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Abstract
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Injury-associated deaths have substantial economic consequences. In 2013, unintentional injury was the fourth leading cause of death, suicide was the tenth, and homicide was the sixteenth; these three causes accounted for approximately 187,000 deaths in the United States. To assess the economic impact of fatal injuries, CDC analyzed death data from the National Vital Statistics System for 2013, along with cost of injury data using the Web-Based Injury Statistics Query and Reporting System. This report updates a previous study that analyzed death data from the year 2000, and employs recently revised methodology for determining the costs of injury outcomes, which uses the most current economic data and incorporates improvements for estimating medical costs associated with injury. Number of deaths, crude and age-specific death rates, and total lifetime work-loss costs and medical costs were calculated for fatal injuries by sex, age group, intent (intentional versus unintentional), and mechanism of injury. During 2013, the rate of fatal injury was 61.0 per 100,000 population, with combined medical and work-loss costs exceeding $214 billion. Costs from fatal injuries represent approximately one third of the total $671 billion medical and work-loss costs associated with all injuries in 2013. The magnitude of the economic burden associated with injury-associated deaths underscores the need for effective prevention.
The number of injury-associated deaths in the United States during 2013 was obtained from National Vital Statistics System, and lifetime costs were obtained from the Web-based Injury Statistics Query and Reporting System database. Injury death rates were calculated using the U.S. Census Bureau's bridged race population estimates for 2013. Lifetime cost estimates, which include lifetime work-loss and medical costs, were computed from average costs of earnings and treating injuries in 2010, adjusted to 2013 prices. For each death record, lifetime work-loss cost was assigned according to the sex and age of the decedent. The sex- and age-specific probability of surviving to a given age was multiplied by the mean earnings of persons of that sex and age using U.S. Census Bureau earnings data, assuming that no one would live beyond age 102 years. Lifetime medical costs were assigned by injury diagnosis and mechanism, place of death, and decedent's age. Medical costs were derived from various sources that measure the cost of transport, examination by a coroner or medical examiner, and health care in multiple settings, including emergency departments, hospitals, and nursing homes. Work-loss costs were developed using earnings data from the U.S. Census Bureau's Current Population Survey and life expectancy data from CDC's National Center for Health Statistics. Number of deaths, rates and total lifetime medical and work-loss costs were examined for 2013, stratified by sex, age, and intent of injury. The distribution of costs by mechanism and intent of injury was also examined for the five highest-cost mechanisms, stratified by intent.
The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 was $214 billion. Males accounted for approximately 78% of these costs and for 67% of injury deaths. Approximately two thirds of injury deaths were unintentional, and these deaths also represented a majority of the cost ($129.7 billion [61%]). Approximately one fifth of injury-related deaths were suicides, and the cost of these deaths ($50.8 billion) accounted for about 24% of all injury death costs. Approximately 8% of injury-related deaths were homicides, and the associated costs ($26.4 billion) accounted for about 12% of the medical and work-loss costs for all injury deaths. Male victims represented 82% of the costs for suicide ($41.7 billion) and 86% of the costs for homicide ($22.5 billion).
Overall, rates of fatal injury increased with age; however, this pattern differed by injury intent, with higher homicide rates among young persons and higher suicide rates among middle-aged adults. The costs associated with fatal injury were concentrated among adolescents and young adults aged 15–24 years and adults aged 25–64 years. The lowest costs and the lowest proportion of costs were associated with injury deaths in persons aged ≥65 years. These differences are also reflected in the mean cost of injury death by intent (Figure 1). The mean medical and work-loss cost of any injury death in 2013 was slightly more than $1.1 million, ranging from just below $1 million for unintentional injuries, to in excess of $1.6 million for homicides; the cost per suicide was $1.2 million.
Among all injury deaths, drug poisonings accounted for 26% of the costs associated with fatal injuries, followed by transportation-related deaths (23%), firearm-related deaths (22%), deaths from suffocation (9%), and deaths resulting from falls (5%). Considerable differences were observed in the proportional distribution of costs accounted for by each mechanism among unintentional deaths, homicides, and suicides. Firearm-related fatal injuries accounted for 75% of the homicide-associated costs and 48% of the suicide-associated costs. Other leading mechanisms contributing to suicide costs were suffocation (including hanging) (29%) and drug poisoning (12%). Costs associated with unintentional injury deaths were primarily related to transportation-related deaths (37%) and drug poisonings (38%)....
Language: en |