Although injury death rates have declined in the past 2 decades for children ages 1–14, 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.⁸³ Total lifetime costs (medical expenses and productivity losses) of injuries among children under age 15 have been estimated to be $59 billion.⁸⁴ In 2019, there were nearly 4,000 fatal injuries and 4 million emergency department (ED) visits for non-fatal injuries among children ages 1–14.⁸⁵ The leading causes of injury differ for children and adolescents (see PHY8.A).

Indicator PHY7.A: Emergency department visit rates for children ages 1–4 and 5–14 by leading causes of injury, 2017–2018

• Among children ages 1–4 and ages 5–14, falls were the leading cause of injury-related ED visits in 2017–2018.
• For both age groups, being struck by or against an object or person was the second leading cause of injury- related ED visits in 2017–2018.
• In 2017–2018, there were 65 ED visits for falls per 1,000 children ages 1–4 and 33 ED visits for falls per 1,000 children ages 5–14. Falls accounted for about 40% of initial injury-related ED visits for children ages 1–4 and nearly one-third of initial injury-related ED visits for children ages 5–14.
• The rates of injury-related ED visits resulting from being struck by or against an object or person were 18 visits per 1,000 for children ages 1–4 and 24 visits per 1,000 for children ages 5–14.
• Injury-related ED visits for injuries caused by natural and environmental factors, including insect and animal bites, were 13 visits per 1,000 for children ages 1–4 and 6 visits per 1,000 for children ages 5–14.

Indicator PHY7.B: Death rates among children ages 1–14 by all causes, all injury causes, and age group, 2009–2019

• The all-cause death rate among children ages 1–4 declined by 4 points, from 27 deaths per 100,000 in 2009 to 23 deaths per 100,000 in 2019. During the same time frame, the injury-related death rate decreased by 2 points to 9 deaths per 100,000 children ages 1–4 in 2019.
• The all-cause death rate among children ages 5–14 was stable from 2009 to 2019 (13 deaths per 100,000 in 2019). During the same time frame, the injury-related death rate was stable from 2009 to 2013 and then increased by nearly 1 point to 6 deaths per 100,000 in 2019.
• In 2019, unintentional injuries (accidents) were the leading cause of death for children ages 1–4 (7 per 100,000) and ages 5–14 (4 per 100,000). Among children ages 1–4, birth defects, cancer, and homicide also were leading causes of death. Among children ages 5–14, cancer and suicide were the second and third leading causes of death in 2019.
• Among both younger and older children, males have higher death rates than females. In 2019, males ages 1–4 had a death rate of 25 per 100,000 compared with 21 deaths per 100,000 for females. Among children ages 5–14, males had a death rate of 15 deaths per 100,000 compared with 12 per 100,000 for females.

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