The incidence of death by injury—which includes accidental and intentional deaths—has been on the decline in the District. The rate of death by injury decreased by 12.7 percent between 1999 and 2014, despite a steady national increase in the rate over that time. The injuries counted include accidental deaths such as a falls or drug overdoses, as well as intentional deaths such as murder or suicide. The actual number of deaths by injury in 2014 (385) is about the same as in 1999 (382), but because the population in the District has steadily increased over that time, the rate has decreased. Only two other states – Alabama and Nevada – saw a decrease from 1999 to 2014, and the District had the largest percentage rate decrease of any state. While some year to year fluctuations occurred in all the states throughout the 15 years, most states have seen a steady rise in death by injury rates.
Until 2010, the District stood apart from Virginia and Maryland as the incidence of death by injury in the city was above the national level. Now the District is more like its neighboring states, all three of which are now below the national rate.
The decline in intentional injury deaths (murder and suicide) is the major factor in the overall decrease in the District’s injury death rates. Compared to 1999, intentional injury death rates have decreased by 40% in the District, while accidental deaths rates have increased by about 17%, although both categories have been somewhat erratic over the period.
Accounting for Population Size
It may be argued that comparison to the national rate is not useful, given the District’s small population. So we also looked at how the District compared to the four least-populous states, two with fewer people than the District (Vermont and Wyoming) and two with more people (Alaska and North Dakota). We found the incidence of death by injury has increased in all four of these states. Alaska’s injury rate grew 11%, Wyoming grew 15%, North Dakota grew 25%, and Vermont grew a whopping 53% increase over 1999 rates.
While intentional injury death rates decreased significantly in the District, the other least populous states saw increases.
All of the least populous states saw increases in accidental injury death rates.
Could the growth the District has experienced over the last 15 years be playing a factor in the injury death rate decrease? If so this would be unique to the District. States with population growth rates higher than the District experienced an injury death rate growth of an average 13.7%, while states with population growth lower than the District experienced an average injury death growth rate of 28.8%. But individual state rates vary so widely, this is not sufficient explanation. Population growth may play a part in our lower injury death rate, but nearly all states saw an increase, so the District’s 12% decrease still stands out.
When we break out the total deaths by sex and race, some of the totals are too small to analyze on a year to year basis. However, we can report that overall injury death rates for whites in the District have increased 43% since 1999, while rates for African Americans has decreased by 7%. These results are driven mainly by the reduction in intentional injury death rates for African Americans, and an increase in accidental injury death rates for whites.
Injury death rates for females in the District have increased 62% since 1999, while rates for males have decreased 28%. Boys and men are still more likely than girls and women to die of injury, which fits with earlier research (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222499/), but the trend away from this stands out.
What is this data?
The data source is the Fatal Injury Data in the National Vital Statistics System (NVSS) operated by the National Center for Health Statistics under the Centers for Disease Control. (http://www.cdc.gov/injury/wisqars/fatal_injury_reports.html)