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1: About this Report

Unintentional injuries are a leading cause of morbidity and mortality among children and adolescents in the United States.(4) A thorough understanding of the demographics of the groups most at risk for common injury causes can help direct resources toward research and programs most likely to reduce the burden.

This report was produced in part to coincide with the release of a World Report on Child Injury Prevention (WHO, 2008).(3) This report provides an overview of patterns of childhood unintentional injury in the United States related to drowning, falls, fires or burns, transportation (e.g. motor vehicle crashes), poisoning, and suffocation, among others.

The burden of deaths and nonfatal injuries due to each cause is shown in this report by age group and sex, as well as the geographic distribution of injury death rates by state. Information on injury deaths is from the National Center for Health Statistics, National Vital Statistics System (i.e. death certificate data), and nonfatal injury information is from the National Electronic Injury Surveillance System – All Injury Program, which represents nonfatal injuries treated in U.S. hospital emergency departments. While use of emergency department data does not capture the burden of all injuries (such as those treated at medical care sites other than emergency departments or those that did not seek care), this information combined with deaths can be helpful to state and local health officials and advocates in prioritizing programs targeting their at-risk populations, to researchers tracking trends or evaluating prevention activities, to policy-makers at all levels determining the best use of limited public health resources, as well as the to general public in identifying injury prevention strategies for themselves, their families and their communities.

The Importance of Childhood Injury Prevention

Worldwide, childhood injuries are a growing problem. Every year, approximately 875,000 children are killed and nonfatal injuries affect the lives of between 10 million and 30 million more globally.(5) Moreover, 95% of these deaths and injuries occur in low and middle income countries.(5) Childhood injuries are also a problem in high income countries such as the United States, where approximately 12,000 children die annually from unintentional injury-related causes.(4)

In the United States, injuries continue to be the leading cause of death among children.(6,7) Among those 1 to 19 years of age, 44% of all deaths are due to unintentional (i.e., accidental) injuries. (Fig 1) (4) For infants, the proportion of deaths due to injury is much less, with only 4% of infant deaths due to unintentional injuries. (Fig 2) Approximately 9.2 million nonfatal injuries are treated in emergency departments each year among children 0 to 19 years of age, translating to an annual nonfatal injury rate of 11,272 per 100,000 population.(4) The estimated cost of unintentional childhood injuries approached $300 billion annually in the United States.(2)

Figure 1: Cause of Death by Injury Status and Intent among Children 1 to 19 Years, United States, 2000 – 2005

Figure 2: Cause of Death by Injury Status and Intent among Children Less Than 1 year, United States, 2000 – 2005



  1. Sleet, DA, RA Schieber, A Dellinger. Childhood injuries. The Enclyclopedia of Public Health, Vol I (Ed., L Breslow). New York: Macmillan Reference, USA 2002, pp 184-187.
  2. Danesco ER, Miller TR, Spicer RS. Incidence and costs of 1987-1994 childhood injuries: demographic breakdowns. Pediatrics 2000;105(2):E27.
  3. WHO. World report on child injury prevention WHO, Geneva 2008
  4. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System [online]. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. [Accessed Aug 2008].
  5. Child and adolescent injury prevention: a global call to action. Geneva, World Health Organization and UNICEF, 2005. [Accessed: September 17, 2008]. *
  6. Bernard SJ, Paulozzi LJ, Wallace DL. Fatal injuries among children by race and ethnicity—United States, 1999-2002. MMWR Surveill Summ 2007; 18;56(5):1-16.
  7. Schnitzer PG. Prevention of unintentional childhood injuries. Am Fam Physician 2006; 74(11):1864-9.
  8. Centers for Disease Control and Prevention. National Center for Health Statistics. VitalStats. [Accessed: Aug 10, 2008].
  9. US Consumer Product Safety Commission. The NEISS sample: design and implementation. In: Kessler E, Schroeder T, eds. Washington, DC: US Consumer Product Safety Commission, 2000.
  10. World Health Organization. Manual of the international statistical classification of disease, injuries, and causes of death, 10th revision. Geneva, Switzerland: World Health Organization; 1999.
  11. Fingerhut L. ICD Framework: External cause of injury mortality matrix [online]. Hyattsville, MD: National Center for Health Statistics. Available from:
  12. CDC. Recommended framework for presenting injury mortality data. In: Reports and Recommendations, August 29, 1997. MMWR 1997:46(No. RR-14):1-30.
  13. Vyrostek SB, Annest JL, Ryan GW. Surveillance for Fatal and Nonfatal Injuries — United States, 2001. In: Surveillance Summaries, September 3, 2004. MMWR 2004;53(No. SS-7):1-57.
  14. Arias E, Schauman WS, Eschbach K, Sorlie PD, Backlund E. The validity of race and Hispanic origin reporting on death certificates in the United States. National Center for Health Statistics. Vital Health Stat 2(148). 2008.
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