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HomeMorbidity & Mortality Weekly Reportindex/list_12208_1State-level Economic Costs of Fatal Injuries — United States, 2019

State-level Economic Costs of Fatal Injuries — United States, 2019

Abstract and Introduction

Introduction

Unintentional and violence-related injury fatalities, including suicide, homicide, overdoses, motor vehicle crashes, and falls, were among the 10 leading causes of death for all age groups in the United States in 2019.* There were 246,041 injury deaths in 2019 (unintentional injury was the most frequent cause of death after heart disease and cancer) with an economic cost of $2.2 trillion.[1] Extending a national analysis,[1] CDC examined state-level economic costs of fatal injuries based on medical care costs and the value of statistical life assigned to 2019 injury records from the CDC’s Web-based Injury Statistics Query and Reporting System (WISQARS). West Virginia had the highest per capita cost ($11,274) from fatal injury, more than twice that of New York, the state with the lowest cost ($4,538). The five areas with the highest per capita total fatal injury costs were West Virginia, New Mexico, Alaska, District of Columbia (DC), and Louisiana; costs were lowest in New York, California, Minnesota, Nebraska, and Texas. All U.S. states face substantial avoidable costs from injury deaths. Individual persons, families, organizations, communities, and policymakers can use targeted proven strategies to prevent injuries and violence. Resources for best practices for preventing injuries and violence are available online from the CDC’s National Center for Injury Prevention and Control.§

The economic cost estimate for injuries that occurred in 2019 uses the societal perspective, including tangible and intangible costs to multiple payers. Costs are presented in 2019 U.S. dollars (USD). WISQARS fatal injury counts are from CDC’s National Vital Statistics System mortality data. In 2019, approximately 70% of U.S. injury deaths (173,040) were attributable to unintentional injuries (among which 36% were related to drug poisoning, 23% to falls, and 22% to motor vehicle traffic); approximately 20% were suicides; and 8% were homicides. Medical costs were adjusted for patient characteristics,[2] including comorbidities, sex, and age, and were modified to 2019 USD** and assigned to WISQARS records by injury mechanism (e.g., fall), intent (e.g., unintentional), and place of death (e.g., inpatient hospital). Aggregated medical costs (e.g., combined intents by mechanism or combined mechanisms by place of death) from reference sources were assigned when specific estimates by intent or mechanism were not available. The average medical cost among 2019 injury deaths was approximately $15,400††; however, many injury deaths had lower costs because the deaths occurred outside a health care setting.[2]

The cost of injury mortality includes value of statistical life, a monetary estimate of the collective value that persons place on mortality risk reduction as derived in research studies through revealed preferences (e.g., observed wage differences for dangerous occupations) or stated preferences from surveys of persons’ willingness to pay for mortality risk reduction.[3] Value of statistical life estimates were assigned by decedent age: 0–17 years, $16.9 million;[4] 18–65 years, $10.7 million;[3] values descending from $6 million (aged 66 years) to $410,000 (aged ≥100 years), reflecting the estimate for persons aged 18–65 years adjusted for older adults’ decreasing general life expectancy and baseline quality of life. Per capita fatal injury costs by U.S. state are presented graphically by injury intent (Figure). Injury fatality rates by state, intent, sex, and age group (0–24 years, 25–64 years, and ≥65 years) were examined to better understand the contributing circumstances in states with the highest per capita total injury costs. All reported data can be queried online using WISQARS. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.§§

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Figure.

State-level fatal injury costs*,† per capita, by intent — United States, 2019
Abbreviation: USD = U.S. dollars.
*2019 USD.
https://wisqars.cdc.gov/cost

The five areas with the highest per capita total fatal injury costs were West Virginia, New Mexico, Alaska, DC, and Louisiana; those with the lowest costs were New York, California, Minnesota, Nebraska, and Texas (Figure).¶¶ West Virginia had the highest per capita cost ($11,274) from fatal injury, more than twice that of New York, the state with the lowest cost ($4,538). The five states with the highest per capita costs for unintentional injury deaths were West Virginia, New Mexico, Delaware, Tennessee, and Ohio; the states with the lowest costs were Maryland, New York, Utah, California, and Nebraska. Per capita unintentional injury cost in West Virginia ($8,607) was approximately triple that in Maryland ($3,054). The five states with the highest per capita costs for suicide were Alaska, Wyoming, Montana, New Mexico, and Colorado; those areas with the lowest costs were DC, New Jersey, New York, Massachusetts, and Maryland. Per capita suicide cost in Alaska ($3,082) was approximately five times than that in DC ($624). The five areas with the highest per capita costs for homicide were DC, Mississippi, Louisiana, Alabama, and New Mexico; the states with the lowest costs were Idaho, Maine, Vermont, Rhode Island, and Massachusetts. Per capita homicide cost in DC ($2,576) was more than 16 times as high as that in Idaho ($159).

State-level injury fatality rates in 2019 by intent, sex, and age group suggest that the five areas with the highest per capita total fatal injury cost face different challenges in injury prevention. West Virginia had the highest age-adjusted unintentional injury fatality rate in the nation (including the highest for males, females, and persons aged 25–64 years) and the second highest for persons aged ≥65 years.*** New Mexico had the second highest age-adjusted unintentional injury fatality rate (including the second highest for males and females and third highest for persons aged 25–64 years) and was among the five states with the highest age-adjusted rate of both suicide (including for males, females, and each of the three assessed age groups) and homicide deaths (including for females and persons aged 25–64 years). Alaska had the nation’s second highest age-adjusted suicide rate (including for males, females, and persons aged 25–64 years, and the highest rate for persons aged 0–24 years) and the highest age-adjusted homicide rate for females. DC had the lowest age-adjusted suicide rate among all areas but the highest homicide rate (including for males and persons aged 0–24 and 25–64 years). Louisiana was among the top three states for the highest rate of age-adjusted homicide deaths (including for males, females, and each of the three assessed age groups).

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