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Medical Journal

The hurting of America
Scripps Howard News Service


April 19, 2006


It might as well be the national motto, for all the times Americans say that, or worse, each day.

In the United States during a typical year, as many as 1 person in 3 gets injured, more than 2.6 million are hospitalized, and nearly 50 million are hurt badly enough to seek medical attention.

Injuries are responsible for more deaths among children, adolescents and young adults than all other causes combined, and claim the lives of some 150,000 Americans of all ages each year.

Beyond the human toll, there's a financial tally as well. A new report by the federal Centers for Disease Control and Prevention concludes that the lifetime costs of injuries occurring in the United States in a single year exceed $406 billion in medical expenses and productivity losses. Such losses include lost wages and fringe benefits, and the inability to perform household responsibilities.




The findings, published in a book, "The Incidence and Economic Burden of Injuries in the United States," are the most comprehensive look at the economic costs of injuries in more than a decade.

The study puts the lifetime medical costs from Americans' injuries in a given year at more than $80 billion, and the lifetime productivity losses at more than $326 billion. Moreover, the researchers note that the actual costs from injuries are likely considerably greater, since they could not calculate the costs for things like police and fire services, the value of time from family and other volunteer caregivers for the injured, or the cost of victims' pain and suffering.

"The financial and economic impact of injuries in the United States is serious," said Dr. Julie Gerberding, the CDC director. "However, by expanding our science-based injury-prevention programs, we can drastically reduce these costs, and even more importantly, help people live longer and healthier lives."

To most of us, the baby tumbling from a high chair, the pre-teen sliding awkwardly into second base or the harried commuter missing a traffic signal and getting crunched are accidents - that is, random, unexpected and unintentional events.

But to public-health experts, injuries are not the result of fate or bad luck, but have causes that can be studied, predicted and prevented. The science of injury prevention has been around for decades, beginning with education efforts early in the last century, and gradually adding government rules and standards for products, homes and public buildings.

Safety engineering and design for things like cars, hot-water heaters and other consumer products took off after World War II, but the federal government has only sponsored injury-prevention research for about 20 years. The CDC's National Center for Injury Prevention and Control has been in place since 1992, and helps support nearly two-dozen injury-research programs at universities around the country.

The head of the injury center, Dr. Ileana Arias, said that "we need greater recognition of the value of prevention efforts. As this study shows, the benefits of preventing things like motor vehicle crashes, falls, residential fires, childhood abuses and other injuries are significant."

But the level of spending for injury research and prevention, compared with the toll, is modest. The CDC's proposed injury-prevention budget for next year is $138 million, down $1 million from this year.

Many of the research programs delve deep into databases and analyze trends to find patterns of injury and suggest ways to prevent them.

For instance, just this week, a CDC-sponsored report from researchers at Johns Hopkins University in Baltimore looked at lawn-mower injuries, which are increasing in frequency and now account for about 2 of every 1,000 injury-related emergency-room visits each year, about 80,000 in 2004.

Most of the wounds occurred in kids under age 15 and in adults 60 and older, and the most common cause of a mowing injury was from debris propelled by the spinning blades.

"If we would keep the kids off the lawn when mowing and off the riding mowers, we could greatly reduce the number of injuries each year," said Dr. David Bishai, senior author of the study and an associate professor at Hopkins' Bloomberg School of Public Health. For those over age 15, injuries most typically occurred while servicing a mower.

Injury research often reveals a lot about our national character.

A recent report in the journal Risk Analysis noted that the "indirect" death toll from 9/11 includes as many as 1,500 Americans who died on the highways after the terror attacks.

Researchers say highway miles driven went up 3 percent in the year following the attacks as air travel sharply declined, and the increase in miles driven was accompanied by more traffic deaths - 1,500 more than would have been expected based on fatality trends over the previous five years.

But a similar study done in Spain following the March 2004 bombings of passenger trains in Madrid found no similar change in travel patterns or highway fatalities there.


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Contact Lee Bowman at BowmanL(at)

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