Data Source
National Center for Health Statistics - Mortality Files; Census Population Estimates Program
The National Center for Health Statistics (NCHS) provides birth and death data drawn from the National Vital Statistics System (NVSS). These data are submitted to the NVSS by the vital registration systems operated in the jurisdictions legally responsible for registering vital events (i.e., births, deaths, marriages, divorces, and fetal deaths).
The Census Bureau’s Population Estimates Program (PEP) uses data on births, deaths, and migration to estimate population changes occurring since the most recent decennial census and produce a vintage, or annual time series of estimates. Each vintage includes the current data year and revised estimates for any earlier years since the last decennial census. Because each vintage of estimates includes all years since the most recent decennial census, the latest vintage supersedes all other estimates produced since the previous decennial census. See thePopulation Estimates Program methodologyfor statements and release notes for each vintage of population estimates.
Key Measure Methods
Injury Deaths is a rate
Injury Deaths is the number of deaths that result from injuries per 100,000 people. This measure includes injuries from intentional causes (such as homicide or suicide) and unintentional causes (such as motor vehicle accidents). Rates measure the number of events (e.g., deaths, births) in a specific time period divided by the average number of people at risk during that period. Rates help us compare data across counties with different population sizes.
Deaths are counted in the county of residence for the person who died, rather than the county where the death occurred
It is important to note that deaths are counted in the county of residence of the deceased. So, even in an injury death occurred across the state, the death is counted in the home county of the individual who died.
Some data are suppressed
A missing value is reported for counties with fewer than 10 injury deaths in the time period.
Caution should be used when comparing these estimates across years
Caution should be used when comparing across years due to methods changes described in the “The method for calculating Injury Deaths has changed” section.
Measure limitations
Injury deaths measure only a small portion of the harm of injuries to people in the U.S. Injuries cause burdens for people such as emergency room visit costs, need for time off work, follow-up healthcare needs, and potential for long-term disability. Data are not available nationwide for injuries not resulting in death.
Numerator
The numerator is the number of deaths with an underlying cause of injury (ICD-10 codes *U01-*U03, V01-Y36, Y85-Y87, Y89) during the five-year period.
Denominator
The denominator is the aggregate annual population for the five-year period.
The method for calculating Injury Deaths has changed
In the 2024 Annual Data Release, data from the Census Bureau's Population Estimates Program were used in the calculation of the denominator for this measure. In previous data releases, the denominator was calculated from the National Center for Health Statistics Bridged-Race Population Estimates; this data series was discontinued in 2023.Thedenominatorchangeandupdatestorace categories in the 2024 Annual Data Releasemeanthatcomparisonswithpreviousyearsshouldbemadewithcaution.
Can This Measure Be Used to Track Progress
This measure can be used to track progress with some caveats. It is important to note that the estimate provided in the Health Snapshots is a five-year average. However, in most counties, it is possible to obtain single-year estimates from the resource below.
Finding More Data
Disaggregation means breaking data down into smaller, meaningful subgroups. Disaggregated data are often broken down by characteristics of people or where they live. Disaggregated data can reveal inequalities that are otherwise hidden. These data can be disaggregated by:
- Age
- Gender
- Race
We recommend starting with the CDC WONDER database, which contains information on injury death rates by race, ethnicity, age, gender, geography, cause of death, and more. Rates can be exported as crude or age-adjusted. Small counties might need to combine multiple years of data to see rates, as CDC suppresses any rates when there are fewer than 10 deaths.
In addition, many states support databases of injury-related hospitalizations or emergency department visits.
References
1 Ahmad FB, Cisewski JA, Xu J, Anderson RN. Provisional mortality data-United States, 2022. Morbidity and Mortality Weekly Report (MMWR). 2023;72(18):488-492.
2 Centers for Disease Control and Prevention (CDC). Wide-ranging ONline Data for Epidemiologic Research (WONDER).
3 Spinks A, Turner C, Nixon J, McClure RJ, Cochrane Injuries Group. The 'WHO Safe Communities' model for the prevention of injury in whole populations. Cochrane Database of Systematic Reviews. 2009;3:CD004445.
4 Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. New England Journal of Medicine. 2022;386(20):1955-1956.
5 Sorenson SB. Gender disparities in injury mortality: Consistent, persistent, and larger than you'd think. American Journal of Public Health. 2011;101(Suppl 1):S353-S358.
6 GBD 2019 Police Violence US Subnational Collaborators. Fatal police violence by race and state in the USA, 1980-2019: A network meta-regression. The Lancet. 2021;398(10307):1239-1255.
7 Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing potentially excess deaths from the five leading causes of death in the rural United States. MMWR Surveillance Summaries. 2017;66(2):1-7.
8 World Health Organization. Injuries and violence. 2021. https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence.
