Healthy People 2010 Focus Area 15: Injury and Violence Prevention Progress Review August 16, 2007

Healthy People 2010 Focus Area 15:

Injury and Violence Prevention

Progress ReviewAugust 16, 2007

Rank All Ages <1 1-4 5-14 15-24 25-34 35-44 45-64 65-74 75+

1

HeartDisease 652,486

CongenitalAnomalies

5,622

UnintentionalInjury 1,641





MalignantNeoplasms

146,476

MalignantNeoplasms

139,417


2

MalignantNeoplasms

553,888

ShortGestation

4,642

CongenitalAnomalies

569

MalignantNeoplasms

1,019

Homicide 5,085

Suicide 5,074

MalignantNeoplasms

14,723


HeartDisease 99,999

MalignantNeoplasms

246,430

3

Cerebro-vascular 150,074

SIDS 2,246

MalignantNeoplasms

399

CongenitalAnomalies

389

Suicide 4,316

Homicide 4,495

HeartDisease 12,925


Chronic Low.Respiratory

Disease 28,390


4


Disease 121,987

MaternalPregnancy

Comp. 1,715

Homicide 377

Homicide 329

MalignantNeoplasms

1,709

MalignantNeoplasms

3,633

Suicide 6,638

DiabetesMellitus 16,347



Disease 76,807

5

UnintentionalInjury

112,012


HeartDisease

187

Suicide 285

HeartDisease

1,038

HeartDisease

3,163

HIV 4,826


DiabetesMellitus 16,093

Alzheimer'sDisease 61,672

Age Group

Leading Causes of Death, 2004

Source: Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Leading Causes of Unintentional Injury Deaths, 2004

Note: Fires/burns includes all fire deaths, not just those that occurred in residences. Healthy People 2010 objective 15-25, highlighted later in this presentation, focuses exclusively on residential fire deaths.Source: Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Rank All Ages <1 1-4 5-9 10-14 15-44 45-64 65-74 75-84 85+

1

MV Traffic 43,432

Suffocation 725

MV Traffic 520

MV Traffic 584

MV Traffic 922

MV Traffic 24,042

MV Traffic 10,024

MV Traffic 2,876

Falls5,682

Falls6,962

2

Poisoning 20,950

MV Traffic 139

Drowning 430

Fires/burns 169

Drowning 138

Poisoning 12,344

Poisoning 7,610

Falls2,255

MV Traffic 3,080

Unspecified 2,716

3

Falls 18,807

Drowning62

Fires/burns 228

Drowning 131

Fires/burns 87

Drowning 1,394

Falls2,577

Suffocation 580

Unspecified 1,635

Suffocation 1,481

4

Unspecified6,173

Fires/Burns 28

Suffocation125

Suffocation 45

Other Land Transport

87

Falls1,220

Fires/burns 931

Unspecified 517

Suffocation1,308

MV Traffic 1,219

5

Suffocation 5,891

Falls23

Pedestrian, Other113

Other Land Transport

37

Suffocation 68

Fires/burns 751

Suffocation 911

Poisoning 421

Fires/burns475

Fires/burns 293

Age Group

• Injuries are the leading cause of death for people ages 1-44.

• Injuries and violence resulted in 167,000 deaths in 2004.

• Each year:– 50 million injury episodes require medical attention,

costing $406 billion in medical expenses and lost productivity.

– 1.4 million people sustain a traumatic brain injury.– 396,000 residential fires result in 3,000 deaths and nearly

14,000 ED visits for injuries.– 1 in 3 adults 65 years and over fall, resulting in about

15,000 deaths.– More than 1 in 7 children experience maltreatment.– Approximately 200,000 people are victims of rape or

sexual assault.

Burden of Injury and Violence

15-1. Traumatic brain injury hospitalizations

15-2. Nonfatal spinal cord injury

hospitalizations

15-3. Firearm-related deaths

15-4. Improper firearm storage in homes

15-5. Nonfatal firearm-related injuries

15-6. State-level child fatality review

Status of Injury Prevention Objectives

Improving

Getting worse

Little or no change*Target met/exceeded Baseline only

15-7. Nonfatal poisonings

15-8. Deaths from poisoning

15-9. Deaths from suffocation

15-10. Emergency department surveillance

of external causes of injury

15-11. Hospital discharge surveillance of external causes of injury

15-12. Emergency department visits due to injury or poisoning

* Percent of targeted change achieved is between -10% and 10%.

15-13. Deaths from unintentional injuries

15-14. Nonfatal unintentional injuries

15-15a. Motor vehicle crash deaths (per 100,000) population

15-15b. Motor vehicle crash deaths(per million miles traveled)

15-16. Pedestrian deaths

15-17. Nonfatal motor vehicle injuries

15-18. Nonfatal pedestrian injuries

15-19. Safety belt use

15-20. Child restraint use

15-21. Motorcycle helmet use

15-22. Graduated driver licensing laws

Status of Unintentional Injury Prevention Objectives

15-23a-b. Bicycle helmet use

15-24. Bicycle helmet laws

15-25. Residential fire deaths

15-26a. Functioning smoke alarms in residences (prop. of persons)

15-26a. Functioning smoke alarms in residences (prop. of homes)

15-27. Deaths from falls

15-28a. Hip fractures in older females

15-28b. Hip fractures in older males

15-29. Drownings

15-30. ED visits for dog bite injuries

15-31a-c. Protective gear in school sports

Improving

Getting worse



15-32. Homicides

15-33a. Child maltreatment incidents

15-33b. Child maltreatment fatalities

15-34. Physical assault by intimate partners

15-35. Rape or attempted rape

15-36. Sexual assault other than rape

15-37. Physical assaults

15-38. Physical fighting among adolescents

15-39. Weapon carrying by adolescents on school property

Status of Violence and Abuse Prevention Objectives

Improving

Getting worse


* Percent of targeted change achieved by most recent data point is between -10% and 10%.

Status of Injury and Violence Prevention Objectives


2010 Target

InjuryPrevention

Unintentional Injury

PreventionViolence

Prevention

Met/exceeded 0 2 3

Improving 4 12 3

Little or no change*

2 2 2

Getting worse

4 4 1

No trend data 2 5 0

Status of Highlighted Objectives


2010 Target

InjuryPrevention

Unintentional Injury

PreventionViolence

Prevention

Met/exceeded Sexual violence

Improving Child maltreatment

Little or no change*

Residential fire deaths

Getting worse

TBI hospitalizations

Deaths from fallsChild maltreatment

deaths

No trend data

Male

0

25

50

75

100

125

150

1998 1999 2000 2001 2002 2003 2004 2005

Traumatic Brain Injury (TBI) Hospitalizations

Obj. 15-1

* Data for males 15-24 years are not age adjusted.Note: TBI is defined as an injury to the head that is documented in a medical record, with one or more of the following conditions attributed to head injury: observed or self-reported decreased level of consciousness, amnesia, skull fracture, objective neurological or neuropsychological abnormality, or diagnoses intracranial lesion. Data are age adjusted to the 2000 standard population. Source: National Hospital Discharge Survey (NHDS), NCHS, CDC.

Age-adjusted rate per 100,000 population

Female

Male 15-24 yrs*

Decrease desired

2010 Target: 41.2

<65 yrs

75+ yrs

65-74 yrs

Rate per 100,000 population

0

50

100

150

200

250

300

350

1998 1999 2000 2001 2002 2003 2004 2005

TBI Hospitalizations

Note: TBI is defined as an injury to the head that is documented in a medical record, with one or more of the following conditions attributed to head injury: observed or self-reported decreased level of consciousness, amnesia, skull fracture, objective neurological or neuropsychological abnormality, or diagnoses intracranial lesion. Source: National Hospital Discharge Survey (NHDS), NCHS, CDC.

Obj. 15-1

Decrease desired

0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0

Total

Female

Male

Less than high school

High school

At least some college

Obj. 15-25

= 95% confidence interval. Note: Based on ICD-10 codes X00-X09 (location = HOME). Data are age adjusted to the 2000 standard population. Education estimates are based on persons aged 25-64 years.

Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Unintentional Residential Fire Deaths, 2004


Decrease desired

2010 Target: 0.2

0.0

0.5

1.0

1.5

2.0

1999 2000 2001 2002 2003 2004


8% decrease (1999-2004)

0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0

Total

American Indian

Asian

Hispanic

White

Black

Black females

Black males


Obj. 15-25

= 95% confidence interval. Note: Based on ICD-10 codes X00-X09 (location = HOME). Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be of any race. One or more races could be recorded. Data by single race categories are for persons for whom only one racial group was recorded. Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.


Decrease desired

2010 Target: 0.2


0

1

2

3

4

5

6


I = 95% confidence interval.

Decrease desired

Note: Based on ICD-10 codes X00-X09 (location = HOME). Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Obj. 15-25

5-18 yrs 85+ yrs45-64 yrs19-44 yrs 65-74 yrs 75-84 yrs0-4 yrs

D.C.

Unintentional Residential Fire Deaths, 2000-2004

N = 2,803/year

* Rate is based on fewer than 20 deaths.Note: Based on ICD-10 codes X00-X09 (location = HOME). Data are age adjusted to the 2000 standard population.Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Obj. 15-25

1.33-3.05 0.98-1.32 0.77-0.970.28-0.76

Unreliable*

Age-adjusted rate per 100,000

(by quartiles)


0

25

50

75

100

125

150

1999 2004

Deaths Due to Unintentional Falls

I = 95% confidence interval.

Decrease desired

Note: Based on ICD-10 codes W00-W19. Trend data shown in insert are adjusted to the 2000 standard population.Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Obj. 15-27

0-18 yrs 85+ yrs45-64 yrs19-44 yrs 65-74 yrs 75-84 yrs

0

2

4

6

8

10

1999 2000 2001 2002 2003 2004


Obj. 15-27

0 2 4 6 8 10

Total

American Indian

Asian

Black

White

Hispanic

Female

Male

Less than high school

High school

At least some college

= 95% confidence interval. Note: Based on ICD-10 codes W00-W19. Data are age adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes Pacific Islander. Black and White exclude persons of Hispanic origin. Persons of Hispanic origin may be of any race. One or more races could be recorded. Data by single race categories are for persons for whom only one racial group was recorded. Education estimates are based on persons aged 25-64 years. Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

Deaths Due to Unintentional Falls, 2004


Decrease desired

2010 Target: 3.3

D.C.

N = 12,667/year

Note: Based on ICD-10 codes W00-W19. Data are age adjusted to the 2000 standard population.Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.

49.0-80.4 35.7-48.9 29.3-35.616.5-29.2

Age-adjusted rate per 100,000

(by quartiles)

Deaths Due to Unintentional Falls Among

Persons 65 and Over, 2000-2004

Obj. 15-27

0

5

10

15

20

2000 2001 2002 2003 2004 2005

Source: National Child Abuse and Neglect System (NCANDS), ACF.

Note: Children are defined as persons under 18 years of age or persons considered minors under State law. Incidents rate includes some child maltreatment deaths. Number of reporting States varies by year.

Child Maltreatment Incidents and Deaths

Obj. 15-33a,b

Incidents per 1,000 children

0

1

2

3

2000 2001 2002 2003 2004 2005

Deaths per 100,000 children

Decrease desired

2010 Target: 10.1 2010 Target: 1.5

Females Males

Incidents per 1,000 children

0

5

10

15

20

Child Maltreatment Incidents, 2005

Decrease desired

Obj. 15-33a

0-3 yrs 8-11 yrs4-7 yrs 12-15 yrs 16-17 yrs


Note: Children are defined as persons under 18 years of age or persons considered minors under State law. Incidents rate includes some child maltreatment deaths. Rates are based on data from 51 States.


Note: Percentages are based on data from 36 reporting States.

0-3 yrs77%

4-7 years13%

8-11 yrs4%

Child Maltreatment Deaths, 2005

Obj. 15-33b

12-17 yrs*6%

17%

12%

3 yr

42%

2 yr

1 yr

< 1 yr

6%

* Includes some deaths to children 18 years or older who were considered minors under State law.


Note: Children are defined as persons under 18 years of age or persons considered minors under State law.Percentages are based on data from 34 reporting States.

29%

16%20%

Mother

Mother and father

Non-parental perpetrator

Father and other

Child Maltreatment Deaths by Perpetrator’s Relationship to Child,

2005

Obj. 15-33b

Father

Mother and other

10%

13%

2%

Unknown or missing

10%

0.00

0.25

0.50

0.75

1.00

1998 1999 2000 2001 2002 2003 2004 2005

Sexual Violence

Obj. 15-35 & 15-36

Incidents per 1,000 populationaged 12 years and over

Sexual assault other than rape

Rape or attempted rape

Source: National Crime Victimization Survey (NCVS), U.S. Department of Justice, Bureau of Justice Statistics.

Decrease desired

2010 Target

0 1.0 2.0 3.0 4.0 5.0

White Black

Other raceTwo or more races

Hispanic

Female

Male

12-15 yrs.

16-19 yrs.

20-24 yrs.

25-34 yrs.

35-49 yrs.

50-64 yrs.

Rape/Sexual Assault Incidents, 2004-2005

Incidents per 1,000 population aged 12 years and over

Decrease desired

*

*

*

* Based on 10 or fewer sample cases; rate should be interpreted with caution. = 95% confidence interval. Note: The categories White, Black and Other race exclude persons of Hispanic origin. Other race includes American Indian, Alaska Native, Asian, and Native Hawaiian and Pacific Islander. Persons of Hispanic origin may be of any race. One or more races could be recorded. Data by single race categories are for persons for whom only one racial group was recorded. Source: National Crime Victimization Survey (NCVS), U.S. Department of Justice, Bureau of Justice Statistics.

Obj. 15-35/15-36

* Based on 10 or fewer sample cases; percent should be interpreted with caution.

28%26%

7%*

Intimate partner

Other relative

Relationship unknown

Stranger

Friend or acquaintance

38%

2%

Obj. 15-35/15-36Note: Percentages sum to greater than 100% due to rounding. Source: National Crime Victimization Survey (NCVS), U.S. Department of Justice, Bureau of Justice Statistics.

Rape/Sexual Assault Against Females by Perpetrator’s Relationship to

Victim, 2005

• About half (24/46) of the objectives have met or are moving toward their targets.

• Rape and sexual assault have decreased since the baseline; both objectives have met their targets.

• Disparities by age, gender, education and geographic location persist for many objectives.

Summary

Progress review data and slides

are available on the web at:

http://www.cdc.gov/nchs/hphome.htmhttp://www.cdc.gov/nchs/hphome.htm

Documents

Healthy People 2010 Focus Area 15: Injury and Violence Prevention Progress Review August 16, 2007