America's Children: Key National Indicators of Well-Being, 2011

Child Injury and Mortality

Although injury death rates have declined over the past two decades, unintentional injuries remain the leading cause of death for children ages 1–4 and ages 5–14. In addition, nonfatal injuries continue to be important causes of child morbidity, disability, and reduced quality of life.⁸⁷ In 2000, the total lifetime costs (medical expenses and productivity losses) of injuries among children ages 0–14 were estimated to be over $50 billion.⁸⁸ For every fatal injury among children ages 1–14, there are 29 injury-related hospitalizations and 1,110 injury-related emergency department visits.⁸⁹ The leading causes of injury differ for children and adolescents (see PHY8.A).

Indicator Phys7.A: Emergency department visit rates for children ages 1–4 and 5–14 by leading causes of injury visits, 2007–2008

• Among children ages 1–14, falls and being struck by or against an object or person are the two leading causes of injury-related emergency department visits. In 2007–2008, there were 45 annual emergency department visits for falls per 1,000 children ages 1–4, whereas the rate was 27 visits per 1,000 children ages 5–14. Falls accounted for 39 percent of initial injury visits for children ages 1–4 and 28 percent of initial injury visits for children ages 5–14.⁹⁰
• Younger children frequently strike furniture after running, tripping, or falling, whereas older children are often struck as a result of play or sports. Emergency department visit rates for being struck by or against an object or person were 16 visits per 1,000 for children ages 1–4 and 19 visits per 1,000 for children ages 5–14. Among children ages 1–4, 17 percent of the emergency department visits resulting from being struck by or against an object or person were related to striking furniture. Among children ages 5–14, 21 percent of the emergency department visits resulting from being struck by or against an object or person were sports-related.⁹⁰
• Emergency department visit rates for injuries caused by natural and environmental factors, poisonings, cutting or piercing from instruments or objects, and motor vehicle traffic crashes ranged between 4 and 7 visits per 1,000 for children ages 1–4 and ranged between 1 and 6 visits per 1,000 for children ages 5–14.
• Emergency department visit rates for poisoning were higher among children ages 1–4 (6 per 1,000) than among children ages 5–14 (1 per 1,000).
• For children ages 1–4 and 5–14, 1 to 2 percent of injury-related emergency department visits resulted in hospitalizations, although the percentage varied by cause.⁹⁰

Indicator Phys7.B: Death rates among children ages 1–4 and 5–14 by all causes and all injury causes, 1980–2009

Indicator Phys7.C: Death rates among children ages 1–4 and 5–14 by cause of death, 2009

• In 2009, the death rate for children ages 1–4 was 26 per 100,000 children, down from 28 per 100,000 in 2008. For children ages 5–14 in 2008 and 2009, the death rate was 14 per 100,000 children. Between 1980 and 2009, the death rate declined by half or more for both age groups.
• Among both younger and older children, Black children had the highest death rates in 2009, at 38 per 100,000 children ages 1–4 and 20 per 100,000 children ages 5–14. Asian or Pacific Islander children had the lowest death rates.
• In 2009, among children ages 1–4 and 5–14, unintentional injuries (accidents) were the leading cause of death: 9 deaths per 100,000 children ages 1–4 and 4 deaths per 100,000 children ages 5–14. For children ages 1–4, the next most frequent causes of death were birth defects (3 per 100,000 children) and homicide and cancer (2 per 100,000 each). For children ages 5–14, the next most frequent causes of death were cancer (2 per 100,000) and homicide and birth defects (1 per 100,000 children each).
• In 2009, the injury death rate was 11 per 100,000 for children ages 1–4 and 6 per 100,000 for children ages 5–14.
• Between 1980 and 2007, motor vehicle traffic and drowning death rates declined by one-half or more among children ages 1–4.
• In 2007, among children ages 10–14, homicide and suicide were the third and fourth leading causes of death (1.2 and 1.0 deaths per 100,000, respectively), after unintentional injuries and cancer.⁹¹

 PHY7A HTML Table, PHY7B HTML Table