Skip directly to search Skip directly to A to Z list Skip directly to site content
CDC Home

The content, links, and pdfs are no longer maintained and might be outdated.

  • The content on this page is being archived for historic and reference purposes only.
  • For current, updated information see the MMWR website.

Years of Potential Life Lost from Unintentional Injuries Among Persons Aged 0–19 Years — United States, 2000–2009

Unintentional injuries are the leading cause of deaths among persons aged 0–19 years in the United States. Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simple method to identify important causes of premature death and specific groups in need of intervention (1). Deaths attributed to unintentional injuries among persons aged 0–19 years number approximately 12,000 each year in the United States; another 9 million young persons are treated for nonfatal injuries in emergency departments (2). To estimate the burden of premature deaths attributed to unintentional injuries among persons aged 0–19 years, CDC calculated state-specific YPLL by sex, age, race, and injury mechanism based on data from the National Vital Statistics System multiple cause of death files for the period 2000–2009. This report summarizes the results of that analysis, which found that an average of 890 years of potential life were lost each year because of unintentional injuries for every 100,000 persons aged 0–19 years. The burden of unintentional injuries was higher among males compared with females, among persons aged <1 year and those aged 15–19 years compared with the other 5-year age groups, among American Indian/Alaska Native (AI/AN) compared with those of any other race/ethnicity, and among those residing in two clusters of adjacent states (the South Central states of Arkansas, Louisiana, Mississippi, and Alabama, and the Mountain states of Montana, Wyoming, and South Dakota) compared with any other region. These estimates can be used to target injury prevention strategies to young persons most at risk.

CDC analyzed data from the National Vital Statistics System multiple cause of death files for the period 2000–2009 (3), the most recent data available. Unintentional injury deaths were defined as those with the underlying cause of death classified by the International Classification of Diseases, 10th Revision (ICD-10) as drowning (W65–W74), falls (W00–W19), fires or burns (X00–X19), transport-related injuries (V01–V99), poisoning (X40–X49), and suffocation (W75–W84) (4), or falling in a category of other injury deaths comprising all other mechanisms of unintentional injuries: cut or pierced, unintentional firearm, machinery, natural and environmental, overexertion, struck by or against an object, and other specified and unspecified.

YPLL was calculated for each decedent by subtracting the age at death in years from 75. Annualized YPLL during 2000–2009 for each demographic group, injury mechanism, and geographic area was calculated by summing its associated YPLL for the 10 years and dividing by 10.

The annualized YPLL per 100,000 for each demographic group, injury mechanism, or geographic area was calculated by dividing its YPLL for 2000–2009 by the sum of the mid-year annual population estimates of the relevant population for 2000–2009. Population estimates used for YPLL rate calculations were bridged-race population figures (5). Annualized YPLL and YPLL rates were calculated at the national and state level; by sex, age, and race; and for the injury mechanisms of drowning, falls, fires or burns, motor vehicle traffic–related, other transportation, poisoning, suffocation, and "all other" mechanisms.

National Level YPLL

Unintentional childhood injuries accounted for 115,613 deaths during 2000–2009. Males contributed almost twice the number of YPLL as females, with an annual rate of 1,137 per 100,000, compared with 630 (Table 1). Persons aged 15–19 years contributed 51% of the total YPLL from unintentional injuries. The YPLL rate per 100,000 by 5-year age group ranged from 367 in persons aged 5–9 years to 1,768 in those aged 15–19 years, but the highest rate in any single-year age group was in persons aged <1 year with 1,977 YPLL per 100,000 each year, of which 71% were attributed to suffocation injuries.

YPLL rates differed by race/ethnicity. The rate was highest among AI/AN males at 1,790 per 100,000, followed by black males at 1,194, and white males at 1,147 (Table 1). Among females, AI/AN females had a YPLL rate nearly twice that of both white and black females and three times that of Asian/Pacific Islander females, who lost an average of 320 years of potential life per 100,000 each year.

Injuries attributed to motor vehicle traffic crashes contributed the bulk (55%) of all YPLL during the period analyzed. The YPLL per 100,000 for motor vehicle traffic–related injuries was 491, five times higher than that for suffocation, the second leading YPLL contributor at 95. Drowning was third, with a YPLL rate of 91 per 100,000. Motor vehicle traffic–related pedestrian injuries contributed more to YPLL (52 per 100,000) than injuries from fire or burns (45), poisoning (52), and falls (14).

State Level YPLL

Thirty states had YPLL rates greater than or equal to the national YPLL rate of 890 per 100,000 persons aged 0–19 years. The YPLL per 100,000 varied among the states, from 416 in Massachusetts to 1,770 in Mississippi. States with the highest YPLL rates were Mississippi (1,770), Alaska (1,592), South Dakota (1,573), and Wyoming (1,543). States with the lowest YPLL rates were Massachusetts (416), New Jersey (470), New York (484), and Connecticut (521) (Table 2 and Figure).

Reported by

Nagesh N. Borse, PhD, Div of Global HIV and AIDS, Center for Global Health; Rose A. Rudd, MSPH, Ann M. Dellinger, David A. Sleet, PhD, Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC. Corresponding contributor: Nagesh N. Borse, nborse@cdc.gov, 404-639-8339.

Editorial Note

This report provides new information on YPLL attributed to unintentional injuries among persons aged 0–19 years, by state, which can be used to prioritize and identify subgroups of the population most at risk. Although recent declines have been observed in the unintentional injury–related crude mortality rate per 100,000 persons aged 0–19 years (from 15.46 in 2000 to 10.96 in 2009), unintentional injuries remain the number one killer among this population in the United States. The burden of unintentional injuries was highest among males, persons aged <1 year and those aged 15–19 years, and AI/ANs. Injuries related to motor vehicle traffic, drowning, and suffocation contributed most to YPLL.

By taking into account the decedent's age at death, YPLL measures premature mortality. Unlike other mortality indicators, YPLL is a more relevant measure for children because it incorporates both the number of those who died and the number of years lost because of premature death. With different injury mechanisms disproportionally affecting persons of different ages (e.g., suffocation being the leading mechanism of death only in those aged <1 year), YPLL reflects this variation. Injury researchers can use state YPLL estimates to develop and evaluate injury prevention programs that reduce YPLL. In addition, federal, state, and local health departments can use these estimates to help guide activities toward meeting Healthy People 2020 objectives for children and adolescents and to help identify and target injury prevention strategies.

The findings of this report are subject to at least one limitation. The analysis was based on death certificate data indicating that an unintentional injury was the underlying cause of death; previous studies have shown that some injury-related deaths are underestimated or misclassified by mechanism on death certificates (6).

Decreasing the burden of injuries is a central challenge for public health in the United States. Most injuries are preventable, and many effective strategies are available to reduce child injury and mortality (7,8). Measuring the burden of injuries with YPLL gives greater weight to the injuries that disproportionately affect younger persons and permits comparison of the premature injury death by sex, age group, race, and state. YPLL will help prioritize implementation of known and effective interventions, such as using safety belts, wearing bicycle and motorcycle helmets, reducing drinking and driving, strengthening graduated driver licensing laws, using safety equipment during sports participation, requiring four-sided residential pool fencing, and encouraging safe sleep practices for infants. Implementing these strategies widely can reduce the burden of injuries to all persons aged 0–19 years (2,7–9). In 2009, in an effort to raise parent's awareness about the leading causes of child injury in the United States and how they can be prevented, CDC published its childhood injury report on patterns of unintentional injuries among persons aged 0–19 years (2), launched a Protect the Ones You Love initiative, and made available a number of resources that can be accessed online at http://www.cdc.gov/safechild. In 2012, CDC launched the National Action Plan on Childhood Injury Prevention (available online at http://www.cdc.gov/safechild/nap) to mobilize action around a set of recommendations for research, communications, policy, health services, education and training, and data and surveillance that can save children's lives (10).

References

  1. CDC. Premature mortality in the United States: public health issues in the use of years of potential life lost. MMWR 1986;35(2 Suppl):1S–11S.
  2. Borse NN, Gilchrist J, Dellinger AM, et al. Unintentional childhood injuries in the United States: key findings from the CDC childhood injury report. J Safety Res 2009;40:71–4.
  3. Xu JQ, Kochanek KD, Murphy SL, et al. Deaths: final data for 2007. Natl Vital Stat Rep 2010;58(19).
  4. World Health Organization. Manual of the international statistical classification of disease, injuries, and causes of death, 10th revision. Geneva, Switzerland: World Health Organization; 1999.
  5. CDC. Postcensal estimates of the resident population of the United States for July 1, 2000–July 1, 2006, by year, county, age, bridged race, Hispanic origin, and sex (Vintage 2006). Available at http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2006. Accessed October 9, 2012.
  6. Nagaraja J, Menkedick J, Phelan KJ, et al. Deaths from residential injuries in US children and adolescents, 1985–1997. Pediatrics 2005;116:454–61.
  7. Peden M, Oyegbite K, Ozanne-Smith J, et al, eds. World report on child injury prevention. Geneva, Switzerland: World Health Organization; 2008. Available at http://www.who.int/violence_injury_prevention/child/injury/world_report/report/en/index.html. Accessed October 9, 2012.
  8. Doll LS, Bonzo SE, Mercy JA, et al, eds. Handbook of injury and violence prevention. New York, NY: Springer Science Business Media, LLC; 2007.
  9. Sleet DA, Ballesteros MF, Borse NN. A review of unintentional injuries in adolescents. Annu Rev Public Health 2010;31:195–212.
  10. CDC. National action plan for child injury prevention. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2012. Available at http://www.cdc.gov/safechild/nap. Accessed October 9, 2012.

What is already known on this topic?

Nationally, deaths attributed to unintentional injuries among persons aged 0–19 years number approximately 12,000 each year in the United States; another 9 million young persons are treated for nonfatal injuries in emergency departments. Quantifying years of potential life lost (YPLL) highlights causes of premature mortality and provides a simple method to identify important causes of early death and specific groups in need of intervention. Although recent declines have been observed in the unintentional injury–related crude mortality rate per 100,000 persons aged 0–19 years (from 15.46 in 2000 to 10.96 in 2009), unintentional injuries remain the number one killer among this population in the United States.

What is added by this report?

This report provides new information on YPLL from unintentional injuries among persons aged 0–19 years, by state, which can be used for prioritization and identifying subgroups of the population most at risk. The burden of unintentional injuries was higher among males, persons aged <1 year and those aged 15–19 years, American Indian/Alaska Native children, and those residing in two clusters of adjacent states (the South Central states of Arkansas, Louisiana, Mississippi, and Alabama, and the Mountain states of Montana, Wyoming, and South Dakota) compared with any other region.

What are the implications for public health practice?

Federal, state, and local health departments can use these estimates to help guide activities toward meeting Healthy People 2020 objectives for children and adolescents and to help identify and target injury prevention strategies to specific subgroups of this population. In 2012, CDC launched the National Action Plan on Childhood Injury Prevention (available online at http://www.cdc.gov/safechild/nap) to help reduce this major killer of children and adolescents.


TABLE 1. Estimated annual number of deaths and annualized years of potential life lost (YPLL) per 100,000 persons aged 0–19 years, by sex, age group, race, and mechanism of unintentional injury — United States, 2000–2009

Characteristic

Annualized no. of deaths

YPLL per year per 100,000

Sex

Male

7,632

1,137

Female

3,930

630

Age group (yrs)

<1

1,081

1,977

1–4

1,634

739

5–9

1,076

367

10–14

1,347

408

15–19

6,423

1,768

Sex and Race

Male

White

6,050

1,147

Black

1,246

1,194

American Indian/Alaska Native

162

1,790

Asian/Pacific Islander

173

566

Female

White

3,077

630

Black

668

683

American Indian/Alaska Native

93

1,080

Asian/Pacific Islander

92

320

Injury mechanism

Drowning

1,105

91

Falls

180

14

Fire or burns

541

45

Motor vehicle traffic–related*

6,647

491

Occupant

3,250

239

Pedestrian

670

52

Pedal cyclist

141

11

Other

222

16

Unspecified

2,364

174

Transportation-related, all other

636

50

Poisoning

722

52

Suffocation

1,067

95

Other injuries

664

52

Total

11,561

890

* Categorized by injured person and includes motor vehicle traffic occupant, motorcyclist, pedal cyclist, pedestrian, occupant or rider of other modes of transport in a motor vehicle traffic crash, and motor vehicle traffic crashes for which the injured person is unspecified.

Cut or pierced, unintentional firearm-related injury, machinery-related injury, injury via natural and environmental cause, overexertion, struck by or against an object, and other specified and unspecified.


TABLE 2. Total number of deaths, annualized years of potential life lost (YPLL) attributed to unintentional injuries per 100,000 persons aged 0–19 years, by state and sex (in descending order of overall YPLL rate) — United States, 2000–2009

State

Total no. of deaths

YPLL per year per 100,000

Male

Female

Total

Male

Female

Non-MVT*

MVT

Total

U.S. overall

76,315

39,298

115,613

1,137

630

399 

491

890

States with YPLL rate > national rate

Mississippi

1,541

837

2,378

2,228

1,292

751

1,019

1,770

Alaska

336

177

513

1,997

1,159

1,072

520

1,592

South Dakota

353

196

549

1,963

1,162

691

882

1,573

Wyoming

222

121

343

1,920

1,142

680

863

1,543

Arkansas

1,214

664

1,878

1,928

1,128

619

919

1,538

Louisiana

1,961

1,000

2,961

1,878

1,023

736

723

1,459

Montana

380

201

581

1,841

1,049

552

905

1,457

Alabama

1,850

977

2,827

1,812

1,019

598

826

1,424

Oklahoma

1,418

729

2,147

1,730

958

598

757

1,355

South Carolina

1,664

819

2,483

1,750

931

569

781

1,350

Kentucky

1,546

789

2,335

1,697

938

609

718

1,327

Missouri

2,065

1,180

3,245

1,599

982

566

732

1,298

Tennessee

2,114

1,120

3,234

1,619

922

551

728

1,279

West Virginia

597

296

893

1,634

860

476

781

1,257

New Mexico

707

376

1,083

1,523

869

455

747

1,202

Idaho

507

291

798

1,433

888

509

658

1,167

Kansas

902

500

1,402

1,412

841

450

684

1,134

Florida

5,216

2,508

7,724

1,458

761

551

567

1,118

North Dakota

185

111

296

1,323

835

368

718

1,086

North Carolina

2,652

1,355

4,007

1,352

747

415

642

1,057

Indiana

1,866

1,050

2,916

1,298

790

521

529

1,050

Arizona

1,861

978

2,839

1,318

747

466

574

1,040

Georgia

2,788

1,434

4,222

1,297

720

466

550

1,016

Nebraska

489

320

809

1,186

828

353

658

1,011

Nevada

669

370

1,039

1,237

740

500

495

995

Texas

7,056

3,739

10,795

1,226

700

406

563

969

Wisconsin

1,424

743

2,167

1,160

651

415

496

911

Iowa

743

394

1,137

1,139

646

347

552

899

Delaware

206

115

321

1,114

664

338

556

894

Maine

307

156

463

1,154

621

382

512

894

States with YPLL rate ≤ national rate

Michigan

2,498

1,339

3,837

1,109

641

447

434

881

Oregon

867

470

1,337

1,103

646

414

466

880

Vermont

139

77

216

1,054

638

344

508

852

Utah

720

407

1,127

1,041

632

390

452

842

Ohio

2,690

1,388

4,078

1,060

588

422

407

829

Colorado

1,078

617

1,695

1,000

620

317

498

815

Pennsylvania

2,851

1,299

4,150

1,075

526

372

435

807

Minnesota

1,114

620

1,734

971

577

363

415

778

Virginia

1,668

822

2,490

1,003

529

338

433

771

Washington

1,399

655

2,054

1,003

507

372

389

761

Illinois

2,674

1,404

4,078

914

518

364

357

721

Hawaii

251

98

349

928

401

333

341

674

Maryland

1,024

523

1,547

813

445

235

398

633

New Hampshire

251

97

348

888

366

313

320

633

California

6,802

3,435

10,237

787

429

246

366

612

District of Columbia

79

36

115

759

380

288

282

570

Rhode Island

160

80

240

705

376

232

312

544

Connecticut

574

215

789

731

300

249

272

521

New York

2,656

1,279

3,935

633

328

236

248

484

New Jersey

1,207

550

1,757

626

306

231

239

470

Massachusetts

774

341

1,115

564

262

177

239

416

* Non–motor vehicle traffic (MVT)–related YPLL rate, which includes injury mechanisms of drowning, falls, fires or burns, other transportation, poisoning, suffocation, and "all other" mechanisms.

MVT-related YPLL rate.


FIGURE. Annualized years of potential life lost (YPLL) attributed to unintentional injuries per 100,000 persons aged 0–19 years — United States, 2000–2009

The figure shows annualized years of potential life lost (YPLL) attributed to unintentional injuries per 100,000 persons aged 0-19 years in the United States during 2000-2009. Thirty states had YPLL rates greater than or equal to the national YPLL rate of 890 per 100,000. The YPLL per 100,000 varied among the states, from 416 in Massachusetts to 1,770 in Mississippi. States with the highest YPLL rates were Mississippi (1,770), Alaska (1,592), South Dakota (1,573) and Wyoming (1,543). States with the lowest YPLL rates were Massachusetts (416), New Jersey (470), New York (484), and Connecticut (521).

Alternate Text: The figure above shows annualized years of potential life lost (YPLL) attributed to unintentional injuries per 100,000 persons aged 0-19 years in the United States during 2000-2009. Thirty states had YPLL rates greater than or equal to the national YPLL rate of 890 per 100,000. The YPLL per 100,000 varied among the states, from 416 in Massachusetts to 1,770 in Mississippi. States with the highest YPLL rates were Mississippi (1,770), Alaska (1,592), South Dakota (1,573) and Wyoming (1,543). States with the lowest YPLL rates were Massachusetts (416), New Jersey (470), New York (484), and Connecticut (521).


Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.


All MMWR HTML versions of articles are electronic conversions from typeset documents. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (http://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

 
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #