Unintentional injury is a leading cause of death in the United States. While many events resulting in injury and death may be accepted as accidents, it is important to understand they are predictable and preventable. Preventing unintentional injuries and reducing their consequences is a public health goal for the nation and Idaho.

Get Healthy Idaho includes unintentional injury death as a priority, specifically motor vehicle crashes, unintentional falls, and accidental poisoning/drug overdose.

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The Centers for Disease Control and Prevention (CDC) defines unintentional injury as “the physical damage that results when a human body is suddenly subjected to energy in amounts that exceed the threshold of physiologic tolerance-or else the result of a lack of one or more vital elements, such as oxygen”.(1) The most common unintentional injuries in the United States are motor vehicle crashes, suffocation, drowning, poisoning, fire/burns, falls, and sports and recreation. The consequences of these include significant impacts on well-being, premature death, poor mental health, and significant healthcare costs.

An individual’s risk of injury and violence may be impacted by many social, personal, economic, and environmental factors.(2) For example, the physical environment, both in the home and community, can affect the rate of injuries related to falls, fires, burns, road traffic incidents, drowning, and violence. Understanding social determinants of health and how they contribute to disparities in injury and violence is key to improving the health and safety of all Americans.

Idaho Unintentional Injury Data

Vital Statistics reports accidents (unintentional injury) as the fourth leading cause of mortality in Idaho. There were 1,163 unintentional deaths in Idaho in 2021. Twenty-seven percent of unintentional injury deaths were motor vehicle related. Males accounted for 64 percent of all unintentional deaths.(3)

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Unintentional injuries were the leading cause of death in Idaho residents 1-44 years of age. Between 2017 and 2021, motor vehicle crashes were the leading cause of injury death in ages 1-24 and accidental poisoning was the leading cause of injury death in ages 25-64, while falls accounted for the leading cause of injury death in Idahoans age 65 and older. In 2021, the leading cause of accidental injury mortality was poisoning and exposure to noxious substances including drug overdoses (326),  falls accounted for 320 deaths, and motor vehicle crashes accounted for 314 deaths. Idahoans aged 65 and older suffered 93 percent of fall deaths in 2021.

Accidental Drug Poisoning Deaths
Idaho has experienced steadily increasing numbers of drug-overdose deaths that has generally mirrored the national trend. From 2017 to 2021, 1,394 Idaho residents died from a drug overdose. Between 2020-2021, Idaho's rate of drug overdose deaths increased by 23 percent, while the rate of fentanyl overdose deaths doubled. In 2021, 85 percent of all drug overdose deaths in Idaho were accidental, 8 percent were undetermined intent, 7 percent were intentional self harm (suicide), and none were assault or homicide. Among drug overdose deaths that involved fentanyl for 2021, 95 percent were accidental, 4 percent were undetermined and 1 percent were intentional self-harm (suicide). Opioids were frequently implicated in Idaho resident drug-overdose deaths. In 2022, 71 percent (270) of drug-overdose deaths, in which one or more specific drugs were identified, involved opioids, and 49 percent (188) involved fentanyl. 

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UNINTENTIONAL INJURY RISK REDUCTION STRATEGIES
 

Reducing Accidental Motor Vehicle Injury Deaths in Children
A Vision Zero strategy being adopted by communities across North America aims to eliminate traffic fatalities and severe injuries. This strategy recognizes that people will sometimes make mistakes, so the road system and traffic policies should be designed to ensure that those mistakes do not result in severe injuries or fatalities. With a shared commitment that all people have the right to move safely in their communities, we can design a transportation system which does not result in the significant loss of life and injury that we see today. 

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Motor vehicle deaths are a leading cause of death among children in Idaho and the United States. According to the CDC, in 2019, 43 percent of 8—12 year children were not buckled up, compared to 41 percent of 4—7 year old’s and 27 percent of children less than 4 years old (with restraint use).4  Almost 50 percent of children riding with unbelted drivers were also unrestrained.(5) Buckling children in age– and size-appropriate car seats, booster seats, and seat belts reduces the risk of serious and fatal injuries. Car seat use reduces the risk for injury in a crash by 71—82 percent for children, when compared with seat belt use alone. Booster seat use reduces the risk for serious injury by 45 percent for children aged 4—8, when compared with seat belt use alone.(6) For older children and adults, seat belt use reduces the risk for death and serious injury by approximately half.(7)

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Reducing Accidental Poisoning Deaths
A poison is a substance that can cause illness, injury, or death. They can be swallowed, inhaled, or absorbed through the skin. Adult poisonings are usually drug related and result from overdoses of illegal drugs and legal drugs taken for non-medical reasons, poisoning from legal drugs taken in error or at the wrong dose, and unanticipated effects from prescription drugs for medical and non-medical reasons.(8)

The best ways to prevent accidental drug overdose deaths are to increase access to substance abuse treatment services, increase and maximize use of prescription drug monitoring programs, which are state-run databases that track prescriptions for controlled substances and can help improve opioid pain reliever prescribing, inform clinical practices, and protect patients at risk, and consideration of policy options in relation to pain clinics to reduce prescribing practices that are risky to patients.(9)

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Reducing Unintentional Fall Injuries and Deaths
Unintentional falls are not an inevitable consequence of aging and can be prevented. Therefore, it is important to take measures to prevent and reduce risk factors for falls throughout older life stages.(10)

 

According to the CDC, fall risk factors include lower body weakness, Vitamin D deficiency, difficulty with walking and balance, medicines that affect balance, vision problems, foot pain or poor footwear, and hazards in the home. Most falls are caused by a combination of these factors. To prevent falls, programs such as Idaho’s Fit and Fall Proof™ exercise program are important to help older adults maintain the strength, balance, and mobility needed for normal daily activities. Additional measures include a physician evaluation of fall risk, having vision and balance checked and medications reviewed, and ensuring the home environment is safe from trip and fall hazards, such as poor lighting, loose cords and rugs.(11)

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References

1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. National Action Plan for Child injury Prevention. Atlanta (GA): CDC, NCIPC; 2012

2. Health People 2020. Retrieved from: www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Injury-and-Violence/determinants

3. Idaho Vital Statistics-Mortality 2021, Idaho Department of Health and Welfare, Division of Public Health, Bureau of Vital Records and Health Statistics

4. National Highway Traffic Safety Administration. Traffic safety facts, 2017 data: occupant protection. Washington, DC: US Department of Transportation, National Highway Traffic Safety Administration; 2019. Available at crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812719

5. Cody BE, Mickalide AD, Paul HP, Colella JM. Child passengers at risk in America: a national study of restraint use. Washington (DC): National SAFE KIDS Campaign; 2002

6. Arbogast KB, Durbin DR, Cornejo RA, Kallan MJ, Winston FK. An evaluation of forward-facing child restraint systems. Accident Analysis and Prevention 2004;36(4):585-9.

7. Arbogast KB, Jermakian JS, Kallan MJ, Durbin DR. Effectiveness of belt positioning booster seats: an updated assessment. Pediatrics 2009;124:1281–6

8. Centers for Disease Control and Prevention. Picture of America. Retrieved from www.cdc.gov/pictureofamerica/pdfs/Picture_of_America_Poisoning.pdf

9. Centers for Disease Control and Prevention. Opioid Overdose. Promising Strategies. Retrieved from: www.cdc.gov/drugoverdose/policy/index.html

10. Unintentional Fall Deaths. Idaho source: Bureau of Vital Records and Health Statistics; Division of Public Health (April 2019)

11. Centers for Disease Control and Prevention. Older Adult Falls. Retrieved from: www.cdc.gov/steadi/patient.html

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