Georgia epidemiology report, Vol. 12, no. 2 (Feb. 1996)

Georgia Epidemiology Report
The Georgia Epidemiology Report is a publication of the Epidemiology Section of the Epidemiology and Prevention Branch, Division of Public Health, Department of Human Resources

February 1996

Volume 12 Number 2

Division Of Public Health
Patrick J. Meehan, M.D. - Director

Trauma in Georgia

Epidemiology and Prevention Branch State Epidemiologist Kathleen E. Toomey, M.D., M.P.H.- Director

Trauma Facts
Trauma (or bodily injury) constitutes one of the nation's most costly public health problems and is the leading cause of death among persons ages

Epidemiology Section

1-44.

Paul A. Blake, M.D., M.P.H.-Director

q Every 10 minutes, 2 persons are killed and 170 suffer a disabling

Surveillance
Jeffrey D. Berschling, M.P.H.; Karen R. Horvat, M.P.H.; Jane E. Koehler, D.V.M, M.P.H.; Patrick L. Osewe, M.D., M.P.H.; Preeti Pathela, M.P.H.; Russell C. Sexton Jr., M.H.S.; Sabrina Walton, M.S.P.H.
Chronic Disease

injury. q In 1993, 6,396 Georgians died of intentional and unintentional inju-
ries, many of which could have been prevented. q Injuries and deaths cost the nation $180 billion and result in 150,000
deaths and more than 80,000 longterm disabilities. In Georgia,

Nancy E. Stroup, Ph.D.-Director Patricia M. Fox, M.P.H.; David M. Homa, Ph.D.,

injuries cost the state an estimated $4.2 billion per year.

M.P.H.; Thomas W. McKinley, M.P.H.; Edward E. Pledger, M.P.A.; D. Lee Warner, M.P.H.

Trauma is preventable and our best strategy to confront the human and

Tuberculosis

financial costs associated with this public health problem is through an

Bharat K. Pattni, M.B.B.S., M.P.H.
HIV\AIDS
Awal D. Khan, Ph.D., M.A.
Sexually Transmitted Diseases

organized trauma care system, including prevention activities, a well-trained Emergency Medical team, committed acute care facilities and improved rehabilitation services. Research has shown that areas with such a broad-based

Quimby E. McCaskill, M.P.H.; Dhelia Williamson, and organized trauma care system experience a reduction in mortality by at

M.S.
Office of Perinatal Epidemiology

least 20-25% as well as a significant decrease in morbidity and cost.

Roger W. Rochat, M.D. - Director

Mary D. Brantley, M.P.H.; Raymond E. Gangarosa, M.D., M.P.H.; Rebekah Hudgins, M.P.H.; Mary P. Mathis, Ph.D., M.P.H.; Florina

Map1. Frequency of Trauma Fatalities by County of Residence*, Georgia 1993

Serbanescu, M.D.; Edward F. Tierney, M.P.H.

Preventive Medicine Residents Lorenzo D. Botto, M.D.; Isabella A. Danel, M.D., M.S.; Hector S. Izurieta, M.D., M.P.H.;Michael M. McNeal, M.D., M.P.H.; Peter Strebel, M.D.;Sherrilyn Wainwright, M.D.;
EIS Officers Luis G. Castellanos, M.D., Ph.D; Patricia M. Dietz, Dr.P.H.

* Includes primary and secondary causes of death

Georgia Epidemiology Report Editorial Board
Editorial Executive Committee Patrick L. Osewe, M.D. - Editor Kathleen E. Toomey, M.D., M.P.H. Mary D. Brantley, M.P.H. Jeffrey D. Berschling, M.P.H.
Mailing List Edward E. Pledger, M.P.A.

The Cost of Trauma to Georgia Injuries cost Georgia much more
than money. The suffering and years of life lost due to traumatic injuries cost every community in more ways than money alone can measure.
q Trauma accounts for 52% of the deaths in children ages 1-9, and 78% of the deaths in children ages 10-19.

Epidemiology Section, Epidemiology & Prevention Branch, Two Peachtree St., N.W., Atlanta, GA 30303-3186

Phone: (404) 657-2588

FAX: (404) 657-2586

q In 1993, traumatic injuries caused over 45,500 hospital admissions, with a total hospital cost of over $545 million.
q The cost of child abuse and neglect in Georgia in 1993 was estimated at over $2 billion. In medical care alone, the cost was over $17 million.
q Compared to the national motor vehicle crash fatality rate of 17 per 100,000, Georgia has a fatality rate of 22 per 100,000.
q 40% of patients reported with traumatic brain injury and/or spinal cord injury are 20 to 44 years old, 65% are male, and 62% are white.
q The greatest number of trauma victims are persons ages 20-64, resulting in 1,100 years of life lost per 100,000 persons.
q Children ages 0-19 account for 35% of the traumatic brain injuries reported in 1994-1995, with one third of these being under the age of five.
Figure 1. Comprehensive Costs per Highway Injury for Ages 0-19*

Homicides and Suicides
Homicides and suicides are respectively the second and third leading cause of injury-related death among Georgians ages 10-44. The majority of these deaths are due to the use of firearms. In 1993, suicides and homicides resulted in over 1,600 deaths. Gunshot wounds also account for a large number of unintentional injuries and deaths. Each year, approximately 230 children across the nation die from accidental shootings.
q White males, ages 10-44, are the most likely to commit suicide.
q Suicides and homicides account for 38% of the injury-related deaths in Georgia.
The leading causes of injury death vary significantly by race and gender. Regardless of the cause of death, males have higher rates than females. White males and females are more likely to die as the result of a motor vehicle crash. African-American males are more likely to die from homicide.
Figure 2. Injury Deaths by Cause, Georgia 1993.

* Total estimated, $14,486,489 in 1994, adjusted for Georgia prices
Motor Vehicle Crashes
Motor vehicle crashes are the leading cause of death for persons ages 10-44 and the second leading cause of death for children ages 1-9. Injuries from motor vehicle crashes result in the largest number of years of life lost before age 65 and cost more than any other injury. Motor vehicle crashes in Georgia accounted for 1,779 deaths in 1993.
q Georgia ranked 15th in the United States for deaths due to motor vehicle crashes.
q The results of a survey in one rural county revealed that 38% of those injured in motor vehicle crashes were under the age of 20.
q In 1993, adults ages 20-44 had the highest rate of motorcycle-related deaths.
q Motor vehicle crashes caused 27% of all trauma related deaths in 1993.
q Over 13,000 cases of traumatic brain injuries (which are commonly underreported) and/or spinal cord injuries were reported from 1989 to 1995, with 45% being due to vehicular crashes.

Note: Includes primary and secondary causes of death, excluding: poisoning (including drug ingestion), legal interventions, and surgical accidents. Other injury causes include water accidents, choking, machinery accidents, drownings, etc.
Other Injuries
Farm Injuries q In a Georgia survey of 15 rural counties, 309 farm injuries were reported from August 1, 1991 through July 31, 1993.
q The farming/forestry/fishing industry ranks second in occupational injuries (31.8 per 100,000 workers), surpassed only by transportation/ material movers (35.3 per 100,000 workers), primarily due to motor vehicle crashes.
Falls q The risk of falling increases with age and 1015% of falls result in serious injuries. q A study in a rural Georgia community found that for children age 14 and under, falls were the leading injury-related cause of admission to the emergency department.
Physical Abuse q There were 4,229 incidents of confirmed physical abuse in children under the age of 18 in 1994.

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q During 1990-1992, 15% of the deaths among pregnant or postpartum women resulted from homicide.
Fires q Eight hundred burn victims were treated in trauma centers throughout Georgia in the first 6 months of 1995. q In 1993, injuries from fire resulted in 184 deaths in Georgia.
Bicycle Accidents q Children and teens ages 19 and under have the highest rate of death due to bicycle injuries. q Ninety percent of the national bicycle-related incidents are the result of collisions with motor vehicles.
Figure 3. Injury Deaths by Race and Gender for the Top Five Causes, Georgia 1993
Note: Only primary cause of death is included.
Prevention Activities
Prevention is the key to reducing injury-related deaths, disabilities and complications. Research, including cost analyses, has shown that prevention is cheaper than treatment and that as prevention activities increase, injuries decrease. Prevention activities must encompass both primary prevention, found in behavior and environmental change programs as well as tertiary prevention, beginning at the scene of an injury, continuing through hospital or trauma care facility treatment and on to rehabilitation services. Finally, the documentation and description of injuries, as can be found in a reliable Trauma Registry, is critical to supporting and furthering all prevention activities.
q Alcohol is involved in about half of all deaths due to motor vehicle crashes and is often involved in homicides, suicides and abuse, indicating that alcohol and drug reduction programs can play a key role in reducing the risk of unintentional and intentional injury.
q For children ages 4-15, every dollar spent on bicycle helmets saves $25 to $31 in costs associated with injury.
q Bicycle helmets prevent 52%-60% of bike-related head injury deaths for all ages.

q Violence is the 12th leading cause of death in the United States. Violence prevention can play a critical role in reducing these injuries and deaths. Several interventions are being used throughout Georgia, including mentoring programs for children and adolescents, conflict resolution training, peer mediation, training for health care providers to identify victims of domestic abuse, as well as public education and awareness programs.
q Lap and shoulder belts, when worn correctly, reduce the chances of occupant death in a crash by 45%.
q Every $40 child safety seat saves $80 in direct health care costs and $1,200 in indirect costs, resulting in a total cost savings of $32 for every $1 spent on a seat.
References and Resources
1. Georgia Vital Statistics, Center for Health Statistics, Division of Public Health, Georgia Department of Human Resources
2. Georgia Health Profile, 1994; CDC, U.S. Department of Health and Human Services
3. Injury Control in the 1990's; A Report to the Second World Conference on Injury Control
4. Childrens' Safety Network, Economics and Insurance Resource Center, National Public Services Research Institute
5. Fatal Injuries to Workers in the U.S., 19801989: A Decade of Surveillance, National and State Profiles; CDC, U.S. Department of Health and Human Services
6. Child Abuse Central Registry, 1993 Annual Report, Division of Family and Children's Services, Georgia Department of Human Resources
7. Georgia Central Registry for Spinal Cord Disabilities and Traumatic Brain Injuries, Roosevelt Warm Springs Institute for Rehabilitation, Division of Rehabilitation Services, Georgia Department of Human Resources
8. Georgia Trauma Registry, Office of Trauma, Division of Public Health, Georgia Department of Human Resources
9. Injury Control Section, Division of Public Health, Georgia Department of Human Resources
10. National Highway Traffic Safety Administration, U.S. Department of Transportation
11. National Safe Kids Campaign 12. Georgia Healthy Farmers Project, Environ-
mental Health Section, Division of Public Health, Georgia Department of Human Resources
This report was contributed by Rebekah Hudgins,Office of Disabilities Prevention and Office of Perinatal Epidemiology; and Susan Czechowicz, Office of Trauma and Office of Perinatal Epidemiology; Division of Public Health, Georgia Department of Human Resources

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The Georgia Epidemiology Report Epidemiology and Prevention Branch Two Peachtree St., NW Atlanta, GA 30303-3186

February 1996

Volume 12 Number 2

Reported Cases of Selected Notifiable Diseases in Georgia

Profile for November 1995

Selected Notifiable Diseases Campylobacteriosis Giardiasis H. influenzae B Meningococcal Disease Rubella Salmonellosis Shigellosis Viral Meningitis Tuberculosis Congenital Syphilis Early Syphilis Other Syphilis Cryptosporidiosis E. coli O157:H7 Legionnaires' Disease Lyme Disease Mumps Pertussis

Total Reported for November
1995 74 43 3 8 0 125 73 9 54 5 204 74 9 1 0 0 2 1

Previous 3 Months Total

Ending in November

1995 1994 1993

266

281

176

195

134

145

8

7

19

33

10

18

0

0

0

647

489

384

275

569

119

35

13

40

173

129

191

14

16

22

606

657

845

247

164

220

40

11

1

8

16

8

0

15

10

0

15

13

3

6

4

7

11

12

Previous 12 Months Total

Ending in November

1995 1994 1993

1081

995

756

566

464

362

68

66

73

115

83

89

0

7

0

1664

1512

1355

1541 1683

500

90

79

180

815

736

771

51

53

130

2490

2627

4006

1043

796

992

109

18

14

28

26

14

20

112

37

20

121

46

10

18

24

28

38

57

The cumulative numbers in the above table reflect the date the disease was first diagnosed rather than the date the report was received at the state

office; and therefore are subject to change over time due to late reporting. The 3 month delay in the disease profile for a given month is designed to minimize any changes that may occur. This method of summarizing data is expected to provide a better overall measure of disease trends and

patterns in Georgia.

* Data not available for this time period

AIDS Profile Update

Report Period

Total Cases Reported *

Percent Female

MSM

Risk Group Distribution (%)

Race Distribution (%)

IDU MSM&IDU HS Blood Unknown White Black Other

Last 12 Mos 02/95 to 01/96 5 Yrs Ago 02/90 to 01/91 Cumulative 01/80 to 01/96

2,234 1,261 14,707

18.8 9.8 13.6

44.9 18.8

4.4

63.0 15.6

6.9

53.3 19.0

6.1

13.7

1.3

16.7

34.1 62.6 3.3

7.4

2.8

4.3

49.8 48.9 1.3

9.8

2.3

9.7

42.0 56.1 1.9

MSM - Men having sex with men

IDU - Injection drug users

* Case totals are accumulated by date of report to the Epidemiology Section

HS - Heterosexual

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