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Trends in mechanism and manner of death from external causes across race and Hispanic origin categories -- U.S. 1999-2003
Arialdi M. MiniñoDivision of Vital Statistics / Mortality Statistics Branch
Presented at the 2006 Data Users’ Conference of the National Center for Health Statistics
July 10-12, 2006Omni Shoreham HotelWashington, DC
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Objectives
Explore 5-year trend in mortality from external causes
Identify noteworthy trends in specified race and Hispanic origin groups:– All races and origins– Hispanic– Non Hispanic White– Non Hispanic Black
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4
Data and Methods
Age-adjusted death rates from National Vital Statistics System (NVSS)
Kendall’s Tau correlation coefficient to identify noteworthy trends
Causes of death are coded and classified as per system of International Classification of Diseases, Tenth Revision (ICD-10)– Injury deaths limited to ICD-10 codes *U01-*U03,
V01-Y36, Y85-Y87, or Y89.
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Data and Methods, continued
Causes of death are further grouped following parameters of the External cause-of-injury mortality matrix (E.C. Matrix).– Jointly developed by the Injury Control and
Emergency Health Services section of the American Public Health Association (APHA) and the International Collaborative Effort on Injury Statistics
– E.C. Matrix shows injury data by both mechanism and intent of death.
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External cause-of-injury mortality matrix
Unintentional Suicide Homicide Undetermined Legal intervention / war
All injury
Cut / pierce
Drowning
.
.
.
Suffocation
Unspecified
intent
mec
han
ism
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Deaths from external causes as percentage of all U.S. deaths, 1999-2003
0%
20%
40%
60%
80%
100%
1999 2000 2001 2002 2003
year
perc
ent o
f all
deat
hs
Other injuries
Homicides
Suicides
Unintentional injuries
Natural deaths
6.2% 6.2% 6.5% 6.6% 6.7%
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Age-adjusted death rates for injury mortality, all intents and mechanisms
40.0
45.0
50.0
55.0
60.0
65.0
70.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
9
Age-adjusted death rates for unintentional injury mortality, all mechanisms
30.0
32.0
34.0
36.0
38.0
40.0
42.0
44.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy decreasing trend
Noteworthy decreasing trend
Noteworthy increasing trend
10
Age-adjusted death rates for suicide injury mortality, all mechanisms
5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
13.0
14.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy decreasing trend
11
Age-adjusted death rates for homicide injury mortality, all mechanisms
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
22.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
12
Age-adjusted death rates for MVT-related injury mortality
14.0
14.2
14.4
14.6
14.8
15.0
15.2
15.4
15.6
15.8
16.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy decreasing trend
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Age-adjusted death rates for MVT-related injury mortality -- vehicle occupant
6.0
6.2
6.4
6.6
6.8
7.0
7.2
7.4
7.6
7.8
8.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
15
Age-adjusted death rates for MVT-related injury mortality -- pedestrian
1.0
1.5
2.0
2.5
3.0
3.5
4.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
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Age-adjusted death rates for MVT-related injury mortality -- motorcyclist
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy increasing trendNoteworthy
increasing trend
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Age-adjusted death rates for MVT-related injury mortality -- unspecified role
3.0
3.5
4.0
4.5
5.0
5.5
6.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy decreasing trend
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Age-adjusted death rates for firearm-related injury mortality (irrespective of intent)
6.0
8.0
10.0
12.0
14.0
16.0
18.0
20.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
19
Age-adjusted death rates for firearm-related injury mortality (unintentional)
0.0
0.2
0.4
0.6
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
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Age-adjusted death rates for firearm-related injury mortality (suicide)
2.0
3.0
4.0
5.0
6.0
7.0
8.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy decreasing trend
Noteworthy decreasing trend
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Age-adjusted death rates for firearm-related injury mortality (homicide)
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy increasing trend
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Age-adjusted death rates for poisoning mortality (irrespective of intent)
4.0
5.0
6.0
7.0
8.0
9.0
10.0
11.0
12.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy increasing trend
Noteworthy increasing trend
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Age-adjusted death rates for falls mortality (irrespective of intent)
3.0
3.5
4.0
4.5
5.0
5.5
6.0
6.5
7.0
1999 2000 2001 2002 2003
year
deat
hs p
er 1
00,0
00 s
tand
ard
popu
latio
n
All origins
Hispanic
Non-Hispanic White
Non-Hispanic Black
Noteworthy increasing trend
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Summary
The following trends were identified as noteworthy (per race and origin category):
Hispanic– decreasing unintentional injury mortality– decreasing firearm-related suicideNon Hispanic White– increasing unintentional injury mortality– increasing motorcycle-related injury mortality– decreasing unspecified role motor vehicle traffic mortality– increasing poisoning mortality– increasing mortality from fallsNon Hispanic Black– decreasing unintentional injury mortality– decreasing suicide mortality– decreasing motor vehicle traffic mortality– decreasing firearm-related suicide– increasing firearm-related homicide mortality
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Concluding remarks
More research needed to determine effect of decreases in unspecified role in MVT death upon other MVT trends identified (e.g. motorcycle-related mortality in nH white).
More research needed to determine effect of decreases in certificates closed as “pending investigation” upon other trends identified (poisoning deaths comes to mind).