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Distinctive injury deaths by state

March 26, 2016
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Maps tell stories. They define our space. They illustrate our surroundings. They inspire our daydreams.

Sometimes, maps serve as mirrors. They tell us about ourselves. They list trends and start conversations, ranging from a serious analysis of diseases by state to a lighthearted look at favorite movies by region.

A pair of researchers, Sara E. Heins and Cassandra K. Crifasi, of the Johns Hopkins Bloomberg School of Public Health, wanted to know what a map might tell us about distinctive injury deaths in each state. Ultimately, such a map could help people be safer. By studying a decade’s worth of statistics and displaying the information within a clear, color-coded map of the United States, policymakers and public health worker could develop targeted interventions to better protect at-risk residents, they thought.

Heins and Crifasi decided to research and publish the most distinctive causes of injury deaths by state. Note the difference: most distinctive, not most popular. Distinctive means disproportionately common. Were fatalities from intentional jumping far more common in Hawaii than in most states? (Yes.) Where were drug-related deaths due to poisoning disproportionately common? (Missouri, Illinois and Pennsylvania.) What about drowning deaths? (Delaware, Rhode Island, Maine and New Jersey.)

The study – Distinctive injury deaths: The role of environment, policy and measurement across states – was published online Jan. 24 in the journal Injury Prevention.

Upon conducting their research, Heines and Crifasi wanted to be careful to avoid one-year statistical blips. They decided to analyze 10 years of data (2004-2013) – all of which they gleaned from the Centers for Disease Control and Prevention’s Web-Based Injury Statistics Query and Reporting System. Researchers determined causes of death based on codes that were listed on death certificates. But the plan was not without limitations: Such codes “may be used inconsistently by states,” the researchers acknowledged. They also wanted to learn whether injury deaths were distinctive because of measurement, environment, or policy and culture.

In the end, the study yielded a mountain of information that could be used to improve safety across the country. The most distinctive injury deaths for each state are:

AlabamaFirearm, unintentional
AlaskaOther transportation, unintentional
ArizonaNatural/environmental
ArkansasFirearm, unintentional
CaliforniaFirearm, legal intervention
ColoradoNon-drug poisoning, suicide
ConnecticutSuffocation, unintentional
DelawareDrowning, suicide
FloridaBicycle/pedal vehicle, unintentional
GeorgiaCut/pierce, unintentional
HawaiiFall, suicide
IdahoOther transportation, unintentional
IllinoisDrug, homicide
IndianaStruck, homicide
IowaMachinery, unintentional
KansasMotor vehicle crash, all, suicide
KentuckyFirearm, unintentional
LouisianaFirearm, unintentional
MaineDrowning, suicide
MarylandStruck, homicide
MassachusettsStruck, homicide
MichiganFire/hot object, homicide
MinnesotaNon-drug poisoning, suicide
MississippiStruck, homicide
MissouriDrug, homicide
MontanaMotor vehicle crash, occupant injured, unintentional
NebraskaMotor vehicle crash, occupant injured, unintentional
NevadaFirearm, legal intervention
New HampshireNon-drug poisoning, suicide
New JerseyDrowning, suicide
New MexicoFirearm, legal intervention
New YorkFall, suicide
North CarolinaCut/pierce, unintentional
North DakotaMachinery, unintentional
OhioNon-drug poisoning, homicide
OklahomaNature, unintentional
OregonFirearm, legal intervention
PennsylvaniaDrug, homicide
Rhode IslandDrowning, suicide
South CarolinaFirearm, unintentional
South DakotaMotor vehicle crash, occupant injured, unintentional
TennesseeFirearm, unintentional
TexasMotor vehicle crash, all, homicide
UtahFirearm, legal intervention
VermontFall, unintentional
VirginiaCut/pierce, unintentional
WashingtonFall, suicide
West VirginiaFirearm, unintentional
WisconsinMotor vehicle crash, all, suicide
WyomingNature, unintentional

The study was the first to Heins’ and Crifasi’s knowledge to use the “most distinctive” approach for injury prevention purposes. The map indicated potential clusters of problem areas, such as unintentional firearm deaths in Southeast states and motor vehicle crashes in the Great Plains.

“These findings can help policymakers and public health practitioners identify injuries that, while not necessarily the most burdensome, warrant attention as the most distinctive injury death in their states,” the researchers wrote in the study. “In states where injuries are distinctive due to differences in policy or culture, the results could also be a useful tool for advocates who could assert, ‘Not only is this injury a problem, it is a problem that we as a state are distinctively bad at addressing.’”

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