NCHS Data Brief ■ No. 385 ■ October 2020

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Motor Vehicle Traffic Death Rates Among Adolescents 

and Young Adults Aged 15–24, by Urbanicity: 

United States, 2000–2018

Sally C. Curtin, M.A., and Betzaida Tejada-Vera, M.S.

Key findings

Data from the National 

Vital Statistics System 

(NVSS)

● The death rate due to motor 

vehicle traffic (MVT) injury 

for persons aged 15–24 was 

stable from 2000 to 2006, 

declined 36% from 2006 (25.1 

per 100,000) to 2010 (16.1), 

and then was stable through 

2018 (14.7).

● Over the 2000–2018 period, 

MVT death rates for males 

aged 15–24 in rural areas were 

about twice those of males in 

urban areas; similarly, rates 

were twice as high for females 

in rural rather than urban areas.

● Although males aged 

15–24 residing in the most 

rural counties (noncore) had 

the highest MVT death rate of 

all urbanicity groups, the rate 

significantly declined from 

2006 to 2018.

● MVT death rates for females 

aged 15–24 were highest in the 

most rural counties (noncore) 

and lowest in the most urban 

counties (large central metro) 

throughout the entire period.

Deaths due to motor vehicle traffic (MVT) injury are a leading cause of death 

for adolescents and young adults aged 15–24, with death rates higher than 

for adults aged 25 and over (1). Adolescent and young adult drivers are less 

experienced, and they tend to be passengers in cars with less experienced 

drivers (2). This report presents trends in death rates due to MVT among 

persons aged 15–24 from 2000 to 2018 by sex, urban-rural classification, and 

urbanicity of county of residence.

MVT death rates for persons aged 15–24 varied over time but 

generally declined between 2000 and 2018.

● In 2018, the MVT death rate for persons aged 15–24 was 14.7 per 

100,000, which was 7% higher than the rate for persons aged 25 and over 

(13.7). This difference narrowed from 2000 when the difference in rates 

was 63% (26.3 compared with 16.1) (Figure 1).

1Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2010; stable trend from 2010 to 2018; p < 0.05. 2Rate for persons aged 15–24 from 2000 to 2018 was significantly higher than for persons aged 25 and over, p < 0.05. 3Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2010; significantly increasing trend from 2010 to 

2018; p < 0.05.

NOTES: Motor vehicle traffic injuries are identified with International Classification of Disease, 10th Revision (ICD–10) codes 

(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], and V89.2). Access data table for Figure 1 at: 

https://www.cdc.gov/nchs/data/databriefs/db385-tables-508.pdf#1. 

SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.

Figure 1. Motor vehicle traffic death rates among persons aged 15–24 and 25 and over: 

United States, 2000–2018

12pt

12pt

12pt

12pt

12pt

25 and over3

15–241,2

2000 2002 2004 2006 2008 2010 2012 2014 2016 2018

Deaths per 100,000 population 

in specified group

NCHS reports can be downloaded from: https://www.cdc.gov/nchs/products/index.htm.
NCHS Data Brief ■ No. 385 ■ October 2020

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● Death rates due to MVT injury for persons aged 15–24 and 25 and over were stable from 

2000 to 2006 but then declined 36% from 2006 to 2010 for those aged 15–24 (from 25.1 per 

100,000 to 16.1) and 21% for those aged 25 and over (from 15.9 to 12.5).

● From 2010 to 2018, rates were stable for persons aged 15–24 but increased 10% among 

those 25 and over.

MVT death rates were about twice as high in rural than urban areas for both 

males and females.

● The MVT death rate for males in rural areas was stable from 2000 to 2007 and then declined 

41% from 2007 (56.8) to 2018 (33.6). The rate declined by an average of 13.6% annually 

from 2007 (56 .8) to 2010 (36.6), and by an average of 1.4% annually from 2010 (36.6) to 

2018 (33.6) (Figure 2).

● Death rates due to MVT for males in urban areas were stable from 2000 (32.2) to 2006 

(31.3), declined 36% from 2006 to 2010 (19.9), and then remained stable through 

2018 (18.0).

● Females in urban and rural areas had similar trends in their MVT death rates over the 

period—rates declined slightly but nonsignificantly from 2000 to 2006, declined by about 

one-third from 2006 to 2010, (from 12.2 to 8.2 for urban and from 26.1 to 18.2 for rural) 

and then were stable from 2010 to 2018.

1Stable trend from 2000 to 2007; significant decreasing trend from 2007 to 2018 with different rates of change over time; p < 0.05. 2Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2010; stable trend from 2010 to 2018; p < 0.05. 

NOTES: Motor vehicle traffic injuries are identified with International Classification of Disease, 10th Revision (ICD–10) codes (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], and V89.2). Urbanicity of county of 

residence is based on the 2013 NCHS Urban-Rural Classification Scheme for Counties; see Data source and methods. In 2018, death rates for rural areas 

were significantly higher than for urban areas for both males and females, p < 0.05. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db385-tables-508.pdf#2.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.

Figure 2. Motor vehicle traffic death rates among persons aged 15–24, by sex and urban-rural classification: 

United States, 2000–2018 Deaths per 100,000 population in specified group

0

20

40

60

80

2000 2002 2004 2006 2008 2010 2012 2014 2016 2018

Female, urban2

Female, rural2

Male, urban2

Male, rural1
NCHS Data Brief ■ No. 385 ■ October 2020

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● MVT death rates for males in rural areas were about twice those of males in urban areas 

over the entire 2000 to 2018 period. Similarly, rates for females in rural areas were about 

twice those of females in urban areas.

From 2000 to 2018, MVT death rates for males aged 15–24 were highest in 

the most rural areas and lowest in most urban areas.

● The MVT death rate for males aged 15–24 in the most rural counties (noncore) was stable 

from 2000 to 2006, and then declined 46% from 2006 (73.8) to 2018 (40.1) at an average of 

13.1% annually from 2007 to 2010 and 1.7% annually from 2010 to 2018 (Figure 3).

● All urbanicity groups except the most rural (noncore) had similar MVT death rate trends for 

males aged 15–24 from 2000 to 2018—rates were stable from 2000 to 2006–2007, declined 

34%–37% through 2010, and then leveled off through 2018.

● MVT death rates for males aged 15–24 decreased with increasing urbanicity. In 2018, the 

rate for the most rural (noncore) counties (40.1) was 2.6 times higher than the rate for the 

most urban (large central metro) counties (15.6).

1Stable trend from 2000 to 2007; significant decreasing trend from 2007 to 2018 with different rates of change over time; p < 0.05. 2Stable trend from 2000 to 2007; significant decreasing trend from 2007 to 2010; stable trend from 2010 to 2018; p < 0.05. 3Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2010; stable trend from 2010 to 2018; p < 0.05. 

NOTES: Motor vehicle traffic injuries are identified with International Classification of Disease, 10th Revision (ICD–10) codes (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], and V89.2). Urbanicity of county of residence is 

based on the 2013 NCHS Urban-Rural Classification Scheme for Counties; see Data source and methods. In 2018, death rates for all urbanicity groups were 

significantly different from each other, p < 0.05. Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db385-tables-508.pdf#3. 

SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.

Figure 3. Motor vehicle traffic death rates among males aged 15–24, by urbanicity of county of residence: United States, 

2000–2018 Deaths per 100,000 population in specified group

0

20

40

60

80

2000 2002 2004 2006 2008 2010 2012 2014 2016 2018

Large central metro2

Large fringe metro3

Small and medium metro3

Micropolitan2

Noncore1
NCHS Data Brief ■ No. 385 ■ October 2020

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From 2000 to 2018, MVT death rates for females aged 15–24 were highest in 

the most rural areas and lowest in most urban areas.

● The MVT death rate for females aged 15–24 in the most rural counties (noncore) was stable 

from 2000 to 2004 and then declined 35% from 2004 (36.2) to 2010 (23.5). The rate then 

leveled off through 2018 (Figure 4).

● All urbanicity groups except the most rural (noncore) had similar MVT death rate trends 

for females aged 15–24 from 2000 to 2018—rates were stable from 2000 to 2006, declined 

30%–42% through 2010–2011, and then leveled off through 2018.

● MVT death rates for females aged 15–24 decreased with increasing urbanicity. In 2018, the 

rate for the most rural (noncore) counties (21.4) was 3.6 times higher than the rate for the 

most urban (large central metro) counties (5.9).

1Stable trend from 2000 to 2004; significant decreasing trend from 2004 to 2010, stable trend from 2010 to 2018; p < 0.05. 2Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2011, stable trend from 2011 to 2018; p < 0.05. 3Stable trend from 2000 to 2006; significant decreasing trend from 2006 to 2010, stable trend from 2010 to 2018; p < 0.05. 

NOTES: Motor vehicle traffic injuries are identified with International Classification of Disease, 10th Revision (ICD–10) codes 

(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], and V89.2). 

Urbanicity of county of residence is based on the 2013 NCHS Urban-Rural Classification Scheme for Counties; see Data source and methods. In 2018, death 

rates for all urbanicity groups were significantly different from each other, p < 0.05. Access data table for Figure 4 at: 

https://www.cdc.gov/nchs/data/databriefs/db385-tables-508.pdf#4.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.

Figure 4. Motor vehicle traffic death rates among females aged 15–24, by urbanicity of county of residence: United States, 

2000–2018

0

10

20

30

40

Large central metro3

Large fringe metro3

Small and medium metro3

Micropolitan2

Noncore1

Deaths per 100,000 population in specified group
NCHS Data Brief ■ No. 385 ■ October 2020

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Summary

MVT death rates for persons aged 15–24 and those aged 25 and over had similar trends from 

2000 to 2010, an initial stable period and then declines of 36% and 21%, respectively. Beginning 

in 2010, rates for those aged 15–24 remained stable whereas rates for those 25 and over increased 

10%. Thus, the difference in rates narrowed over the period, from 63% higher for persons aged 

15–24 in 2000 to 7% higher in 2018.

MVT death rates for persons aged 15–24 were highest among males in rural areas. However, rural 

males aged 15–24 were the only group that had a significant decline from 2007 to 2018. Rates 

for males in the other urbanicity groups and females, regardless of urbanicity, leveled off in more 

recent years.

For both males and females, those in the most rural areas (noncore) had higher rates than all other 

urbanicity areas, and rates consistently declined with increasing urbanicity. In 2018, MVT death 

rates for males residing in the most rural (noncore) counties were 2.6 times the rates for those 

residing in the most urban (large central metro) counties (40.1 compared with 15.6); likewise, 

MVT death rates for females in 2018 were 3.6 times higher for those in noncore counties than in 

large central metro counties (21.4 compared with 5.9).
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Data source and methods

Mortality and population data are from the National Center for Health Statistics’ 1999–2018 

underlying cause-of-death mortality files (CMF) (3). MVT deaths were identified using 

International Classification of Diseases, 10th Revision (ICD–10) underlying cause-of-death 

codes 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], and V89.2 (4). Death rates for each year 

were calculated using the total number of MVT deaths to persons aged 15–24 as the numerator 

and dividing by the population in that age group and multiplying by 100,000. Population data for 

2000 and 2010 are April 1 bridged-race census counts, for 2001–2009 they are July 1 intercensal 

estimates, and for 2011–2018 they are July 1 postcensal estimates based on the 2010 census.

Urbanization level of the decedent’s county of residence was categorized using the 2013 

National Center for Health Statistics Urban–Rural Classification Scheme for Counties (5). In 

this scheme, counties are classified into six urbanization levels based primarily on metropolitan–

nonmetropolitan status and population distribution. Metropolitan counties include large 

central counties, the fringes of large counties (suburbs), medium counties, and small counties. 

Nonmetropolitan counties include micropolitan statistical areas and noncore areas, including 

open countryside, rural towns (populations of less than 2,500), and areas with populations of 

2,500–49,999 that are not part of larger labor market areas. In this report, the urban or rural 

classification in Figure 2 was based on the following groupings: the urban classification contains 

the four metropolitan groups of large central, large fringe, medium and small metro; the rural 

classification contains the two nonmetropolitan groups of micropolitan and noncore. In 

Figures 3 and 4, which contain the detailed urbanicity groups, the medium and small metro 

groups were combined to simplify the findings.

Trends in MVT death rates in Figures 1–4 were evaluated using the Joinpoint Regression 

Program (6). The Joinpoint software was used to fit weighted least-squares regression models 

to the estimated proportions on the logarithmic scale. The default settings allowed for as few 

as three observed time points in the beginning, ending, and middle line segments, including the 

joinpoints. Using these settings, a maximum of three joinpoints were searched for using the grid 

search algorithm and permutation test, and an overall alpha level of 0.05. Pairwise comparisons 

between gender, urban or rural classification, and urbanicity of county were tested using the z test 

statistic at the 0.05 level of significance.

About the authors

Sally C. Curtin and Betzaida Tejada-Vera are with the National Center for Health Statistics, 

Division of Vital Statistics.
NCHS Data Brief ■ No. 385 ■ October 2020

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References

1. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital 

Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. 

Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf.

2. Young drivers: 2017 data. (Traffic Safety Facts. Report no DOT HS 812 753). National 

Center for Statistics and Analysis. Washington, DC: National Highway Traffic Safety 

Administration. 2019.

3. National Center for Health Statistics. Underlying cause of death, 1999–2018. CDC 

WONDER online database. 2016. Available from: https://wonder.cdc.gov/ucd-icd10.html.

4. World Health Organization. International statistical classification of diseases and related 

health problems, 10th revision (ICD–10). 2008 ed. Geneva, Switzerland. 2009.

5. Ingram DD, Franco SJ. 2013 NCHS urban–rural classification scheme for counties. National 

Center for Health Statistics. Vital Health Stat 2(166). 2014. Available from: https://www.cdc.gov/

nchs/data/series/sr_02/sr02_166.pdf.

6. National Cancer Institute. Joinpoint Regression Program (Version 4.7.0.0) [computer 

software]. 2019.
NCHS Data Brief ■ No. 385 ■ October 2020

Keywords: death certificates • traffic accidents • National Vital 

Statistics System

Suggested citation

Curtin SC, Tejada-Vera B. Motor vehicle 

traffic death rates among adolescents and 

young adults aged 15–24, by urbanicity: 

United States, 2000–2018. NCHS Data 

Brief, no 385. Hyattsville, MD: National 

Center for Health Statistics. 2020.

Copyright information

All 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.

National Center for Health 

Statistics

Brian C. Moyer, Ph.D., Director

Amy M. Branum, Ph.D., Acting Associate 

Director for Science

Division of Vital Statistics

Steven Schwartz, Ph.D., Director

Isabelle Horon, Dr.P.H., Acting Associate 

Director for Science

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