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Unintentional injuries are the leading cause of morbidity and mortality among children in the United States. This report uses data from the National Vital Statistics Systems and the National Electronic Injury Surveillance System - All Injury Program to provide an overview of unintentional injuries related to drowning, falls, fires or burns, transportation-related injuries, poisoning, and suffocation, among others during the period 2000 - 2006. Results are presented by age group and sex, as well as the geographic distribution of injury death rates by state.

Some of the key findings from this report include the following:

Injury Deaths

  • On average, 12,175 children 0 to 19 years of age died each year in the U.S. from an unintentional injury.
  • Males had higher injury death rates than females.
    The death rate for males was almost two times the rate for females, and males had a higher injury death rate compared to females in all childhood age groups.
  • Injuries due tos transportation were the leading cause of death for children.
    The highest death rates were among occupants of motor vehicles in traffic. There were also a substantial number of pedestrian and pedal cyclist deaths among children. Combining all unintentional injury deaths among those between 0 and 19 years, motor vehicle traffic-related deaths were the leading cause.
  • The leading causes of injury death differed by age group.
    For children less than 1 year of age, two-thirds of injury deaths were due to suffocation. Drowning was the leading cause of injury death for those 1 to 4 years of age. For children 5 to 19 years of age, the most injury deaths were due to being an occupant in a motor vehicle traffic crash.
  • Risk for injury death varied by race.
    Injury death rates were highest for American Indian and Alaska Natives and were lowest for Asian or Pacific Islanders. Overall death rates for whites and African-Americans were approximately the same.
  • Injury death rates varied by state depending upon the cause of death.
    Overall, states with the lowest injury death rates were in the northeast. Fire and burn death rates were highest in some of the southern states. Death rates from transportation-related injuries were highest in some southern states and some states of the upper plains, while lowest rates occurred in states in the northeast region.
  • For injury causes with an overall low burden, death rates greatly varied by age.
    The poisoning death rate for those older than 15 years of age was at least five times the rates of the younger age groups, and the suffocation death rate for those less than one year was over 16 times the rates for all older age groups.

Nonfatal Injuries

  • An estimated 9.2 million children annually had an initial emergency department visit for an unintentional injury.
  • Males generally had higher nonfatal injury rates than females.
    For children 1 to 19 years of age, nonfatal injury rates were higher among males than females, while the rates were approximately the same for those less than 1 year.
  • Injuries due to falls were the leading cause of nonfatal injury.
    Each year, approximately 2.8 million children had an initial emergency department visit for injuries from a fall. For children less than 1 year of age, falls accounted for over 50% of nonfatal injuries.
  • The majority of nonfatal injuries were from five causes.
    Falls was the leading cause of nonfatal injury for all age groups less than 15. For children ages 0 to 9, the next two leading causes were being struck by or against an object and animal bites or insect stings. For children 10 to 14 years of age, the next leading causes were being struck by or against an object and overexertion. For children 15 to 19 years of age, the three leading causes of nonfatal injuries were being struck by or against an object, falls, and motor vehicle occupant injuries.
  • Nonfatal injury rates varied by age group.
    Nonfatal suffocation rates were highest for those less than 1 year of age. Rates for injuries from fires or burns, and drowning were highest for children 4 years and younger. Children 1 to 4 years of age had the highest rates of nonfatal falls and poisoning. Injury rates related to motor vehicles was highest in children 15 to 19 years of age.


Injuries are among the most under-recognized public health problems facing the United States today. About 20 children die every day from a preventable injury – more than die from all diseases combined.(1) Injuries requiring medical attention or resulting in restricted activity affect approximately 20 million children and adolescents and cost $17 billion annually in medical costs.(2)

Today we recognize that these injuries, like the diseases that once killed children, are predictable, preventable and controllable. The U.S. Centers for Disease Control and Prevention works closely with other federal and state agencies, national, state and local organizations and research institutions to reduce deaths and nonfatal injuries, disabilities and costs of childhood injuries in the United States.

The release of this CDC Childhood Injury Report coincides with the launch of the World Report on Child Injury Prevention (2008) developed by the World Health Organization and UNICEF.(3) Our report complements the World Report and highlights the nature of the problem in the United States.

The CDC report can inform the work of practitioners, policy-makers, elected officials, and researchers to better understand the problem and take the necessary steps to reduce the devastating burden childhood injuries place on this nation.

Grant Baldwin, Ph.D., MPH
Division of Unintentional Injury Prevention
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention



  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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