Data Source

"National Center for Health Statistics - Mortality Files: Data on deaths and births were provided by NCHS and drawn from the National Vital Statistics System (NVSS). These data are submitted to the NVSS by the vital registration systems operated in the jurisdictions legally responsible for registering vital events (i.e., births, deaths, marriages, divorces, and fetal deaths). In prior years of the Rankings, Premature Death was calculated by the National Center for Health Statistics, but the Mortality-All County (micro-data) file was requested this year. This allowed County Health Rankings to calculate Premature Death and Life Expectancy themselves. While most calculations of mortality rates can be downloaded from CDC WONDER, the calculation of Years of Potential Life Lost and Life Expectancy requires raw data files." 

Measure Methods

• "Injury Deaths is a rate: Injury Deaths is the number of deaths that result from injuries per 100,000 people.  This measure includes injuries from intentional causes (such as homicide or suicide) and unintentional causes (such as motor vehicle accidents). Rates measure the number of events (e.g., deaths, births) in a specific period (generally one or more years) divided by the average number of people at risk. Rates help us compare data across counties with different population sizes."

• "Deaths are counted in the county of residence for the person who died rather than the county where the death occurred: It is important to note that deaths are counted in the county of residence of the deceased. So, even if an injury death occurred across the state, the death is counted in the home county of the individual who died."

• "Some data are suppressed: A missing value is reported for counties with fewer than ten injury deaths in the time frame."

• "Measure limitations: Injury deaths measure only a small portion of the harm of injuries to people in the U.S. Injuries cause burdens for people such as emergency room visit costs, the need for time off work, follow-up healthcare needs, and the potential for long-term disability. Data are not available nationwide for injuries not resulting in death."

• "Numerator: The numerator includes traffic accidents involving motorcycles, 3-wheel motor vehicles, cars, vans, trucks, buses, street cars, ATVs, industrial, agricultural, and construction vehicles, and bicyclists or pedestrians when colliding with any of these vehicles over a 7-year period (ICD10 codes: V02-V04 (.1, .9), V09.2, V12-V14 (.3-.9), V19 (.4-.6), V20-V28 (.3-.9), V29-V79 (.4-.9), V80 (.3-.5), V81.1, V82.1, V83-V86 (.0-.3), V87 (.0-.8), and V89.2). The numerator does not include deaths due to boating accidents and airline crashes."

• "Denominator: The denominator is the aggregate annual population over the 7-year period."

• "Can This Measure Be Used to Track Progress?: This measure can be used to track progress with some caveats. It is important to note that the estimate provided in the County Health Rankings is a 5-year average. However, in most counties, it is possible to obtain single-year estimates from the resource included below."

Source: Injury Deaths | County Health Rankings & Roadmaps

References

• Ahmad FB, Cisewski JA, Anderson RN. Provisional mortality data—United States. Morbidity and Mortality Weekly Report 2022 Apr 29; 71(17): 597–600.

• Centers for Disease Control and Prevention (CDC). Wide-ranging ONline Data for Epidemiologic Research (WONDER).

• Spinks A, Turner C, Nixon J, McClure RJ, Cochrane Injuries Group. The 'WHO Safe Communities' model for preventing injury in whole populations. Cochrane Database of Systematic Reviews 2009(3).

• Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. New England journal of medicine 2022;386(20), 1955-1956.

• Sorenson SB. Gender disparities in injury mortality: consistent, persistent, and larger than you'd think. American journal of public health 2011, 101(S1): S353-S358.

• GBD 2019 Police Violence US Subnational Collaborators. Fatal police violence by race and state in the USA, 1980-2019: a network meta-regression. The Lancet 2021; 398(10307): 1239-1255. Accessed: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01609-3/fulltext

• Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing potentially excess deaths from the five leading causes of death in the rural United States. MMWR Surveillance Summaries 2017, 66(2): 1.

• Word Health Organization. Injuries and violence; March 19, 2021. Accessed from: https://www.who.int/news-room/fact-sheets/detail/injuries-and-violence.