, and Asian or Pacific 

Islander. Hispanic or Latino origin includes persons 

of Mexican, Puerto Rican, Cuban, Central and South 

American, and other or unknown Latin American 

or Spanish origins. Persons of Hispanic origin may 

be of any race. Starting in 1997, Hispanic origin of 

decedent was reported by all 50 states and the District 

of Columbia. 

Quality of race and Hispanic origin data in mortality 

statistics—Information about the race and Hispanic 

ethnicity of the decedent is reported by the funeral 

director as provided by an informant, often the 

surviving next of kin, or, in the absence of an 

informant, on the basis of observation. Death rates 

by race and Hispanic origin are based on information 

from death certificates (numerators of the rates) and 

on population estimates from the U.S. Census Bureau 

(denominators). Race and ethnicity information 

from the census is by self-report. To the extent that 

race and Hispanic origin are inconsistent between 

these two data sources, death rates will be biased. 

Studies have shown that persons self-reported as 

American Indian, Asian, or Hispanic on census and 

survey records may sometimes be reported as white 

or non-Hispanic on the death certificate, resulting in 

an underestimation of deaths and death rates for the 
177 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

American Indian, Asian, and Hispanic groups. Bias 

also results from undercounts of some population 

groups in the census, particularly young black males, 

young white males, and elderly persons, resulting 

in an overestimation of death rates. The net effects 

of misclassification and undercover age result in 

overstated death rates for the white population 

and black population estimated at 1% and 5%, 

respectively; understated death rates for other 

population groups are estimated as follows: American 

Indians, 21%; Asian or Pacific Islanders, 11%; and 

Hispanics, 2%.

For more information, see Rosenberg HM, Maurer JD, 

Sorlie PD, et al. Quality of death rates by race and 

Hispanic origin: A summary of current research, 1999. 

National Center for Health Statistics. Vital Health Stat. 

2(128) 1999.

For more information on coding race using vital 

statistics, see National Center for Health Statistics, 

Technical Appendix. Vital Statistics of the United 

States, Vol. I, Natality, and Vol. II, Mortaltity, Part 

A, available from http://www.cdc.gov/nchs/nvss.

htm. See related Appendix I, Population Census and 

Population Estimates. 

National Health Interview Survey—The categories for 

race are consistent with 1997 OMB federal standards 

as discussed above. Hispanic refers to all persons who 

are of Hispanic or Latino origin and may be of any race 

or combination of races. In the NHIS, questions on 

Hispanic origin precede questions on race. Figure 23 

and its accompanying data table report Hispanic, nonHispanic white, and non-Hispanic black. Non-Hispanic 

persons of a given race (in this instance, white or 

black) indicated that they were not of Hispanic or 

Latino origin and only indicated the single race group. 

In addition, Appendix II of Health, United States, 

2007 has more detailed information on the history 

of race and Hispanic origin classification in all NCHS 

data systems; see http://www.cdc.gov/nchs/data/hus/

hus07.pdf#tocappii.

Rate—A rate is a measure of some event, disease, 

or condition in relation to a unit of population, along 

with some specification of time. See related Age 

adjustment; Population.

Death rate—This is calculated by dividing the number 

of deaths in a population in a year by the midyear 

resident population. For census years 1990 and 2000, 

death rates are based on the enumerated census 

counts of the resident population as of April 1. For 

the noncensus years 1985–1989 and 1991–1999, rates 

were based on national intercensal estimates of the 

resident population as of July 1. For the noncensus 

years 2001–2004, rates were based on national 

postcensal estimates of the resident population as 

of July 1. Death rates are expressed as the number 

of deaths per 100,000 population. Annual percent 

changes in death rates shown in Figures 4 and 6 

are based on rounded rates as necessitated by the 

software used to calculate change. See related, 

Average percent change and test of trends.

Relative standard error—The relative standard error 

(RSE) is a measure of an estimate’s reliability. The RSE 

of an estimate is obtained by dividing the standard 

error of the estimate (SE(r)) by the estimate itself (r). 

This quantity is expressed as a percentage of the 

estimate and is calculated as follows:

RSE = 100 x (SE(r)/r)

Estimates with large RSEs are considered unreliable. In 

this chartbook, the following guidelines were followed.

For mortality data, the following rules were applied 

based on the number of deaths.

Number of deaths < 20 Show asterisk in place of 

number or rate.

Number of deaths ≥ 20 Show number or rate with 

no asterisk.

This criterion corresponds to an approximate RSE of 

22%.
178 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

For the National Health Interview Survey, National 

Hospital Discharge Survey, National Hospital 

Ambulatory Medical Care Survey, and National 

Ambulatory Medical Care Survey, the following rules 

were applied based on the RSE of estimates:

RSE > 30% Show asterisk in place of number 

or rate.

20% ≤ RSE ≤ 30% Show number or rate with an 

asterik. 

RSE < 20% Show number or rate with no 

asterisk.

Rounding of estimates—Data shown in text are 

sometimes rounded to the nearest whole number, 

whereas the data table shows numbers rounded to 1 

decimal place. The whole number in the text is based 

on the unrounded estimate. For example, if the data 

table shows 10.5, that may be the result of an estimate 

of 10.476. The whole number in the text would be 10. 

The only exceptions to data tables showing more than 

1 decimal place occur when the standard error (SE) is 

greater than 0.0 but less than 0.5; those SEs are shown 

to 2 decimal places.

Significance testing—When testing the difference 

between two rates, R1 and R2, the normal 

approximation may be used to calculate a test 

statistic, Z, such that 

Z = (R1 - R2)/SQRT (SE(R1)

2+ SE(R2

)

2

)

If │Z│ ≥ 1.96, then the difference between the rates 

is considered statistically significant at the 0.05 level. 

If │Z│< 1.96, then the difference is not considered 

statistically significant. 

Standard error—Standard error is a measure of an 

estimate’s random variability. For each figure in this 

chartbook, the accompanying data table includes the 

data point graphed as well as the standard error (SE) 

of the data point. The SE associated with crude and 

age-specific death rates assumes that the population 

denominator is a constant. The SE of a death rate is 

calculated as

where D is the number of deaths and R is the rate. In 

some figures, standard errors are shown for percents 

of deaths; these are calculated as SQRT(p*(1-p)/n), 

where p is the percent and n is the number of deaths 

in the denominator. For age-adjusted death rates, the 

SE is calculated as

See “Deaths: Injuries, 2002” reference below.

See Age adjustment and Table VII.

SEs from each of the sample surveys were calculated 

using SUDAAN software, which uses a first-order 

Taylor series approximation of the deviation of the 

estimates from their expected values.

References:

Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. 

Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. 

Hyattsville, MD: National Center for Health Statistics. http://www.

cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_10.pdf. 2006. 

Research Triangle Institute. SUDAAN (Release 9.0.1) [computer software]. Research Triangle Park, NC: Research Triangle Institute. 2005 

Urbanization—Urbanization is the degree of urban 

(city-like) character of a particular geographic area. 

This report uses the 2006 Urban-Rural Classification 

Scheme for Counties, which is a six-level classification 

scheme developed by NCHS to categorize the 

3,141 U.S. counties and county-equivalents based 

on their urban and rural characteristics. The 

classification scheme includes four metropolitan (or 

urban) categories and two nonmetropolitan (or rural) 

categories. The county classifications are based 

on the following information: 1) the 2003 OMB 

definitions of metropolitan and nonmetropolitan 

counties (with revisions through 2005); 2) the 2003 

Rural-Urban Continuum Codes developed by the 

Economic Research Service of the U.S. Department 

of Agriculture; 3) 2004 postcensal county population 
179 Injury in the United States: 2007 Chartbook

Appendix II–Definitions and Methods

estimates; and 4) county-level data on several 

settlement density, socioeconomic, and demographic 

variables from census 2000. The six categories of the 

2006 NCHS Urban-Rural Classification Scheme for 

Counties are large central metro (central counties of 

metro areas of 1 million or more population), large 

fringe metro (outlying counties of metro areas of 1 

million or more population), medium metro (metro 

areas of 250,000 to 999,999 population), small metro 

(metro areas of 50,000 to 249,999 population), 

nonmetropolitan micropolitan, and nonmetropolitan 

noncore. For more information on this classification 

scheme, see http://www.cdc.gov/nchs/r&d/rdc_

urbanrural.htm.
180 Injury in the United States: 2007 Chartbook

Related References:

Injury data overview

Fingerhut LA, Warner M. Injury Chartbook. Health, 

United States, 1996–1997. Hyattsville, MD: National 

Center for Health Statistics. 1997.

Injury classification

Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie 

EJ, et al. An introduction to the Barell body region by 

nature of injury diagnosis matrix. Inj Prev 8(2):91–6. 

2002.

CDC. Recommended framework for presenting 

injury mortality data. MMWR Recommendations and 

Reports 46(RR–14):1–30. 1997.

Fingerhut LA, Warner M. The ICD–10 injury mortality 

diagnosis matrix. Inj Prev 12(1):24–9. 2006.

Links to all frameworks for classifying injury mortality 

and morbidity: http://www.cdc.gov/nchs/about/

otheract/injury/tools.htm.

For a listing of all ICD–9, ICD–9 CM, and ICD–10 

codes for each external cause category, see Tables 

II–V. 

See Table VI for information on comparability ratios. 

Also, see the following websites: http://www.cdc.gov/

nchs/datawh/statab/unpubd/comp.htm, http://www.

cdc.gov/nchs/datawh/nchsdefs/comparabilityratio.

htm, http://www.cdc.gov/nchs/ppt/duc2004/

Fingerhut_Warner.ppt.

Urban-rural classification

Ingram DD, Franco S. 2006 NCHS urban-rural 

classification scheme for counties [online]. Available 

from: ftp://ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_Documentation/OAE/urbanrural/

methodology.doc. 2006.

Injury severity

For a discussion of measuring injury severity: 

http://www.cdc.gov/nchs/data/injury/DicussionDocu.

pdf.

International injury statistics

The website for the International Collaborative Effort 

on Injury Statistics. Available from: http://www.cdc.

gov/nchs/advice.htm.

Deaths

Anderson RN, Miniño AM, Fingerhut LA, Warner 

M, Heinen MA. Deaths: Injuries, 2001. National 

vital statistics reports; vol 52 no 21. Hyattsville, MD: 

National Center for Health Statistics. 2004.

Miniño AM, Anderson RN, Fingerhut LA, Bourdreault 

MA, Warner M. Deaths: Injuries, 2002. National 

vital statistics reports; vol 54 no 10. Hyattsville, MD: 

National Center for Health Statistics. 2006.

The National Association of Medical Examiners has a 

tutorial online for classifying injury deaths. See http://

www.thename.org and click on tutorials on the left 

hand side of the page. 

Deaths, occupational injuries

http://www.bls.gov/iif/oshcfoi1.htm

Hospital discharges

Heinen M, Hall MJ, Boudreault MA, Fingerhut LA. 

National trends in injury hospitalizations, 1979–2001. 

National Center for Health Statistics.

http://www.cdc.gov/nchs/data/injury/

InjuryChartbook79-01.pdf. March 2005.
181 Injury in the United States: 2007 Chartbook

Related References:

Emergency department visits

Fingerhut L. Recommended definition of initial injury 

visits to emergency departments

for use with the NHAMCS-ED data. Health E-Stat. 

Hyattsville, MD: National Center for Health Statistics. 

Available from: http://www.cdc.gov.nchs/products/

pubs/pubd/hestats/injury/injury.htm. November 2006.

Injury episodes, data from the National Health 

Interview Survey

http://www.cdc.gov/nchs/nhis.htm

http://www.cdc.gov/nchs/about/otheract/injury/injury_

interview.htm

Deaths and injuries: Falls

Injury Surveillance Workgroup on falls. Consensus 

recommendations for surveillance of falls and fallrelated injuries. Atlanta (GA): State and Territorial 

Injury Prevention Directors Association, 2006.

Stevens JA, Ryan G, Kresnow MS. Fatalities and 

injuries from falls among older adults—United States, 

1993–2003 and 2001–2005. MMWR 55(45):1221–4. 

2006. 

Stevens JA, Corso PS, Finkertein EA, Miller TR. The 

costs of fatal and non-fatal falls among older adults. 

Inj Prev 12(5):290–5. 2006.

For preventing falls among older adults, see http://

www.cdc.gov/ncipc/duip/preventadultfalls.htm.

Deaths and injuries: Firearms

Beaman V, Annest JL, Mercy JA, Kresnow M, Pollock 

DA. Lethality of firearm-related injuries in the United 

States population. Ann Emerg Med 35(3):258–66. 

2000.

Motor vehicle traffic accident prevention

Centers for Disease Control and Prevention: http://

www.thecommunityguide.org/mvoi/default.htm.

Motor vehicle traffic accidents, alcohol-related

National Highway Traffic Safety Administration: 

http://www.nhtsa.dot.gov/people/outreach/safesobr/

13qp/facts/factzero.html.

http://www.nhtsa.dot.gov/people/injury/alcohol/Com

munity%20Guides%20HTML/PDFs/Public_App7.pdf.

National Center for Injury Prevention and Control 

website concerning impaired driving: 

http://www.cdc.gov/ncipc/duip/spotlite/3d.htm.

National Highway Traffic Safety Administration website 

concerning impaired driving:

http://www.nhtsa.dot.gov/portal/site/nhtsa/menuitem.

18e416bf1b09b6bbbf30811060008a0c/.

Mothers Against Drunk Driving (MADD)

http://www.madd.org

Insurance Institute for Highway Safety alcohol and 

drugs website

http://www.iihs.org/research/topics/alcohol_drugs.

html