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5.0 Definitions for WISQARS Fatal Injury

This help file section provides in-depth definitions of the terms used to represent data elements in WISQARS Fatal. You can access these definitions by topic section (below) or by the report request pages (click on an underlined word to view its definition).

Definitions for Mortality (Fatal Injury) Reports

Definitions for Leading Causes of Death

Definitions for Years of Potential Life Lost

5.1 Definitions for Mortality (Fatal Injury) Reports

This tutorial provides a step-by-step overview to getting started with (WISQARS™) Fatal Injury Reports. The purpose of the tutorial is to help you access mortality data quickly and easily.


This section provides definitions of data elements and specific categories within data elements available from WISQARS Fatal mortality (fatal injury) reports. The data elements in the main report options are cause or mechanism of injury; intent of injury; census region / state of residence; year(s) of report; race, hispanic origin, and sex of the deceased; and output options.   Some of these elements are made up of categories, which also are defined below.  The advanced report options address output groups, age adjusting, and age selection.

5.1.1 Data Elements: Cause (Mechanism) and Intent (Manner) of Injury

The cause, or mechanism, of injury is the way in which the person sustained the injury; how the person was injured; or the process by which the injury occurred.  Intent of injury is whether an injury was caused by an act carried out on purpose by oneself or by another person(s), with the goal of injuring or killing.

5.1.1a  Terrorism Cause

As of October 2003, WISQARS includes terrorism as a cause of injury. For 2001, ICD-10 terrorism codes were added to respective intent (or manner of death) and cause of injury categories. For more details on these terrorism codes, see CDC's National Center for Health Statistics website. These deaths from terrorism were associated with the September 11, 2001 terrorism attacks in New York City, Pennsylvania, and Virginia; a total of 2,926 U.S. residents lost their lives in this tragic event in 2001. In addition, one U.S. resident died in 2002 as a result of the 2001 terrorist attacks.

Please note that these deaths also are included in the homicide and suicide counts and death rates presented in WISQARS. The new "terrorism" option allows users to produce Fatal Injury Reports for only terrorism-related deaths. These terrorism-related deaths break out as follows:

2001 Deaths of U.S. Residents from Terrorism (September 11, 2001)

Cause of Death Number of U.S. Residents
All Terrorism Deaths 2,926
U01.1 Terrorism Involving Destruction of Aircraft (homicide) 2,922
U03.0 Terrorism Involving Explosions and Fragments (suicide)       4
Place of Death Occurrence Number of U.S. Residents
All Places 2,926
New York City 2,705
Virginia    177
Pennsylvania     42
Massachusetts       1
Missouri       1
State of Residence Number of U.S. Residents
All States  2,926
Arizona        2
California      45
Colorado        3
Connecticut      63
Delaware        1
District of Columbia      15
Florida        3
Georgia        4
Hawaii        2
Illinois      10
Indiana        1
Kentucky        1
Louisiana        2
Maine        3
Maryland      50
Massachusetts      91
Michigan        3
Missouri        2
Nevada        2
New Hampshire        9
New Jersey     692
New Mexico        1
New York 1774
North Carolina        1
Ohio        1
Pennsylvania      32
Rhode Island       5
Tennessee       1
Texas       2
Utah       1
Virginia    104

5.1.1b  Intent Categories

Suicide
- intentionally self-inflicted injury that results in death

Homicide - injuries inflicted by another person with intent to injure or kill, by any means. Excludes injuries due to legal intervention and operations of war. Justifiable homicide is not identified in WISQARS.

Legal Intervention - injuries inflicted by the police or other law-enforcing agents, including military on duty, in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order, and other legal actions. Excludes injuries caused by civil insurrections.

Operation of War – Injuries to military personnel or civilians caused by war or civil insurrection, including those occurring during the time of war or insurrection and after cessation of hostilities. The number of deaths in this category ( i.e., ICD-9 codes E990-E999 for 1981 through 1998 and ICD-10 codes Y36.0-.9 for 1999 to present ) is small (e.g. 14 in 2003). These operation of war deaths are included in totals, but can not be reported separately using WISQARS.

5.1.1c  Cause and Intent Combinations for 1999 and Later Data
The cause you select, together with the intent you select, allows you to narrow the search to a particular injury category.  Not all combinations are valid (legitimate or applicable).  The table below shows the available cause options and intent options.  An X indicates a valid cause-intent combination.  For instance, the cause drowning / submersion and the intent suicide are a valid combination, so an "X" appears in the box for that combination.  Drowning / submersion and legal intervention are not valid, so the box for that combination is blank.

Table 5.1.1 : Valid Cause and Intent Combinations for 1999 and Later Data 

Cause / Mechanism

Total

 Intent / Manner

Unintentional Suicide Homicide Homicide and Legal Intervention Legal Inter-
vention 
Violence Related Undetermined
All Injury/Adverse Effects X X            
All Injury X X X X X X X X
Cut/piercing X X X X X X X X
Drowning/
Submersion
X X X X X   X
Fall X X X X     X X
Fire/burn X X X X     X X
  Fire/flame X X X X     X X
  Hot Object X X X X     X X
Residential Fire/Flame X X            
Firearm X X X X X X X X
Machinery X X            
Transportation- related X X X  X X   X  
Motor Vehicle (MV), Overall X X  X X X   X X
MV Traffic X X           X
  Occupant X X            
  Motorcycle X X            
  Pedal Cycle X X            
  Pedestrian X X            
  Other X X            
  Unspecified X X            
Pedal Cycle, Other X X            
Pedestrian, Other X X            
Pedal Cycle X X            
Pedestrian X X            
Other Land Transport X X  X X X   X X
Transport, Other X X            
Natural / Environmental X X            
Non-Firearm     X X        
Overexertion X X            
Poisoning X X X X X X X X
Struck by, against X X X X X X X  X
Suffocation X X X X     X X
Terrorism     X X X   X  
Other specified, classifiable X X X X X X X X
Other specified, not elsewhere classifiable(NEC) X X X X X X X X
Unspecified X X X X X X X X
Adverse Effects X              
  Medical Care X              
  Drugs X              

The specific injury causes are from the Final ICD-10 Matrix (available from the National Center for Health Statistics website; requires Adobe Acrobat)  and defined by their International Classification of Disease, 10th revision (ICD-10) codes.  The definitions of ICD-10 codes are available from the CDC's WONDER system.  Similar to the table above, this framework shows the cause or mechanism of injury along one axis and the intent of injury along the other.  The Injury Mortality Reports include the causes from this framework as well as the following additional categories: 

Cause of Injury ICD-10 Codes
All Injury and Adverse Effects V01-Y36, Y40-Y89
Unintentional Injury and Adverse Effects V01-X59 ,Y40-Y86, Y88
Overall Motor Vehicle V02-V04,V09.0,V09.2,V12-V14, V19.0-V19.2, V19.4-V19.6, V20-V79, V80.3-V80.5,V81.0-V81.1, V82.0-V82.1,V83-V86,V87.0-V87.8,; 
V88.0-V88.8,V89.0,V89.2
Pedal Cyclist V12-V14(.3-.9),V19(.4-.6),V10-V11, V12-V14(.0-.2),V15-V18,
V19(.0-.3,.8,.9)
Pedestrian V02-V04 (.0,.1,.9), V01,V05,V06,
V09 (.0,.1,.2,.3,.9)
Residential Fire/flame* X00-X09 and Place of Accident = Home
Non-Firearm Suicide X60-X71 X75-X84, Y87.0
Non-Firearm Homicide X85-X92, X96-Y09, Y87.1
Non-Firearm Homicide/Legal Intervention X85-X92, X96-Y09, Y87.1, Y35 (.1-.9), Y89.0

* The percentage of Fire/flame deaths (E890-E899) with no stated place of accident was approximately 6.03% for data from 1999.  Please bear these figures in mind when interpreting your results.
 

Cause and Intent Combinations for 1998 and Earlier Data
The cause you select, together with the intent you select, allows you to narrow the search to a particular injury category.  Not all combinations are valid (legitimate or applicable), however.  The table below shows the available cause options and intent options.  An X indicates a valid cause-intent combination.  For instance, the cause drowning / submersion and the intent suicide are a valid combination, so an "X" appears in the box for that combination.  Drowning / submersion and legal intervention are not valid, so the box for that combination is blank.

Table 5.1.2 : Valid Cause and Intent Combinations for 1998 and Earlier Data 

Cause / Mechanism

Total

 Intent / Manner

Unintentional Suicide Homicide Homicide and Legal Intervention Legal Inter-
vention 
Violence Related Undetermined
All Injury/Adverse Effects X X            
All Injury X X X X X X X X
Cut/piercing X X X X X X X X
Drowning/
Submersion
X X X X X   X  
Fall X X X X     X X
Fire/burn X X X X     X X
  Fire/flame X X X X     X X
  Hot Object X X X X     X X
Residential Fire/Flame X X            
Firearm X X X X X X X X
Machinery X X            
Motor Vehicle (MV), Overall X X            
MV Traffic X X           X
  Occupant X X            
  Motorcycle X X            
  Pedal Cycle X X            
  Pedestrian X X            
  Unspecified X X            
Pedal Cycle, Other X X            
Pedestrian, Other X X            
Pedal Cycle X X            
Pedestrian X X            
Transport, Other X X            
Natural / Environmental X X X       X X
Bites/Stings x X            
Non-Firearm     X X        
Overexertion X X            
Poisoning X X X X X X X X
Struck by, against X X   X X X X  
Suffocation X X X X     X X
Other specified, classifiable X X X X X X X X
Other specified, not elsewhere classifiable(NEC) X X X X X X X X
Unspecified X X X X X X X X
Adverse Effects X              
  Medical Care X              
  Drugs X              

 

The specific injury causes are from the Recommended Framework for Presenting Injury Mortality Data (requires Adobe Acrobat) and defined by their International Classification of Disease, 9th revision (ICD-9) codes.  The definitions of ICD-9 codes are available from the National Center for Health Statistics WONDER system.  Similar to the table above , this framework shows the cause or mechanism of injury along one axis and the intent of injury along the other.  The mortality reports include the causes from this framework as well as the following additional categories:

Cause of Injury ICD-9 Codes
All Injury and Adverse Effects E800-E999
Unintentional Injury and Adverse Effects E800-E949
Overall Motor Vehicle E810-E825
Pedal Cyclist E800-E807(.3), E810-E825(.6), E826.1,.9, E827-E829(.1)
Pedestrian E800-807(.2), E810-E825(.7), E826-E829(.0)
Residential Fire/flame* E890-E899 and Place of Accident = Home
Non-Firearm Suicide E950-E954, E955.5-E959
Non-Firearm Homicide E960-E964, E965.5-E969
Non-Firearm Homicide/Legal Intervention E960-E964, E965.5-E969, E971-E979

* The percentage of Fire/flame deaths (E890-E899) with no stated place of accident varied between 2.8% and 4.1% for data from 1983-1998, for 1982 the percentage was 7.2% and for 1981 it was 6.6%. Please bear these figures in mind when interpreting your results.

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5.1.2 Data Element: Census Region / State of Residence

Data reported by census region or state are based on where the deceased lived (state of residence). Census regions are as follows:

Census Region States
Northeast CT MA ME NH NJ NY PA RI VT
South AL AR DC DE FL GA KY LA MD MS NC OK SC TN TX VA WV
Midwest IA IL  IN KS MI MN MO ND NE OH SD WI 
West AK  AZ  CA CO HA ID  MT NM  NV OR UT WA WY

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5.1.3 Data Element: Year(s) of Report

You can request an injury mortality report for data from 1999 and later or for 1981 to 1998.   If you desire a report for a single year, enter the same year in both of the Year(s) of Report fields (e.g., 1997 to 1997).  Be aware that selecting a large number of years at a time may require a long response time.  Also, note that you cannot request a report for 1999 and later and any year from 1981 to 1998.  The external cause of injury coding for 1999 and later years, based on the ICD-10 classification system, is notably different from external cause coding for 1998 and earlier years, based on the ICD-9 classification system. You may not be able to compare numbers of deaths and deaths rates computed for some external causes of injury based on 1999 and later data to those based on data from 1998 and earlier.  Consequently, use caution when doing trend analysis of numbers of deaths and death rates across these years.  For more information, see Data Sources.

When selecting more than one year, the order in which you enter these years will affect the report appearance (see the Output Groups section).  For example, if you  request a report for 1994-1996, you have the option of entering either 1996 and 1994, or 1994 and 1996.  If you select 1994 and 1996, the report will begin with 1994.  If you select 1996 and 1994, the report will begin with 1996.  

If you request reports by other categories (e.g., sex, race, age groups), the order in which you select years does not affect how the report looks.  

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5.1.4 Data Element: Race

WISQARS Fatal reports race data in six categories: 

  • All races 
  • American Indian/Alaskan Native  
  • Asian/Pacific Islander  
  • Black
  • White
  • Other races. 

For 1992 on, the Other Races category represents the sum of American Indian/Alaskan Native and Asian/Pacific Islander categories. From 1992 on, there are only four race classifications: Americans Indian/Alaskan Native, Asian/Pacific Islander, Black, and White    

Prior to 1992, the All Other Races category applied to people who didn’t correspond to any of the other four categories and were limited to a few hundred cases per year (approximately 0.02%). Beginning in 1992, this category is imputed using the race category from the previous record.  Because the All Other Races category was used before 1992, deaths from Other Races may not add up to the number of deaths for American Indian/Alaskan Native and Asian/Pacific Islander categories for the years prior to 1992.

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5.1.5 Data Element: Hispanic Origin

Hispanic origin includes persons of Mexican, Puerto Rican, Cuban, Central and South American, and other or unknown Spanish origin.  Persons of Hispanic origin may be of any race.  

In 1990, reporting of Hispanic origin on death certificates occurred in all but three states--Louisiana, New Hampshire, and Oklahoma.  From 1990 through 1996, Hispanic origin data from those three states were excluded for those years when their reporting level was not sufficient for comparing with the other states.  

In February of 2002, NCHS discovered a problem with its underlying mortality data concerning the number of Hispanics in Alabama. In that year there were 127 deaths originally coded as Hispanics that should have been coded as Non-Hispanic (see reference). The 127 Hispanics represent approximately 60% of all the Hispanic deaths in Alabama for 1990. As a result, we have changed all the Hispanic Origin data to "Unknown" for Alabama for 1990.  For more information, see Vital Statistics of the United States, 1990, Volume II, Mortality, Part A.

Hispanic Origin data is missing or unknown for approximately 20% of the data from Connecticut for 1990. However this will not likely have a noticeable impact on the numbers reported. Additionally there was some miscoding of the underlying NCHS mortality data that was discovered for Connecticut in 1991. These miscodings concerned Mexicans who were coded as Puerto Ricans and Puerto Ricans who were coded as Mexicans (see reference). Since WISQARS reports ethnicity only as Hispanic, these miscoded data were not deemed to significantly impact the results from WISQARS.  For more information, see Vital Statistics of the United States, 1990, Volume II, Mortality, Part A.

All states provided Hispanic origin data at sufficient levels for comparability starting in 1997.   Including a state's Hispanic origin data does not imply that Hispanic origin reporting for a state was at 100%, however.  As a result, the number of deaths for Hispanics and non-Hispanics may not equal total deaths. 

The table below shows the states that did not provide sufficient reporting of Hispanic origin data and the year(s) that their Hispanic data are excluded. 

States Year(s) Excluded
Louisiana 1990
New Hampshire 1990-1992
Oklahoma 1990-1996

When a state's data were excluded from analysis, both the population and the number of deaths were excluded from any calculation. 

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5.1.6 Data Element: Sex   

Options for the sex category are males only, females only, or both.

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5.1.7 Output Options

The standard output option presents the data in a formatted table.  The text-only option does not feature formatting, so it may view or print more quickly.

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5.1.8 Advanced Report Options

Advanced report options allow you to further tailor the report you request to your information needs.  The advanced options include output group(s), age adjusting, and age selection.    

Output Group(s)
You can request a report that includes separate mortality data for various groups by selecting specified attributes (year, state, age, age group, race, and sex).  For example, if you request sex, then the report will separate the data by male and female. Up to four attributes can be selected, and the order in which you select them affects the report's display..

For example, if you request a report with an Output Group of YEAR and SEX for 1997-1996 Injury Deaths, the output will appear in the following form:                        

Year Sex Deaths
1997 Males 103,010
Females 43,390
---------------- ------------------
1997 146,400
1996 Males 103,930
Females 43,196
--------------- ------------------
1996 147,126
------------- ----------------
Overall 293,526

The same report ordered by SEX and YEAR would produce the following result:

Sex Year Deaths
Males 1997 103,010
1996 103,930
-------------- ----------------
Males 206, 940
Females 1997 43,390
1996 43,196
-------------- --------------
Females 86,586
--------------- ---------------
Overall 293,526

Because of the way age-adjusted rates are computed, you cannot obtain age-specific rates and age-adjust at the same time.  If you select an output order of age group and choose a standard year for age-adjusting, the request for age-adjusted rates to be ignored.   

The options for output groups can impact the response time of your request significantly.  The state and age group options use many resources.  Using both state and age group options in a request may cause the request to fail or timeout.  To avoid this problem, restrict the age range or select a specific state. 

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Age Selection
You can select the age range for a report in three ways:

  • All ages (default), which includes those of unknown age.
  • Specific age ranges, which allows you to choose a specific age-range in 5-year increments.  This selection allows you to restrict the age-range of the query, but the report will still contain age-adjusted rates.  If you want a report on a single 5-year age group, both fields should contain the same value (e.g., 0-4 to 0-4).
  • Customized ages, which allows you to select any valid age range and provides the most flexibility in constructing the report.  This selection is particularly useful if you want to target a specific group of people whose ages may not conveniently fall into 5-year age groups, such as teenagers (age 13-19).  If you need data for a single age, simply repeat the age value in both fields (e.g., 3 to 3).

Note: Age ranges include the ages specified.  For example, the age range 15-19 includes those who are 15 years old and those who are 19 years old.  Also note that population estimates are not available for a single year of age for all standard years.  Therefore, age adjusting of custom ranges cannot be done.

Age Adjusting
Some injuries occur more often among certain age groups than others.  For instance, falls are more common among the elderly than among any other age group. Age adjustment enables you to compare injury rates without concern that differences are because of differences in the age distributions between different populations or for the same population over time.

The standard year identifies the year to which you want to age adjust.  The year you choose is not important, only that each rate you compare is adjusted to the same year.  For data prior to 1999, age adjusting was typically done to the year 1940.  Starting with 1999 mortality data, the year 2000 is the default age to which to adjust.  You also can select the years 1970, 1980, and 1990 for any injury mortality request.  

Because of the way age-adjusted rates are computed, WISQARS Fatal may not be able to display age-adjusted rates for all categories on a report. For instance, a report by sex will have age-adjusted rates for males and for females, not both sexes combined. If you desire an age-adjusted rate for both sexes, you should request an age-adjusted report without choosing the output group of sex. Also, because of the way age-adjusted rates are computed, you cannot get age-specific rates and age-adjusted rates at the same time. If you select a report sorted by age group AND choose a standard year for age adjusting, WISQARS  will ignore the request for age-adjusted rates automatically.

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