A new report published in The Lancet has found that during the first 3 decades of life, injuries and violence are the most common cause of death for Americans.
Nearly 180,000 people die every year as a result of injuries and violence, with millions more surviving but being left with ongoing physical, emotional and financial problems.
For people aged 1-30, 79% of deaths are caused by unintentional injury (59.6%), suicide (20.5%) and homicide (19.9%). In comparison, 20% of deaths are a result of chronic diseases such as cancer, heart disease and birth defects, and 1% are due to infectious diseases such as influenza and pneumonia.
Unintentional injuries include assault, car crashes, drowning, drug overdoses, falls and firearm-related injuries.
It is reported that 38,329 people died from drug overdoses in 2010, with nearly 60% of these related to prescription drug usage. Three quarters of prescription drug overdoses were related to opioid analgesics.
The number of people dying as a result of opioid overdose has quadrupled since 1990, and is linked to a rise in sales of prescription painkillers. The study reports that four times more prescription painkillers were sold to pharmacies, hospitals and doctors' offices in 2010 than in 1999.
The study also found that suicides were twice as common as homicides, with 38,364 recorded suicide deaths in 2010 compared with 16,259 homicides. The highest suicide rates were found in Alaskan Natives, Native Americans and non-Hispanic white people. Homicide rates were most common in African Americans, and both suicide and homicide rates were far higher in men than women.
Injuries and violence have a strong impact on the American economy. They incur the cost of medical care, lost productivity and are linked to a range of longstanding health problems and chronic diseases.
Around 180,000 deaths annually are due to injuries and violence, and as such are preventable.
The authors report that the estimated medical costs of unintentional injuries in 2010 in the US were $81.6 billion. This is an enormous figure, especially when compared with the medical costs associated with HIV infection in the same year which were around $12.6 billion.
Overall, it is estimated that the 31.2 million unintentional and violence-related nonfatal injuries that occurred in 2010 cost the US over $500 billion in medical care and lost productivity. This figure does not take into account any legal costs or costs of treatment given non-medically or for health problems associated with or worsened by violence and injuries.
The authors are keen to assert that injuries and violence can be prevented; they are not accidents and are not inevitable. If measures are taken by policy makers, public health professionals and those working in clinical medicine, these numbers can be reduced.
Attitudes need to change
Lead author Dr. Tamara M. Haegerich, PhD, at the Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, believes that attitudes need to change to prevent injuries and death:
"Although figures in public health maintain a common understanding of the definition, causes, and solutions to injuries and violence, this recognition might not be widely accepted by other audiences, including policy makers, clinical health professionals, and the public."
She refers to seatbelt laws and drink driving laws as examples of cost-effective interventions that have been proven to reduce the numbers of deaths due to injury.
Dr. Haegerich says that there are other interventions, such as early childhood home visitation, therapeutic foster care and school-based violence prevention programs that have also proven to be effective, and that "expanding these programs could reduce the numbers of injuries even further."
The authors conclude that if clinical medicine and public health partnerships are able to work together effectively, injury and violence can be reduced. The key is for injury and violence to be framed as preventable, and for emphasis to be placed on finding effective interventions and presenting these to policymakers.
The research was carried out by Centers of Disease Control and Prevention researchers from Atlanta, GA, and is part of a series of articles, "The health of Americans." Previous entries in this series have been reported on by Medical News Today and include studies on the long-term impact of Obamacare and the slowing growth of health care expenditure.