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Injuries, Violence Are Leading Causes of Death for Young Americans

CDC researcher calls for broader preventive measures
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Wednesday, July 2, 2014
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TUESDAY, July 1, 2014 (HealthDay News) -- Nearly 80 percent of deaths of Americans age 30 and younger result from injury or violence, U.S. health researchers reported Tuesday.

More young Americans die from injury than from any other cause, according to a study by the U.S. Centers for Disease Control and Prevention. These fatalities stem from automobile crashes, drowning, firearm-related injuries, falls, assault, drug overdoses and other preventable causes.

"Nearly 180,000 people of all ages in the U.S. die every year from injury and violence -- that's one death every three minutes," said lead author Tamara Haegerich, a researcher in CDC's division of unintentional injury prevention.

In 2010, the top three causes of death for young people were unintentional injury, suicide and homicide, according to the report, published online July 2 in The Lancet.

Injuries are expensive. In 2010, the estimated cost of the 31.2 million unintentional and violence-related nonfatal injuries was more than $500 billion in medical care and lost productivity, the researchers found.

"Injuries and violence are not inevitable -- they can be prevented," Haegerich said.

The report on unintended injury and violence highlights the need for wide-reaching prevention efforts, the reseachers said.

Programs designed to prevent injury and violence can work, Haegerich and other experts said. Child safety-seat requirements, seat belt laws, and drinking-and-driving laws have reduced the number of deaths from injury and reduced related costs, she said.

Dr. Leopoldo Malvezzi, trauma director at Miami Children's Hospital in Florida, calls injury prevention a "public health issue."

"When prevention strategies are used, they are effective, but some measures get lost in political infighting," he said. "This country has the biggest number of firearm-related deaths. No other civilized country has this kind of number."

Gun-safety laws would prevent both suicides and homicides, Malvezzi said. "People can kill themselves in two seconds if they have access to a gun -- even if they didn't really mean to -- whereas it takes a lot of effort to kill yourself if you don't have a gun and typically you don't do it," he said.

Malvezzi believes that deaths from injury and violence can be prevented through coordinated public health programs.

"What saves tens of thousands of lives are systems that work so people don't get hurt," he said. "Hospitals have to have an injury-prevention program. That, strangely enough, saves more people than even a trauma program."

For example, Miami Children's Hospital requires that parents prove they have a proper infant car seat before the child can leave the hospital, Malvezzi said.

Dr. Alan Kaplan, director of emergency medicine at Plainview Hospital in Plainview, N.Y., agreed that prevention efforts are essential.

"Enormous potential exists in education regarding the prevention of motor vehicle accidents, falls in the elderly, prescription drug overdoses, suicide/homicide and child safety, to name a few," he said.

Haegerich said school-based violence prevention programs and therapeutic foster care instead of juvenile incarceration have proven effective. Expanding these and other programs could reduce injuries, she said.

But good ideas and programs don't lead to immediate improvements, Kaplan said. "There is difficulty in communicating these messages to the public," he said. "It is also expensive."

Other 2010 findings from the report follow:

  • For all ages, the top five causes of injury deaths were motor-vehicle crashes, poisoning, falls, firearm suicides, and firearm homicides.
  • Almost four-fifths of deaths of young adults were due to injuries, with only one-fifth due to chronic diseases, and only 1 percent from infectious diseases.
  • Suicides were more than twice as common as homicides (38,364 suicides versus 16,259 murders).
  • The highest rates of suicide were found among Native American and Alaskan Natives (16.9 per 100,000) and whites (14.9 per 100,000).
  • Homicide rates for blacks (18.6 per 100,000) were twice those of Native Americans and Alaskan Natives and several times higher than other groups.
  • Compared to women, men were about four times more likely to commit suicide (nearly 20 per 100,000 versus 5 per 100,000) or murder (8.3 per 100,000 versus 2.2 per 100,000).
  • Deaths from narcotic painkillers such as oxycodone and hydrocodone nearly quadrupled since 1990, reaching more than 38,300.

SOURCES: Tamara Haegerich, Ph.D., researcher, division of unintentional injury prevention, U.S. Centers for Disease Control and Prevention; Leopoldo Malvezzi, M.D., director, trauma program, Miami Children's Hospital, Miami, Fla.; Alan Kaplan, M.D., director, emergency medicine, Plainview Hospital, Plainview, N.Y.; July 2, 2014, The Lancet, online

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