Burden of Injury Full Report

8/14/2019 Burden of Injury Full Report

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The Burden of In ur in Iowa

December 2008Data from 2002-2006


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Acknowledgments

ThisreportwouldnothavebeenpossiblewithoutthesupportofBinnieLeHewattheIowaDepartmentofPublicHealth

(IDPH)andJohnLundell,CorinnePeekAsaPhD.andJamesC.TornerPhDattheUniversityofIowaInjuryPrevention

ResearchCenter

(IPRC).

The

workgroup

extends

its

appreciation

for

their

invaluable

guidance,

support

and

leadership.

Dataworkgroupmembers: Thekeymembersofthedataworkgroup,responsibleforthedataanalysisanddraftingof

thisreport,include(inalphabeticorder): SuningCao(IDPH),OusmaneDiallo(IDPH),KathyLeinenkugel(IDPH),James

TornerPhD.(IPRC),LondaVanderwal(IPRC),andTracyYoung(IPRC).

Programadvisorygroupmembers: Thefollowingindividualsassistedwiththeplanningandreviewofthereport. They

representvarious

unintentional

and

intentional

injury

programs

in

public

health.

They

are,

in

alphabetical

order:

KatrinaAltenhofen(IDPHBureauofEmergencyMedicalServices),SallyClausen(IDPHBureauofFamilyHealth),Debbi

Cooper(IDPHBureauofEnvironmentalHealthServices),ScottFalb(IowaDept.ofTransportation),JohnFiedler(IDPH

BureauofEmergencyMedicalServices),JohnHedgecoth(IDPHDivisionofAcuteDiseasePrevention&Emergency

Response),CindyHeick(IDPHBureauofEmergencyMedicalServices),CarolHinton(IDPHBureauofFamilyHealth),

DonnaJohnson(IDPHBureauofHealthStatistics),CraigKeough(localpublichealth),BinnieLeHew(IDPHBureauof

Disability&ViolencePrevention),KathyLeinenkugel(IDPHOccupationalSafetyandHealthSurveillanceProgram),Louise

LexPhD.(IDPHBureauofCommunicationandPlanning),JohnLundell(UniversityofIowa,InjuryPreventionResearch

Center),CorriePeekAsaPhD.(UniversityofIowa,InjuryPreventionResearchCenter),andLisaRoth(BlankChildrens

Hospital SAFEKids).

Citation: IowaDepartmentofPublicHealth

TheBurdenofInjuryinIowa,ComprehensiveInjuryReport,20022006. December2008.


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1

TableofContents

ListofTables ........................................................................................................................................................................... 3

Authorsofthisreport............................................................................................................................... .............................. 4

Introduction............................................................................................................................... ............................................. 9

Purposeofthisreport............................................................................................................................... .......................... 9

Whatyouwillfindinthisreport............................................................................................................................... ........ 10

Howtousethisreport............................................................................................................................... ........................ 11

OverviewoftheburdenofinjuryinIowa ........................................................................................................................... 12

InjuryisamajorcauseofdeathinIowa ............................................................................................................................ 13

Motorvehicle

crashes

are

the

leading

cause

of

injury

death

in

Iowa............................................................................... 14

Injuryrates(per100,000Iowans)byrace,20022006...................................................................................................... 17

Injuryrates(per100,000Iowans)byagegroup,20022006 ............................................................................................ 18

Injurydeath,hospitalizationandemergencydepartmentvisitratesdifferbycountysize,20022006 ..........................19

Injuriesarealargepercentageofalldeaths,hospitalizations,andemergencydepartmentvisits,andvariesbyage

groupinIowa,20022006.................................................................................................................................................. 20

MostinjuriesinIowaareunintentional,20022006 ......................................................................................................... 21

Yearsofpotentiallifelostbycausesandintent ................................................................................................................ 21

Specificinjuryindicators ............................................................................................................................... ....................... 24

ComparisonofallindicatorsinIowa............................................................................................................................... . 24

Indicatorsforallinjuries,Iowa,20022006 .......................................................................................................................25

Indicatorsfordrowning,Iowa,20022006 ........................................................................................................................27

Indicatorsforunintentionalfalls,Iowa,20022006 .......................................................................................................... 28

Indicatorsforunintentionalfalls,Iowa,20022006 .......................................................................................................... 29

Indicatorsforunintentionalfirerelatedinjuries,Iowa,20022006..................................................................................31

Indicatorsforunintentionalfirerelatedinjuries,Iowa,20022006..................................................................................32

Indicatorsforfirearmrelatedinjuries,Iowa,20022006 .................................................................................................. 34

Indicatorsforhomicide/assault,Iowa,20022006 ............................................................................................................ 35


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Indicatorsforhomicide/assault,Iowa,20022006 ............................................................................................................ 36

Indicatorsformotorvehicletrauma,Iowa,20022006 .................................................................................................... 38

Indicatorsforpoisoning,Iowa,20022006 ........................................................................................................................ 40

Indicatorsforsuicide/suicideattempts,Iowa,20022006 ................................................................................................ 41

Indicatorsfor

suicide/suicide

attempts,

Iowa,

2002

2006 ................................................................................................ 42

Hospitalchargesperindicator,Iowa,20022006 .............................................................................................................. 46

Iowacrashoutcomedataevaluationsystem...................................................................................................................... 48

Crashdatalinkedtodeathcertificates(20032006)........................................................................................................ 48

LinkedMVfatalitiesbyvehicletypeorrole ................................................................................................................. 48

Demographiccharacteristics,safetydeviceuseandalcoholuseforMVTrelateddeathsinIowa ..........................49

Percentageof

fatally

injured

drivers

of

passenger

vehicles

with

blood

alcohol

concentration

(BAC)

of

0.08

percent

orgreater,bydriverage ............................................................................................................................... ............... 50

Linkagebetweencrashdataandhospitalizations .......................................................................................................... 51

Demographiccharacteristics,safetydeviceuseandalcoholuseformotorvehiclerelatedhospitalizationsinIowa,

20022006 ............................................................................................................................... ...................................... 51

TBIseveritylevelbymotorcyclehelmetuse hospitalizations.................................................................................. 52

Linkagebetweencrashdataandemergencydepartment(ED)data,20032006 .......................................................... 53

Demographiccharacteristics,safetydeviceuseandalcoholuseformotorvehiclerelatedEDvisitsinIowa,2003

2006 ............................................................................................................................... ............................................... 53

DiscussionandRecommendations ............................................................................................................................... ....... 54

Comparisons............................................................................................................................... ....................................... 54

HealthyIowans2010indicators ............................................................................................................................... ........ 55

Recommendations ............................................................................................................................... ............................. 56

ANNEXES ............................................................................................................................... ................................................ 57

Annex1. DATAANALYSISMETHODS............................................................................................................................... 57

Annex3.REFERENCES ............................................................................................................................... ........................ 60

Annex4. DATATABLESPRODUCEDINTHISREPORT...................................................................................................... 60


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ListofTables

Table1:FiveleadingcausesofALLdeathsinIowabyagegroupsandtotal#ofdeaths,20022005 .................................13

Table2:FiveleadingcausesofINJURYdeathsinIowabyagegroupsandtotal#ofdeaths,20022005 ...........................14

Table3:

All

injury

indicators

Total

#and

rates,

2002

2006 ................................................................................................ 24

Table4:Demographiccharacteristics,safetydeviceuseandalcoholuseforMVTrelateddeathsinIowa........................ 49

Table5:FatalinjuriesandBACbydriver'sage ..................................................................................................................... 50

Table6:Demographiccharacteristics,deviceuseandalcoholuseforMVTrelatedhospitalizationsinIowa,20022006.51

Table7:TBIseveritylevelbymotorcycleuse hospitalizations...........................................................................................52

Table8:Demographiccharacteristics,safetyuseandalcoholuseforMVTrelatedEDvisits,20032006..........................53

Forfurtherinformationoracopyofthisreport,pleasecontacttheIowaDepartmentofPublicHealth,Bureauof

DisabilityandViolencePreventionat(515)2815032ortheInjuryPreventionResearchCenterattheUniversityofIowa

at(319)

335

4458.

Electroniccopiesofthereportareavailableathttp://www.idph.state.ia.us/bh/injuryprevention.asp


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Acronymsusedinthisreport

CDCCentersforDiseaseControlandPrevention

CODESCrashOutcomeDataEvaluationSystem

EDvisitsEmergencydepartmentvisits(outpatient)

EMSEmergencymedicalservices

IDOTIowaDepartmentofTransportation

IDPH

Iowa

Department

of

Public

Health

IPRCUniversityofIowaInjuryPreventionResearchCenter

MVTMotorVehicleTraffic

NCIPCNationalCenterforInjuryPreventionandControl

NIOSHNationalInstituteforOccupationalSafety&Health

STIPDAStateandTerritorialInjuryPreventionDirectorsAssociation

TBITraumaticbraininjury

TSACTraumaSystemAdvisoryCouncil

WISQARSWebbasedInjuryStatisticsQueryandReportingSystem

YPLLYearsofpotentiallifelost

Authorsof

this

report

ThisreportwasdevelopedthroughtheStateofIowaInjuryPreventionandSurveillancePartnership(asubcommitteeof

TSAC),whosemissionistofacilitatestatewideinjurypreventionimprovementbyleadingasystematicprocesstogather,

review,analyzeanddisseminateinformationaboutinjuriesandinjurypreventioninIowa. Thefollowingorganizations

werethekeymembersoftheworkinggroupthatdevelopedthisreport:

IowaDepartmentofPublicHealth(IDPH)

BureauofDisabilityandViolencePrevention

Thisbureauworkswithcommunitiestoreducetheincidenceandseverityofunintentionalandintentional

injuriesresulting

from

disability

and

violence.

Through

data

collection

and

analysis,

strategic

planning

and

the

implementationofevidencebasedprograms,bureaustaffworkstoreducetheburdenoftheseinjuriesinIowa.

Thebureauisorganizedintotwooffices. WithintheOfficeofDisabilityandHealtharetheAdvisoryCouncilon

BrainInjuries,DisabilityPrevention/ReducingSecondaryConditionsProgram,andtheTraumaticBrainInjury

Program. WithintheOfficeofViolencePreventionaretheAbuseEducationReviewPanel,DomesticAbuse

DeathReviewTeam,HealthCareResponsetoViolenceAgainstWomen,SexualViolencePreventionandYouth

SuicidePreventionProgram.

BureauofHealthStatistics

TheBureaustaffmaintainsacomprehensivedataandsurveillancesystemcapableofmonitoringprogresson

healthobjectives,identifyingemerginghealthissues,andsupportingpolicydevelopment.Thebureauregularly

analyzeshealthdataresidinginthedepartment,conductsresearchonhealthissues,providesaccesstohealth

informationforthestateandpublic,andsupportsotherhealthdataactivitiesasappropriate.

DivisionofEnvironmentalHealth(OccupationalHealthProgramandConsumerProductSafety)

TheIDPHOccupationalSafetyandHealthSurveillanceProgram(OSHSP)ispartoftheEnvironmentalHealth

DivisionandfundedthroughNIOSHtoprovidefundamentalandenhancedsurveillanceandpublichealth

activitiesspecifictoworkrelatedillnessandinjury. Networkingwithstateandlocalprograms,dataiscollected,

analyzed,andreportedregardingspecificOSHindicators,includingoccupationalfatalities,pesticidepoisonings,

andadultleadexposures. OSHSPisalsoinvolvedinoutbreakinvestigationsregardinginfectiousdiseaseor

environmentalexposuresthatarelinkedtoworksituations.


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BureauofEmergencyMedicalServices(EMS)

IowahasanallinclusivetraumacaresystemthathasbeenoperationalsinceJanuary1,2001.TheIDPHBureau

ofEMSisdesignatedtheleadagencyforthestatetraumasystem. Fromconception,keytrauma/EMS

stakeholdershaveconvenedregularlytoadvisethedepartmentonstrategiestoachieveoptimaltraumacare

delivery,implementastatewidetraumasystem,assess,andevaluatesystemeffectiveness. TheTraumaSystem

AdvisoryCouncil(TSAC),asestablishedbyIowaCode147A,hasbeenmeetingsinceOctoberof1995.

Representationis

multidisciplinary

and

includes

21

members.

The

TSAC

has

subcommittees

that

include:

1)

hospitalcategorizationandverification,2)triageandtransferprotocols,AdultandPediatric,3)injuryregistry,4)

injuryprevention/healthpromotion,5)educationandtraining,and6)rehabilitation. TSACmeetssemi

annually. TheSystemEvaluationQualityImprovementCommittee(SEQIC),alsoestablishedbycodeand

meetingsinceOctober1996,hasestablishedandimplementedastatewidesystemevaluationprocess.

Representationismultidisciplinaryandincludes20memberswhomeetthreetimesperyearforongoingsystem

evaluation. ResearchersatTheUniversityofIowasInjuryPreventionResearchCenterreviewtheIowaTrauma

PatientData. ThisgrouppresentsitsdataanalysisduringSEQICmeetings.

ThebureaualsohousestheunintentionalinjurypreventionandtheEMSpediatricprograms. Theseprograms

promotebicycle,pedestrianandmotorvehiclesafety,aswellasimprovedresponsestochildrenservedthrough

IowasEMSsystem.

BureauofFamilyHealth

Thebureauiscomprisedofmanyprogramsrelatedtomaternalandchildhealth. Theprogramsthataimto

reduceinjurytochildrenandadolescentsaretheChildDeathReviewTeam,theHealthyChildCareIowa

program,andtheSchool/AdolescentHealthprogram.

UniversityofIowaInjuryPreventionResearchCenter(IPRC)

Foundedin1990,theIPRCisoneof12injury"CentersofExcellence"fundedbytheNationalCenterforInjury

PreventionandControl,CentersforDiseaseControlandPrevention.ThethemeoftheIowaCenterispreventionand

controlof

rural

injuries,

but

the

Center

works

with

injuries

in

all

of

Iowa.

The

IPRC

aims

to

prevent

and

control

injuries

in

highriskpopulations,includingchildren,theelderly,farmers,andfarmfamiliesbysupportingresearchandtrainingand

bydisseminatingresearchresultstopolicymakers. TheIPRChasanumberofcoregroups,includingadministration,

evaluation,simulation,training,andresearchsupport. Thetrainingcorepreparesgraduatestudentstomeettheneed

fornewacademicfacultyinthefieldofoccupationalinjuryprevention,andtheresearchsupportcoreservesasthe

backbonefortheIPRCresearchprogramwhichprovidesresourcestoIPRCinvestigators,universityinjurycontrol

researchers,andinjurycontrolcollaboratorsinthecommunity.TheIPRCisfundedbyCDCgrantCCR703640.

TheIowaDepartmentofTransportation(DOT)

TheIowaDOT,MotorVehicleDivisionOfficeofDriverServices,collectsandmaintainsdataonallmotorvehicle

relatedaccidentsinIowa. Thisoffice,alongwiththeOfficeofTrafficandSafety,providescrashdataanalysistoinform

driverandhighwaysafetyprogramming. ThedataareusedtodeveloptheIowaComprehensiveHighwaySafetyPlan,

guidingeffortstoachieveastandardofsafertravelacrossthestate. ThesetwoofficespartnerwiththeIowa

DepartmentofPublicSafetysGovernorsTrafficSafetyBureau,toimplementmotorvehiclesafetyprogramsforthe

public.


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ExecutiveSummary

InjuriesaremajorpublichealthconcernsthataffectthelivesofallIowans,regardlessofage,race,gender,orsizeof

county. UnintentionalinjuriesaretheleadingcauseofdeathforIowansbetweentheagesof1and34,whilesuicides

and/orhomicidesalsorankamongthetop5leadingcausesofdeathforIowansbetweentheagesof1and54.

Unintentionalinjuryisthe5thleadingcauseofdeathforallIowans,withover1,500injurydeathsoccurringonaverage

eachyear(from2002 2006)inIowa. Injuriesalsoleadtomorethan17,000hospitalizationsinIowaeachyearandmore

than250,000emergencydepartment(ED)visits. Further,untoldnumbersofIowansdonotseekmedicalcareformany

oftheinjuriestheymayincur. Becauseinjuriesarepreventable,theyleadtounnecessarymedicalcosts,economic

losses,reducedproductivity,andimmensephysicalandemotionalstrain.

Purposeofthisreport

Thisreport,thefirstcomprehensiveonetoexamineinjuryinIowa,isintendedto:

presentaclearpictureoftheburdenofinjuriesinIowa(fromtheyears2002to2006)intermsofmortality,

morbidity,andcauses;

provideinformationtostateandlocalpolicymakers,countyhealthdepartments,healthpractitioners,

hospitals,andcivicgroupstoimproveinjurycareandstimulateandstrengtheninjurypreventionefforts;

documentIowassuccessinmeetingtheHealthyIowans2010goalsrelatedtoinjury;and

provideinformationontheinjuryindicatorsspecifiedbytheCentersforDiseaseControlandPreventions

NationalCenterforInjuryPreventionandControl(CDC/NCIPC).

Tofurthertheseends,adetailedreportofinjuriesineachcountyofIowahasalsobeendevelopedandisreferencedin

thisreport.

Sourcesofinformation

ThedatapresentedinthisreportarebasedondeathcertificatesfromtheIowaDepartmentofPublicHealth,theIowa

HospitalAssociationhospitalinpatient(referredtoashospitalizations)/outpatient(referredtoasEDvisits)discharge

data,andtheIowatraumaregistry,includingagriculturalinjuries.

Keyfindings(20022006)

Over1,500injuryrelateddeathsoccurredonaverageeachyear(from2002 2006)inIowa6%ofalldeathsin

Iowa. Inaddition,injuriesledtomorethan17,000hospitalizationsandmorethan250,000EDvisitseachyearin

Iowa.

UnintentionalinjuriesweretheleadingcauseofdeathforIowansbetweentheagesof1and34andthe5th

leadingcauseofdeathforallIowans.


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Keyconclusions

ContinuedandstrengthenedcollectionofdataisvitaltomonitortrendsininjuriesinIowaandtoassessthe

effectivenessandimpactofinjurypreventionstrategies.

o Healthcareprovidersmustbeencouragedtocompletelyandaccuratelycodeandreportallinjuriesso

thataclearerpictureoftheburdenofinjuryinIowaisavailable,whichinturnenablesimproved

preventionefforts.

o TheIDPHneedstocreateandsupportbothaninternalworkgroupandanexternaladvisorycommittee

tosupporttheestablishmentofaninjuryandviolencepreventionprogramandraisethevisibilityand

importanceofinjuryandviolencepreventionwithinstategovernment.Thecreationofasubcommittee

connectedtoTSACisagoodstepinthatdirection.

o Inthesummerof2004,theIDPHdirectorrecognizedthefragmentationandthesilosmodusoperandiof

thepublichealthsystem. Hecommissionedaworkgrouptomakerecommendationsforredesigning

publichealthinthestatetolimitinconsistentservicedelivery. Asafirststep,theworkgroupdeveloped

standardsforlocalandstateofficials,includinginjurypreventionasaseparatefocusarea.

Injurypreventioneffortscanbetargetedtothosegroupswiththegreatestriskbyusingthedatapresentedin

thisreport.

IowahasexceededmanyofthegoalsestablishedforinjuriesbytheHealthyIowans2010initiative;however,

muchworkisstillneededtocontinuetoreducetheburdenofinjuryinIowa. Theseeffortsinclude:

o Theuseofpubliceducation,legislative/policy,andtechnologicalstrategiestoreducethenumberof

injuriesandinjurydeathsinIowa.

o Promotingpreventionprogramsthatuseacombinationofstrategies,suchasanecologicalmodel

targetingindividual,

relationship,

organizational,

and

community

levels

of

intervention.

These

are

proventobemoreeffective.


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Introduction

InjuriesaremajorpublichealthconcernsthataffectthelivesofallIowans,regardlessofage,race,gender,orsizeof

county. UnintentionalinjuriesaretheleadingcauseofdeathforIowansbetweentheagesof1and34,whilesuicides

and/orhomicidesalsorankamongthetopfiveleadingcausesofdeathforIowansbetweentheagesof1and54.

Unintentionalinjuries(oftencalledaccidents)arethe5thleadingcauseofdeathintheUnitedStates(2004)1,aswellas

inIowa,withover1,500injurydeathsoccurringonaverageeachyear(from2002 2006)inIowa. Further,injuriesare

thethirdleadingcauseofprematuredeathinIowa,measuredinyearsofpotentiallifelost.

However,deathsareonlyaportionoftheimpactofinjuryonIowaasindicatedinFigure1below2. Injuriesleadtomore

than17,000hospitalizationseachyearinIowawithanaveragecostofcareofover$9,000pervisitandmorethan

250,000emergencydepartment(ED)visits(averagecostpervisitofnearly$1,000). Inaddition,someIowaresidents

seekmedicalcareoutsideofthestate,leadingtoanestimated1,200additionalIowanswhoarehospitalizeddueto

injuriesoutsidethestateeachyear. AsnotedinFigure1,untoldnumbersofIowansdonotseekmedicalcareformany

oftheinjuriestheymayincur. Injurysurvivorsmayhavetheirregularactivitiesofdailylivingdisruptedtemporarilyor

maybepermanentlydisabled. Becauseinjuriesarepreventable,theyleadtounnecessarymedicalcosts,economic

losses,reduced

productivity,

and

immense

physical

and

emotional

strain.

Figure1. IowaInjuryPyramid

Purposeofthisreport

Sinceinjuriesarepreventable,strategiesandpoliciescanbedevelopedtoreducethisburden. However,todevelop

effectivestrategies,

communities

and

policymakers

must

understand

the

extent

and

nature

of

injuries

incurred

in

the

state. Thisreport,thefirstofitskindinIowa,intendstopresentaclearpictureoftheburdenofinjuriesinIowa(from

theyear2002to2006),intermsofmortality,morbidity,causes,andanindicationofthecostsofmedicalcarefor

variousinjuries.

1Source:NationalVitalStatisticsReport,Vol.55,N19,Aug.2007.

2Sourcesofdataforpyramid: IowaDepartmentofPublicHealthvitalrecords,StateTraumaRegistry,IowaHospitalAssociation

hospitalinpatient/outpatientdischargedata.PyramidincludesonlyIowaresidentsseekingmedicalcarewithinthestate.


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Becauseofthedetrimentalimpactofinjuriesonthestate,Iowahasadoptedanumberofinjuryrelatedgoalsaspartof

theHealthyIowans2010initiative. ThisreportdocumentsIowassuccessinreducinginjuries,particularlyinrelationto

thesegoals,andpointstofurthereffortsthatcanbemadetocontinuethisreduction.

Further,thisreportisintendedtoprovideinformationtostateandlocalpolicymakers,countyhealthdepartments,

healthpractitioners,hospitals,andcivicgroupsontheinjuriestoIowanstreatedwithinthestate. Thesedataare

categorizedbycause,type,intent,andotherindicators,whichcanimproveinjurycareandstimulateandstrengthen

injurypreventionefforts.

Thisreportalsoaddressestherecommendationsofthe2007visitoftheStateandTerritorialInjuryPreventionDirectors

Association(STIPDA)officialstoIowa,includingthetaskofpreparingareporttoaddresstheteninjuryindicators

specifiedbytheCentersforDiseaseControlandPrevention(CDC)NationalCenterforInjuryPreventionandControl

(NCIPC).

Whatyouwillfindinthisreport

ThisreportcombinesdatafromIowaDepartmentofPublicHealth(IDPH)deathcertificates,IowaHospitalAssociation

hospitalinpatient/outpatientdischargedata,IowaCrashOutcomesDataEvaluationSystem(CODES)andtheIowa

traumaregistry,includingagriculturalinjuries.Themainleadingcausesofinjurydeaths,hospitalizations,andEDvisitsby

age,gender,race(wheneveravailable)andcostsaredescribed.

Moreinformationontheauthorsofthereport,thesourcesofdata,andthemethodsofdataanalysisusedinthereport

areavailableinthetechnicalnotessectionattheendofthisdocument.

ThereportbeginswithanoverviewoftheburdenofinjuryinIowa,includingacomparisonofinjurytootherpublic

healthconcerns,yearlyinjurytrends,demographicsofthoseinjured,intentofinjuries,andtheyearsofpotentiallifelost

duetoinjury. Informationoninjuryrelateddeaths,hospitalizations,andEDvisitsarepresented. Keydataare

presentedin

graphical

form,

with

key

points

and

comparisons

also

noted.

DataoneachoftheCDCspecificinjuryindicators,bygenderandagegroup,arethenpresentedinasimilarformatto

thatoftheoverviewsection. Datafordeaths,hospitalizations,andEDvisitsarepresentedforallindicators. Dataon

injuriesincurredinmotorvehiclecrashesfromtheIowaCrashOutcomesDataEvaluationSystem(CODES)arethen

presentedindetail.

Furthercomparisonsofthedata,includingtotheHealthyIowans2010indicators,arethenpresented,alongwith

conclusionsandrecommendationsfromthedata.

Detailedinformationonthemethodsusedtocalculatethedata,includingthesourcesofdata,analysismethods,and

variablesused

for

the

data

are

presented

in

Annex

1of

this

report.

ThisreportalsocontainsalinktoreportsfromeverycountyofIowa,detailingtheinjurydeathandhospitalizationrates

forthatcountybygender,agegroup,andcauseofinjury. Thesereportsshouldbeespeciallyhelpfultocountyandlocal

publichealthofficialstodeveloppoliciesandprogramsandincreaseadvocacyforinjurypreventioneffortsatalocal

level.Localagenciesinterestedininjurypreventioneffortscanalsousethesedatatobetterinformtheireffortsatthe

locallevel. Thesereportsareavailablefromthefollowing:

TheUniversityofIowaIPRCWebsiteathttp://www.publichealth.uiowa.edu/iprcand
http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/http://www.public-health.uiowa.edu/iprc/


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IDPHWebsiteat: http://www.idph.state.ia.us/bh/injuryprevention.asp

ThedatatablessupportingthedatapresentedinthereportareavailableasaPDFfilefromtheIDPHWebsiteat

http://www.idph.state.ia.us/bh/injuryprevention.asp.

Howtousethisreport

Thisreport

is

intended

to

provide

information

on

the

burden

of

injury

in

Iowa

to

assist

communities,

health

practitioners

andstateandlocalpolicymakerstodevelopstrategiesandpoliciestoreduceinjuriesinthestate.

Toaccomplishthisgoal,potentialusesofthisreportmayincludethefollowing:

Providinginformationtothemediatoraiseawarenessamongthemandthegeneralpublicabouttheburdenof

injuriesinIowa. Mediaoutletsmaybeparticularlyreceptivetosuchinformationafteratraumaticinjuryhas

occurredthathasattractedagreatdealofmediaattention.

Promotingtheneedforinjurypreventioneffortsamonglegislators,communitygroups,andothersthrough

targetedpresentationsandcampaigns.

o Informedlegislators(atlocal,state,andnationallevels)canhelpadvocateforinjurypreventionefforts.

o Diversegroupsworkingtogethercanidentifyprioritiesandmaximizepreventionstrategiesand

resourcestopreventinjuries.

o StateandlocalpublichealthofficialscangainIdeasfromcurrentandproposedinjurypreventionefforts

indicatedinreport.

Encouraginghealthcarepractitioners(hospitals,clinics,etc)tostrengthentheirinjurypreventionefforts.

Guidingtheallocationofresourcestoinjurypreventionandprioritizing/planninginjurypreventionefforts.

Providingbackgroundinformationforinjurypreventionactivitiesandgrantapplications.


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OverviewoftheburdenofinjuryinIowa

ThefollowingpagespresentanoverviewoftheburdenofinjuryonallIowansfrom2002 2006,unlessotherwisenoted.

ThedatainthefirsttableshowthatinjuryisanimportantpublichealthconcernforallagegroupsinIowa. Theleading

causesofinjuryinIowaineachagegrouparethenpresentedtoprovideinsightonpreventioneffortsthatareneededin

variousportionsofthelifespanofIowans.Next,thetrendsofinjuryoverthefiveyearperiodarepresentedtoprovide

informationonanymajorchangesinthedataovertime,whichcaninformdecisionsonpotentialinterventions,

legislativeorreportingmethodchanges,andothersimilarefforts.

Dataarethenpresentedonthedifferingimpactthatinjurieshaveonmalesandfemales,peopleofdifferentraces,age

groups,andruralcomparedtourbanresidents. Thisinformationcanassistwiththedesignofinjurypreventionandcare

effortstotargetspecificsegmentsofthepopulation. Datashowtheproportionofalldeaths,hospitalizationsandED

visitsthatareduetoinjuries,whichunderlinesthelargeburdenofinjuriesonhealthcaresystemsandonallsociety.

Dataarethenpresentedontheintentofinjuries,whichemphasizestheneedforcontinuedandspecificeffortsto

preventbothunintentionalinjuries(oftencalledaccidents),aswellashomicidesandsuicides(intentionalinjuries). This

sectionconcludeswithdataontheyearsofpotentiallifelostduetoinjuriesanddemonstratesthedisproportionate

impactofinjuriesontheyoungpeopleofIowawhoarethefutureofthestate.

Whenconsideringthedataintheoverviewsection,pleasenotethefollowing:

Thedatafordeathsandhospitalizationsaretheyearlyaveragesfrom20022006,andthedataforEDvisits

istheyearlyaveragefrom20032006,unlessotherwisenoted.

DataforhospitalizationsandEDvisitsincludeallhospitalizationsandEDvisits,ratherthanonlyreporting

thefirsthospitalizationorEDvisitforeachinjury.

NotethattheEDvisitdataarefrom20032006astheEDvisitdatafrom2002wererecordedinadifferent

mannerthan20032006. Also,thedatafromCDCWISQARSinthefirsttwotablesarefrom20022005as

theCDC

data

from

2006

were

not

available

at

the

time

this

report

was

drafted.

Ratesarereportedasaverageyearlyratesper100,000populationunlessnotedotherwise. Theserates

weredeterminedbycalculatingtherateforeachyearper100,000peopleinthestateorcounties(as

appropriate),addingtherates,anddividingbythetotalnumberofyearsofdata(5fordeathsand

hospitalizationsand4forEDvisits),forayearlyaverage.

Allratesreportedinthissectionareageadjustedtothe2000USpopulation,unlessnotedotherwise. More

informationondetailsoftheageadjustmentandratecalculationisavailableinAnnex1ofthisreport. Itis

knownthatthenumberofhospitalizationsandEDvisitsforvariousinjurycausesisunderreported,as22%

ofhospitalizationsand16%ofEDvisitrecordsareNOTcodedwithanelectroniccausecode.

Reportedvaluesforfrequenciesofvariouseventsmaynotexactlymatchthevaluesinothersectionsofthe

reportduetomissingdataforthevariableanalyzedinthatparticularsection.

AllagegroupingsarepresentedusingCDClifespanages,whichissimilartotheNationalInstitutefor

OccupationalSafetyandHealth(NIOSH)occupationalagegroupings.

MoredetailedtechnicalnotesandmethodologyareincludedinAnnex1ofthisreport.


15/62


16/62

Motorvehiclecrashesaretheleadingcauseofinjuryde

MotorvehicletrafficdeathsaretheleadingcauseofinjuryrelateddeathsforallagesofIowans,followedbyfa

ofinjurydeathvarybyagegroup.

Table2:

Five

leading

causes

of

INJURY

deaths

in

Iowa

by

age

groups

and

total

#of

deaths,

2002

2005

Rank


17/62


18/62

16

Injuryaffectsgenders,races,andagegroupsinIowadifferently:

20022006averageratesofinjury(per100,000Iowans)bygender

Therate

of

males

dyinginIowadueto

injury(69)isnearly

doublethatoffemales

(37).

Thedifferences

betweengendersvary

greatly,dependingon

thespecificindicator

andage

of

the

victim.

Iowafemaleshavea

greaterinjuryhospital

izationrate,buta

lowerEDvisitrate

thanmales.

Cautionisneeded

wheninterpreting

thesedifferencessince

theratesarenotage

adjusted.


19/62

17

Injuryrates(per100,000Iowans)byrace,20022006

Thecrudeinjurydeath

rateforblacksinIowa(54)

iscomparable

to

that

of

whites(54).

Blacks(1,528)inIowaare

3timesmorelikelytobe

hospitalizedforaninjury

thanwhites(467).

Blacksaremorethan2

timesmorelikelytogoto

theEDforaninjurythan

whites.

Otherracialgroups

combinedtogether

(Hispanic,Asians,Natives,

etc.)havelowercrude

ratesforinjurydeaths,

hospitalizationsandED

visitsthanwhitesand

blacks.

Alargeamountofdataon

race(22%and21%)is

missingfor

hospitalizationsandED

visits,respectively.

Cautionshouldbeused

wheninterpretingthese

resultssincetherates

were

not

age

adjusted.


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18

Injuryrates(per100,000Iowans)byagegroup,20022006

InjurydeathandhospitalizationratesinIowaincreasedwithage. Ratesofinjurydeaths(369)andhospitalizations

(5,026)

are

by

far

the

highest

in

those

aged

85

and

over.

o Hospitalizationratesforseniors(85+)inotherNCIPCreportingstates(in2004)rangefrom2,600to

6,800/100,000population;thus,Iowaisalsowithinthisrange.

Injury relatedEDvisitratesweregreatestamongyouthandtheelderly. Iowaadultsbetweentheagesof45and

74hadalowrateof5EDvisitsper100people,contrastedwithyouthaged15to24thathaddoubletherate,of

approximately12EDvisitsper100people.

EDvisitratesduetoinjurieswerehighestamong15 to24yearolds,followedbythoseaged85+.


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19

Injurydeath,hospitalizationandemergencydepartmentvisit

ratesdifferbycountysize,20022006

MoredetailedinformationontheburdenofinjuryineachcountyinIowaisavailableasanannextothisreport.

The5yearaveragecrude

injurydeath

rate

was

greatestinlesspopulated

counties(rateof

67/100,000).

Comparedtocountieswith

over50,000people(rateof

45),countieswith


22/62

20

Injuriesarealargepercentageofalldeaths,hospitalizations,and

emergencydepartmentvisits,andvariesbyagegroupinIowa,

20022006

Injuriesaccountedfor6%ofall

deathsinIowa.However,this

percentagevariesbyage

group.

Youthsaged1524aretheage

groupwithbyfarthegreatest

proportionofdeathsfrom

injury

(74%)

compared

to

all

deaths.

Youngadults(aged2534)have

thesecondhighestproportion

(56%)ofdeathsduetoinjury.

Therefore,injurypreventionis

averyimportantpublichealth

issueforallentitiesworking

withchildrenandyouth.

Onaverage,injury

hospitalizationsrepresented

5%ofallhospitalizations.

Amongchildrenbetween514

yearsold,injuryhospital

izationscorrespondedto13%

ofallhospitalizations,the

highestproportionofallage

groups.

ThepercentofinjuryEDvisits

asaproportionofallEDvisits

ishighestamongthoseage5to

14(43%).

Overall,oneinfour(27%)ED

visitsisduetoinjury.


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21

MostinjuriesinIowaareunintentional,20022006

Yearsofpotentiallifelostbycausesandintent

73%ofinjurydeathsinIowa

(20022006)wereclassifiedas

unintentional,with21%as

suicideand4%ashomicide.

Iowasunintentionalinjury

(Iowa:35vs.US:39)and

homicidedeathrates(Iowa:2

vs.US:6)arelowerthanthe

nationalaverage,whilethe

suiciderateishigherthanthe

nationalaverage(Iowa:12vs.

US:11).

Foreveryonedeathdueto

unintentionalinjury

(rate=

35),

therearenearly10

hospitalizations(rate=339).

22%ofinjuryrelatedhospital

visitsdidnothaveanintent

coded.

Forevery100Iowans,there

were,onaverage,6to7ED

visitsduetounintentional

injuries(from20022006).

The

age

adjusted

rate

of

homicide/assaultrelatedED

visits(319)wasgreaterthanthe

suiciderelatedEDvisitrates

(50).

Thesuiciderateislargerthan

thehomicideratefordeaths

andhospitalizations.

Mechanismsof

intentional

injuries

(violence)

in

Iowa

Firearms(50%),suffocation(27%),andpoisonings(20%)aretheleadingmechanismsofsuicidedeathsinIowa.

Firearms(52%),cut/pierce(15%),andsuffocation(7%)aretheleadingmechanismsofhomicidedeathsinIowa.

Althoughpoisoningsareonlythe3rdleadingmechanismofdeathbysuicide,theyarebyfartheleading

mechanismofsuicideattemptrelatedhospitalizations,withanaverageof1,400casesperyear.

Struckby/against(4.6/100,000),followedbycut/pierce(1.9/100,000)aretheleadingmechanismsofassault

relatedinjuryhospitalizations.


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22

Yearsofpotentiallifelostbycausesandintent

0.0 20,000.0 40,000.0 60,000.0 80,000.0 100,000.0 120,000.0

OphtalmicENTOtherBlood

ConnectiveUrinaryUnclassifiedInfection

MentalDigestiveCongenitalEndocrine

CNSRespiratInjuryCancers

Cardiovasc


25/62

23

InIowa,(from20022006),cardiovasculardiseasesaretheleadingcauseoftotalYPLLfollowedbycancers

andinjury. Injuriescontributedtoover34,000YPLL.

Lookingattheaverageyearsofpotentiallifelost,congenitaldiseasesarethegreatestcontributors(64

YPLL),

with

all

injuries

(22

YPLL)

being

the

third

largest

contributor.

Unintentionalinjuries,particularlyMVTbyfar,havethegreatestimpactonthetotalYPLL.

Onaverage,Iowanswhodiedin20022006byunintentionaldrowninglost37yearsofpotentiallife.

Unintentionalfirearm(34years)andhomicidebyfirearm(31years)werethe2ndand3rdYPLLmechanisms.

Note: Inthethirdandfourthgraphs,theintent/causecombinationswithanaverageof


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24

Specificinjuryindicators

TheCenterforInjuryPreventionandControl,CentersforDiseaseControlandPrevention(CDC),incollaborationwith

theStateandTerritorialInjuryPreventionDirectorsAssociation(STIPDA),haveidentified10areasofprimaryconcern

relatedto

tracking

the

burden

of

injury

in

aparticular

state.

Injury

indicators

associated

with

each

of

these

areas

describesahealthoutcomeofaninjury,suchashospitalizationordeath,orafactorknowntobeassociatedwithan

injury7. Thissectionprovidesinformationoneachoftheseindicatorsandtheirrelationshipstootherindicators.

ItmustbenotedthattheindicatorsareNOTmutuallyexclusiveassomeoftheindicatorsarecauses(fires),others

intents(suicideorhomicide)andtypes(traumaticbraininjury)ofinjury. Therefore,thenumbersofincidents,rates,and

thechargesforoneinjurycasemayalsobeincludedinthenumber,ratesandchargesofmultipleindicators.Pleasealso

notethatthevaluesreportedinthechartforhospitalchargesperindicatorincludeonlythechargessubmittedbythe

hospitaltothepayer. Theyareincludedonlyasageneralmeansofcomparingaportionofthecostsofinjuriesrelated

toeachofthevariousindicators.

NotealsothathospitalizationorEDdatacannotbecompareddirectlytodeathdata,asthepopulationstheyaredrawn

fromaredifferent. Thisdatatableispresentedonlytomakegeneralcomparisonsbetweenandamongthedifferent

indicators.

Pleasealso

note

that

unless

otherwise

stated,

all

rates

are

reported

as

incidents

per

100,000

Iowans

and

adjustedtothe2000USpopulation.Reportedvaluesforfrequenciesofvariouseventsmaynotexactlymatchthe

valuesinothersectionsofthereportduetomissingdataforthevariableanalyzedinthatparticularsection. More

informationonthecalculationmethodsandinjurycodingschemeisavailableinthemethodssectioninAnnex1.

ComparisonofallindicatorsinIowa

Table3:AllinjuryindicatorsTotal#andrates,20022006

Deaths(2002-2006)

Hospitalizations(2002-2006)

Emergencydepartment visits

(2003-2006)

Indicator area AverageN^ Rate* AverageN^ Rate* AverageN^ Rate*All injuries 1,558 48.3 17,272 520.5 267,073 8,953.8

Drowning+ 29 1.0 15 0.5 79 2.8

Fallsu 314 8.5 7,121 197.3 61,891 1,984.0

Fire-relatedu

29 0.9 119 4.0 1,087 37.6

Firearm-related 197 6.5 69 2.4 185 6.4Homicide/Assault 55 1.9 276 12.0 7,024 242.7Motor vehicletraffic (MVT)

u 420 13.2 1,648 54.8 18,911 638.9

Poisoning 165 5.6 2,008 68.9 3,423 113.2Suicide 332 11.1 1,483 51.7 1,547 53.3Traumatic brain

injury (TBI) 554 17.3 1,821 56.8 15,456 504.9^TheAverageNiscalculatedbyaddingthetotalnumberofincidentsoverthe4or5yearperiodanddividingbytheappropriatenumberofyears,forayearlyaverage.

*Allratesarereportedper100,000populationandareageadjustedtothe2000USpopulation.+

Thedrowningindicatorincludesnotonlyunintentionaldeaths,butallhospitalizationsandEDvisits.

uDatafortheseindicatorsincludeonlyunintentionalinjuries.

7FromCDCNCIPC,availableat:http://www.cdc.gov/ncipc/


27/62


28/62

26

InIowa,overthefiveyearperiodofthisreporttherewere,onaverage,1,558injurydeaths;17,267injury

hospitalizations;and234,542EDvisitsperyear.

Injurydeathratesvarygreatlybyage;however,acrossallages,crudeinjurydeathratesweretwiceashigh

inIowamales(69/100,000)asinIowafemales(36/100,000).

o Therate

of

injury

deaths

is

by

far

the

highest

in

Iowans

over

84

years

old

(males:

468/100,000;

females:

327/100,000).

o Therateofinjurydeathswasnearlythreetimeshigherininfants(males:30/100,000;females:

16/100,000)thaninchildrenaged14(males:10/100,000;females:7/100,000).

o Asshownbythedatainthepreviouspoint,theinjurydeathrateofmaleinfantsisdoublethatoffemale

infants. However,genderdifferencesininjurydeathratesaresmallforchildrenbetweentheagesof1

and14.

o Genderdifferencesindeathratesweregreaterafter14yearsofage,withthedeathratethreetimes

higherformales(70/100,000)thanfemales(23/100,000)inthe15to24yearoldagegroup. Iowa

maleswho

are

25

64

years

old

are

more

than

2.5

times

as

likely

to

die

from

injuries

as

females

in

that

agegroup.

o Femaledeathrates(368/100,000)increasedsubstantiallyinthoseover84yearsold,butstilldidnot

reachthemaledeathrate(468/100,000).

Theageandgenderdistributionforinjuryhospitalizationsissimilartothatofinjurydeaths,exceptthatolder

femalesarehospitalizedforinjuriesmoreoftenthanoldermales.

o Acrossallagegroups,femaleshada26percentgreaterinjuryhospitalizationratethanmales,witha

yearlyaveragehospitalizationrateof643/100,000vs.509/100,000,respectively. However,eachage

grouphasdifferentcharacteristics.

o AmongIowansundertheageof65,maleshadhigherinjuryhospitalizationratesthanfemales. Among

Iowanslessthanoneyearofage,malesaretwiceaslikelyasfemalestobehospitalizedduetoinjuries.

o Thefemaleinjuryhospitalizationratesteadilyincreasedwithagetosurpassthatofmales. InIowans

aged5564,malesandfemaleshadnearlythesamehospitalizationratesof464/100,000and

448/100,000,respectively.

o Afterthe6574agegroups,thetrendreversed.Hospitalizationratesforfemalesincreasedsignificantly,

exceedingthatofmales(900/100,000vs.706/100,000,respectively),andcontinuedtoincreaseinthe

olderagegroups.

Therate

of

injury

ED

visits

is

greatest

in

the

15

24

age

groups,

with

another

peak

in

seniors

(85+).

o EventhoughmalesofallageshadahigherrateofinjuryEDvisitsthanfemales(8,813vs.6,881per

100,000Iowans,respectively),femaleEDvisitrateswereonaverage13percenthigheraftertheageof

65.

o Iowamalesaged15to24aremorelikelythanfemales(13,759vs.9,180/100,000Iowans,respectively)

togototheEDforaninjury. Thisgenderdifferencebecomeslesspronouncedafterage34.


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27

Indicatorsfordrowning,Iowa,20022006

AlthoughdrowningdeathratesarelowinIowa(1.0/100,000),lowerthanthenationalNCIPCstates2004average

(1.3/100,000),itisstillthe3rdleadingcauseofinjurydeathforIowansundertheageof14.Thisunderlinesthe

importanceofpreventionforunintentionaldrowning,particularlyininfantsandchildren.

o0


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28

Overthefiveyearperiodofthisreport,drowninginIowaresultedinanaverageof29deaths,15

hospitalizations,and63EDvisitsperyear.

Drowningisthe3rdleadingcauseofinjurydeathforIowansundertheageof14,andthe5thleadingcause

ofinjurydeathinthoseaged15to24.

Whilethere

were

few

drowning

related

hospitalizations

in

Iowa

on

average

(15

cases/year),

there

was

a

largernumberofdeaths(29cases/year),whichdemonstratestheseverityofanydrowningincidents.

AlthoughtheannualaveragedeathratefordrowninginIowafor20022006islow(1.0/100,000),lower

thanthe2004nationalaverageofNCIPCstates(1.3/100,000),itisanimportantcauseofinjuryamong

certainagegroups.

o Becausetherearelownumbersofdrowningdeathsincertainagegroups(lessthan5insome

groups),onlygeneralpatternsfromtheresultantratesshouldbeconsidered.

o Undertheageof15,drowningdeathratesaresimilarbetweenmalesandfemales. InIowans15

yearsand

older,

males

were

more

than

twice

as

likely

as

females

to

die

from

drowning.

o Thehighestyearlyaveragenumberofdrowningdeathsoccurredamong15 to24yearoldmales

(6cases/year),resultinginarateof2.7per100,000;whileonlyonedrowningdeathwasreported

amongthesameagefemales,withasubsequentrateof0.5per100,000.

Iowasdrowninghospitalizationrate(0.5/100,000)isslightlylowerthantheNCIPCstatesaverageof0.7

per100,000,andvariesbyageandgender.

o Onaverage,from20022006,therewereninemalesofallageshospitalizedfordrowningperyear

andsixfemales.

o Undertheageoffive,drowningrelatedhospitalizationratesarehigheringirls(


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29

Indicatorsforunintentionalfalls,Iowa,20022006

TherateoffallrelateddeathsinIowa(8.5/100,000)isabovethenationalaverage(6.2/100,0008),partiallyduetothe

largeproportionofseniors(85+)inIowa,theagegroupwithbyfarthehighestrateofdeathsfromfalls(males:

244/100,000andfemales:204/100,000). FallsarealsotheleadingcauseofinjuryhospitalizationsandEDvisitsinIowa.

.

8CDCWISQARS(20022005)www.cdc.gov/ncipc/wisqars/


32/62

30

.

Note:HospitalizationdataareforfallsinIowa,20022006;emergencydepartmentvisitsareforfallsinIowa,20032006.


33/62

31

Althoughfallsarethe2ndleadingcauseofinjurydeathsinIowa(yearlyaverageof314),fallsarethe

leadingcauseofinjuryhospitalizationsandEDvisits,withrespectiveyearlyaveragesofmorethan7,100

and57,000.

Fallsaccountfor20percentofallinjurydeaths,41percentofinjuryhospitalizations,and23percentofall

injuryEDvisitsinIowa.

Theoverallfallrelateddeathratewasaboutthesameformales(10/100,000)andfemales(11/100,000).

However,deathratesandgenderdifferencesvariedwitheachagegroup.

o Fallrelateddeathsmainlyoccurinpeopleover74yearsold,withbyfarthehighestrateinthose

overtheageof84(males:244/100,000;females:204/100,000). Theaveragedeathrate

increasedasageincreased,aftertheageof14.

o Fallrelateddeathrateswerehigherinmalesineveryagegroup.

o Inthe15to24yearolds,theaveragedeathrateformaleswas0.9/100,000vs.0.5/100,000for

females.By55yearsofage,therateincreasedto8/100,000(males)vs.3/100,000(females).

o Thegreatestdifferencebetweenfalldeathratesinmalesandfemalesofthesameageoccurred

inthe2534agegroupwheremales(1.7/100,000)werefivetimesmorelikelythanfemales

(0.3/100,000)todiefromafall.

o Amongthoseaged55to64,injurydeathratesinmales(8/100,000)weremorethandoublethat

offemales(3/100,000).

Thedemographicpatternoffallrelatedhospitalizationsisverysimilartothatofdeathsfromfalls,except

thatmanymoreelderlyfemalesthanelderlymalesarehospitalizedduetofalls.

o Femalesofallages(317/100,000)hadtwicethehospitalizationrateofallmales(156/100,000).

o Inthe35 to44yearoldagegroup,males(82/100,000)hadan80percentincreasedrateoffall

relatedhospitalizationsoverfemales(45/100,000).However,inthe55 to64yearoldagegroup,

femalerates(211/100,000)were30percentgreaterthaninmales(161/100,000)andcontinued

toincreasewithage.

o Ratesinwomenage85andover(3,834/100,000)werenearlydoublethatofmenage85+

(2,242/100,000).

FallrelatedEDvisitratesweregreaterinallfemales(2,079/100,000)thaninallmales(1,748/100,000)

anddifferedgreatlywithage.

o Fallrelated

ED

visit

rates

peaked

in

those

85+

(males:

6,114/100,000,

females:

7,901/100,000),

withasmallerpeakinages14(males:4,205/100,000,females:3,189/100,000).

o MaleshadhigherratesoffallrelatedEDvisitsinallagegroupsuntiltheageof25,afterwhich

femaleratessteadilyincreasedcomparedtomales.

o Aftertheageoffour,EDvisitratessteadilydeclinedforbothgendersuntilages4554(females)

and5564(males),wheretheratesbegantosteadilyincreaseforbothgenders.


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32

Indicatorsforunintentionalfirerelatedinjuries,Iowa,20022006

AlthoughtherateoffirerelateddeathsinIowa(0.9/100,000)isslightlylowerthanthenationalNCIPCstates2004

average(1.1/100,000),fireinjuriesarestillamajorconcerninIowa,particularlyincertainagegroups.Firescanbe

particularlydeadlyfortheelderlyinIowa,withmalesovertheageof74havingbyfarthehighestdeathrates(7584:

6.9/100,000;85+:

7.6/100,000).

.


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33

EachyearinIowa,onaverage,thereare29firerelateddeaths,119hospitalizationsand922EDvisits.

Firerelateddeathsaretwiceaslikelytooccurinmen(1.3/100,000)asinwomen(0.6/100,000),but

theseratiosvarywithage.

o Malesoverage74arethemostlikelygrouptodiefromfirerelatedinjuries(ages7584,rateof

6.9/100,000;ages85+,rateof7.6/100,000). Amongfemales,the85+agegroupisthemost

likelytodiefromfirerelatedinjuries(3.2/100,000).

o Therewere,however,lessthanfivedeathsineveryage/gendergroup,whichmakes

interpretationofanyratecalculationdifficult.

Firesareparticularlydeadlyfortheelderly,astheirabilitytoescapefromafireisoftenlimitedby

mobility. Infact,thefirerelateddeathratesforbothmenandwomen,inboththe7584and85+age

categories

is

nearly

equal

to

fire

related

hospitalization

rate

for

that

same

gender/age

category.

o Thedifferencebetweendeathandhospitalizationratesisthehighestformalesinthe25 to34

yearoldcategory(17hospitalizationsforeverydeath)andforfemales,inthe35 to44yearold

category(7.5hospitalizationsforeverydeath).

Firerelatedhospitalizationsare,onaverage,fourtimesgreaterinmales(6.5/100,000)thaninfemales

(1.5/100,000)andvarywithage.

o Thedifferencebetweengendersisgreatestinthe7584(males:10.4/100,000,females:

1.1/100,000)andthe2534agegroups(males:9.5/100,000,females:1.7/100,000).Malesaged

75

84

have

the

highest

fire

related

hospitalization

rate

overall,

and

those

25

34

have

the

second

highestrate.

RatesoffirerelatedEDvisitswerethreetimeshigherinallmales(47/100,000)thaninallfemales

(15/100,000).

o RatesoffirerelatedEDvisitspeakedinmenaged1524(78.6/100,000)andgraduallydecreased

withage. Girlsaged14hadthehighestrateoffirerelatedEDvisits(25.4/100,000),with

femalesaged1524havingthesecondhighestrate(21.4/100,000),followedbyagradual

declineinsubsequentagegroups.

o Thegender

difference

in

rates

of

fire

related

ED

visits

is

largest

in

the

55

to

64

year

old

age

groupwheremales(32/100,000)arefourtimesmorelikelythanfemales(8/100,000)tohavea

firerelatedEDvisit.


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34

Indicatorsforfirearmrelatedinjuries,Iowa,20022006

TherateoffirearmrelateddeathsinIowa(6.5/100,000)ismuchlowerthanthenationalNCIPCstates2004average

(10/100,000).Firearmrelateddeathratesarethehighestamongmalesovertheageof74(ages7584:22/100,000and

ages85+:23/100,000),mainlyduetosuicides. However,firearmrelatedhospitalization(10/100,000)andEDvisitrates

(24/100,000)

are

highest

in

15

to

24

year

old

males

and

gradually

decrease

with

age.

.


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35

Onaverage,therewere197firearmrelateddeathsperyearinIowa,morethantheaverageyearly

numberoffirearmrelatedhospitalizations(69)orEDvisits(163).

o 95percentofallfirearmrelateddeathsinIowaareintentional(81%suicidesand14%homicides).

FivepercentoffirearmrelateddeathsinIowaareunintentional.

o Asageincreases,anincreasinglylargerportionofthefirearmrelateddeathsinIowaisdueto

suicidecomparedwithhomicide.

Thisispartiallyduetothelownumbersofhomicidesduetofirearmsinmanyagegroups.

Theagegroupwiththelargestaveragenumberofhomicidesduetofirearmsisthe15 to

24yearolds,withninefatalitieseachyear. Onaverage,eachoftheagegroupsunderthe

ageof14andovertheageof55have


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36

Indicatorsforhomicide/assault,Iowa,20022006

Whilethehomicidedeathrate(1.9/100,000)inIowaisconsiderablylowerthanthe2004nationalaverageoftheNCIPC

states(5.9/100,000),therateofassaultrelatedhospitalizationsandparticularlyEDvisitsissubstantiallyhigher,

particularlyamongyouthandyoungadultmales(aged1534). Infantsalsohaveahighrateofassaultrelated

hospitalizations.

.


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37

InIowa,onaveragefrom20022006,therewere55homicidedeaths,276assaultrelated

hospitalizations,and6,473assaultrelatedEDvisits. Thistranslatesintoanaverageofmorethanone

homicideperweek,nearlyoneassaultrelatedhospitalization,andnearly18assaultrelatedEDvisitsper

dayinIowa.

Overall,thehomicidedeathrateinIowaishigherinmales(2.3/100,000)thaninfemales(1.4/100,000).

Theresultingrateratioshowsthat,overall,homicideratesinmaleswere60percenthigherthanin

females.

o Malesaged1524hadthehighestaveragenumberofhomicides(9),followedbythoseaged25

34and3544(eachwith7cases).

o Overtheageof45,theaveragenumberofhomicidesperyearwasfiveorlessforbothmalesand

females. TherewasnoagegroupoffemalesinIowawithanaveragenumberofhomicides

greaterthanfive.

o Onaverage,

there

was

one

homicide

per

year

among

both

female

and

male

infants

(

Documents

Burden of Injury Full Report