Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014
Authors: Rose A. Rudd, Noah Aleshire, Jon E. Zibbell, R. Matthew Gladden
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

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 MortalityRisks 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.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 MorbidityRisks 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. Recent Trends in Injury Mortality and MorbidityOverall 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.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.