Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

State-Level Lifetime Medical and Work-Loss Costs of Fatal Injuries — United States, 2014



Feijun Luo, PhD1; Curtis Florence, PhD1 (View author affiliations)

View suggested citation


Summary

What is already known about this topic?

Injuries are a leading cause of death in the United States. Injury-associated deaths result in a substantial economic burden to the United States: the total estimated lifetime medical and work-loss costs were $214 billion in 2013. Injury and violence prevention strategies can save lives and reduce costs.

What is added by this report?

Lifetime costs and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for each of four injury intent categories (all intents, unintentional, suicide, and homicide) for 2014. Economic burdens varied widely among the states and DC. Lifetime costs per capita ranged from $1,233 (New Mexico) to $491 (New York) among fatal injuries of all intents, from $815 (West Virginia) to $261 (Maryland) among unintentional injuries, from $338 (Alaska) to $107 (New Jersey) among suicides, and from $273 (DC) to $24 (Hawaii) for homicides.

What are the implications for public health practice?

States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas. States that consistently have lower lifetime costs per capita across different intents of injuries might have successful injury prevention experiences that could be shared with states with higher per capita costs.


Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas.

The numbers of injury-associated deaths in each of the 50 states and DC in 2014 were obtained from the National Vital Statistics System, and state-level lifetime costs were obtained from the Web-based Injury Statistics Query and Reporting System database (3). Injury death rates were calculated using the U.S. Census Bureau’s bridged race population estimates for 2014. Lifetime costs, which include lifetime medical and work-loss costs, were computed by multiplying the number of injury deaths by average costs of treating injuries and earnings in 2010, adjusted to 2014 prices. Medical costs were derived from various sources that measure the costs of transport, health care in multiple settings, including emergency departments, hospitals, and nursing homes, and examination by a coroner or medical examiner (4). 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. Numbers of deaths, rates, lifetime costs, and lifetime costs per capita (lifetime costs divided by the state population) were examined for each state and DC. Lifetime costs per capita were used for comparisons across states. Four intents of fatal injuries were considered: all intents,* unintentional, suicide, and homicide. For each intent, state-level lifetime costs were estimated for the total population, for males and females, and for all intents. State-level lifetime costs were also estimated for three age groups: young (0–24 years), middle (25–64 years), and older (≥65 years). State-level lifetime costs per capita were provided for the total population for each intent. In some state-intent-population combinations, average medical costs were statistically unstable, but these costs accounted for <1% or <5% of average lifetime costs. When both average medical costs and average work-loss costs were statistically unstable or when the mortality rates were unstable or missing, lifetime costs or lifetime costs per capita were not presented.

Top

Injuries from All Intents

Injury mortality rates (per 100,000), lifetime costs (in 2014 U.S. dollars), and lifetime costs per capita (in 2014 U.S. dollars) varied widely among the 50 states and DC for each of the four intents. Overall, total injury-related mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 and $491 (New York) (Table 1). The rates of overall male and female injury mortality were highest in New Mexico (141.1 and 63.7, respectively), and lowest in New York (58.9 and 23.1, respectively). New York also had the lowest injury mortality rate among persons aged ≥65 years (87.1). The states with the highest and lowest lifetime fatal injury costs were California ($20.9 billion) and Vermont ($406 million), respectively. California had the highest number of injury deaths (18,152) and DC the lowest number of injury deaths (385). The lifetime costs per capita for injuries of all intents ranged from $491 to $1,233 (Figure). The five states with the highest lifetime fatal injury costs per capita were New Mexico ($1,233), West Virginia ($1,162), Alaska ($1,091), Louisiana ($1,041), and Oklahoma ($1,040); states with the lowest lifetime costs per capita were New York ($491), New Jersey ($533), California ($538), Massachusetts ($550), and Minnesota ($557).

Top

Unintentional Injuries

West Virginia had the highest lifetime costs per capita for fatal unintentional injuries ($815), the highest unintentional injury mortality rate among males (95.2), and the highest unintentional injury mortality rate among persons aged 25–64 years (88.5) (Table 1). Maryland had the lowest lifetime costs per capita for fatal unintentional injuries ($261), the lowest total unintentional injury mortality rate (26.4), the lowest male unintentional injury mortality rate (36.9), and the lowest unintentional injury mortality rate among persons aged 25–64 years (23.3). New Mexico had the highest total unintentional injury mortality rate (71.9) and the highest female unintentional injury mortality rate (49.9). California had the highest lifetime costs for fatal unintentional injuries ($12.2 billion) and the highest number of unintentional injury deaths (11,804).

Top

Suicides

Alaska and New Jersey had the highest and lowest lifetime suicide costs per capita ($338 and $107, respectively) (Table 2). Montana had the highest total suicide rate (23.8), the highest male suicide rate (36.8), and the highest female suicide rate (11.4). DC had the lowest number of suicides (52), total suicide rate (7.7), male suicide rate (12.3), and lifetime costs ($73 million). California had the highest lifetime costs ($4.9 billion) and the highest number of suicides (4,214).

Top

Homicides

The highest and lowest lifetime homicide-related mortality costs per capita were in DC ($273) and Hawaii ($24), respectively (Table 2). DC had the highest total homicide rate (13.2), the highest male homicide rate (22.3), and the highest female homicide rate (4.8). New Hampshire, Maine, and Massachusetts had the lowest total homicide rate (1.3), the lowest male homicide rate (2.6), and the lowest female homicide rate (0.5), respectively. California had the highest lifetime homicide-related costs ($3.1 billion) and the highest number of homicides (1,813).

Top

Discussion

Economic burdens of fatal injuries varied widely in the 50 states and DC for each of the four categories of intent. Across all the four fatal injury intents, some states consistently had lower lifetime costs per capita than most other states. For example, New York, New Jersey, and California ranked among the five lowest states in terms of lifetime costs per capita for injuries of all intents, unintentional injuries, and suicides. In contrast, New Mexico ranked among the five highest states in terms of lifetime costs per capita for injuries of all intents, unintentional injuries, and suicides. Varying economic burdens of fatal injuries in the 50 states and DC might be attributed to the different injury mortality rates, the different medical costs resulting from different medical procedures, and the different demographic characteristics of injury decedents, such as sex and age.

Implementation of effective injury prevention strategies is needed to help reduce the substantial lifetime medical and work-loss costs associated with fatal injuries. The differing state-level lifetime costs per capita for fatal injuries suggests an urgent need in some states to prevent injuries. States that consistently have lower lifetime costs per capita across different intents of injuries might have successful injury prevention experiences that could be shared with states with higher per capita costs.

The findings in this report are subject to at least four limitations. First, the costs account for medical and work-loss costs associated with decedents. Other societal costs, such as criminal justice costs and the pain and suffering of family members, were not considered. Second, work-loss costs, based on the mean earnings of the general population by sex and specific age groups, might be over- or underestimated because the mean earnings of decedents might differ from those of the general population. Third, intent of fatal injury, as determined from the manner of death assigned on death certificates by coroners or medical examiners, might differ across jurisdictions (5). Finally, unintentional fatal injuries were not broken down into more specific categories such as motor vehicle crashes, drug overdoses, traumatic brain injuries, and older adult falls, so that this report cannot indicate the economic burdens of those specific categories of unintentional injuries.

During 2005–2014, the number of unintentional fatal injuries increased 15%, from 117,809 to 136,053, and unintentional injury moved from the fifth to the fourth leading cause of death; the number of suicides rose 31%, from 32,637 to 42,773, and suicide moved from the eleventh to the tenth leading cause of death (2,6). The increasing incidence and economic burden of injuries, particularly unintentional injuries and suicides, call for effective prevention programs and strategies. For example, the CDC Guideline for Prescribing Opioids for Chronic Pain provides prescribing recommendations for opioid pain medication to patients aged ≥18 years with chronic pain in primary care settings (7), which could be adopted by states and might reduce the number of persons who overdose prescribed opioid medications. To reduce motor vehicle crash fatalities, states could increase seatbelt use with primary enforcement seatbelt laws that cover everyone in the vehicle (8) or consider requiring car seats and booster seats for children through at least age 8 years or until seatbelts fit properly (9). The 2012 Surgeon General’s National Strategy for Suicide Prevention suggests that strategies enhancing social support, community connectedness, and access to mental health and preventive services and measures to reduce stigma and barriers associated with seeking help might alleviate suicide risk across the lifespan (10). The estimates of state-level economic burdens of fatal injuries will permit policy makers to compare the costs of implementing prevention programs and strategies with the cost savings garnered from the aversion of fatal injuries.

Top


Corresponding author: Feijun Luo, fluo@cdc.gov, 770-488-3896.

Top

1Division of Analysis, Research and Practice Integration, National Center for Injury Prevention and Control, CDC.

Top

* All intents category includes legal intervention and undetermined intent of injury, in addition to unintentional, suicide, and homicide.

Lifetime costs or lifetime costs per capita of homicides were not presented for New Hampshire, North Dakota, South Dakota, Vermont, and Wyoming because those states had unstable average medical and work loss costs or unstable homicide rates.

Top

References

  1. Florence C, Simon T, Haegerich T, Luo F, Zhou C. Estimated lifetime medical and work-loss costs of fatal injuries—United States, 2013. MMWR Morb Mortal Wkly Rep 2015;64:1074–7. CrossRef PubMed
  2. Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: final data for 2014. National Vital Statistics Reports, Vol. 65, No. 4. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2016. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf
  3. CDC. Web-Based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: US Department of Health and Human Services; 2016. https://www.cdc.gov/injury/wisqars
  4. Lawrence BA, Miller TA. Medical and work loss cost estimation methods for the WISQARS cost of injury module. Calverton, MD: Pacific Institute for Research & Evaluation; 2014. http://www.pire.org/documents/WisqarsCostMethods.pdf
  5. Breiding MJ, Wiersema B. Variability of undetermined manner of death classification in the US. Inj Prev 2006;12(Suppl 2):ii49–54. CrossRef PubMed
  6. Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: final data for 2005. National Vital Statistics Reports, vol. 52, no. 10. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2008. https://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf
  7. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1). CrossRef PubMed
  8. CDC. Prevention status reports: motor vehicle injuries. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://wwwn.cdc.gov/psr/NationalSummary/NSMVI.aspx
  9. CDC. Buckle up: restraint use state fact sheets. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://www.cdc.gov/motorvehiclesafety/seatbelts/states.html
  10. Office of the Surgeon General. National Action Alliance for Suicide Prevention. 2012 national strategy for suicide prevention: goals and objectives for action. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2012. https://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full-report.pdf

Top

Return to your place in the textTABLE 1. Deaths from injuries of all intents and unintentional injuries, rates per 100,000 population, lifetime medical and work-loss costs, and lifetime medical and work-loss costs per capita, by state — United States, 2014
StateAll intentsUnintentional injuries
TotalSexAge group (yrs)TotalSexAge group (yrs)
MaleFemale0–2425–64≥65MaleFemale0–2425–64≥65
Alabama
No. of deaths (rate)3,625 (73.2)2,440 (105.3)1,185 (44.1)534 (31.6)2,224 (89.6)867 (121.9)2,463 (49.2)1,525 (65.9)938 (34.4)360 (21.5)1,396 (55.6)707 (100.5)
Costs, million USD (per capita, USD*)4,372 (902)3,3171,0389833,1381632,767 (571)1,9677846421,943130
Alaska
No. of deaths (rate)615 (85.8)441 (119.9)174 (50.4)105 (36.3)427 (106.1)83 (141.0)379 (54.9)260 (74.2)119 (35.6)54 (18.5)259 (64.7)66 (116.2)
Costs, million USD (per capita, USD*)804 (1,091)63417019359217448 (608)34110994a34913
Arizona
No. of deaths (rate)5,079 (72.6)3,387 (100.4)1,692 (45.5)603 (25.1)2,900 (85.4)1,575 (152.7)3,322 (46.8)2,077 (61.5)1,245 (32.5)357 (14.9)1,710 (50.0)1,254 (122.9)
Costs, million USD (per capita, USD*)5,604 (832)4,3261,2591,1293,9422603,226 (479)2,4258166522,247201
Arkansas
No. of deaths (rate)2,280 (75.2)1,522 (105.7)758 (46.4)316 (30.7)1,330 (89.6)634 (140.9)1,458 (47.2)907 (62.8)551 (32.6)189 (18.4)757 (50.4)512 (114.8)
Costs, million USD (per capita, USD*)2,719 (917)2,0526425871,9041171,623 (547)1,1804203471,08091
California
No. of deaths (rate)18,152 (44.9)12,820 (66.0)5,332 (25.0)2,495 (17.6)11,109 (52.5)4,544 (90.2)11,804 (29.1)7,847 (40.6)3,957 (18.3)1,437 (10.2)6,832 (32.0)3,531 (69.8)
Costs, million USD (per capita, USD*)20,894 (538)16,7464,2094,76014,76680312,171 (314)9,4502,8082,6868,765601
Colorado
No. of deaths (rate)3,883 (72.2)2,543 (98.1)1,340 (46.9)471 (25.3)2,168 (74.5)1,243 (193.4)2,517 (47.1)1,513 (60.1)1,004 (34.4)254 (13.6)1,221 (41.7)1,042 (163.2)
Costs, million USD (per capita, USD*)4,175 (779)3,2029898732,9151942,317 (433)1,6916404591,602154
Connecticut
No. of deaths (rate)2,140 (53.9)1,373 (76.7)767 (33.0)205 (16.6)1,152 (60.8)783 (129.5)1,642 (40.8)1,005 (56.8)637 (26.4)120 (9.7)824 (44.2)698 (114.1)
Costs, million USD (per capita, USD*)2,186 (608)1,6824644051,5841171,446 (402)1,1003302341,126100
Delaware
No. of deaths (rate)629 (65.8)433 (97.0)196 (37.4)79 (25.0)383 (81.5)167 (114.8)425 (43.9)270 (60.2)155 (29.1)50 (15.8)239 (50.6)136 (94.8)
Costs, million USD (per capita, USD*)775 (829)59218414654931472 (505)3341398833824
District of Columbia
No. of deaths (rate)385 (56.2)264 (81.7)121 (33.7)50 (19.8)250 (67.6)85 (111.1)217 (32.7)130 (42.4)87 (24.0)12 (4.8§)133 (36.8)72 (94.0)
Costs, million USD (per capita, USD*)479 (726)370979735713194 (294)1306116311
Florida
No. of deaths (rate)13,673 (61.5)9,216 (88.4)4,457 (35.8)1,672 (26.7)7,363 (71)4,636 (119.5)9,433 (41.2)5,932 (56.2)3,501 (27)1,025 (16.5)4,610 (44.3)3,796 (97.5)
Costs, million USD (per capita, USD*)14,763 (742)11,4113,3263,1119,9927739,478 (476)7,0552,3861,8596,301608
Georgia
No. of deaths (rate)6,002 (60.1)4,061 (85.8)1,941 (36.5)946 (25.8)3,589 (66.8)1,467 (128.1)3,964 (40.1)2,491 (53.8)1,473 (27.6)561 (15.4)2,197 (40.6)1,206 (106.9)
Costs, million USD (per capita, USD*)7,055 (699)5,4521,5821,7554,9102714,232 (419)3,1171,1041,0092,927214
Hawaii
No. of deaths (rate)733 (47.3)527 (70.6)206 (24.0)79 (16.1)428 (57.5)226 (92.5)476 (29.9)327 (43.9)149 (16.3)47 (9.6)246 (32.9)183 (73.8)
Costs, million USD (per capita, USD*)825 (581)68414814958839482 (340)389868634030
Idaho
No. of deaths (rate)1,156 (71.2)742 (95.2)414 (48.4)172 (29.4)607 (75.0)377 (172.7)765 (46.5)457 (58.8)308 (35.0)100 (17.1)341 (41.6)324 (149.2)
Costs, million USD (per capita, USD*)1,274 (780)91635031181463785 (480)54723817745852
Illinois
No. of deaths (rate)6,983 (52.0)4,808 (75.9)2,175 (29.6)1,123 (25.0)4,006 (58.3)1,853 (101.7)4,644 (34.2)2,918 (46.5)1,726 (22.9)557 (12.4)2,506 (36.3)1,581 (86.5)
Costs, million USD (per capita, USD*)8,297 (644)6,5501,6972,1045,7593114,833 (375)3,5791,2061,0153,502256
Indiana
No. of deaths (rate)4,462 (66.5)3,007 (94.1)1,455 (40.1)687 (29.0)2,685 (79.9)1,088 (115.6)2,974 (43.8)1,853 (58.3)1,121 (30.0)390 (16.6)1,665 (49.2)919 (97.3)
Costs, million USD (per capita, USD*)5,240 (794)4,0591,1901,2883,7181963,166 (480)2,3398237162,279160
Iowa
No. of deaths (rate)2,045 (58.4)1,300 (81.2)745 (37.4)237 (21.5)936 (58.4)872 (161.7)1,517 (41.9)898 (55.8)619 (29.3)135 (12.4)586 (36.3)796 (146.9)
Costs, million USD (per capita, USD*)1,987 (639)1,4934794351,2421401,292 (416)937343243756123
Kansas
No. of deaths (rate)1,987 (65.2)1,292 (89.8)695 (41.7)266 (24.7)1,046 (71.2)675 (154)1,377 (44.1)829 (57.4)548 (31.5)157 (14.6)634 (42.7)586 (132.3)
Costs, million USD (per capita, USD*)2,223 (765)1,6975054911,4381151,367 (471)1,00433928485597
Kentucky
No. of deaths (rate)3,634 (80.7)2,466 (114.5)1,168 (48.8)427 (27.8)2,343 (102.7)864 (138.4)2,622 (58.3)1,677 (78.8)945 (39.1)296 (19.3)1,616 (71)710 (114.9)
Costs, million USD (per capita, USD*)4,296 (973)3,3001,0107673,3141642,966 (672)2,1967755232,293131
Louisiana
No. of deaths (rate)3,654 (77.5)2,576 (113.8)1,078 (43.7)659 (39.6)2,334 (95.9)659 (107.8)2,344 (49.6)1,584 (70.5)760 (30.4)381 (22.9)1,440 (58.9)522 (86.1)
Costs, million USD (per capita, USD*)4,839 (1,041)3,8051,0081,2333,4301272,855 (614)2,2036666852,04597
Maine
No. of deaths (rate)952 (65.0)633 (93.4)319 (38.5)105 (26.5)492 (71.3)354 (146.8)690 (45.9)429 (63.1)261 (30.0)63 (15.9)320 (46.7)306 (126.7)
Costs, million USD (per capita, USD*)960 (722)736215200a64960626 (470)46715211742350
Maryland
No. of deaths (rate)3,482 (56.1)2,426 (83.7)1,056 (31.0)462 (22.6)2,129 (65.9)891 (109.3)1,674 (26.4)1,046 (36.9)628 (17.3)183 (9)772 (23.3)719 (88.3)
Costs, million USD (per capita, USD*)4,233 (708)3,3768388883,0491491,560 (261)1,1833633401,039114
Massachusetts
No. of deaths (rate)3,452 (47.4)2,361 (70.4)1,091 (26.4)335 (13.8)2,132 (59.4)984 (92.1)2,692 (36.8)1,767 (53.2)925 (21.9)230 (9.4)1,577 (44.3)884 (82.4)
Costs, million USD (per capita, USD*)3,707 (550)3,0327116482,9361582,508 (372)2,0595034442,143138
Michigan
No. of deaths (rate)6,652 (63.8)4,392 (89.2)2,260 (39.9)967 (27.6)3,807 (74.2)1,878 (122.5)4,422 (41.5)2,714 (55.0)1,708 (28.9)532 (15.4)2,283 (43.9)1,607 (104.6)
Costs, million USD (per capita, USD*)7,539 (761)5,7661,7491,7805,1943224,338 (438)3,1681,1729433,014264
Minnesota
No. of deaths (rate)3,226 (54.3)1,956 (71.6)1,270 (37.4)361 (19.6)1,465 (50.0)1,400 (168.8)2,385 (39.2)1,327 (49.0)1,058 (29.8)197 (10.7)888 (30.3)1,300 (155.9)
Costs, million USD (per capita, USD*)3,041 (557)2,2277716701,9532101,855 (340)1,2965263581,137190
Mississippi
No. of deaths (rate)2,477 (81.8)1,702 (120.0)775 (47.4)443 (40.7)1,421 (93.4)612 (149)1,712 (56.2)1,085 (77.0)627 (37.8)288 (26.9)903 (58.7)520 (127.4)
Costs, million USD (per capita, USD*)2,872 (959)2,3066018071,9631101,816 (607)1,3794475121,21592
Missouri
No. of deaths (rate)4,672 (74.1)3,142 (105.9)1,530 (43.9)675 (32.2)2,658 (85.7)1,339 (143.6)3,110 (48.5)1,911 (64.3)1,199 (33.4)407 (19.6)1,585 (50.9)1,118 (119.7)
Costs, million USD (per capita, USD*)5,371 (886)4,2131,1591,2493,7672303,203 (528)2,3798307312,185186
Montana
No. of deaths (rate)902 (83.1)586 (110.5)316 (56.2)121 (34.9)475 (91.4)306 (183.8)581 (52.6)343 (64.8)238 (40.5)75 (21.8)253 (49.1)253 (153.3)
Costs, million USD (per capita, USD*)973 (950)72923921965355579 (566)41116013335944
Nebraska
No. of deaths (rate)1,116 (56.0)752 (80.6)364 (32.9)161 (23.7)563 (58.9)392 (134.7)781 (38.2)492 (52.8)289 (24.7)95 (13.9)338 (35.1)348 (118.5)
Costs, million USD (per capita, USD*)1,139 (605)91324529675461697 (370)54316917244652
Nevada
No. of deaths (rate)1,948 (67.0)1,359 (94.6)589 (39.7)251 (26.6)1251 (81.2)446 (121.7)1,166 (40.1)750 (52.1)416 (28.1)144 (15.3)722 (46.4)300 (83.6)
Costs, million USD (per capita, USD*)2,294 (808)1,7815344641,665851,319 (465)97535926594954
New Hampshire
No. of deaths (rate)1,001 (70.8)645 (97.9)356 (44.6)92 (20.1)584 (84.9)325 (154.8)716 (50.4)435 (67.2)281 (34.2)56 (12.1)376 (55.7)284 (135.6)
Costs, million USD (per capita, USD*)1,022 (771)80022617479855664 (500)51515610452246
New Jersey
No. of deaths (rate)4,210 (44.4)2,881 (65.2)1,329 (25.4)555 (18.8)2,454 (51.1)1,200 (88.4)2,970 (30.8)1,935 (43.9)1,035 (19.1)319 (10.8)1,597 (33.1)1,053 (77.2)
Costs, million USD (per capita, USD*)4,765 (533)3,8069611,0743,4652012,991 (335)2,3686576072,238171
New Mexico
No. of deaths (rate)2,163 (101.9)1,443 (141.1)720 (63.7)291 (38.5)1,303 (124.7)569 (185.9)1,534 (71.9)958 (94.3)576 (49.9)173 (22.8)899 (85.7)462 (152.4)
Costs, million USD (per capita, USD*)2,573 (1,233)1,9656035421,8441011,659 (796)1,2144453151,25079
New York
No. of deaths (rate)8,585 (40.2)5,801 (58.9)2,784 (23.1)1,046 (15.1)4,934 (45.9)2,600 (87.1)5,945 (27.5)3,799 (38.8)2,146 (17.2)587 (8.5)3,095 (28.7)2,259 (75.5)
Costs, million USD (per capita, USD*)9,689 (491)7,5941,9871,9876,8584365,772 (292)4,4431,3021,0954,158363
North Carolina
No. of deaths (rate)6,541 (63.7)4,358 (90.8)2,183 (39.2)890 (25.6)3,709 (71.0)1,940 (140.2)4,558 (44.3)2,881 (60.9)1,677 (29.5)552 (16.0)2,378 (45.4)1,626 (118.7)
Costs, million USD (per capita, USD*)7,310 (735)5,6741,6071,6815,1483344,620 (465)3,5171,0931,0213,255270
North Dakota
No. of deaths (rate)514 (64.1)353 (89.5)161 (38.6)82 (27.0)258 (68.6)174 (149.1)349 (42.8)219 (56.8)130 (29.4)44 (14.6)146 (39.3)159 (135.8)
Costs, million USD (per capita, USD*)545 (737)44710015836730312 (422)245698220526
Ohio
No. of deaths (rate)8,366 (69.4)5,541 (97.9)2,825 (42.9)984 (24.8)5,062 (85.5)2,320 (128.0)6,178 (50.6)3,828 (68.0)2,350 (34.6)576 (14.5)3,595 (60.6)2,007 (110.6)
Costs, million USD (per capita, USD*)9,370 (808)7,2172,1431,8207,0384036,200 (535)4,6071,6091,0414,874338
Oklahoma
No. of deaths (rate)3,522 (88.8)2,277 (119.9)1,245 (59.6)485 (34.6)2,069 (104.3)968 (176.8)2,421 (60.3)1,465 (77.3)956 (44.5)283 (20.3)1,308 (65.0)830 (152.5)
Costs, million USD (per capita, USD*)4,035 (1,040)3,0249818932,8411712,508 (647)1,8126865111,747141
Oregon
No. of deaths (rate)2,773 (64.1)1,805 (88.6)968 (40.8)286 (22.1)1,477 (69.0)1,010 (161.8)1,803 (40.8)1,072 (52.7)731 (29.5)156 (12.1)826 (38.3)821 (131.8)
Costs, million USD (per capita, USD*)2,704 (681)2,0756245301,9321591,504 (379)1,1113832851,068122
Pennsylvania
No. of deaths (rate)9,224 (66.1)6,111 (94.1)3,113 (40.0)1,102 (25.4)5,245 (78.8)2,875 (127.4)6,640 (46.6)4,091 (63.0)2,549 (31.5)683 (15.8)3,454 (52.1)2,503 (109.7)
Costs, million USD (per capita, USD*)10,089 (789)7,8742,2292,0857,2254776,420 (502)4,8201,6331,2564,687404
Rhode Island
No. of deaths (rate)748 (62.8)475 (88.8)273 (40.0)59 (15.2)422 (75.6)267 (143.4)592 (49.0)360 (67.9)232 (32.7)33 (8.6)316 (57.0)243 (129.3)
Costs, million USD (per capita, USD*)771 (731)57617911357841526 (498)3871346242036
South Carolina
No. of deaths (rate)3,608 (72.0)2,422 (103.1)1,186 (44.0)564 (33.8)2,111 (83.4)933 (132.2)2,436 (48.2)1,519 (65.0)917 (33.4)334 (20.3)1,333 (52.1)769 (110.0)
Costs, million USD (per capita, USD*)4,279 (885)3,3099621,0542,9251692,693 (557)1,9846956151,821136
South Dakota
No. of deaths (rate)642 (71.1)415 (97.4)227 (45.9)110 (35.9)320 (75.8)212 (149.9)462 (49.2)282 (65.6)180 (34.3)67 (22.1)195 (45.6)200 (139.9)
Costs, million USD (per capita, USD*)687 (805)50517219744835422 (495)30211111927031
Tennessee
No. of deaths (rate)5,237 (77.4)3,489 (110.5)1,748 (47.2)631 (27.9)3,093 (90.2)1,512 (163.1)3,781 (55.5)2,361 (75.3)1,420 (37.6)361 (16.0)2,116 (61.4)1,304 (141.7)
Costs, million USD (per capita, USD*)5,947 (908)4,5561,3961,1624,2622733,900 (595)2,8711,0306502,843228
Texas
No. of deaths (rate)14,652 (55.6)10,164 (79.8)4,488 (32.8)2,454 (24.4)8,777 (62.2)3,419 (115.9)9,723 (37.2)6,398 (51.2)3,325 (24.2)1,498 (14.9)5,434 (38.3)2,789 (95.4)
Costs, million USD (per capita, USD*)17,522 (650)13,8693,7404,54912,34061510,648 (395)8,2372,5122,7207,485486
Utah
No. of deaths (rate)1,924 (73.0)1,265 (97.1)659 (49.7)286 (23.5)1,190 (85.7)446 (158.9)1,167 (45.3)726 (57.5)441 (33.5)141 (11.5)662 (47.6)364 (130.0)
Costs, million USD (per capita, USD*)2,362 (803)1,7945645251,726781,251 (425)93731525094261
Vermont
No. of deaths (rate)478 (68.2)291 (91.0)187 (45.4)54 (24.6)208 (64.2)216 (207.0)322 (44.4)168 (53.3)154 (34.9)25 (10.9)112 (34.5)185 (179.2)
Costs, million USD (per capita, USD*)406 (648)3148810226532228 (365)161624614027
Virginia
No. of deaths (rate)4,701 (54.7)3,141 (77.2)1,560 (33.7)634 (21.9)2,618 (57.9)1,449 (132.9)3,147 (36.7)1,962 (49.2)1,185 (25.2)362 (12.5)1,577 (34.9)1,208 (111.6)
Costs, million USD (per capita, USD*)5,166 (620)3,9961,1281,1963,6552443,004 (361)2,2657206712,163194
Washington
No. of deaths (rate)4,428 (59.6)2,909 (81.9)1,519 (38.2)530 (22.0)2,446 (63.3)1,451 (149.5)2,997 (39.9)1,821 (51.8)1,176 (28.8)304 (12.6)1,451 (37.0)1,242 (128.6)
Costs, million USD (per capita, USD*)4,600 (651)3,5501,0521,0043,2622402,727 (386)2,0207085641,873197
West Virginia
No. of deaths (rate)1,897 (98.0)1,253 (134.8)644 (62.6)201 (33.9)1,170 (125.0)526 (166.2)1,380 (71.1)874 (95.2)506 (47.9)122 (20.6)818 (88.5)440 (140.5)
Costs, million USD (per capita, USD*)2,149 (1,162)1,5995303691,618941,507 (815)1,0993932251,13377
Wisconsin
No. of deaths (rate)4,032 (64.2)2,463 (85.0)1,569 (43.7)480 (24.1)1,965 (64.8)1,587 (174.2)3,015 (46.7)1,696 (58.4)1,319 (35.1)275 (13.8)1,279 (41.6)1,461 (159.6)
Costs, million USD (per capita, USD*)3,934 (683)2,8959679062,6172292,499 (434)1,7657005081,665203
Wyoming
No. of deaths (rate)514 (86.6)355 (119.2)159 (52.2)81 (39.6)322 (105.3)111 (141.4)361 (60.2)234 (78.4)127 (40.8)46 (22.3)225 (72.4)90 (116.0)
Costs, million USD (per capita, USD*)581 (995)45413414941521384 (658)2861038329117

* Costs per capita calculated only for totals.
Average medical cost was statistically unstable; however, it accounted for less than 1% of combined average cost.
§ Rates based on ≤20 deaths might be unstable.
Both average medical cost and average work loss cost were statistically unstable.

Top

Return to your place in the textTABLE 2. Suicide and homicide deaths, rates per 100,000 population, lifetime medical and work-loss costs, and lifetime medical and work-loss costs per capita, by state — United States, 2014
StateSuicidesHomicides
TotalSexTotalSex
MaleFemaleMaleFemale
Alabama
No. deaths (rate)715 (14.5)569 (24.3)146 (5.6)374 (8.0)304 (13.4)70 (2.8)
Costs, million USD (per capita, USD*)897 (185)755143606 (125)53276
Alaska
No. deaths (rate)167 (22.0)138 (34.8)29 (7.9)37 (4.7)22 (5.3)15 (4.1)
Costs, million USD (per capita, USD*)249 (338)2203261 (83)38—**
Arizona
No. deaths (rate)1,244 (18.0)945 (27.7)299 (8.7)322 (5.0)249 (7.7)73 (2.2)
Costs, million USD (per capita, USD*)1,528 (227)1,222293538 (80)44882
Arkansas
No. deaths (rate)515 (17.2)406 (27.9)109 (7.2)217 (7.6)158 (11.3)59 (4.1)
Costs, million USD (per capita, USD*)671 (226)550119323 (109)25862
California
No. deaths (rate)4,214 (10.5)3,234 (16.7)980 (4.7)1,813 (4.6)1,514 (7.6)299 (1.5)
Costs, million USD (per capita, USD*)4,927 (127)3,9869333,103 (80)2,794337
Colorado
No. deaths (rate)1,083 (19.8)843 (31.3)240 (8.7)177 (3.3)124 (4.5)53 (2.1)
Costs, million USD (per capita, USD*)1,421 (265)1,174252282 (53)21558
Connecticut
No. deaths (rate)379 (9.7)276 (14.8)103 (5.1)99 (2.8)75 (4.3)24 (1.3)
Costs, million USD (per capita, USD*)475 (132)36898170 (47)14225
Delaware
No. deaths (rate)126 (13.2)100 (22.3)26 (5.3)57 (6.5)47 (10.9)10 (2.2)
Costs, million USD (per capita, USD*)168 (179)140—**98 (105)87—**
District of Columbia
No. deaths (rate)52 (7.7)39 (12.3)13 (4.0)97 (13.2)79 (22.3)18 (4.8)
Costs, million USD (per capita, USD*)73 (110)59—**180 (273)152—**
Florida
No. deaths (rate)3,035 (13.8)2,328 (21.9)707 (6.3)1,158 (6.2)915 (9.8)243 (2.5)
Costs, million USD (per capita, USD*)3,332 (167)2,7016241,852 (93)1,584282
Georgia
No. deaths (rate)1,294 (12.6)998 (20.6)296 (5.6)658 (6.5)518 (10.2)140 (2.8)
Costs, million USD (per capita, USD*)1,622 (161)1,3232921,087 (108)933155
Hawaii
No. deaths (rate)204 (13.6)163 (21.5)41 (5.4)30 (2.3)21 (3.0)††
Costs, million USD (per capita, USD*)283 (199)2434334§ (24)—**—**
Idaho
No. deaths (rate)320 (20.1)240 (30.5)80 (10.1)36 (2.4)22 (3.0)14 (1.7)
Costs, million USD (per capita, USD*)391 (239)2998949§ (30)—**—**
Illinois
No. deaths (rate)1,398 (10.4)1,110 (17.1)288 (4.2)792 (6.2)679 (10.6)113 (1.8)
Costs, million USD (per capita, USD*)1,780 (138)1,4743041,409 (109)1,307123
Indiana
No. deaths (rate)948 (14.3)756 (23.4)192 (5.6)364 (5.7)290 (9.0)74 (2.3)
Costs, million USD (per capita, USD*)1,210 (183)1,023194597 (90)51586
Iowa
No. deaths (rate)407 (12.8)327 (20.7)80 (5.2)78 (2.5)50 (3.2)28 (1.8)
Costs, million USD (per capita, USD*)520 (167)43781114 (37)8732§
Kansas
No. deaths (rate)455 (15.7)356 (25.0)99 (6.6)104 (3.6)75 (5.2)29 (2.1)
Costs, million USD (per capita, USD*)624 (215)511111168 (58)13234
Kentucky
No. deaths (rate)727 (15.9)582 (26.2)145 (6.2)203 (4.7)153 (7.1)50 (2.3)
Costs, million USD (per capita, USD*)927 (210)771151303 (69)25355
Louisiana
No. deaths (rate)679 (14.3)506 (22.2)173 (7.0)538 (11.6)428 (18.6)110 (4.7)
Costs, million USD (per capita, USD*)888 (191)692176941 (202)796135
Maine
No. deaths (rate)220 (15.7)174 (25.5)46 (6.7)23 (2.0)15 (2.6)††
Costs, million USD (per capita, USD*)269 (202)2194935§ (26)—**—**
Maryland
No. deaths (rate)606 (9.8)470 (16.1)136 (4.2)387 (6.6)312 (10.8)75 (2.4)
Costs, million USD (per capita, USD*)763 (128)617140692 (116)59391
Massachusetts
No. deaths (rate)596 (8.3)472 (13.6)124 (3.4)110 (1.6)91 (2.7)19 (0.5)
Costs, million USD (per capita, USD*)782 (116)657126197 (29)17624
Michigan
No. deaths (rate)1,354 (13.2)1,062 (21.3)292 (5.6)589 (6.2)465 (9.8)124 (2.6)
Costs, million USD (per capita, USD*)1,735 (175)1,461276990 (100)831149
Minnesota
No. deaths (rate)686 (12.2)525 (18.8)161 (5.9)101 (1.9)69 (2.6)32 (1.2)
Costs, million USD (per capita, USD*)914 (168)741172170 (31)12540
Mississippi
No. deaths (rate)380 (12.5)299 (20.8)81 (5.3)332 (11.3)277 (19.4)55 (3.5)
Costs, million USD (per capita, USD*)481 (161)40674530 (177)48462
Missouri
No. deaths (rate)1,017 (16.3)817 (27.2)200 (6.3)441 (7.5)357 (12.3)84 (2.8)
Costs, million USD (per capita, USD*)1,302 (215)1,091205745 (123)65094
Montana
No. deaths (rate)251 (23.8)197 (36.8)54 (11.4)30 (2.9)23 (4.4)††
Costs, million USD (per capita, USD*)302 (295)2505240 (39)—**—**
Nebraska
No. deaths (rate)251 (13.4)202 (21.7)49 (5.4)63 (3.4)47 (5.0)16 (1.7)
Costs, million USD (per capita, USD*)313 (166)26351108 (58)91—**
Nevada
No. deaths (rate)573 (19.5)449 (31.2)124 (8.2)176 (6.3)138 (9.8)38 (2.7)
Costs, million USD (per capita, USD*)669 (236)547124266 (94)23541§
New Hampshire
No. deaths (rate)247 (17.6)191 (27.5)56 (8.1)17 (1.3)††††
Costs, million USD (per capita, USD*)302 (228)25149—**—**—**
New Jersey
No. deaths (rate)786 (8.3)590 (12.9)196 (4.1)372 (4.4)302 (7.2)70 (1.6)
Costs, million USD (per capita, USD*)958 (107)748203654 (73)56880
New Mexico
No. deaths (rate)449 (21.0)350 (33.4)99 (9.2)135 (6.8)106 (10.5)29 (2.9)
Costs, million USD (per capita, USD*)594 (285)50198218 (105)18332§
New York
No. deaths (rate)1,700 (8.1)1,262 (12.5)438 (4.0)662 (3.3)536 (5.5)126 (1.2)
Costs, million USD (per capita, USD*)2,139 (108)1,6744351,157 (59)1,010147
North Carolina
No. deaths (rate)1,351 (13.0)984 (19.8)367 (6.9)551 (5.6)435 (8.9)116 (2.3)
Costs, million USD (per capita, USD*)1,685 (169)1,296369730 (73)769128
North Dakota
No. deaths (rate)137 (17.5)113 (27.8)24 (6.7)15 (2.0)13 (3.0)††
Costs, million USD (per capita, USD*)195 (264)169—**—**—**—**
Ohio
No. deaths (rate)1,491 (12.6)1,163 (20.1)328 (5.7)578 (5.2)472 (8.4)106 (1.9)
Costs, million USD (per capita, USD*)1,939 (167)1,588344955 (82)843122
Oklahoma
No. deaths (rate)736 (19.1)561 (29.5)175 (9.2)250 (6.5)183 (9.5)67 (3.5)
Costs, million USD (per capita, USD*)999 (258)801186409 (105)31683
Oregon
No. deaths (rate)782 (18.7)614 (30.1)168 (7.9)99 (2.4)65 (3.1)34 (1.7)
Costs, million USD (per capita, USD*)911 (229)755157131 (33)10433
Pennsylvania
No. deaths (rate)1,817 (13.3)1,440 (21.6)377 (5.6)620 (5.1)492 (8.1)128 (2.0)
Costs, million USD (per capita, USD*)2,307 (180)1,9283781,059 (83)901149
Rhode Island
No. deaths (rate)113 (10.0)82 (14.9)31 (5.4)27 (2.5)23 (4.2)††
Costs, million USD (per capita, USD*)159 (151)120—**45 (43)—**—**
South Carolina
No. deaths (rate)753 (15.1)579 (24.4)174 (6.8)363 (7.5)286 (12.1)77 (3.1)
Costs, million USD (per capita, USD*)953 (197)785170587 (121)50384
South Dakota
No. deaths (rate)141 (17.0)109 (25.9)32 (7.9)26 (3.2)15 (3.6)11 (2.7)
Costs, million USD (per capita, USD*)197 (231)16237—**—**—**
Tennessee
No. deaths (rate)948 (14.1)746 (23.3)202 (5.8)379 (5.9)309 (9.6)70 (2.2)
Costs, million USD (per capita, USD*)1,241 (189)1,032214595 (91)52382
Texas
No. deaths (rate)3,254 (12.2)2,528 (19.5)726 (5.4)1,389 (5.1)1,059 (7.8)330 (2.5)
Costs, million USD (per capita, USD*)4,264 (158)3,4907542,240 (83)1,867386
Utah
No. deaths (rate)559 (20.6)418 (31.0)141 (10.5)61 (2.1)39 (2.7)22 (1.4)
Costs, million USD (per capita, USD*)802 (273)63415889 (30)6725
Vermont
No. deaths (rate)124 (18.6)102 (30.7)22 (7.2)16 (2.9)13 (4.8)††
Costs, million USD (per capita, USD*)148 (237)131—**—**—**—**
Virginia
No. deaths (rate)1,122 (12.9)870 (20.7)252 (5.7)339 (4.1)249 (5.9)90 (2.2)
Costs, million USD (per capita, USD*)1,412 (170)1,150252555 (67)449105
Washington
No. deaths (rate)1,119 (15.2)854 (23.5)265 (7.2)211 (3.0)157 (4.4)54 (1.6)
Costs, million USD (per capita, USD*)1,404 (199)1,147253333 (47)27263
West Virginia
No. deaths (rate)359 (18.1)280 (28.6)79 (8.1)103 (5.9)70 (7.9)33 (3.9)
Costs, million USD (per capita, USD*)426 (230)34671156 (85)11341
Wisconsin
No. deaths (rate)769 (13.1)598 (20.6)171 (5.9)166 (3.0)126 (4.5)40 (1.4)
Costs, million USD (per capita, USD*)981 (170)806170274 (48)22745
Wyoming
No. deaths (rate)120 (20.7)96 (32.3)24 (8.7)24 (4.4)16 (5.8)††
Costs, million USD (per capita, USD*)153 (262)13121—**—**—**

* Costs per capita calculated only for totals.
Average medical cost was statistically unstable; however, it accounted for less than 1% of combined average cost.
§ Average medical cost was statistically unstable; however, it accounted for less than 5% of combined average cost.
Rates based on ≤20 deaths might be unstable.
** Both average medical cost and average work loss cost were statistically unstable.
†† State-level counts and rates based on <10 deaths have been suppressed.

Top

Return to your place in the textFIGURE. Costs per capita* of fatal injuries of all intents — United States, 2014
	The figure above is a map of the United States showing the costs per capita of fatal injuries of all intents in the U.S. during 2014.

* In 2014 U.S. dollars.

Top

Suggested citation for this article: Luo F, Florence C. State-Level Lifetime Medical and Work-Loss Costs of Fatal Injuries — United States, 2014. MMWR Morb Mortal Wkly Rep 2017;66:1–11. DOI: http://dx.doi.org/10.15585/mmwr.mm6601a1.

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 HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables.

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

Top