Profile of Injuries in Georgia 2005 ACKNOWLEDGMENTS Georgia Department of Human Resources ........................................................ B.J. Walker, Commissioner Division of Public Health ............................................................................... Stuart Brown, M.D., Director Environmental Health & Injury Prevention Branch................................. Michael R. Smith, M.S., Director Injury Prevention Section ...........................................................................................Lisa Dawson, Director Epidemiology Branch .............................................................................Paul Blake, M.D., M.P.H., Director Chronic Disease, Injury, and Environmental Epidemiology Section ......................................................................................................Kenneth E. Powell, M.D., M.P.H., Chief Office of Health Information and Policy........................................ Gordon R. Freymann, M.P.H., Director Suggested Citation Yeager DM, Wu M, Mertz KJ, Dawson L, Mesfin J, Lindemer K, Powell KE. Profile of Injuries in Georgia 2005. Georgia Department of Human Resources; Division of Public Health; Injury Prevention Section and Chronic Disease, Injury, and Environmental Epidemiology Section, 2005. Publication number DPH05-044HW. Feedback Please share your comments with us about the usefulness of this report. Direct your comments and questions to: Injury Prevention Section Georgia Division of Public Health 2 Peachtree Street, NW Atlanta, GA 30303 (404) 657-6335 Sponsored by Grant# U17/CCU414824-07 from The Centers for Disease Control and Prevention. TABLE OF CONTENTS Highlights.......................................................................... 4 Introduction ...................................................................... 5 Profile of Injuries Overview of All Injuries......................................... 7 Motor Vehicle-Related ........................................... 15 Falls......................................................................... 23 Poisoning ................................................................ 31 Fire-Related ............................................................ 37 Drowning and Near-Drowning............................... 45 Suicide and Suicide Attempts ................................ 53 Homicide and Assaults .......................................... 61 Conclusions....................................................................... 69 Appendix County and District Data ....................................... 72 Appendix I Definitions and Abbreviations ......... 92 Appendix II - Methods............................................ 93 References ......................................................................... 99 Profile of Injuries in Georgia HIGHLIGHTS From 1999 through 2001, injuries caused approximately 4,750 deaths per year in Georgia. Unintentional injuries, such as motor vehicle collisions and falls, were the 4th leading cause of death in Georgia, with an average of 3,150 deaths per year. Unintentional and intentional injuries combined accounted for 80% of all deaths among persons ages 15-24 years. Suicide was the 11th most common cause of death in Georgia, with an average of 873 deaths per year in Georgia. Homicide was the 14th most common cause of death in Georgia, with an average of 645 deaths per year. Death rates in Georgia are higher than those in the United States as a whole for six of the seven most common types of injuries. Injury-related hospitalizations resulted in nearly $668 million in hospital charges per year. 4 Introduction INTRODUCTION Injuries are a significant public health problem in Georgia. Injury is defined as unintentional or intentional damage to the body resulting from acute exposure to thermal, mechanical, electrical, or chemical energy or from the absence of such essentials as heat or oxygen. Each year approximately 4,750 Georgians die from injury, and the death rate for Georgians is higher than the US rate for most causes of injury. Injury deaths are only part of the injury burden in Georgia. For every injury death, there are about eight inpatient hospitalizations in Georgia, an estimated 35 outpatient visits,1 about 270 emergency department visits,2 and approximately 600 injury visits to physicians' offices.3 Those who survive suffer either temporary or permanent pain, possible lifelong disability, and different degrees of economic consequences as a result of injuries. Most injuries can be prevented through the use of existing technology and environmental changes. The public health approach to injury prevention is to define the problem, identify risk and protective factors, develop and test prevention strategies, and assure widespread adoption of proven injury prevention principles and strategies. Injury data are crucial for the proper development of injury prevention programs. Identifying populations at risk for specific injuries assists in the support and development of appropriate prevention programs. The purpose of the Profile of Injuries in Georgia 2005 is to describe the burden of injuries in Georgia and identify risk and protective factors. The Profile of Injuries in Georgia 2005 presents updated information for the years 1999 through 2001 on fatal and non-fatal injuries in Georgia using death certificate and hospital discharge data. Both unintentional and intentional injuries are included. Unintentional injuries include drowning, falls, fire, motor vehicle trafficrelated incidents/crashes, and poisoning. Suicide and homicide fall under the category of intentional injury. The seven causes of injury listed in this profile accounted for about 81% of all injury deaths and 76% of all injury hospitalizations from 1999 to 2001. In each section of this report, a specific cause of injury is addressed and a definition of the mechanism of injury is included; comparisons are made to identify at-risk groups according to age, race and sex. Each section also includes prevention strategies, current Georgia Division of Public Health programs, and relevant web based resources. 5 Profile of Injuries in Georgia 6 Top Ten Leading Causes of Death in Georgia, 1999-2001 Age Group Rank <1 (n=3,308) 1-4 (n=538) 5-14 (n=752) 15-24 (n=3,167) 25-34 (n=4,446) 35-44 (n=9,262) 45-54 55-64 65-74 75-84 85+ Total (n=16,092) (n=23,169) (n=36,308) (n=50,021) (n=42,410) (n=189,466) 1 Congenital Unintentional Unintentional Unintentional Unintentional abnormalities injury injury injury injury 631 202 345 1,407 1,190 Cancer 1,588 Cancer 4,408 Cancer 7,733 Cancer 11,266 Heart diseases 15,628 Heart diseases 15,425 Heart diseases 53,781 2 Short gestation/LBW 571 Homicides 56 Cancer 82 Homicides Homicides 509 497 Heart diseases 1,563 Heart diseases 3,842 Heart diseases 6,443 Heart diseases 10,229 Cancer 10,520 Cancer 4,350 Cancers 40,512 3 SIDS 333 Congenital abnormalities 42 Homicides 50 Suicides 391 Suicides 487 Unintentional Unintentional injury injury 1,396 1,258 Chronic lung 1,131 Chronic lung 2,665 Stroke 4.233 Stroke 4,326 Stroke 13,096 4 Maternal complication 125 Cancer 32 Congenital abnormalities 41 Cancer 141 HIV 445 HIV 926 Stroke 770 Stroke 1,117 Stroke 2,186 Chronic lung 3,290 Alzheimers Unintentional 2,007 injury 9,440 5 RDS 123 Heart diseases 31 Heart diseases 40 Heart diseases 121 Heart diseases 392 Suicides 556 HIV 556 Unintentional injury 779 Diabetes mellitus 1,010 Alzheimers 1,485 Flu/ pneumonia 1,746 Chronic lung 9.119 6 Unintentional injury 110 Septicemia 11 Suicides 21 HIV 50 Cancer 389 Homicides 410 Chronic liver 530 Diabetes mellitus 730 Chronic kidney 788 Diabetes mellitus 1,264 Chronic lung 1,575 Diabetes 4,425 7 Bacterial sepsis 85 Chronic lung 10 Benign tumor 10 Congenital abnormalities 46 Stroke 73 Stroke 338 Suicides 451 Chronic liver Unintentional Flu/ disease injury pneumonia 461 764 1,206 Chronic kidney 999 Pneumonia & Influenza 4,041 Diseases of Benign 8 circulatory system tumor 85 9 Chronic lung 10 Pregnancy/ childbirth 26 Diabetes mellitus 64 Chronic liver 231 Diabetes mellitus 387 Chronic kidney 426 Septicemia 673 Chronic kidney 1,161 Septicemia Alzheimers 902 3,825 9 Placenta, Cord, Membrane 75 Anemia 9 Anemias 8 Stroke 24 Septicemia 49 Diabetes melitius 192 Chronic lung 299 Septicemia 397 Flu/ Unintentional Unintentional pneumonia injury injury 517 1,117 871 Chronic Kidney 3,798 10 Necrotizing enterocolitis 64 Perinatal condition 8 Septicemia stroke 7 Septicemia 17 Pregnancy/ childbirth 43 Septicemia 116 Septicemia 262 Suicides 283 Chronic liver disease 402 Septicemia 1,054 Diabetes mellitus 762 Septicemia 3,542 Overview Of All Injuries OVERVIEW OF ALL INJURIES Deaths Injuries in Georgia caused an average of 4,753 deaths per year from 1999 to 2001 (Table 1). Unintentional injuries accounted for an average of 3,147 deaths per year and were the 4th leading cause of death in Georgia. For Georgians from 1 to 34 years of age, unintentional injuries were the leading cause of death, accounting for 44% of deaths in that age group. Among intentional injuries, suicides and homicides were responsible for an average of 873 and 645 injury deaths per year, respectively, and ranked as the 11th and 14th leading causes of death in Georgia. The top three causes of death for Georgians between the ages of 15 and 34 years were unintentional injuries, homicides and suicides. Combined, unintentional (49%) and intentional (31%) injuries accounted for 80% of all deaths among persons aged 15-24 years. Georgia's death rates for unintentional injury, suicide, and homicide were all higher than the United States death rates by 19%, 4%, and 26% respectively (Table 1). From 1999 to 2001, if the injury death rate in Georgia had been equal to the injury death rate in the U.S., an estimated 695 Georgians per year would not have died. Table 1. Injury Deaths, Injury Death Rates, and Excess Injury Deaths, Georgia 1999-2001 Table 1. Injury Deaths, Injury Death Rates, and Excess Injury Deaths, Georgia, 1999-2001 Type of Injury 1999-2001 Average per Number of Deaths Year Unintentional Injuries 9440 3147 Motor Vehicle 4077 1359 Falls 1166 389 Poisoning 995 332 Fire/Burn 375 125 Drowning 351 117 Other Unintentional 2476 825 Suicide 2620 873 Homicide 1936 645 Legal Intervention 27 9 Other and Undetermined 237 79 All Injuries 14260 4753 * US rate is year 2000 only Average annual age-adjusted death rate, 1999-2001 Age-Adjusted Death Rate, GA 42.4 17.2 6.2 4.1 1.7 1.4 11.7 11.1 7.7 0.1 1.0 62.3 Age-Adjusted Death Rate, US* 35.5 15.7 4.8 4.6 1.2 1.3 7.8 10.7 6.1 0.1 1.4 53.7 Excess Deaths per Year, GA 554 124 115 -42 42 10 314 35 130 1 -33 695 7 Profile of Injuries in Georgia Injuries are the major cause of premature deaths in the United States. In Georgia, unintentional injuries, suicide and homicide were the third, fifth and sixth leading causes of years of potential life lost (YPLL) respectively (Figure 1). Figure 1. Leading Causes of Years of Figure 1. LeadiPngotCeanutsieasl oLfifYeeLaorsstof(YPPotLeLn)t*ia,lGLeifoerLgioas,t 2(Y0P01LL)*, Georgia, 2001 Cancer Heart Diseases Untentional Injuries Perinatal conditions Suicides Homicides HIV Congenital malformation Stroke Chronic lung diseases Diabetes 0 200 400 600 800 1000 1200 1400 1600 YPLL per 100,000 Although one third of all injury deaths occurred among persons aged 25 to 44 years (Table 2), the death rate for injuries increased sharply after the age of 75 years (Figure 2). Persons 85 years and older had the highest rate of injury death among all age groups, largely due to the increased risk for death from falls among the elderly. Children ages 1 to 14 years old had the lowest overall injury death rates (Figure 2.) Table 3.TNaubmlbeer2o.fNDeuamthsbbeyrAogfe,DRaecaetahnsd bSeyx:AAglel I,nRjuaricees, GaenodrgSiae, x19: 99-2001 All Injuries, Georgia, 1999-2001 Table 3. NumberWohifteDeaths by Age, RBlaaccke and Sex: All InOjtuherries, Georgia, 1999-2A0v0e1rage Age Group Total Male Female Male Female Male Female per year White Black Other Average AgUenGdreor u5p 132 93 98 87 5 5 T4o2ta0l 140 Male Female Male Female Male Female per year 5-14 147 94 118 58 3 3 423 141 Under 5 132 93 98 87 5 5 420 140 15-24 1145 342 677 146 27 7 2344 781 5-14 147 94 118 58 3 3 423 141 25-44 2229 836 1124 378 61 19 4647 1549 15-24 1145 342 677 146 27 7 2344 781 45-64 1628 674 612 187 28 13 3142 1047 25-44 2229 836 1124 378 61 19 4647 1549 65+ 1459 1254 298 258 6 9 3284 1095 45-64 1628 674 612 187 28 13 3142 1047 Total 6740 3293 2927 1114 130 56 14260 4753 65+ 1459 1254 298 258 6 9 3284 1095 Total 6740 3293 2927 1114 130 56 14260 4753 8 Overview Of All Injuries Figure 2. Age-Specific Death Rates: All Injuries, Georgia, 1999-2001 Figure 2. Age-Specific Death Rates: All Injuries, Georgia, 1999-2001 400 350 Death rate per 100,000 population 300 250 200 150 100 50 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group Figure 3: Age-Adjusted Death Rates by Race and Sex: All Injuries, Georgia, 1999-2001 Figure 3: Age-Adjusted Death Rates by Race and Sex: All Injuries, Georgia, 1999-2001 Males had a higher rate of dying 120 from an injury (92.0 per 100,000 Death rate per 100,000 population population) than females (36.7 per 100 100,000 population). Whites and blacks had the same rate of dying 80 from an injury (64.0 per 100,000 60 population for both). Black males had the highest death rate from injuries 40 (102.7 per 100,000 population) among all race/sex groups (Figure 3). 20 0 White Male White Female Black Male Black Female 9 Profile of Injuries in Georgia Death Rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Both Georgia's and the U.S. injury death rates decreased from 1979 to 1993, and have remained relatively unchanged since 1994. Compared to the U.S. rate, the death rate from injuries in Georgia has been consistently higher during the past two decades (Figure 4). From 1999 to 2001, if the injury death rate in Georgia had been equal to the injury death rate in the U.S., an estimated 695 Georgians per year would Figure 4. nAot hgaeve-dAiedd. justed Death Rates: All Injuries, Georgia and US, 1981-2001 Figure 4. Age-Adjusted Death Rates: All Injuries, Georgia and US, 1979-2001 100 90 80 70 60 50 40 30 20 10 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US About 66% of all injury deaths in Georgia were unintentional in nature, with motor vehicle-related deaths accounting for almost half (44%) of the unintentional injury deaths. Together, homicides and suicides accounted for 32% of injury deaths. Legal intervention and unknown causes accounted for 2% of injury deaths (Figure 5). Figure 5. Injury Deaths by Cause, Figure 5. InjuGryeDoeragthias,b1y9C9a9us-e2, 0G0e1orgia, 1999-2001 Other and Legal Undetermined Intervention 2% <1% Homicide 14% Suicide 18% Unintentional Injuries 66% Poisoning 7% Drowning 2% Falls 8% Motor Vehicle 29% Fire/Burn 3% Other 17% 10 Overview Of All Injuries Map 1. Age-adjusted Death Rate by County of Residence: All Injuries, Georgia, 1994-2001 Map 1. Age-adjusted Death Rate by County: All Injuries, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Injury deaths per 100,000 population Rate not calculated (less than 10 deaths) <67.0 >=67.0 and <81.0 >=81.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Henry Clayton Fayette Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Washington Upson Columbia McDuffie Richmond Burke Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 11 Profile of Injuries in Georgia Hospitalizations Deaths represent only part of the public health burden from injuries. Data from the Georgia hospital inpatient discharge data system indicate that from 1999 through 2001, more than 110,000 injury-related hospitalizations occurred (an average of 36,674 hospitalizations per year) resulting in an average of 201,300 days in hospital stay and nearly $668 million in hospital charges per year (Table 4). Among all injuryrelated hospitalizations, almost 80% were unintentional in nature with 39% of them resulting from falls and 20% resulting from motor vehicle related injuries. Unintentional injuries accounted for 80% of total hospitalization days and 80% of total hospital charges for injuries. Assault and suicide attempts together contributed 11% of total injury hospitalizations (Figure 6). TablTea4b.leIn4j.uInryjuHryoHsposiptaitlailzizaattiioonn,, HHoospspitiatlaizlaiztiaontioRnatResa, tes, LengLtehnogtfhSotfaSytaaynadndToTtoatallCChhaarrggeess,,GGeeoorgrigai,a1,91999-92900-12001 Type of Injury Unintentional Injuries Motor Vehicle Falls Poisoning Fire/Burn Drowning Other Unintentional Suicide Attempt Assault Legal Intervention Other and Undetermined Not E-coded All Injuries Number 87,754 22,404 43,024 3,987 1,171 188 16,980 6,692 5,972 76 1,734 7,793 110,021 Average per Year 29,251 7,468 14,341 1,329 390 63 5,660 2,231 1,991 25 578 2,598 36,674 Hospitalization Rate, GA 408.9 93.0 220.8 17.3 5.0 0.8 72.1 26.7 23.8 0.3 7.1 37.0 503.8 Average Inpatient Days per Year 160,424 49,958 77,258 4,431 3,840 401 24,536 6,427 11,663 170 2,574 20,042 201,301 Average Charges per Year $ 528,508,094 $ 196,010,944 $ 214,436,130 $ 11,485,697 $ 23,928,726 $ 1,319,966 $ 81,326,630 $ 19,654,545 $ 36,478,011 $ 522,508 $ 8,854,317 $ 74,476,812 $ 668,494,286 FigureF8ig. uInrjeur6y.HInosjpuirtayliHzaotisopnistbaylizCaautisoe,nGs eboyrgCiaa,u1s9e9,9-2001 Georgia, 1999-2001 Not E-coded 7% Undetermined 2% Legal Intervention <1% Homicide Attempt 5% Suicide Attempt 6% Unintentional Injuries 80% Poisoning 4% Drowning <1% Falls 39% Motor Vehicle 20% Fire 1% Other Unintentional 15% 12 Overview Of All Injuries Males and females each accounted for half of the total injury hospitalizations. Of those hospitalized for injuries, 72% were non-Hispanic whites. Nearly 26% of the hospitalizations were among persons 24-44 years of age (Table 5). TTaabbllee55..NNuummbbeerrooffHHoospspitiatlaizliaztaiotinosnbsybAy gAegeGGroruopu,pR, RacaeceanadndSeSxe:x: AAll Injurriiees, GGeeorgia, 199999--22000011 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 819 547 2,078 1,160 5,106 2,691 10,292 5,999 7,665 6,669 8,324 24,100 34,284 41,166 Black Male Female 724 500 1,181 625 3,048 1,215 6,491 3,021 3,561 2,069 1,503 3,020 16,508 10,450 Hispanic Male Female 77 123 70 124 201 1,039 267 1,447 145 290 340 131 1,100 3,154 Total* 3,021 5,468 13,819 28,474 21,005 38,125 110,021 Average per Year 1,007 1,823 4,606 9,491 7,002 12,708 36,674 *Total includes all other races/ethnicity. Figure 7. Age-Specific Hospitalization Rates: Figure 6. Age-SpecAiflicl IHnojsupriitaelsiz,aGtieonorRgaitaes,:1A9ll9I9n-ju2r0ie0s,1Georgia, 1999-2001 Hospitalization Rate per 100,000 population The risk for injury hospitalization 5000 increased with age. Persons 75 years 4500 of age and older had a much higher 4000 rate of injury-related hospitalization 3500 than younger people, with the highest 3000 rate being among those 85 years and 2500 older (4,600 per 100,000 population). 2000 Children had the lowest injury 1500 hospitalization rate among all age 1000 groups (Figure 7). 500 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group When comparing race/sex categFoirgiuerse, 7. AgFe-iAgdujurseted8H. oAspgiteal-izaadtiojnuRstateesdbyHRoacsepaintdaSleixz:aAtllioInnjurRiesa, tGeeosrgbiay, 1999-2001 males had a higher rate of hospitalization Race and Sex: All Injuries, Georgia, 1999-2001 Hospitalization Rate per 100,000 population from injury (528 per 100,000 population) 800 than females (454 per 100,000 700 population). Hispanics had a higher rate (603 per 100,000 population) 600 than non-Hispanic blacks (446 per 500 100,000 population) and non-Hispanic whites (508 per 100,000 population). 400 Hispanic males had the highest rate of 300 injury hospitalization (739 per 100,000 200 population), while non-Hispanic black females (329 per 100,000 population) 100 had the lowest hospitalization rate among all the sex/race/ethnic groups (Figure 8). 0 Non-Hispanic Non-Hispanic Non-Hispanic Non-Hispanic Hispanic Hispanic White Male White Black Male Black Male Female Female Female 13 Profile of Injuries in Georgia Map 2. Age-adjusted Hospitalization Rate by County of Residence: All Injuries, Georgia, 1999-2001 Map 2. Age-adjusted Hospitalization Rate by County: All Injuries, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Fannin Gilmer Pickens Towns Union White Lumpkin Rabun Stephens Injury hospitalizations per 100,000 population <484.5 >=484.5 and <600.0 >=600.0 Dawson Floyd Bartow Hall Banks Franklin Hart Cherokee Forsyth Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 14 Motor Vehicle Related MOTOR VEHICLE-RELATED Georgians aged 15 to 24 years and 74 to 85 years were more likely to die from motor vehicle crashes than Georgians in other age groups. Georgia youth aged 15 to 24 years had the highest hospitalization rate for motor vehicle crash injuries among all age groups. Motor vehicle traffic related injuries are defined as those injuries resulting from a crash involving a motor vehicle traveling on a public roadway. Motor vehicle traffic-related deaths and hospitalizations include injuries involving automobiles, vans, trucks, motorcycles, and other motorized cycles known or assumed to be traveling on public roads or highways. Injuries affect occupants of motorized vehicles, pedestrians, pedal cyclists, or occupants of other non-motorized vehicles. Death from Motor Vehicle-Related Crashes Motor vehicle traffic-related injury is the leading cause of injury death in Georgia, accounting for 29% of all injury deaths and 43% of all unintentional injury deaths. From 1999 to 2001, 4,077 Georgians died from injuries sustained in motor vehicle crashes, an average of 1,359 per year. Among these, 24% were between 15 and 24 years of age, 68% were male, and 72% were white (Table 6). Table 6. Number of Deaths by Age, Race and Sex: Table 12. NumMboertoofrDVeaethhiscblyeA-Rgee,lRaatceeda,ndGSeeoxr: gMiaV,-R1e9la9te9d-,2G0e0or1gia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 33 24 73 44 505 202 605 283 449 184 325 211 1990 948 Black Male Female 20 10 43 35 181 66 276 119 173 50 55 45 748 325 Other Male Female 1 1 1 2 12 4 17 10 9 5 1 3 41 25 Total* 89 198 970 1310 870 640 4077 Average per year 30 66 323 437 290 213 1359 *Total includes all other races/ethnicity. 15 Profile of Injuries in Georgia Death Rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 The death rate from motor vehicle crashes in Georgia has been consistently higher than the death rate for the United States since 1979. Both rates decreased from 1979 to 1992 and have remained unchanged since then (Figure 9). During the period 1999 through 2001, if the death rate for motor vehicle-related crashes idnieGdeforormgiamhoatdorbeveenhiceFlqeu-iragellatuotertdheactr3aos2fhte.hseA(TUagnbiletee-1dA).Stdatjeus, santeesdtimDateeda1t2h4 pRerasotnessp:er year would not have Motor VeFhigiucrlee-9R.eAlgaete-dA,dGjuestoerdgiDaeaanthd RUaSt,es1:981-2001 Motor Vehicle-Related, Georgia and US. 1979-2001 35 30 25 20 15 10 5 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Figure 10. Age-Specific Death Rates: Motor Vehicle-Related. Georgia, 1999-2001 Figure 30. Age-Specific Death Rates: Motor Vehicle-Related, Georgia, 1999-2001 Death Rate Per 100,000 Population 40 35 Georgians 15 to 24 years and those 75 30 years and older were more likely to die 25 from motor vehicle crashes than other 20 age groups (Figure 10). 15 10 5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 16 Motor Vehicle Related Death Rate per 100,000 population Figure 11. Age Adjusted Death Rates by Race and SexF:igMureot3o1.r AVgeeh-iAcdleju-sRteedlDaetaetdh,RGateeos brgyiRaa,c1e9a9nd9-S2ex0:01 Motor Vehicle-Related, Georgia, 1999-2001 120 100 80 60 40 20 The death rate from motor vehicle crashes was 2.3 times higher for males (24.8 per 100,000 population) than for females (10.6 per 100,000 population). Whites were equally likely to die from motor vehicle crashes (18.4 per 100,000 population) as blacks (16.3 per 100,000 population). White males and black males had the highest death rates from motor vehicle crashes among all the race/sex groups (Figure 11). 0 White Male White Female Black Male Black Female For persons dying in motor vehicle collisions, 36% of death certificates did not record the position of the victim (driver, occupant of car, pedestrian, etc), while 33% were indicated as occupants, and another 10% were pedestrians (Figure 12). FigurFei1gu2r.eT3y3p.eToyfpPeeorfsoPnerKsoinlleKdililnedMinotMoroVtoerhViceleh-icRlelCatreadshC, rash, GGeeoorrggiiaa,, 11999999--22000011 Unspecified 36% Motorcyclist 4% Pedal Cyclist 1% Pedestrian 10% Other 16% Occupant 33% 17 Profile of Injuries in Georgia Map 3. Age-adjusted Death Rate by County of Residence: Motor Vehicle, Georgia, 1999-2001 Map 8. Age-adjusted Death Rate by County: Motor Vehicle, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Motor Vehicle deaths per 100,000 population Rate not calculated (less than 10 deaths) <24.0 >=24.0 and <31.0 >=31.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 18 Motor Vehicle Related Hospitalizations from Motor Vehicle-Related Crashes Motor vehicle related injures were the 2nd leading cause of injury hospitalizations, accounting for 20% of all injury hospitalizations. From 1999 to 2001, there were a total of 22,404 hospitalizations from motor vehicle crash-related injuries, an average of 7,468 per year, resulting in an average of 49,960 hospitalization days and nearly $196 million in hospital charges per year. Of those hospitalized, 25% were 15 to 24 years old, 58% were male, and 64% were white (Table 7). TabTleab7l.eN13u. mNubmerbeorfoHf HoossppiittaalliizzaatitoinosnbsybAygAe,gRea,cReaacned Saenxd: Sex: MotMoortoVreVhiechliecl-eR-Reelalatteedd,,GGeeoorgrigai,a1,91999-92090-12001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 128 82 618 2,235 378 1,302 2,935 1,632 1,676 1,234 873 1,146 8,465 5,774 Black Male Female 125 97 353 208 871 482 1,513 899 716 483 202 197 3,780 2,366 Hispanic Male Female 16 14 38 24 292 98 345 108 76 42 12 23 779 309 Total* 498 1,710 5,493 7,726 4,414 2,539 22,404 Average per Year 166 570 1,831 2,575 1,471 846 7,468 *Total includes all other races/ethnicity. Georgians 15 to 24 years had the highest hospitalization rate for motor vehicle crash injuries compared to all other age groups (Figure 13). Figure 34. Age-Specific Hospitalization Rates: Motor Vehicle-Related, Figure 13. Age-SpecificGHeoorsgpiiat,a1li9z9a9ti-o2n00R1ates: Motor Vehicle- Related, Georgia, 1999-2001 180 Hospitalization Rate per 100,000 Population 160 140 120 100 80 60 40 20 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 19 Profile of Injuries in Georgia The hospitalization rate from motor vehicle crashes was higher for males (115.3 per 100,000 population) than females (71.8 per 100,000 population). Among the race/ethnic groups, Hispanics had a significantly higher hospitalization rate (118.3 per 100,000 population) than non-Hispanic whites (93.0 per 100,000 population) and non-Hispanic blacks (90.5 per 100,000 population). Hispanic males had the highest hospitalization rate (142.9 per 100,000 population) among all race/ethnic/sex groups (Figure 14). Figure 1F4ig.uMArego3et5-o.AMrAdgVojeteuo-hArstiVdcejeuldhesit-HceRldeoe-HRslpoaeslitaptetiaetdald,il,izzGGaaeettioiooornrgngiRai,Raat1,ea9s1t9eb99yd-92R90ba0-yc12eR0aa0n1dceSeaxn: d Sex: 160 Hospitalization Rate per 100,000 population 140 120 100 80 60 40 20 0 White Male White Female Black Male Black Female Hispanic Male Hispanic Female Figure 36. TFyigpVueerheoi1fc5lPe.-eTRrysepolaentoeHfdoPCserprasistohan,liGHzeeoodsrpgiinitaaM,li1zo9et9do9ir-n2VM0e0oh1tiocrle Crash, Georgia, 1999-2001 Other 1% Unspecified 8% Occupant 75% Motorcyclist 7% Pedal Cyclist 1% Pedestrian 8% Of persons hospitalized for motor vehicle crash-related injuries, 75% were motor vehicle occupants, 8% were pedestrians and 7% were motorcyclists (Figure 15). 20 Dade Whitfield Murray Habersham Motor Vehicle Related Map 4. Age-adjusted Hospitalization Rate by County of Residence: Map 9. AgMe-oatdojur sVteedhiHcloes,pGitealoizrgaitiao,n1R99at9e-b2y00C1ounty: Motor Vehicle, Georgia, 1994-2001 Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Motor Vehicle injury hospitalizations per 100,000 population Rate not calculated (less than 10 hospitalizations) <97.0 >=97.0 and <130.0 >=130.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 21 Profile of Injuries in Georgia Motor Vehicle Related Prevention Strategies Georgians 15 to 24 years had the highest motor vehicle-related hospitalization rate and the second highest motor vehicle-related death rate. Interventions targeting this group for seat belt use, prohibitions on driving under the influence of alcohol or other drugs (DUI), and adherence to speed limits would help reduce injuries and deaths from motor vehicle crashes. Proper and consistent use of child safety seats and booster seats for infants and young children and placing all children under 12 years of age in the back seat would reduce the number of children and youth killed or hospitalized due to motor vehicle crashes. Visible and consistent enforcement of child safety laws is a critical component for increasing child safety seat usage among parents and caregivers. Enforcing helmet laws for children riding their bicycles can reduce the severity of head injury. Creating safety zones for pedestrians by putting up physical barriers, using pedestrian bridges, overpasses, underpasses, traffic islands, and other measures would reduce the incidence of pedestrian injuries. Additionally, improving and maintaining adult supervision of young children crossing streets, and incorporating pedestrian skills training into school health education curriculum would reduce pedestrian injuries to children. Injury Prevention Programs for Motor Vehicle Related Injuries The Injury Prevention Section of the Division of Public Health, Department of Human Resources, supports local communities to promote the correct and consistent use of child restraint devices through the distribution of child restraint devices (infant, convertible, booster, and special needs seats) and the provision of appropriate training on correct installation of child restraint devices. The statewide Child Occupant Safety Project is supported by a grant from the Governor's Office of Highway Safety and on average distributes 5,000 child restraint devices per year to parents and caregivers. The Injury Prevention Section also supports programs to increase the use of bicycle helmets. Children under age 16 are required by Georgia law to wear a helmet when riding a bicycle. The Injury Prevention Section can provide technical assistance to groups interested in implementing (and evaluating) bicycle helmet promotion programs among at-risk children and their families. Motor Vehicle Related Prevention Resources National Highway Transportation Safety Administration http://www.nhtsa.dot.gov/ SAFE KIDS of GA http://www.choa.org/safety/ safekids.shtml CDC Community Guide http://www.thecommunityguide.org/ National SAFE KIDS Campaign http://www.safekids.org/ American Academy of Pediatrics http://www.aap.org/family/ carseatguide.htm Governor's Office of Highway Safety http://www.gohs.state.ga.us/ 22 Falls FALLS Older Georgians were more likely to die from falls than younger people. Approximately 40% of total unintentional injury-related hospitalizations were from falls, with older Georgians and Hispanic men having the highest rates. Falls include tripping and stumbling on the same level; colliding with another person; falling from furniture or playground equipment; or falling from one level to another such as from stairs and steps, ladders, trees, or buildings/structures. Deaths from Falls From 1999 through 2001, 1,166 Georgians died from fall-related injuries, an average of 389 per year. Persons 65 years and older accounted for the majority of fallrelated deaths (75%). Men accounted for more fall-related deaths than women up to the age 65 years. Whites accounted for 84% of all fall-related deaths (Table 8). Table 8. Number of Deaths by Age, Race and Sex: Falls, Georgia, Table 8. Number of Deaths by A1g9e,9R9a-c2e0a0n1d Sex: Falls, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 3 0 0 1 16 1 45 12 99 31 327 450 490 495 Black Male Female 2 1 1 0 2 0 15 6 43 9 52 44 115 60 Other Male Female 0 0 0 0 0 0 1 0 1 0 4 0 6 0 Total 6 2 19 79 183 877 1166 Average per year 2 1 6 26 61 292 389 23 Profile of Injuries in Georgia Since 1979, the death rate from falls in Georgia has been consistently higher than the rate for the United States; however, both US and Georgia death rates decreased from 1979 through 1986 with relatively little change since then (Figure 16.) During the period 1999 through 2001, if the death rate for falls in Georgia had been equal to that of the United States, an estimated 115 persons per year would not have died from falls (Table 1). Figure 18. Age-AdjFuisgtuerde D16e.aAthgeR-Aadtejuss:tFedalDlse,aGtheoRragtieas:and US, 1981-2001 Falls, Georgia and US, 1979-2001 Death rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 10 9 8 7 6 5 4 3 2 1 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Figure 17. Age-Specific Death Rates: Falls, Figure 16. Age-SGpeecioficrgDieaat,h1R9at9es9:-F2al0ls0, G1eorgia, 1999-2001 160 Death rate per 100,000 population 140 120 100 80 60 40 20 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group Older Georgians were more likely to die from falls than younger people, with the rate showing a sharp increase for persons 75 years and older (Figure 17). 24 Falls The death rate from falls was almost twice as high for males (8.5 per 100,000) as for females (4.7 per 100,000). Whites were more likely to die from falls (6.9 deaths per 100,000 population) than blacks (4.0 deaths per 100,000 population). White males had the highest death rate from falls (9.2 per 100,000 population) among the race/sex groups (Figure 18). Figure 18. Age-Adjusted Death Rates by Race and Sex, Figure 17. Age-AdjustedFDaelaltsh,RGateesobrygRiaac,e1a9nd99Se-x2:0F0al1ls, Georgia, 1999-2001 Death rate per 100,000 population 10 9 8 7 6 5 4 3 2 1 0 White Male White Female Black Male Black Female Among fall deaths, location was not recorded on 58% of the death certificates, 12% were falls from the same level, 8% were falls off of furniture, and 7% were falls from one level to another level such as playground equipment or building level (Figure 19). FiFgiguurree1199..LLocattiionsooffFFaalllsl,sG, Geoerogrigai,a1,919999-92-0200101 Unspecified 58 % Same level 12% One level to another 7% Ladders or scaffolding 3% Building or ot structure 6% Furniture 8% Stairs or steps 6% 25 Profile of Injuries in Georgia Dade Whitfield Murray Habersham Map 5. Age-adjusted Death Rate by County of Residence: Falls, Georgia, 1994-2001 Map 4. Age-adjusted Death Rate by County: Fall, Georgia, 1994-2001 Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Fall deaths per 100,000 population Rate not calculated (less than 10 deaths) <5.5 >=5.5 and <6.8 >=6.8 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 26 Falls Hospitalizations from Falls Falls were the leading cause of hospitalizations among the major injury mechanisms, accounting for 40% of all injury hospitalizations. There were a total 43,024 hospitalizations from falls between 1999 and 2001, an average 14,341 per year, resulting in an average of 77,258 hospitalization days and nearly $214 million in hospital charges per year. Of those hospitalized for falls, 66% were females, 80% were non-Hispanic whites, and 65% were persons 65 years and older (Table 9). Table 9. Number of Hospitalizations by Age, Race and Sex: Table 9. Number of HospiFtaalilzlast,ioGnes obyrgAigae,, R1a9c9e9a-n2d0S0ex1: Falls, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 185 135 531 277 504 181 1,969 1,028 2,548 2,834 5,370 18,993 11,107 23,448 Black Male Female 139 83 213 128 209 86 798 460 798 697 744 2,036 2,901 3,490 Hispanic Male Female 32 27 29 12 187 9 327 49 78 47 81 273 734 417 Total* 645 1,225 1,226 4,784 7,159 27,950 43,024 Average per Year 215 408 409 1,595 2,386 9,317 14,341 *Total includes all other races/ethnicity. Figure 20. Age-Specific Hospitalization Rates: Figure 20. Age-SpeFciafilclsH, oGspeiotarlgiziaat,io1n9R9a9te-s2:0F0a1lls, Georgia, 1999-2001 Hospitalization Rate per 100,000 population Older Georgians had a much higher 4500 risk for fall-related injury hospitalization 4000 than younger Georgians. The 3500 hospitalization rate for fall-related 3000 injuries was highest for those 85 years 2500 and older (3,900 per 100,000) (Figure 2000 20). 1500 1000 500 0 Females had a higher rate of fall- <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group related injury hospitalization (238.9 per 100,000 population) than males (176.8 per 100,000 population). Among FigurFeig21u.rAeg2e-1A.dAjugsete-daHdojsupsittaelidzaHtioonsRpaitteaslbizyaRtaicoenasndbySex: Race and FSaellxs:, GFaeollrsg,iaG, 1e9o9r9g-2ia00,11999-2001 Hospitalization Rate per 100,000 population the race/ethnic groups, Hispanics 300 (280.1 per 100,000 population) had a 250 significantly higher hospitalization rate than non-Hispanic whites (241.4 per 200 100,000 population) and non-Hispanic 150 blacks (134.5 per 100,000 population). Hispanic males had the highest fall- 100 related hospitalization rate (282.4 per 50 100,000 population) among all the race/ethnic/sex groups (Figure 21). 0 White Male White Female Black Male Black Female Hispanic Male Hispanic Female 27 Profile of Injuries in Georgia The location of almost half of the falls resulting in hospitalization was not specified; 27% were falls at the same level, and another 9% were falls from one level to another level (Figure 22). FigurFeig2u2r.eL22o.cLaoticoantisonofofFFaalllss,, GGeeoorrggiaia, ,1919999-92-0200101 Same Level 27% Not Specified 49% One Level to Another 9% Ladder 4% Building 2% Stairs 5% Furniture 4% 28 Falls Map 6. Age-adjusted Hospitalization Rate by County of Residence: Falls, Georgia, 1999-2001 Map 5. Age-adjusted Hospitalization Rate by County: Fall, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Fall Injury hospitalizations per 100,000 population Rate not calculated (less than 10 hospitalizations) <204.0 >=204.0 and <247.0 >=247.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 29 Profile of Injuries in Georgia Fall Related Prevention Strategies In Georgia, 65% of those hospitalized after falls and 75% of those dying from falls were persons 65 years and older. Strength training and regular physical activity programs for the elderly would decrease the number of falls and related mortality and morbidity. Services that assess environmental, medical, and behavioral risk factors for falls in the homes of elderly individuals would provide opportunity to remove or rectify safety hazards in the home. Such measures would include installing improved lighting, installing railings, removing loose rugs, and covering slippery surfaces in order to reduce the likelihood of falls and subsequent death and injury among the elderly. Implementing health care provider review of medicines, and having regular vision checks for the elderly are also recommended prevention measures. For children, safety precautions to prevent falls from furniture, windows, stairs and playgrounds are critical. These include constant supervision of infants on furniture (beds, chairs, changing tables), installing window guards and safety gates for stairs, removing furniture in close proximity to windows, and avoiding the use of baby walkers. Use of age-appropriate playground equipment under adult supervision, use of proper safety equipment when engaged in sports, and adequate safety precautions at construction sites would also serve to reduce the incidence and severity of fall related injuries. Injury Prevention Programs for Fall Related Injuries The Injury Prevention Section of the Department of Human Resources, Division of Public Health works with local communities, the Division of Public Health's Child Health Program and Chronic Disease Prevention Branch, and the state's Division of Aging Services to reduce injuries from falls. The Injury Prevention Section has distributed "Remembering When: A Fire and Fall Prevention Program for Older Adults" to fire deparments and health departments. The curriculum was developed by the CDC's National Center for Injury Prevention and Control (NCIPC), the National Fire Protection Association (NFPA), the U.S. Consumer Product Safety Commission, and other partners. It uses lesson plans, brochures, fact sheets, game cards, and other educational materials to present 16 life-saving lessons for elderly persons. The Injury Prevention Section has also collaborated with SAFE KIDS to improve playground safety for children. Efforts are being made to increase the number of trained playground inspectors and the number of playgrounds inspected. The Injury Prevention Section continues to seek resources to support fall prevention programs in Georgia. Falls Prevention Resources CDC: US Fall Prevention Programs for Seniors http://www.cdc.gov/ncipc/falls/default.htm National Osteoporosis Foundation http://www.nof.org/patientinfo/fall_prevention.htm American Academy of Pediatrics http://www.aap.org/family/tippmain.htm National Resource Center on Aging and Injury http://www.nrcai.org/ 30 POISONING Poisoning Georgians aged 35 to 54 years had the highest poisoning death rate among all age groups. Forty percent of these deaths were caused by narcotics and hallucinogens. An average of 1,329 Georgians were hospitalized each year due to poisonings during the 1999-2001 period. Poisoning is defined as exposure to toxic or poisonous substances that cause a negative reaction of the body. Those substances include sedatives, psychotropic medications, narcotics, hallucinogens, anesthetics, and other drugs; liquids such as alcohol or pesticides; gases and vapors such as carbon monoxide or utility gas; and other noxious substances or chemicals. Deaths from Poisoning From 1999 through 2001, 995 Georgians died from accidental poisoning, an average of 332 per year. Of those dying, the majority (83%) were aged 25 to 64 years, 65% were males and 75% were white (Table 10). Table 10. Number of Deaths by Age, Race and Sex: Poisoning, Georgia, 1999-2001 Table 14. Number of Deaths by Age, Race and Sex: Poisoning, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 5 0 1 0 68 14 267 133 127 92 19 21 487 260 Black Male Female 5 0 3 1 9 2 66 41 69 24 11 9 163 77 Other Male Female 1 0 0 0 1 0 4 0 0 1 0 1 6 2 Total 11 5 94 511 313 61 995 Apevreryaegaer 4 2 31 170 104 20 332 31 Profile of Injuries in Georgia The death rate from poisoning in Georgia was comparable to the US rate from 1979 to 1991. From 1992 to 2000, the Georgia death rate was lower than the US rate, with both Georgia and US rates increasing (Figure 23). Poisoning in Georgia was the only major injury mechanism with an average death rate lower than the national rate during 1999-2001. Death rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Figure 23. Age-Adjusted Death Rates: Figure 39. Age-AdjuPsotiesodnDinega,tGheRoragteias:aPnodiUsoSn, i1n9g7,9G-2e0o0r1gia and US, 1981-2001 6 5 4 3 2 1 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Figure 24. Age-Specific Death Rates: Figure 37. Age-SPpoecisifoicnDinegat,hGReaotersg: Piaoi1so9n9in9g-,2G0e0or1gia, 1999-2001 Death rates from poisoning were highest for persons 35 to 54 years old (Figure 24). The lowest death rate was among children between the ages of 1 and 14 years. Death rate per 100,000 population 9 8 7 6 5 4 3 2 1 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 32 Poisoning The death rate from poisoning was twice as high for males (5.4 per 100,000 population) as for females (2.7 per 100,000 population). Whites had a higher death rate (4.5 per 100,000 population) than blacks (3.9 per 100,000 population). Black males and white males had the highest poisoning death rates among all race/sex groups (Figure 25). Figure 25. Age-Adjusted Death Rates by Race and Sex: Poisoning, Figure 38. Age-Adjusted DeathGReatoesrbgyiaR,ac1e9an9d9S-e2x:0P0oi1soning, Georgia, 1999-2001 7 6 Death rate per 100,000 population 5 4 3 2 1 0 White Male White Female Black Male Black Female Narcotics and hallucinogens caused 40% of all accidental poisoning deaths in 1999-2001. Cocaine is included in this subgroup (Figure 26). Figure 40. Poisonings by Type, Figure 26. Poisoning by Type, Georgia, 1999-2001 GA, 1999-2001 Narcotics and hallucinogens 40% Alcohol 3% Gases and Vapours 5% Sedative 5% Pesticides,organic solvents, and other unspecified chemicals 3% Other unspecified medications 44% There were too few poisoning deaths per county to allow for calculation of reliable rates. 33 Profile of Injuries in Georgia Hospitalizations from Poisoning During the period 1999 through 2001, 3,984 Georgians were hospitalized for poisoning, an average of 1,329 per year, resulting in an average of 4,431 hospitalization days and nearly $11 million in hospital charges per year. Of those hospitalized, about 59% were 25 to 64 years old, 49% were females, and 62% were whites (Table 11). Table 11. Number of Hospitalizations by Age, Race and Sex: Table 15. Number of HosPpoitaisliozantiionngs b, yGAegoe,rRgaiace, a1n9d 9Se9x-:2P0oi0so1ning, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 83 82 30 20 145 114 385 357 298 367 170 403 1,111 1,343 Black Male Female 75 67 18 25 40 47 284 169 261 150 91 119 769 577 Hispanic Male Female 7 7 3 3 6 10 25 6 1 3 0 5 42 34 Total* 352 108 375 1,247 1,099 803 3,984 Average per Year 117 36 125 416 366 268 1,328 Hospitalization Rate per 100,000 population *Total includes all other races/ethnicity. FigFiugruere412P7.o.AiAsgogene--inSSgpp,eeGccieiffioiccrgHHiaoo,sps1pi9ti9at9lai-lzi2az0tai0to1inonRaRtaeste: s: Poisoning, Georgia, 1999-2001 50 Children 5 to14 years had the lowest 45 poisoning hospitalization rate of all age 40 groups. Persons 65 years and older and 35 children between the ages of 1 and 4 30 years had the highest hospitalization 25 rates (Figure 27). 20 15 10 5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group The rate of hospitalization from poisoning was similar for males (17.8 per FiFgiugruere284.2A. Ageg-ea-dAjdujsutestdedHHosopsiptiatlailzizaatitoionnRRaatteess by Hospitalization Rate per 100,000 population 100,000 population) and females (16.7 per 100,000 population). Non-Hispanic blacks (22.9 per 100,000 population) were more likely to be hospitalized than non-Hispanic whites (15.9 per 100,000 byRRacaeceaannddSSeexx: :PPooisiosonniningg, ,GGeeoorgrgiaia,,11999999--22000011 35 30 25 population) and Hispanics (9.5 per 20 100,000 population). Among all race/ 15 ethnic/sex groups, non-Hispanic black 10 males had the highest hospitalization 5 rate from poisoning (Figure 28) 0 34 White Male White Female Black Male Black Female Hispanic Male Hispanic Female Poisoning Figure 43. Poisonings by Type, Map 7. Age-adjusted HospitalizationGReaotregbiay,C1o9u9n9ty-2o0f 0R1esidence: Poisoning, Georgia, 1999-2001 Map 10. Age-adjusted Hospitalization Rate by County: Poisoning,TrGanq2eu9i%loizerrsgia, 1994-2001 Dade Whitfield Murray Habersham Pesticides /Other 10% Catoosa Walker Chattooga Gordon Fannin Gilmer Pickens Towns Union White Lumpkin Rabun Alcohol 3% Gases/Vapors Stephens 3% Poisoning hospitalzations per 100,000 population Rate not calculated (less than 10 hospitalizations) <15.5 >=15.5 and <23.0 Opiates 18% >=23.0 Dawson Floyd Bartow Hall Banks Franklin Hart Cherokee Forsyth Other Drugs Jackson Madison 25% Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Henry Clayton Fayette Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Washington Upson Columbia McDuffie Richmond Burke Cocaine 12% Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Crisp Pulaski Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 35 Profile of Injuries in Georgia Figure 43. Poisonings by Type, Figure 29. PGoeisonrignigas,b1y 9Ty9p9e-, 2G0eo0r1gia, 1999-2001 Pesticides /Other 10% Alcohol 3% Gases/Vapors 3% Tranquilizers 29% Opiates 18% Sedatives and tranquilizers accounted for 29% of poisoning hospitalizations, opiates accounted for 18%, and cocaine accounted for 12% of poisoning hospitalizations (Figure 29). Other Drugs 25% Cocaine 12% Poisoning Prevention Strategies Death data indicate that narcotics and hallucinogens caused 40% of all accidental poisoning deaths. Continued efforts to reduce the prevalence of drug abuse and addiction are needed to prevent accidental poisoning deaths and hospitalizations. Disposing of old medicine properly, providing safe and secure storage for poisonous substances, and publicizing poison control centers can also prevent poisoning injuries. Injury Prevention Programs for Poisonings The Injury Prevention Section supports poisoning prevention efforts by providing data on poisonings to community coalitions. Poisoning Prevention Resources Georgia Poison Center http://www.georgiapoisoncenter.org/ (1-800-222-1222) American Association of Poison Control Centers (AAPCC) http://www.aapcc.org/ AAPCC Poison Help Line http://www.1-800-222-1222.info/ Poison Prevention Week Council http://www.poisonprevention.org National Center for Environmental Health (NCEH) CDC Childhood Lead Prevention Program http://www.cdc.gov/nceh/lead/ lead.htm NCEH information on Carbon Monoxide http://www.cdc.gov/nceh/ airpollution/carbonmonoxide/ default.htm National Lead Information Center http://www.epa.gov/lead/nlic.htm (800-424-LEAD (5323)) 36 FIRE Fire-Related Blacks were 3 times more likely to die from fires (3.7 per 100,000 population) than whites (1.2 per 100,000 population). Fire-related injury hospitalizations had the longest average hospital stays (10 days per visit) and the highest average hospital charges ($61,000 per visit) among all injury hospitalizations. Fire-related injuries and deaths occur most often as a result of fires in private or public buildings, however, such injuries may also occur under other scenarios such as forest fires, or ignition of clothing or inflammable materials. Injuries from certain types of burns, such as scalds, were not included in this report due to death coding system changes. Deaths from Fire A total of 375 Georgians died from fire during 1999 to 2001, an average of 125 deaths per year. Victims were disproportionately elderly, with 34% being older than 65 years of age. Sixty percent were male and 52% were white (Table 12). Table 12. Number of Deaths by Age, Race and Sex: Fire/Burn, Georgia, 1999-2001 Table 10. Number of Deaths by Age, Race and Sex: Fire/Burn, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 10 4 5 2 10 3 28 14 38 22 33 25 124 70 Black Male Female 5 11 5 4 7 1 25 12 28 14 32 37 102 79 Other Male Female 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total 30 16 21 79 102 127 375 Average per year 10 5 7 26 34 42 125 37 Profile of Injuries in Georgia The death rate from fires in Georgia has been consistently higher than the death rate in the United States since 1979. Both the national and state rates decreased from 1979 to 1998 (Figure 30). From 1999 through 2001, if the death rate for fires in Georgia had been equal to that of the United States, an estimated 42 persons per year would not have died from fires (Table 1). Figure 30. Age-Adjusted Death Rates: Figure 25. Age-AdjuFsitreed, GDeeoartghiaRaantedsU: FS,ir1e9,7G9-e2o0r0g1ia and US, 1981-2001 Death rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 6 5 4 3 2 1 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Young children and the elderly were more likely to die from fires than persons in other age groups. Georgians aged 5 to 34 years had the lowest fire death rates (Figure 31). Death rate per 100,000 population Figure 31. Age-Specific Death Rates: Fire, Georgia, 1999-2001 Figure 23. Age-Specific Death Rates: Fire, GA, 1999-2001 12 10 8 6 4 2 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 38 Fire-Related The rate of dying from fires was 1.8 times higher for males (2.3 per 100,000 population) than for females (1.3 per 100,000 population). Blacks were 3 times more likely to die from fires (3.7 per 100,000 population) than whites (1.2 per 100,000 population). Black males had the highest fire death rate (5.0 per 100,000 population) among all race/sex groups (Figure 32). Death rate per 100,000 population Figure 32. Age-Adjusted Death Rates: FigurFei2re4.,AGgee-oArdgjiuasteadnDdeaUthSR, a1te9s99by-2R0ac0e1and Sex: Fire, Georgia, 1999-2001 6 5 4 3 2 1 0 White Male White Female Black Male Black Female Eighty-six percent (86%) of all fire deaths occurred in buildings or structures, which includes private and public dwellings (Figure 33). FigFuigreur3e3.2L6o. cLatoicoantsioonfsFoaftaFliFreir,eGs,AG,e1o9rg9i9a-,21090919-2001 Building or structure 86% Not in Building or structure 5% Ignition of clothing 5% Ignition of inflammable material 1% Other 1% Unspecified 2% 39 Profile of Injuries in Georgia Dade Whitfield Murray Habersham Map 8. Age-adjusted Death Rate by County of Residence: Fire, Georgia, 1994-2001 Map 6. Age-adjusted Death Rate by County: Fire, Georgia, 1994-2001 Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Fire deaths per 100,000 population Rate not calculated (less than 10 deaths) <2.1 >=2.1 and <3.0 >=3.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 40 Fire-Related Hospitalizations from Fire There were 1,171 hospitalizations in 1999-2001 as a result of fire-related injuries (an average of 390 hospitalizations per year) resulting in an average 3,840 hospitalization days and nearly $24 million in hospital charges per year. Although fire accounted for only 1% of all injury-related hospitalizations, the average fire-related hospitalization lasted twice as long and cost 34 times more than other injury hospitalizations in Georgia. Of those hospitalized from fire-related injuries, 67% were males and 58% were whites (Table 13). Table 13. Number of Hospitalizations by Age, Race and Sex: Fire, Georgia, 1999-2001 Table 11. Number of Hospitalizations by Age, Race and Sex: Fire, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 17 9 78 14 79 11 160 48 127 28 51 62 512 172 Black Male Female 14 5 38 11 23 10 82 45 68 28 43 44 268 143 Hispanic Male Female 2 0 1 3 13 0 16 1 3 0 0 0 35 4 Total* 49 149 140 362 267 204 1,171 Average per Year 16 50 47 121 89 68 390 *Total includes all other races/ethnicity. The hospitalization rate for fire-related injuries increased with age and was highest for those 85 years and older (Figure 34). Figure 34. Age-Specific Hospitalization Rates: Fire, Georgia, 1999-2001 Figure 27. Age-Specific Hospitalization Rates: Fire, Georgia, 1999-2001 Hospitalization Rate per 100,000 population 18 16 14 12 10 8 6 4 2 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 41 Profile of Injuries in Georgia The rate of hospitalization from fire-related injury was 2.7 times higher for males (7.4 per 100,000 population) than for females (rate 2.7 per 100,000 population). Non-Hispanic blacks (7.0 per 100,000 population) were more likely than non-Hispanic whites or Hispanics (both 4.5 per 100,000 population) to be hospitalized for fire-related injuries. Black males had the highest hospitalization rate among all race/ ethnic/sex groups (Figure 35). Figure 35. Age-adjusted Hospitalizations by Figure R28a.cAegea-nAdjuSsetexd: HFiorsep,itaGliezaotriogniaR,at1e9s 9by9-R2ac0e0a1nd Sex: Fire, Georgia, 1999-2001 12 Hospitalization Rate per 100,000 population 10 8 6 4 2 0 White Male *Less than 10 hospitalizations White Female Black Male Black Female Hispanic Male Hispanic Female* Twenty eight percent (28%) of all fire-related hospitalizations resulted from fires in private buildings, and 38% were caused by ignition of highly inflammable materials. Almost 20% of all fire-related hospitalizations were not coded for location (Figure 36.) FiguFriegu3r6e.2L9o. cLaotcGiaoetniooonrgsfioaFf,irF1ei9rCe9,a9Gu-2seio0nr0gg1iHa,o1s9p9i9ta-2li0z0a1tion, Unspecified 21% Other 4% Ignition of inflammable material 30% Private Building 22% Other/Unspecified Building 3% Not in building 10% Ignition of clothing 10% 42 Fire-Related Map 9. Age-adjusted Hospitalization Rate by County of Residence: Fire, Georgia, 1999-2001 Map 7. Age-adjusted Hospitalization Rate by County: Fire, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Fire injury hospitalizations per 100,000 population Rate not calculated (less than 10 hospitalizations) <5.5 >=5.5 and <12.0 >=12.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 43 Profile of Injuries in Georgia Fire Related Injury Prevention Strategies Appropriately placed and maintained smoke detectors in homes, emergency fire exit plans, and fire extinguishers are proven ways of reducing death and serious injuries from residential fires. Other measures of reducing fire-related injuries include enforcing existing building fire codes, and placing matches and lighters out of the reach of children. Injury Prevention Programs for Fire Related Injuries The Injury Prevention Section of the Department of Human Resources, Division of Public Health, supports a multi-faceted fire prevention program that includes the identification of highrisk neighborhoods and resident education on the risk factors for residential fires. The Program stresses the importance of having a family evacuation plan in case of fire and coordinates and leads the installation of smoke alarms in homes without adequate smoke alarm coverage. The program conducts followup visits to continually monitor the effectiveness of the programs. Neighborhoods selected for the program typically include low-income households with large numbers of children or elderly residents and with old structures that can be readily consumed by fire. Firemen and volunteers are responsible for the residence inspection and keeping records as to where the detectors are installed and providing follow-up visits. The program is sponsored by grants from the Centers for Disease Control and Prevention and the Georgia Fire Fighters Burn Foundation. National SAFE KIDS estimates that $60 is saved for every dollar spent on a smoke detector. Since its inception in 1999, the Residential Fire Prevention Program of the Injury Prevention Section has documented 83 cases where residents were alerted to evacuate in time by smoke alarms installed through the program. Fire Prevention Resources National Fire Protection Association http://www.nfpa.org/catalog/home/index.asp National SAFE KIDS Campaign http://www.safekids.org/tier2_rl.cfm?folder_id=171 Georgia Firefighters Burn Foundation http://www.gfbf.org/ U.S. Consumer Product Safety Commission http://www.cpsc.gov/spscpub/pubs/fire_sfy.html U.S. Fire Administration http://www.usfa.fema.gov/public/ 44 Drowning and Near-Drowning DROWNING & NEAR DROWNING Children ages 1 to 4 years and 15 to 24 years had a significantly higher risk for drowning than Georgians in other age groups More than half of the hospitalizations for near drowning resulted from incidents in swimming pools, and almost half (42%) of those hospitalized were children under 5 years of age. Drowning and submersion deaths include deaths involving swimming pools, natural open water (rivers, lakes, or seas), bathtubs and other bodies of water where no watercrafts were involved. Deaths from Drowning Drowning is an important injury concern, as it was the 2nd leading cause of unintentional injury death for children 1 to 4 years of age. From 1999 through 2001, 351 Georgians drowned, an average of 117 per year. Of these, 37% were children under the age of five or young adults between the ages of 15 and 24 years. Eighty percent (80%) were male, and 62% were white (Table 14). Table 14. Number of Deaths by Age, Race and Sex: Drowning, Georgia, 1999-2001 Table 6. Number of Deaths by Age, Race and Sex: Drowning, Georgia, 1999-2001 Age Group White Male Female Black Male Female Other Male Female Total Average per year Under 5 20 16 8 2 2 5-14 11 6 27 6 0 15-24 47 3 32 2 2 25-44 45 10 24 2 1 45-64 34 12 14 1 0 65+ 10 3 5 4 0 Total 167 50 110 17 5 1 49 16 1 51 17 0 86 29 0 82 27 0 61 20 0 22 7 2 351 117 45 Profile of Injuries in Georgia Death rate per 100,000 population 1979 2980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 The death rate from drowning in Georgia decreased from 1979 to 1993 but remains slightly higher than the US rate (Figure 37). From 1999 through 2001, if the death rate for drowning in Georgia had been equal to the death rate for drowning in the United States, an estimated 10 persons per year would not have died from drowning in Georgia (Table 1). Figure 11. Age-AdjusFteigduDree3a7th. ARgae-teAsd:juDsrteodwDnienagth, GRaetoersg:ia and US, 1981-2001 Drowning, Georgia and US, 1979-2001 4 3.5 3 2.5 2 1.5 1 0.5 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Children 1 to 4 years of age and young adults 15 to 24 years of age had a significantly higher risk for drowning than other age groups (Figure 38). Figure 38. Age-Specific Death Rates: Drowning, Georgia, 1999-2001 Figure 9. Age-Specific Death Rates: Drowning, GA, 1999-2001 3.5 Death rate per 100,000 population 3 2.5 2 1.5 1 0.5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 46 Drowning and Near-Drowning The rate of drowning was about four times higher for males (2.3 per 100,000 population) than for females (0.6 per 100,000 population). Whites (1.4 per 100,000 population) were slightly less likely than blacks (1.8 per 100,000 population) to die from drowning. Among the race/ethnic/sex groups, black males had the highest drowning rate (3.2 per 100,000 population) (Figure 39). Figure 39. Age-Adjusted Death Rates by Race and Sex: FiDgurroe w10n. AinDggero-,AwGdnjieunsogt,erdGgDeiaoeragatihan,Rd1a9tU9es9S-b2y,00R11a9c9e9an-d2S0e0x:1 3.5 3 2.5 2 Death rate per 100,000 population 1.5 1 0.5 0 White Male White Female Black Male Black Female More than one-third (39%) of all the drownings occurred in open water, and almost half (48%) of the open water victims were teenagers or young adults between 15 and 34 years of age. Of those who drowned in a swimming pool (14% of all drownings), 59% were children ages 1 to 14 years old. (Figure 40). FiFgiugruere401.2D. rDorwonwinnginbgybTyyTpey,pGe,eGorAgi,a1,919999-92-0200101 Open water 39% Bathtub 9% Swimming Pool 14% Unspecified 26% Other 12% 47 Profile of Injuries in Georgia Map 10. Age-adjusted Death Rate by County of Residence: Drowning, Georgia, 1994-2001 Map 3. Age-adjusted Death Rate by County: Drowning, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Drownings per 100,000 population Rate not calculated (less than 10 deaths) >1.4 >=1.4 and <1.9 >=1.9 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 48 Drowning and Near-Drowning Hospitalizations from Near Drowning From 1999 through 2001, 188 Georgians were hospitalized for near-drowning, an average of 63 per year, resulting in an average of 400 days in hospital stay and nearly $1.3 million in hospital charges per year. Although drowning incidents resulted in fewer hospitalizations than deaths, near-drownings ranked 2nd in hospital charges per visit among all the injury mechanisms, with average charges of approximately $21,000. Of all those hospitalized for near-drownings, 42% were children under 5 years of age, 61% were males, and 47% were whites (Table 15). Table 15. Number of Hospitalizations by Age, Race and Sex: Near-Drowning, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 29 17 9 3 5 1 8 3 3 1 7 3 61 28 Black Male Female 15 4 16 16 12 0 3 1 3 0 0 0 49 21 Hispanic Male Female 1 3 0 0 3 0 1 0 0 0 0 0 5 3 Total* 79 52 21 18 8 10 188 Average per Year 26 17 7 6 3 3 63 *Total includes all other races/ethnicity. Children under 5 years of age had the highest hospitalization rates among all age groups (Figure 41). Figure 41. Age-Specific Hospitalization Rates: Figure 13. Age-SpecificNHeaors-pDitaroliwzantinogn,RGaetoesr:gNiae,a1r9-D99ro-2w0n0in1g, Georgia, 1999-2001 6 Hospitalization Rate per 100,000 population 5 4 3 2 1 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 49 Profile of Injuries in Georgia The rate of near-drowning hospitalization was higher among males (rate 1.1 per 100,000 population) than among females (rate 0.5 per 100,000 population). Whites (0.6 per 100,000 population) and blacks (0.8 per 100,000 population) were equally likely to be hospitalized for near-drowning. However, black males had the highest near-drowning hospitalization rate among all race/ethnic/sex groups (Figure 42). Figure 42. Age-Adjusted Hospitalization Rates by Race and Sex: FigureN1e4.aAr-gDe-ArodwjusnteidngH,osGpeitaolrizgaitaio,n1R9at9e9s -b2y 0R0ac1e and Sex: Near-Drowning, Georgia, 1999-2001 1.4 Hospitalization Rate per 100,000 population 1.2 1 0.8 0.6 0.4 0.2 0 White Male White Female Black Male Black Female *Less than 10 hospitalizations; rate not calculated Hispanic Male* Hispanic Female* More than half of the hospitalizations for near-drowning (55%) occurred after incidents in swimming pools, and almost 78% of persons affected were children under 15 years of age. Near-drowning incidents in open water accounted for 24% of hospitalizations with a majority (77%) of those affected being children under 15 years old (Figure 43.) FiguFreig4ur3e. 1N5.eNare-aDr-Drorowwnniinngg bbyy TTyyppee, ,GGeoerogriag,ia19, 9199-92090-12001 Open Water 24% Bathtub 10% Unspecified 6% Other 5% Swimming Pool 55% There were too few hospitalizations per county to allow for calculation of reliable county-specific hospitalization rates for near drowning. 50 Drowning and Near-Drowning Drowning Related Prevention Strategies Many of the drownings could have been prevented through constant adult supervision of children near swimming pools and open water (lakes, ponds, etc), enforcing ordinances for child proof fencing around pools, covering pools with appropriate covers, and using effective barriers around ponds and open water. Parental knowledge of cardiopulmonary resuscitation (CPR) could greatly increase the chance for survival or reduce the severity of injury to children in neardrowning cases. Other prevention measures include utilizing Coast Guard approved personal floatation devices (PFD) when involved in water-related recreational activities, avoiding swimming after dark, and avoiding the use of alcohol or other drugs before and during recreational water activities. Injury Prevention Programs for Drowning Related Injuries The Injury Prevention Section of the Georgia Department of Human Resources, Division of Public Health, works with local communities and other state agencies to develop drowning prevention programs. These include the support of PFD provision programs on major open water recreational waterways. These programs have frequently involved partnerships with local coalitions through which the Injury Prevention Section provides district or county specific data on drowning or near drowning related mortality and morbidity. 51 Profile of Injuries in Georgia Drowning Prevention Resources The following organizations and web sites provided recommendations and best practices on preventing drowning related deaths and near-drowning injuries. American Academy of Pediatrics http://www.aap.org/family/tipppool.htm The Medical Center of Central Georgia http://www.mccg.org/childrenshealth/safety/waterhub.asp American Red Cross http://www.redcross.org/services/bss/tips/healthtips/safetywater.html U.S. Consumer Product Safety Commission http://www.cpsc.gov/cpscpub/pubs/chdrown.html Children's Safety Network http://www.childrenssafetynetwork.org/ National Safety Council http://www.nsc.org/library/facts/drown.htm U.S. Coast Guard, Office of Boating Safety http://www.uscgboating.org/ The United States Lifesaving Association http://www.usla.org/index.html 52 Suicide and Suicide Attempts SUICIDE / SUICIDE ATTEMPT Suicide is the second leading cause of injury death and the eleventh overall leading cause of death in Georgia. The majority (90%) of hospitalizations for suicide attempts were due to poisonings, with white females having the highest hospitalization rate among all race/ethnic/sex groups. Suicide (death) or suicide attempt (nonfatal) is an intentional injury with the intent to harm or kill oneself. Deaths from Suicide Suicide is the second leading cause of injury death and the eleventh overall leading cause of death in Georgia. From 1999 through 2001, 2,620 Georgians committed suicide, an average of 873 deaths per year. Of those dying from suicide, 40% were 25 to 44 years of age, 80% were males, and 85% were white (Table 16). Table 16. Number of Deaths by Age, Race and Sex: Suicide, Georgia, 1999-2001 Table 17. Number of Deaths by Age, Race and Sex: Suicide, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 0 0 14 3 244 51 662 189 501 159 332 74 1753 476 Black Male Female 0 0 1 2 82 7 149 20 55 8 21 3 308 40 Other Male Female 0 0 1 0 5 2 20 3 7 4 1 0 34 9 Total 0 21 391 1043 734 431 2620 Average per year 0 7 130 348 245 144 873 53 Profile of Injuries in Georgia Death rate per 100,000 population 1979 2980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 The death rate from suicide in Georgia is similar to the death rate in the US. The suicide rates for both Georgia and the US have remained almost unchanged over the past two decades (Figure 44). Figure 53. Age-Adjusted Death Rates: Figure 44. Age-Adjusted Death Rates: Suicide, Georgia, 1979-2001 Suicide, GA, 1981-2001 16 14 12 10 8 6 4 2 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US The suicide rate in Georgia was highest among persons aged 75 to 84 years (Figure 45). Death rate per 100,000 population Figure 45. Age-Specific Death Rates: FigSuuricei5d1e., AGgeeo-rSgpiae,ci1fi9c9D9-e2a0th0R1 ates: Suicide, GA, 1999-2001 25 20 15 10 5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 54 Suicide and Suicide Attempts The suicide rate was 4.5 times higher for males (19.2 per 100,000 population) than for females (4.2 per 100,000 population). Whites were more likely to die from suicide (13.7 per 100,000 population) than blacks (5.1 per 100,000 population). White males had the highest suicide rate (22.9 per 100,000 population) among all the race/sex groups (Figure 46). Figure 46. AFgigeu-rAed5j2u. sAteged-ADdejuastthedRDaetaeths RbayteRsace and Sex: by RSauceicainddeS, eGxe: oSurgiciiad,e,1G9A99, 1-929090-21001 25 Death rate per 100,000 population 20 15 10 5 0 White Male White Female Black Male Black Female Firearms were the most common method for suicide in Georgia, accounting for 70% of total suicides from 1999 to 2001, while hanging or suffocation accounted for 14% and poisoning accounted for 12% of suicides (Figure 47). Figure 47. Suicide by Method Used, Georgia, 1999-2001 Figure 54. Suicide by Method Used, GA, 1999-2001 Cutting 1% Jumping 1% Other 2% Firearm 70% Poisoning 12% Hanging or Suffocation 14% 55 Profile of Injuries in Georgia Map 11. Age-adjusted Death Rate by County of Residence: Suicide, Georgia, 1994-2001 Map 13. Age-adjusted Death Rate by County: Suicide, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Suicides per 100,000 population Rate not calculated (less than 10 deaths) <12.0 >=12.0 and <14.0 >=14.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 56 Suicide and Suicide Attempts Hospitalizations from Suicide Attempts Suicide attempts were the third leading cause of injury hospitalizations. From 1999 through 2001, a total of 6,688 Georgians were hospitalized for suicide attempts, an average of 2,229 per year, resulting in approximately 6,400 hospitalization days and $19.7 million in hospital charges per year. Of those hospitalized, about 51% were 25 through 44 years old, 61% were female and 73% were white (Table 17). Table 17. Number of Hospitalizations by Age, Race and Sex: Suicide Attempt, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 1 0 31 139 428 580 1,029 1,464 413 598 90 101 1992 2,882 Black Male Female 0 0 10 53 171 252 335 437 84 98 11 10 611 850 Hispanic Male Female 0 1 0 7 20 42 26 38 6 13 5 0 57 101 Total* 3 251 1,555 3,415 1,241 223 6,688 Average per Year 1 84 518 1,138 414 74 2,229 *Total includes all other races/ethnicity. Hospitalization Rate per 100,000 population FFiigguurree5458.. AAggee--SSppeeccifiificcHHoossppititaalliizzaattiioonn RRaatteess:: SSuuiicciiddee AAtttteemmpptt,, GGeeoorrggiiaa,, 11999999--22000011 50 45 40 35 30 25 20 15 10 5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group Georgians aged 15 to 44 years had the highest hospitalization rate for suicide attempts among all age groups (Figure 48). 57 Profile of Injuries in Georgia The rate of hospitalization for suicide attempts was higher for females (31.5 per 100,000 population) than for males (22.2 per 100,000 population). Non-Hispanic whites were more likely to be hospitalized (30.9 per 100,000 population) than non-Hispanic blacks (19.8 per 100,000 population) and Hispanics (18.3 per 100,000 population). White females had the highest hospitalization rate among all race/ethnic/sex groups (Figure 49). Figure 49. AgeF-iAgdurjeu5s6te. AdgHe-oAsdpjuisttaedlizHaotspioitnaliRzaatitoensRbaytesRace and Sex: by RSuacieciadned SAetxt:eSmuipcitd,eGAettoemrgpita, G, 1eo9r9gi9a-, 21909091-2001 40 Hospitalization Rate per 100,000 population 35 30 25 20 15 10 5 0 White Male White Female Black Male Black Female Hispanic Male Hispanic Female The methods used for attempted suicides resulting in hospitalization were different from the methods used for completed suicides. The majority (90%) of hospitalizations for suicide attempts were due to poisoning, while 4% were from firearm injuries and 4% from cutting/piercing (Figure 50). Figure 50F. iSguuirceid5e7.ASttueimcidpet bAyttMemeptht od Used, by MethoGdeoUrsgeida,, G19e9o9rg-i2a0,011999-2001 Poisoning 90% Suffocation 1% Firearm 4% Cut/Pierce 4% Other 1% 58 Dade Whitfield Murray Habersham Suicide and Suicide Attempts Map 12. Age-adjusted Hospitalization Rate by County of Residence: Map 14.SAuigcei-daedjAutstteedmHpto,sGpietaolrigzaiati,o1n9R9a9t-e2b0y01County: Suicide Attempt, Georgia, 1994-2001 Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Suicide attempt hospitalizations per 100,000 population Rate not calculated (less than 10 deaths) <26.0 >=26.0 and <40.0 >=40.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Crisp Pulaski Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 59 Profile of Injuries in Georgia Suicide/Suicide Attempt Prevention Strategies Suicide may be prevented by increasing awareness of the risk factors for suicide, identifying the warning signs of major depression and suicidal thoughts, and referring those experiencing depression or suicidal ideation for appropriate treatment. In addition, because 70% of suicides in Georgia were committed with firearms, and 90% of suicide attempt hospitalizations were from poisoning, such as sedatives, restricting access to firearms as well as to sedatives by people at higher risk of suicide will also help reduce the incidence of suicide attempts. Injury Prevention Programs for Suicide/Attempted Suicide The former Georgia Legislature, through a publicprivate partnership with the Suicide Prevention Advocacy Network (SPAN USA), designated funds for development of a Georgia Suicide Prevention Plan. SPAN, in collaboration with the Injury Prevention Section of the Division of Public Health, Georgia Department of Human Resources, and the National Mental Health Association of Georgia, engaged nearly 1,000 Georgians in this year-long effort. The Injury Prevention Section is continuing its collaboration with SPAN, their partners and other advocates to increase community awareness of suicide and implement best practice programs that address youth suicide. Suicide Prevention Resources Georgia Suicide Prevention Plan http://www.georgiasuicidepreventionplan.org/ Suicide Prevention Action Network http://www.spanusa.org/ Suicide Prevention Action Network: Georgia http://www.spanusa.org/GSPP.html American Association of Suicidology http://www.suicidology.org/ 1-202-237-2280 American Foundation for Suicide Prevention http://www.afsp.org/ National Institute of Mental Health (NIMH) http://www.nimh.nih.gov National Strategy for Suicide Prevention http://www.mentalhealth.org/suicideprevention/ National Youth Violence Prevention Resource Center http://www.safeyouth.org/ 1-866-SAFEYOUTH (723-3968) 60 HOMICIDE / ASSAULT Homicide and Assaults Black males were four times more likely to die from homicide than white males, and accounted for 60% of all the homicide deaths. Males, especially black males and Hispanic males, had a higher hospitalization rate than females from assault. Homicide (death) or assault (nonfatal) is defined as an intentional injury with the intent to harm or kill. Deaths from Homicide From 1999 through 2001, 1,936 Georgians died from homicide, an average of 645 per year. Of those dying, 73% were between the ages of 15 and 44 years, 74% were males and 60% were black (Table 18). Table 18. Number of Deaths by Age, Race and Sex: Table 16. Number ofHDoeamthiscbidy eA,geG, Reaocregainad,S1e9x:9H9o-m2i0ci0de1, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 15 15 14 12 111 32 225 93 121 43 27 23 513 218 Black Male Female 28 32 16 7 308 53 431 141 94 35 18 7 895 275 Other Male Female 1 0 1 0 5 0 12 5 8 3 0 0 27 8 Total 91 50 509 907 304 75 1936 Average per year 30 17 170 302 101 25 645 61 Profile of Injuries in Georgia Death rate per 100,000 population 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 The death rate from homicide in Georgia has been consistently higher than the US rate since 1979. Both rates have decreased over the past two decades (Figure 51). During the period 1999 through 2001, if the death rate for homicides in Georgia had been equal to the death rate for homicides in the United States, an estimated 130 persons per year would not have died (Table 1). FiguFriegu4re65. 1A. Aggee--AAddjjuussteteddDeDaethatRhatResa:tes: HHomomiciciiddee,, GGeoArgaianadnUd USS, ,11998791--22000011 18 16 14 12 10 8 6 4 2 0 NOTE.The dotted line indicates a change in coding systems used for cause of death. ICD-9 codes were used in 1979-1998 and ICD-10 codes were used in 1999-2001 GA US Infants less than one year old and persons aged 15 to 44 years had the highest homicide rates of all age groups (Figure 52). FFigiguHurroeem45i24c.i.dAAeg,egG-eSe-poSerpgciiefaci,ci1fDi9ce9a9Dt-he2a0Rt0ah1teRs:ates: Homicide, GA, 1999-2001 16 14 Death rate per 100,000 population 12 10 8 6 4 2 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 62 Homicide and Assaults The rate of homicide was about 3 times higher for males (12.0 per 100,000 population) than for females (4.0 per 100,000 population). Blacks were more likely to die from homicide (16.0 per 100,000 population) than whites (4.5 per 100,000 population). Black males had the highest homicide rate (25.6 per 100,000 population) among all the race/sex groups (Figure 53). Figure 53. Age-adjusted Death Rates by RFaicgeuarend45S.exA:gHeo-Amdicjuidsete,dGDeoeragtiha,R1a9te9s9-b2y0R01ace and Sex: Homicide, GA, 1999-2001 30 Death rate per 100,000 population 25 20 15 10 5 0 White Male White Female Black Male Black Female Firearms were the most common method used for homicide in Georgia, accounting for 63% of all homicides from 1999 through 2001 (Figure 54). Figure 54. Homicide by Method Used, Georgia, 1999-2001 Figure 47. Homicide by Method Used, GA, 1999-2001 Other 10% Fire 2% Unspecified 12% Struck by or against 2% Cutting 8% Hanging or suffocation 3% Firearm 63% 63 Profile of Injuries in Georgia Map 13. Age-adjusted Death Rate by County of Residence: Homicide, Georgia, 1994-2001 Map 11. Age-adjusted Death Rate by County: Homicide, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Homicides per 100,000 population Rate not calculated (less than 10 deaths) <6.1 >=6.1 and <10.0 >=10.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Washington Burke Upson Harris Talbot Muscogee Chattahoochee Marion Taylor Bibb Crawford Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Pulaski Crisp Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 64 Homicide and Assaults Hospitalizations from Assaults There were a total of 5,972 injury hospitalizations from assaults from 1999 to 2001, an average of 1,991 per year, resulting in approximately 11,600 hospitalization days and almost $37 million in hospital charges per year. Of those hospitalized, about 75% were between the ages of 15 and 44 years, 78% were male and 63% were black (Table 19). Table 19. Number of Hospitalizations by Age, Race and Sex: Assault, Georgia, 1999-2001 Table 17. Number of Hospitalizations by Age, Race and Sex: Assault, Georgia, 1999-2001 Age Group Under 5 5-14 15-24 25-44 45-64 65+ Total White Male Female 52 30 11 5 289 48 627 138 202 77 36 57 1,217 355 Black Male Female 70 60 63 15 805 134 1,608 340 530 82 35 33 3,111 664 Hispanic Male Female 11 4 5 4 132 6 162 9 30 2 2 0 342 25 Total* 258 106 1,456 3,012 971 169 5,972 Average per Year 86 35 485 1,004 324 56 1,991 *Total includes all other races/ethnicity. Infants and persons between the ages of 15 and 44 years had the highest assault hospitalization rates among all age groups (Figure 55). Hospitalization Rate per 100,000 population FFiigguurree 4585.. AAggee--SSppeeccifiifcicHHoospspitiatalilzizaatitoionnRRaatetess: : AAssssaauulltt,, GGeeoorrggiiaa,,11999999--22000011 50 45 40 35 30 25 20 15 10 5 0 <1 1-4 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age Group 65 Profile of Injuries in Georgia The rate of hospitalization due to assault was 4.5 times higher for males (38.8 per 100,000 population) than for females (8.7 per 100,000 population). Non-Hispanic blacks had a higher assault hospitalization rate (52.5 per 100,000 population) than non-Hispanic whites (10.0 per 100,000 population). Non-Hispanic black males and Hispanic males had the highest hospitalization rates from assault among all race/ethnic/sex groups (Figure 56). Figure 56. FAiggeu-rAed4j9u.sAtegde-HAodsjpuisttaedlizHaotsiopintaRliaztaetisonbyRRataecse and Sex: by RaceAasnsdauSletx, :GAesosraguilat, G19e9o9rg-i2a0, 011999-2001 Hospitalization Rate per 100,000 population 100 90 80 70 60 50 40 30 20 10 0 White Male White Female Black Male Black Female Hispanic Male Hispanic Female Among all assault injuries that resulted in hospitalization, 24% were inflicted by firearms, 23% by cutting/ piercing, and 20% by unarmed fights (Figure 57). FiguFreig5u7re. A50ss.aAuslstabuylt MbyeMtheothdoUd sUesde,dG, eGoAr,g1ia9,9199-29090-12001 Struck by blunt/ thrown object 13% Other 7% Battering 4% Unspecified 8% Cut/Pierce 23% Unarmed Fight 20% Firearm 24% Rape 1% 66 Homicide and Assaults Map 14. Age-adjusted Hospitalization Rate by County of Residence: Assault, Georgia, 1999-2001 Map 12. Age-adjusted Hospitalization Rate by County: Assault, Georgia, 1994-2001 Dade Whitfield Murray Habersham Catoosa Walker Chattooga Gordon Floyd Bartow Fannin Towns Union Rabun Gilmer Pickens White Lumpkin Stephens Dawson Hall Banks Franklin Hart Cherokee Forsyth Assault injury hospitalizations per 100,000 population Rate not calculated (less than 10 hospitalizations) <17.0 >=17.0 and <28.0 >=28.0 Jackson Madison Elbert Polk Paulding Cobb Haralson Carroll Douglas Fulton Gwinnett Barrow Dekalb Walton Clarke Oconee Oglethorpe Wilkes Rockdale Newton Morgan Greene Taliaferro Lincoln Clayton Fayette Henry Heard Coweta Spalding Butts Jasper Putnam Hancock Warren Glascock Columbia McDuffie Richmond Troup Meriwether Pike Lamar Monroe Jones Baldwin Jefferson Burke Washington Upson Harris Talbot Muscogee Chattahoochee Marion Bibb Crawford Taylor Peach Macon Houston Wilkinson Twiggs Bleckley Laurens Johnson Treutlen Jenkins Screven Emanuel Candler Bulloch Effingham Montgomery Quitman Stewart Schley Sumter Randolph Terrell Lee Dooly Crisp Pulaski Wilcox Turner Dodge Wheeler Telfair Ben Hill Jeff Davis Toombs Appling Evans Tattnall Long Bryan Liberty Chatham Webster Clay Calhoun Dougherty Early Baker Miller Mitchell Seminole Decatur Grady Worth Tift Colquitt Cook Thomas Brooks Irwin Coffee Berrien Atkinson Lanier Lowndes Clinch Bacon Wayne Pierce Ware Brantley McIntosh Glynn Charlton Camden Echols 67 Profile of Injuries in Georgia Homicide/Assault Prevention Strategies Firearms caused 63% of homicides in Georgia. Methods for reducing homicide deaths include reducing the illegal acquisition and use of firearms by criminals and juvenile offenders, increasing education on safe use and storage of firearms, promoting awareness of anger management skills, and implementing programs to reduce bullying and violence against women. Injury Prevention Programs for Homicide/Assault The Injury Prevention Section is collaborating with the Family Health Branch on a Violence Against Women Project funded by CDC through its Core Capacity grant. A statewide needs assessment has been conducted to describe the magnitude of domestic violence and sexual assault in Georgia, increase collaboration with stakeholders, and assess gaps in services for prevention, intervention and services for victims. A strategic plan is under development to strengthen services in communities through best practices and increase collaboration and awareness of health and social service providers, the criminal justice system and Violence Against Women programs. Homicide/Assault Prevention Resources National Sexual Violence Resource Center National Resource Center on Domestic http://www.nsvrc.org/ Violence 877-739-3895 http://www.vawnet.org/ National Violence Against Women ( 800-537-2238) Prevention Research Center Rape, Abuse & Incest National Network http://www.vawprevention.org/ (RAINN) 843-792-2945 http://www.rainn.org/ National Youth Violence Prevention hotline: 800.656.HOPE Resource Center The National Center for Injury Prevention http://www.safeyouth.org/ and Control (NCIPC) Violence Against Women Electronic http://www.cdc.gov/ncipc/dvp/dvp.htm Network U. S. Department of Justice, Office for http://www.vawnet.org/ Victims of Crime National Center for Victims of Crime http://www.ncvc.org phone: 202.467.8700 fax: 202.467.8701 Office for Victims of Crime Resource Center National Criminal Justice Reference Service 18006276872 (TTY 1877712-9279) National Domestic Violence Hotline http://ojp.usdoj.gov/ovc/ http://www.ndvh.org/ phone hotline: 1.800.779.SAFE (7233) U.S. Department of Justice Violence Against Women Office National Network to End Domestic Violence http://www.ojp.usdoj.gov/vawo/ http://www.nnedv.org/ (202-543-5566) National Youth Violence Prevention Resource Center http://www.safeyouth.org/ 1-866-SAFEYOUTH (723-3968) 68 Conclusions CONCLUSIONS Summary of Data: Injuries are an important public health problem in Georgia. From 1999 through 2001, unintentional injuries were the 4th leading cause of death, and suicide was the 11th leading cause of death in Georgia. Unintentional injuries, suicide and homicide were the third, fifth and sixth leading causes of premature death, respectively. For all leading causes of injury death except poisoning, fatality rates were higher for Georgia than for the United Sates as a whole. In addition to deaths, injuries caused about 37,000 hospital visits, $668 million in hospital charges, and more than 200,000 hospitalization days. Data indicate that certain populations are at higher risk for injury death or hospitalization than others. Many deaths from drowning and hospitalizations from near-drowning in Georgia occurred in children less than 15 years of age. About two-thirds (65%) of fall-related injury hospitalizations and 75% of deaths from falls were for people ages 65 years and older. Georgians aged 15 to 24 years and those 75 years and older had the highest rates of motor vehicle-related deaths and hospitalizations. Adults aged 35 to 54 years had the highest death rate from poisoning. In general, males, adolescents, young adults and the elderly had the highest risk for death from injuries. Males, especially Hispanic males, had a higher risk for injury hospitalization than females. Black males were most likely to die from homicide. Data also show that certain places or methods for injuries played important roles in injury related deaths or hospitalizations in Georgia. For fire related injuries, 86% of deaths took place in private buildings or structures. Of all accidental poisonings, 40% were caused by narcotics and hallucinogens. Firearms were used in 63% of homicides and 70% of suicides. Rates for homicide and assault injuries were greater in urban areas. 69 Profile of Injuries in Georgia Role of Primary Prevention: Injuries are not accidents. On the contrary, nearly all the injuries covered in this profile are predictable, controllable events that can be anticipated and prevented. Injury Prevention programs employ several major components to construct effective prevention programs. While injury prevention programs can be implemented at the local, state, or even the federal level, the most effective programs are often created at the local level, where a multifaceted, need-based program can be developed and evaluated for its effectiveness to meet local priorities. The Injury Prevention Section relies on the following strategies to address the burden of injuries in Georgia. 1. Improve and maintain injury data collection and dissemination through an active injury surveillance system 2. Promote the use of injury prevention guidelines and evaluation measures that are based upon current evidence based research and literature 3. Build effective relationships across emergency medical services, trauma networks, and other partner agencies to increase collaboration and reduce missed opportunities for preventing injuries 4. Develop effective communication channels to deliver injury prevention messages at the local level 5. Promote the institutionalization of injury prevention in the forms of dedicated job descriptions and mandated programs 6. Develop leadership and infrastructure to identify, promote and respond to injury prevention needs at the state and local level 7. Strengthen state and local legislation and policies that lead to reduction in injuries 8. Promote primary prevention as an integral component of a successful trauma network 70 County and Health District Data COUNTY AND HEALTH DISTRICT DATA 71 Profile of Injuries in Georgia Table 20. Injury deaths by county, Georgia, 1994-2001 County Motor Vehicle Deaths 1994-2001 Fall Deaths 1994-2001 Total Rate Total Rate Fire Deaths 1994-2001 Total Rate APPLING 55 42 10 8 14 11 ATKINSON 16 30 2 - 5 - BACON 27 35 5 - 2 - BAKER 6 - 2 - 0 - BALDWIN 70 21 15 5 6 - BANKS 37 37 3 - 2 - BARROW 94 30 17 7 7 - BARTOW 135 25 13 3 10 2 BEN HILL 33 25 9 - 4 - BERRIEN 45 36 8 - 0 - BIBB 208 17 86 7 29 2 BLECKLEY 32 36 5 - 6 - BRANTLEY 34 32 6 - 5 - BROOKS 55 44 11 7 1 - BRYAN 49 31 3 - 1 - BULLOCH 78 20 19 7 15 4 BURKE 92 54 5 - 10 6 BUTTS 43 30 8 - 2 - CALHOUN 15 34 2 - 0 - CAMDEN 42 13 5 - 8 - CANDLER 22 31 5 - 2 - CARROLL 178 27 32 6 7 - CATOOSA 59 15 15 5 8 - CHARLTON 23 30 2 - 1 - CHATHAM 257 14 100 6 41 2 CHATTAHOOCHEE 14 28 4 - 0 - CHATTOOGA 50 26 8 - 4 - CHEROKEE 153 16 34 6 4 - CLARKE 107 15 34 7 7 - CLAY 6 - 2 - 0 - CLAYTON 273 16 54 6 13 1 CLINCH 15 28 5 - 4 - COBB 500 12 191 8 35 1 COFFEE 82 30 12 6 8 - COLQUITT 98 31 13 4 18 6 COLUMBIA 99 15 20 6 6 - COOK 33 28 5 - 2 - COWETA 119 19 28 7 5 - CRAWFORD 19 22 6 - 2 - CRISP 41 25 12 7 8 - DADE 72 31 27 5 - 1 - County and Health District Data Drowning Deaths 1994-2001 Total Rate Suicide Deaths 1994-2001 Total Rate Homicide Deaths 1994-2001 Total Rate Total Injury Deaths 1994-2001 Total Average Annual Rate 4 - 10 8 9 - 127 16 98 2 - 8 - 5 - 50 6 99 3 - 8 - 14 17 79 10 100 0 - 1 - 1 - 12 2 39 10 3 42 13 31 8 205 26 61 1 - 13 12 3 - 78 10 78 7 - 38 13 17 6 227 28 75 3 - 71 13 32 5 356 45 66 3 - 14 11 18 13 97 12 71 4 - 18 15 5 - 98 12 79 28 2 158 13 198 16 905 113 73 3 - 18 20 7 - 83 10 93 3 - 13 12 3 - 84 11 82 1 - 14 11 15 12 114 14 89 5 - 26 16 16 9 124 16 79 8 - 35 9 22 6 223 28 62 7 - 20 12 19 11 187 23 111 2 - 20 14 15 11 114 14 82 0 - 6 - 3 - 32 4 73 9 - 26 8 20 5 132 17 42 2 - 14 21 10 14 75 9 106 9 - 99 15 37 5 470 59 74 4 - 35 9 18 4 192 24 49 2 - 5 - 3 - 45 6 60 27 1 204 12 276 15 1112 139 62 2 - 12 14 5 - 49 6 85 3 - 23 12 12 7 134 17 70 15 1 96 9 27 2 441 55 49 8 - 77 11 78 10 370 46 53 0 - 5 - 5 - 20 3 74 24 1 174 11 169 9 888 111 57 2 - 7 - 8 - 55 7 108 40 1 438 11 194 4 1890 236 51 6 - 31 12 35 13 226 28 87 8 - 39 12 28 9 247 31 79 8 - 57 9 25 4 282 35 48 4 - 17 15 12 11 84 11 71 7 - 80 13 30 5 365 46 64 1 - 14 16 6 - 56 7 66 2 - 20 13 19 12 137 17 83 0 - 13 11 9 - 83 10 71 73 Profile of Injuries in Georgia Table 20. Injury deaths by county, Georgia, 1994-2001, Continued Motor Vehicle Deaths 1994-2001 Fall Deaths 1994-2001 Fire Deaths 1994-2001 County Total Rate Total Rate Total Rate DAWSON DECATUR DEKALB DODGE DOOLY DOUGHERTY DOUGLAS EARLY ECHOLS EFFINGHAM ELBERT EMANUEL EVANS FANNIN FAYETTE FLOYD FORSYTH FRANKLIN FULTON GILMER GLASCOCK GLYNN GORDON GRADY GREENE GWINNETT HABERSHAM HALL HANCOCK HARALSON HARRIS HART HEARD HENRY HOUSTON IRWIN JACKSON JASPER JEFF DAVIS JEFFERSON JENKINS JOHNSON JONES 74 27 26 4 - 0 - 55 26 9 - 6 - 734 15 265 8 44 1 51 34 9 - 7 - 27 33 6 - 7 - 114 15 25 4 19 3 139 21 23 5 11 2 22 22 3 - 8 - 5 - 0 - 0 - 72 28 11 7 5 - 43 28 12 7 9 - 63 37 11 7 7 - 30 38 2 - 4 - 47 32 14 7 1 - 103 17 26 6 3 - 137 20 41 6 15 2 139 22 22 6 8 - 54 37 9 - 3 - 865 15 307 7 119 2 55 38 8 - 5 - 8 - 0 - 0 - 93 17 25 5 10 2 84 26 17 6 6 - 53 30 15 8 5 - 34 32 5 - 4 - 518 14 96 5 19 1 77 29 12 4 7 - 233 24 35 5 20 2 31 43 2 - 9 - 68 35 7 - 7 - 44 25 9 - 2 - 51 30 7 - 2 - 19 23 1 - 5 - 102 14 26 5 11 1 110 14 35 7 19 2 22 29 2 - 2 - 105 36 9 - 8 - 31 39 5 - 5 - 41 40 2 - 1 - 48 35 4 - 7 - 25 37 3 - 5 - 15 22 3 - 1 - 57 32 6 - 3 - County and Health District Data Drowning Deaths 1994-2001 Suicide Deaths 1994-2001 Homicide Deaths 1994-2001 Total Injury Deaths 1994-2001 Total Rate Total Rate Total Rate Total Average Annual Rate 0 - 10 10 1 - 61 8 60 5 - 22 11 19 9 149 19 72 47 1 450 9 649 12 2717 340 59 2 - 15 10 8 - 117 15 79 1 - 14 17 3 - 76 10 91 14 2 72 10 89 11 431 54 58 5 - 80 13 32 4 360 45 57 2 - 9 - 12 14 72 9 72 2 - 2 - 3 - 14 2 71 6 - 35 14 9 - 164 21 69 2 - 25 16 16 11 137 17 88 3 - 31 19 18 11 176 22 107 0 - 10 13 5 - 58 7 73 4 - 33 21 8 - 132 17 86 8 - 62 9 18 3 275 34 47 7 - 90 13 38 5 460 58 66 6 - 77 12 12 2 325 41 56 4 - 27 17 16 12 143 18 95 83 1 632 11 1226 19 4113 514 70 4 - 27 18 10 7 138 17 92 1 - 2 - 1 - 16 2 70 17 3 73 13 30 6 345 43 65 5 - 48 15 15 5 235 29 75 6 - 29 17 24 14 165 21 93 1 - 11 11 7 - 79 10 74 46 1 390 10 155 4 1556 195 46 2 - 42 16 10 4 186 23 71 19 2 111 11 58 6 608 76 65 3 - 4 - 9 - 75 9 102 2 - 36 18 16 8 182 23 94 2 - 36 20 6 - 114 14 66 3 - 24 14 15 9 130 16 73 1 - 14 18 4 - 65 8 83 9 - 114 15 36 4 399 50 56 7 - 105 13 46 5 406 51 54 1 - 10 14 9 - 64 8 86 5 - 45 15 17 6 233 29 80 0 - 10 13 5 - 67 8 85 5 - 13 13 7 - 84 11 84 3 - 17 13 8 - 106 13 77 2 - 2 - 8 - 62 8 93 2 - 7 - 4 - 41 5 63 2 - 28 17 14 8 135 17 79 75 Profile of Injuries in Georgia Table 20. Injury deaths by county, Georgia, 1994-2001, Continued Motor Vehicle Deaths 1994-2001 Fall Deaths 1994-2001 Fire Deaths 1994-2001 County Total Rate Total Rate Total Rate LAMAR LANIER LAURENS LEE LIBERTY LINCOLN LONG LOWNDES LUMPKIN MACON MADISON MARION MCDUFFIE MCINTOSH MERIWETHER MILLER MITCHELL MONROE MONTGOMERY MORGAN MURRAY MUSCOGEE NEWTON OCONEE OGLETHORPE PAULDING PEACH PICKENS PIERCE PIKE POLK PULASKI PUTNAM QUITMAN RABUN RANDOLPH RICHMOND ROCKDALE SCHLEY SCREVEN SEMINOLE SPALDING STEPHENS 76 30 25 6 - 1 - 10 19 0 - 0 - 100 29 17 5 14 4 31 19 5 - 0 - 92 19 11 6 13 3 16 24 6 - 3 - 12 20 0 - 1 - 96 14 28 6 6 - 30 20 7 - 1 - 34 33 4 - 4 - 63 33 6 - 2 - 16 32 3 - 1 - 53 32 5 - 6 - 30 38 3 - 3 - 65 36 13 7 9 - 19 38 2 - 0 - 56 33 8 - 5 - 43 28 14 10 2 - 17 26 4 - 0 - 33 28 9 - 3 - 67 26 7 - 3 - 208 15 71 6 28 2 93 21 27 8 8 - 28 16 5 - 1 - 28 31 5 - 2 - 139 26 21 7 2 - 42 23 11 8 1 - 42 28 10 7 2 - 29 24 6 - 3 - 25 25 3 - 2 - 77 27 13 5 5 - 20 28 8 - 3 - 48 35 10 8 3 - 7 - 1 - 3 - 32 29 9 - 1 - 21 31 6 - 3 - 255 17 38 3 30 2 87 17 24 6 4 - 5 - 3 - 3 - 34 30 4 - 6 - 27 35 3 - 5 - 89 20 21 5 7 - 54 26 12 5 5 - County and Health District Data Drowning Deaths 1994-2001 Suicide Deaths 1994-2001 Total Rate Total Rate Homicide Deaths 1994-2001 Total Rate Total Injury Deaths 1994-2001 Total Average Annual Rate 1 - 13 11 8 - 78 10 66 2 - 1 - 2 - 17 2 33 4 - 39 11 25 7 254 32 74 2 - 20 12 6 - 72 9 46 11 3 44 12 46 8 255 32 66 1 - 9 - 4 - 45 6 69 3 - 6 - 7 - 39 5 61 6 - 83 13 65 9 359 45 56 1 - 30 21 17 12 118 15 82 4 - 13 13 14 13 91 11 88 5 - 24 12 10 5 153 19 82 2 - 4 - 9 - 43 5 87 5 - 14 8 16 9 129 16 78 6 - 10 13 7 - 67 8 86 5 - 17 9 27 15 164 21 90 2 - 5 - 2 - 40 5 78 6 - 21 13 19 11 162 20 95 4 - 23 15 16 10 128 16 83 2 - 6 - 4 - 40 5 65 0 - 14 12 8 - 87 11 74 4 - 32 13 13 5 169 21 70 22 1 148 10 130 9 776 97 55 8 - 45 10 39 9 284 36 67 1 - 13 7 8 - 64 8 37 3 - 10 11 7 - 69 9 76 5 - 68 13 21 4 325 41 67 6 - 22 12 11 6 118 15 68 1 - 28 17 8 - 130 16 85 5 - 13 11 9 - 82 10 70 1 - 11 11 10 10 64 8 65 6 - 53 19 25 9 222 28 78 0 - 6 - 7 - 64 8 91 4 - 22 15 9 - 115 14 84 0 - 3 - 4 - 20 3 102 1 - 14 11 12 12 91 11 80 1 - 6 - 6 - 64 8 97 27 2 157 10 203 12 930 116 62 7 - 56 11 18 3 271 34 56 1 - 3 - 4 - 22 3 77 3 - 17 14 11 10 92 12 79 0 - 6 - 3 - 60 8 79 14 3 57 13 50 11 304 38 68 3 - 21 11 9 - 137 17 67 77 Profile of Injuries in Georgia Table 20. Injury deaths by county, Georgia, 1994-2001, Continued Motor Vehicle Deaths 1994-2001 Fall Deaths 1994-2001 Fire Deaths 1994-2001 County Total Rate Total Rate Total Rate STEWART SUMTER TALBOT TALIAFERRO TATTNALL TAYLOR TELFAIR TERRELL THOMAS TIFT TOOMBS TOWNS TREUTLEN TROUP TURNER TWIGGS UNION UPSON WALKER WALTON WARE WARREN WASHINGTON WAYNE WEBSTER WHEELER WHITE WHITFIELD WILCOX WILKES WILKINSON WORTH 13 30 3 - 1 - 63 25 30 11 4 - 36 67 3 - 4 - 10 60 4 - 0 - 52 33 7 - 8 - 30 44 8 - 2 - 30 33 6 - 3 - 17 19 3 - 3 - 81 25 17 5 16 5 67 22 12 5 14 4 59 30 9 - 8 - 16 20 4 - 0 - 20 40 3 - 3 - 111 24 24 5 18 4 22 30 2 - 2 - 29 36 4 - 1 - 27 19 8 - 4 - 49 22 16 6 4 - 78 16 37 8 13 3 107 26 17 5 2 - 71 25 20 6 6 - 16 35 1 - 6 - 50 31 7 - 1 - 43 21 9 - 8 - 4 - 2 - 0 - 16 38 3 - 1 - 28 20 6 - 1 - 122 19 34 7 11 2 12 20 5 - 1 - 35 42 6 - 3 - 35 41 1 - 5 - 54 32 10 7 10 6 Rate = Annual age-adjusted mortality rate Poisoning death rates 1994-2001 not shown because comparability ratio not available at time of analysis. 78 County and Health District Data Drowning Deaths 1994-2001 Suicide Deaths 1994-2001 Total 0 5 1 0 3 0 2 0 5 6 3 0 3 5 3 1 1 6 3 6 9 1 4 4 0 2 1 10 1 2 0 2 Rate 1 - Total 7 26 5 3 32 11 14 9 47 37 27 8 1 61 9 13 17 32 50 48 51 5 22 30 1 5 31 83 7 10 15 19 Rate 11 20 17 15 14 13 14 13 17 13 15 10 12 18 14 15 21 13 12 19 11 Homicide Deaths 1994-2001 Total Rate Total Injury Deaths 1994-2001 Total Average Annual Rate 6 - 39 5 89 18 7 212 27 82 13 24 71 9 132 1 - 21 3 125 13 8 134 17 85 8 - 68 9 103 5 - 83 10 88 10 12 52 7 59 31 9 254 32 76 30 10 200 25 69 42 21 172 22 86 2 - 43 5 52 3 - 36 5 72 33 7 306 38 66 10 14 54 7 75 8 - 65 8 84 0 - 80 10 57 10 5 142 18 64 23 5 296 37 60 29 7 257 32 64 24 9 220 28 76 3 - 36 5 75 11 7 128 16 80 7 - 118 15 61 0 - 9 1 - 1 - 40 5 94 5 - 95 12 67 26 4 399 50 65 5 - 37 5 60 7 - 84 11 98 6 - 76 10 93 16 9 134 17 80 79 Profile of Injuries in Georgia Table 21. Injury hospitalizations by county, Georgia, 1999-2001 County Motor Vehicle 1999-2001 Fall 1999-2001 Poisoning 1999-2001 Fire 1999-2001 Total No. Rate Total No. Rate Total No. Rate Total No. Rate APPLING 74 143.5 92 189.6 12 23.5 ATKINSON 33 147.9 55 313.6 7 - BACON 51 166.0 88 307.9 4 - BAKER 6 - 10 82.5 1 - BALDWIN 136 103.9 228 203.3 12 10.5 BANKS 65 159.0 90 267.6 9 - BARROW 162 121.0 276 259.0 26 22 BARTOW 285 129.0 458 258.3 46 20.6 BEN HILL 69 130.2 152 280.9 11 20.8 BERRIEN 97 202.4 150 315.0 7 - BIBB 512 110.6 1,074 233.7 93 20.1 BLECKLEY 34 98.4 82 234.1 6 - BRANTLEY 45 108.1 80 225.7 6 - BROOKS 47 95.4 117 210.8 9 - BRYAN 103 154.0 112 250.4 10 15.2 BULLOCH 163 101.4 245 197.8 14 10.4 BURKE 103 158.2 111 184.1 4 - BUTTS 77 132.9 140 274.2 8 - CALHOUN 24 132.2 55 287.3 5 - CAMDEN 29 28.2 79 138.4 10 12 CANDLER 51 184.1 70 208.5 21 67.2 CARROLL 383 146.8 861 403.8 51 20.8 CATOOSA 38 24.1 134 100.6 15 9.9 CHARLTON 8 - 49 204.7 3 - CHATHAM 579 83.7 1,335 196.9 97 14.2 CHATTAHOOCHEE 13 61.4 7 - 1 - CHATTOOGA 92 123.9 215 275.5 19 25.9 CHEROKEE 324 82.0 652 248.3 53 15 CLARKE 248 90.6 486 233.8 42 18.7 CLAY 2 - 12 81.2 0 - CLAYTON 523 75.8 810 213.8 55 8 CLINCH 19 93.7 49 258.9 2 - COBB 1,231 71.0 2,686 241.3 282 17.4 COFFEE 176 159.5 206 233.8 22 20.5 COLQUITT 169 135.5 310 251.8 23 18.5 COLUMBIA 169 65.1 271 146.6 27 12.4 COOK 93 201.7 142 303.6 16 33.6 COWETA 257 98.9 530 276.6 56 23.2 80 2 - 4 - 0 - 1 - 8 - 1 - 10 8.3 15 6.6 6 - 9 - 47 10.3 5 - 3 - 2 - 7 - 8 - 12 17.1 1 - 2 - 2 - 5 - 6 - 0 - 0 - 33 4.8 0 - 4 - 11 2.8 17 6.8 0 - 13 2.5 0 - 32 2.2 15 14.5 15 12.4 12 4.6 6 - 8 - County and Health District Data Near Drowning 1999-2001 Suicide Attempts 1999-2001 Assault 1999-2001 Total Injury Hospitalizations* 1999-2001 Total Total No. Rate No. Rate Total No. 0 - 11 22.0 6 1 - 12 51.8 6 0 - 13 43.0 10 0 - 1 - 1 5 - 44 30.5 29 0 - 18 42.8 4 0 - 47 34.3 21 2 - 84 35.9 31 2 - 27 52.6 18 0 - 29 59.7 18 7 - 255 55.5 206 0 - 15 44.3 2 0 - 10 23.4 3 0 - 7 - 11 1 - 21 30.0 8 1 - 28 16.9 17 0 - 20 31.1 17 0 - 18 30.3 16 0 - 3 - 10 2 - 24 17.2 9 2 - 1 - 7 2 - 115 43.2 41 1 - 26 16.2 1 0 - 3 - 0 8 - 192 27.8 306 0 - 9 - 4 2 - 36 50.1 14 1 - 67 15.0 23 1 - 84 29.4 73 0 - 1 - 1 8 - 137 19.5 138 1 - 4 - 7 11 0.6 358 18.7 238 0 - 38 34.4 35 3 - 28 22.5 23 2 - 55 19.6 19 0 - 24 52.7 11 3 - 71 26.1 32 Rate 35.2 19.2 15.4 13.8 35.9 37.7 44.4 23.8 11.3 27.0 26.8 55.6 15.6 44.0 19.3 5.7 27.7 18.9 12.4 30.7 19.0 7.1 24.5 11.7 Total Average Average No. Annual Rate Annual No. LOS Average Annual Total Charges 272 176 223 40 599 233 717 1,165 399 421 2,851 171 203 254 357 641 331 332 133 198 212 1,873 263 76 3,169 43 530 1,488 1,161 21 2,167 119 6,244 722 816 749 396 1,282 91 59 74 13 200 78 239 388 133 140 950 57 68 85 119 214 110 111 44 66 71 624 88 25 1,056 14 177 496 387 7 722 40 2,081 241 272 250 132 427 542.7 871.0 753.9 334.8 485.3 622.7 598.1 579.0 754.0 877.6 618.4 493.6 525.5 487.1 617.2 458.8 523.5 610.4 715.7 248.0 707.5 808.3 184.1 298.9 462.5 256.8 698.9 466.8 493.9 167.5 419.5 607.2 451.7 709.5 661.9 334.4 851.5 575.3 551 257 351 66 1,289 432 1,392 2,040 568 561 5,313 311 366 448 656 1,210 635 552 227 274 375 3,504 432 113 5,893 112 793 2,515 2,414 37 4,395 172 10,754 1,129 1,545 1,143 607 2,317 $1,866,203 $1,014,407 $1,165,009 $206,958 $3,200,452 $1,351,924 $4,956,128 $8,586,646 $1,532,959 $1,513,710 $17,202,756 $1,028,560 $1,525,369 $1,130,578 $2,844,769 $4,873,028 $2,549,202 $2,125,736 $581,523 $751,968 $1,166,496 $10,308,728 $1,186,799 $386,408 $23,021,136 $530,905 $3,012,074 $9,777,687 $7,916,268 $117,731 $15,924,477 $447,391 $34,779,470 $4,661,028 $5,458,490 $4,548,815 $1,650,958 $7,645,271 81 *Total number includes injuries from undetermined causes as well as those injuries that were not E-coded. Profile of Injuries in Georgia Table 21. Injury hospitalizations by county, Georgia, 1999-2001, Continued County Motor Vehicle 1999-2001 Fall 1999-2001 Poisoning 1999-2001 Fire 1999-2001 Total No. Rate Total No. Rate Total No. Rate Total No. Rate CRAWFORD 27 74.8 46 166.2 1 - CRISP 75 117.0 167 253.4 17 27.5 DADE 10 20.7 34 81.1 2 - DAWSON 71 149.2 90 269.7 7 - DECATUR 66 79.9 209 253.0 16 19.7 DEKALB 1,414 72.3 2,703 194.5 257 14.2 DODGE 81 141.6 159 272.8 12 21.1 DOOLY 42 125.3 71 210.2 8 - DOUGHERTY 226 79.0 544 209.3 51 18.2 DOUGLAS 285 102.8 457 246.1 54 21.6 EARLY 11 32.7 20 47.1 0 - ECHOLS 5 - 7 - 2 - EFFINGHAM 140 126.1 136 178.2 15 13.1 ELBERT 70 116.6 202 289.4 20 33.5 EMANUEL 119 187.2 204 306.5 9 - EVANS 47 154.1 68 211.0 2 - FANNIN 53 93.7 139 188.0 11 17.7 FAYETTE 171 67.0 453 235.0 15 5.8 FLOYD 267 97.8 858 302.9 69 25.9 FORSYTH 175 64.6 228 118.4 17 6.6 FRANKLIN 104 172.6 205 301.3 29 48.3 FULTON 2,440 101.7 4,586 236.8 730 31.6 GILMER 62 93.1 164 243.5 11 15.1 GLASCOCK 16 207.1 40 372.1 3 - GLYNN 169 85.1 498 228.5 37 18.2 GORDON 168 129.4 280 249.7 23 18.3 GRADY 73 106.4 151 206.9 9 - GREENE 31 70.4 90 203.0 5 - GWINNETT 1,050 63.8 1,667 186.6 162 10.4 HABERSHAM 116 109.7 248 230.4 21 20.1 HALL 485 121.5 766 238.3 47 13.4 HANCOCK 52 175.7 58 202.4 6 - HARALSON 148 196.3 254 330.5 10 13.1 HARRIS 63 90.9 104 157.1 6 - HART 51 76.3 181 225.7 7 - HEARD 39 119.4 64 219.9 8 - HENRY 324 97.7 465 207.8 26 8.6 HOUSTON 244 76.9 605 250.4 53 18 IRWIN 46 157.7 72 232.2 5 - JACKSON 173 144.5 278 262.7 25 21.1 JASPER 50 151.5 80 257.5 3 - 82 1 - 4 - 0 - 1 - 9 - 47 2.4 4 - 2 - 29 10.1 6 - 5 - 0 - 8 - 13 21.6 4 - 6 - 3 - 4 - 20 7.5 3 - 4 - 114 5.1 4 - 1 - 12 5.9 5 - 5 - 3 - 28 1.9 4 - 10 2.6 2 - 5 - 5 - 1 - 2 - 5 - 23 7.2 1 - 6 - 0 - County and Health District Data Near Drowning 1999-2001 Suicide Attempts 1999-2001 Assault 1999-2001 Total Injury Hospitalizations* 1999-2001 Total Total No. Rate No. Rate Total No. Rate Total Average Average No. Annual Rate Annual No. LOS Average Annual Total Charges 0 - 7 - 1 - 115 38 366.1 224 $703,926 0 - 44 71.7 28 44.1 417 139 649.5 709 $2,134,475 0 - 6 - 1 - 70 23 159.3 111 $275,801 0 - 8 - 3 - 266 89 679.1 480 $1,850,874 0 - 32 39.8 15 18.9 456 152 555.3 802 $1,676,387 18 1.0 455 21.7 559 26.2 7,166 2,389 428.7 14,157 $43,569,986 0 - 39 68.4 5 - 378 126 655.5 679 $2,090,303 0 - 15 45.0 8 - 211 70 628.9 353 $1,035,427 2 - 91 32.5 89 31.3 1,355 452 497.6 2,633 $8,689,079 0 - 69 23.3 43 14.6 1,166 389 509.9 2,104 $6,997,880 0 - 3 - 1 - 72 24 191.4 162 $865,784 0 - 1 - 1 - 24 8 275.1 45 $73,260 0 - 25 21.5 14 12.2 422 141 440.5 775 $3,372,487 0 - 19 33.2 17 30.1 446 149 691.7 829 $3,204,035 1 - 33 53.0 19 30.8 504 168 778.3 965 $4,138,293 0 - 4 - 10 32.3 186 62 593.5 402 $1,742,653 0 - 16 29.4 4 - 291 97 448.1 338 $1,230,941 1 - 32 12.1 12 5.1 870 290 400.9 1,496 $5,013,473 3 - 83 31.7 48 18.2 1,785 595 646.6 2,992 $10,096,351 2 - 35 13.9 10 3.3 823 274 370.7 1,342 $6,729,267 0 - 41 70.0 14 24.2 504 168 789.3 851 $2,331,446 22 0.9 658 26.0 1,835 70.9 13,796 4,599 621.3 27,735 $90,180,877 0 - 13 20.0 5 - 346 115 510.4 514 $1,776,951 0 - 1 - 0 - 74 25 803.5 107 $274,425 4 - 72 36.6 46 24.0 1,121 374 537.4 2,075 $6,788,732 0 - 76 57.7 17 13.1 734 245 602.4 1,203 $3,985,861 0 - 13 19.7 14 21.0 351 117 497.4 724 $1,749,841 0 - 6 - 7 - 196 65 447.0 396 $1,451,694 10 0.5 334 18.2 151 8.5 4,823 1,608 402.2 8,047 $30,122,979 0 - 36 34.5 9 - 568 189 533.2 1,019 $3,362,676 2 - 53 12.9 40 9.6 1,985 662 558.1 3,867 $13,322,676 1 - 10 34.0 6 - 170 57 584.6 677 $1,205,786 0 - 41 55.3 15 20.4 617 206 812.0 1,276 $2,951,615 0 - 10 15.2 7 - 264 88 387.4 475 $1,419,546 0 - 15 22.2 11 17.2 338 113 450.3 604 $1,564,783 0 - 14 42.8 3 - 177 59 570.5 317 $925,833 3 - 80 23.0 38 10.5 1,238 413 444.9 2,213 $8,357,263 5 - 139 41.5 51 15.1 1,468 489 528.1 2,526 $6,574,287 0 - 6 - 5 - 178 59 597.2 283 $763,722 0 - 42 33.7 17 13.5 706 235 616.7 1,271 $4,349,747 0 - 9 - 8 - 200 67 624.2 389 $1,265,043 83 *Total number includes injuries from undetermined causes as well as those injuries that were not E-coded. Profile of Injuries in Georgia Table 21. Injury hospitalizations by county, Georgia, 1999-2001, Continued County Motor Vehicle 1999-2001 Fall 1999-2001 Poisoning 1999-2001 Fire 1999-2001 Total No. Rate Total No. Rate Total No. Rate Total No. Rate JEFF DAVIS 57 149.8 80 234.5 13 33.9 JEFFERSON 72 139.8 112 198.9 12 22 JENKINS 34 136.0 46 175.9 5 - JOHNSON 35 134.2 66 218.7 2 - JONES 66 98.0 57 99.7 7 - LAMAR 52 109.7 78 170.1 5 - LANIER 30 138.3 44 234.6 3 - LAURENS 146 109.9 257 189.2 33 24.3 LEE 48 68.5 89 203.1 8 - LIBERTY 105 62.9 112 157.8 12 7.9 LINCOLN 37 157.4 50 207.1 4 - LONG 22 86.2 28 218.2 0 - LOWNDES 240 88.7 565 274.4 47 19.4 LUMPKIN 54 88.2 103 201.4 5 - MACON 42 104.0 70 168.7 1 - MADISON 95 124.5 190 290.5 25 33.5 MARION 27 130.4 25 133.7 6 - MCDUFFIE 105 167.0 161 269.9 13 21.1 MCINTOSH 34 109.2 48 155.4 4 - MERIWETHER 77 114.0 124 176.3 8 - MILLER 19 102.6 43 178.6 5 - MITCHELL 64 93.2 138 209.2 5 - MONROE 64 101.9 108 196.6 10 15.4 MONTGOMERY 36 142.0 48 232.0 3 - MORGAN 53 116.0 109 234.6 2 - MURRAY 84 78.7 169 223.4 28 24.6 MUSCOGEE 461 82.3 906 181.7 106 20.1 NEWTON 189 103.4 333 221.8 23 13 OCONEE 63 87.2 121 204.7 6 - OGLETHORPE 29 80.2 50 144.7 5 - PAULDING 202 88.4 289 209.9 26 12.4 PEACH 95 131.8 153 256.1 23 33.5 PICKENS 65 99.7 152 240.0 0 - PIERCE 86 181.1 114 261.1 11 24.2 PIKE 49 124.6 65 178.6 4 - POLK 147 129.5 354 307.2 22 19.6 PULASKI 36 130.2 89 296.3 11 37.2 PUTNAM 69 127.4 111 206.7 7 - QUITMAN <5 - 7 - 0 - RABUN 46 105.6 66 122.9 9 - RANDOLPH 30 127.0 55 193.0 0 - 84 7 - 9 - 2 - 3 - 1 - 3 - 2 - 8 - 9 - 9 - 3 - 1 - 14 5.4 3 - 1 - 7 - 1 - 5 - 6 - 5 - 3 - 12 17.7 5 - 1 - 2 - 3 - 14 2.6 3 - 2 - 3 - 7 - 6 - 2 - 6 - 6 - 7 - 2 - 5 - 1 - 2 - 4 - County and Health District Data Near Drowning 1999-2001 Suicide Attempts 1999-2001 Assault 1999-2001 Total Injury Hospitalizations* 1999-2001 Total Total Total No. Rate No. Rate No. Rate Total No. Average Annual No. Rate Average Average Annual LOS Annual Total Charges 1 - 29 75.7 7 - 283 94 778.5 496 $1,969,563 0 - 16 32.9 15 29.5 306 102 574.4 449 $1,454,956 2 - 6 - 8 - 146 49 572.6 226 $758,760 0 - 5 - 2 - 137 46 498.3 237 $779,818 0 - 11 15.7 5 - 202 67 314.8 353 $1,403,616 0 - 7 - 7 - 212 71 454.9 424 $1,699,244 0 - 6 - 2 - 126 42 621.8 206 $463,269 1 - 53 40.8 28 21.7 658 219 490.8 1,350 $4,504,270 0 - 22 29.0 8 - 248 83 437.8 485 $1,871,452 0 - 28 16.4 28 14.7 397 132 352.2 755 $3,247,015 0 - 12 49.7 4 - 141 47 590.3 269 $869,412 0 - 1 - 4 - 79 26 431.9 171 $721,195 2 - 70 25.6 50 17.4 1,363 454 585.0 2,404 $5,729,908 2 - 24 36.4 9 - 264 88 466.2 425 $1,151,766 1 - 10 25.6 7 - 198 66 484.5 690 $2,146,925 0 - 38 49.2 11 14.4 463 154 649.5 267 $988,775 0 - 6 - 3 - 79 26 399.2 313 $1,004,756 0 - 35 55.8 27 43.3 447 149 725.3 905 $3,233,012 1 - 9 - 6 - 150 50 485.2 159 $439,610 0 - 15 23.0 9 - 319 106 464.8 639 $1,759,898 0 - 6 - 5 - 105 35 504.4 143 $382,402 1 - 12 17.7 16 23.6 365 122 542.7 784 $2,396,541 0 - 23 35.4 8 - 289 96 486.1 518 $1,719,744 0 - 4 - 8 - 135 45 585.5 225 $702,937 1 - 10 22.1 8 - 237 79 512.6 483 $1,622,668 1 - 73 64.7 10 9.1 454 151 488.7 684 $1,687,365 4 - 263 47.0 160 28.7 2,431 810 459.3 4,458 $12,775,365 3 - 77 41.1 33 17.9 824 275 494.3 1,402 $5,372,562 0 - 8 - 1 - 271 90 413.2 477 $1,620,773 0 - 11 30.7 4 - 125 42 350.5 228 $689,949 0 - 21 7.8 14 5.1 728 243 403.2 1,216 $4,093,685 0 - 38 50.8 13 16.8 421 140 633.5 653 $2,140,215 0 - 14 21.9 8 - 302 101 468.1 506 $2,069,111 1 - 14 29.6 11 24.1 298 99 651.3 539 $1,801,280 0 - 5 - 7 - 191 64 498.9 344 $1,452,579 0 - 38 35.2 20 18.1 795 265 698.8 1,388 $4,849,218 0 - 13 48.1 4 - 188 63 649.7 279 $795,428 0 - 14 25.4 5 - 253 84 465.7 603 $1,780,154 0 - 1 - 0 - 20 7 226.4 42 $142,481 1 - 10 23.9 3 - 203 68 429.6 288 $821,004 0 - 3 - 10 43.6 136 45 538.1 280 $932,674 *Total number includes injuries from undetermined causes as well as those injuries that were not E-coded. 85 Profile of Injuries in Georgia Table 21. Injury hospitalizations by county, Georgia, 1999-2001, Continued County Motor Vehicle 1999-2001 Fall 1999-2001 Poisoning 1999-2001 Fire 1999-2001 Total No. Rate Total No. Rate Total No. Rate Total No. Rate RICHMOND 560 94.2 867 171.7 89 15.7 ROCKDALE 173 84.7 361 234.7 22 11.3 SCHLEY 15 137.0 21 213.1 0 - SCREVEN 48 110.6 105 211.1 12 26.7 SEMINOLE 51 183.5 80 260.5 6 - SPALDING 180 104.0 404 249.4 18 10.5 STEPHENS 95 120.9 247 283.4 18 25 STEWART 19 124.9 30 133.1 1 - SUMTER 86 89.8 220 210.3 29 31 TALBOT 36 183.2 36 171.1 1 - TALIAFERRO 9 - 7 - 0 - TATTNALL 88 134.8 133 225.9 12 19.3 TAYLOR 50 192.9 56 209.7 5 - TELFAIR 51 142.2 116 283.7 8 - TERRELL 28 86.2 65 185.5 11 34 THOMAS 138 109.3 336 245.3 12 9.5 TIFT 145 128.1 285 269.6 31 26.6 TOOMBS 104 136.1 176 229.1 10 12.9 TOWNS 27 94.7 85 187.2 5 - TREUTLEN 21 106.3 46 225.3 5 - TROUP 202 115.3 532 302.7 49 27.5 TURNER 50 179.1 89 310.7 12 41.8 TWIGGS 26 84.1 41 146.2 3 - UNION 60 128.9 142 194.7 8 - UPSON 78 95.3 209 221.4 13 14.7 WALKER 100 55.0 376 198.1 35 18.4 WALTON 146 85.3 287 198.1 20 12.2 WARE 114 108.0 265 215.1 37 34.4 WARREN 36 199.9 46 199.1 5 - WASHINGTON 60 96.8 139 210.9 5 - WAYNE 72 92.6 171 246.5 14 17.6 WEBSTER 5 - 10 136.3 0 - WHEELER 20 115.3 42 234.8 9 - WHITE 87 155.0 128 202.0 8 - WHITFIELD 191 77.8 549 267.6 29 11.9 WILCOX 40 163.0 72 271.8 6 - WILKES 43 135.1 97 252.1 10 28.1 WILKINSON 52 169.2 63 211.4 6 - WORTH 75 113.6 121 200.1 5 - Rate = Annual age-adjusted hospitalization rate 86 40 7.0 3 - 0 - 7 - 3 - 9 - 13 16.6 1 - 7 - 2 - 1 - 6 - 1 - 9 - 2 - 13 10.0 7 - 4 - 0 - 1 - 7 - 3 - 5 - 3 - 7 - 1 - 13 7.8 19 17.4 3 - 10 16.7 7 - 0 - 0 - 3 - 6 - 4 - 6 - 9 - 10 15.2 County and Health District Data Near Drowning 1999-2001 Suicide Attempts 1999-2001 Assault 1999-2001 Total Injury Hospitalizations* 1999-2001 Total Total Total No. Rate No. Rate No. Rate Total No. Average Annual No. Rate Average Average Annual LOS Annual Total Charges 6 - <5 - 0 - <5 - 0 - <5 - 0 - 0 - 0 - 0 - 0 - <5 - 0 - <5 - <5 - <5 - <5 - <5 - 0 - 0 - <5 - 0 - 0 - 0 - 0 - 0 - <5 - <5 - 0 - <5 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - <5 - <5 - 241 40.0 222 60 28.6 24 3 - 0 6 - 10 2 - 5 37 21.5 42 35 47.2 17 2 - 13 31 30.9 18 3 - 7 0 - 3 18 26.0 21 8 - 10 17 48.9 9 4 - 5 24 19.4 24 22 18.7 35 30 39.1 42 3 - 1 5 - 5 105 60.8 41 5 - 5 4 - 8 21 40.4 2 21 26.6 10 52 28.9 17 36 19.5 22 37 36.4 45 3 - 11 15 24.5 14 7 - 6 1 - 1 5 - 3 19 33.1 6 82 32.4 39 5 - 5 9 - 8 9 - 10 17 27.0 11 37.2 2,611 870 470.9 4,786 $18,107,204 11.1 804 268 455.6 1,316 $4,630,027 - 57 19 546.2 95 $302,079 24.3 282 94 613.4 499 $2,083,475 - 248 83 863.3 272 $479,231 24.1 895 298 535.2 1,491 $6,605,221 24.0 545 182 669.8 959 $3,015,685 93.2 89 30 525.4 160 $477,304 19.1 539 180 540.8 1,118 $3,641,042 - 118 39 586.3 249 $782,636 - 28 9 431.9 60 $222,830 30.3 392 131 629.1 793 $3,089,581 39.5 163 54 623.4 343 $1,105,796 - 273 91 728.0 474 $1,937,204 - 178 59 527.0 378 $1,443,777 19.4 746 249 565.5 1,411 $3,325,659 30.9 744 248 673.1 1,231 $3,905,281 55.1 453 151 590.7 816 $3,239,164 - 146 49 399.5 283 $883,092 - 94 31 471.3 170 $633,658 23.5 1,229 410 700.9 2,293 $4,983,768 - 216 72 760.9 366 $1,015,696 - 121 40 406.6 230 $862,471 - 307 102 512.9 426 $1,192,128 12.4 438 146 495.2 706 $1,802,971 9.6 722 241 386.5 1,135 $3,147,499 12.0 661 220 416.8 1,202 $3,979,425 44.3 677 226 605.1 1,173 $4,041,168 61.3 136 45 686.0 262 $822,010 22.3 313 104 491.8 507 $2,352,039 - 346 115 473.9 657 $1,884,065 - 28 9 390.6 49 $109,613 - 102 34 578.2 141 $365,609 - 341 114 568.3 599 $2,086,455 15.6 1,126 375 504.9 2,080 $4,873,638 - 165 55 646.7 365 $1,167,288 - 235 78 676.7 463 $1,416,630 33.2 193 64 636.5 389 $1,596,118 16.7 307 102 484.2 593 $1,807,607 *Total number includes injuries from undetermined causes as well as those injuries that were not E-coded. 87 Profile of Injuries in Georgia Table 22. Injury deaths by health district, Georgia, 1994-2001 Motor Vehicle Deaths 1994-2001 Fall Deaths 1994-2001 Health District Total Number Rate Total Number Rate Northwest (Rome) 857 22.6 178 5.4 North Georgia (Dalton) 488 21.1 106 6.2 North (Gainesville) 803 25.1 137 4.8 Cobb/Douglass 639 13.2 213 7.6 Fulton 865 14.9 307 6.6 Clayton 273 16.2 54 6.2 East Metro (Lawrenceville) 698 14.8 147 5.8 DeKalb 734 15.0 265 8.1 LaGrange 933 21.1 203 5.6 South Central (Dublin) 313 30.4 62 5.9 North Central (Macon) 772 21.4 201 6.4 East Central (Augusta) 755 23.1 107 3.9 West Central (Columbus) 569 20.9 166 6.7 South (Valdosta) 387 22.6 76 5.1 Southwest (Albany) 647 24.0 117 4.6 East (Savannah) 329 15.9 111 6.0 Southeast (Waycross) 675 27.8 120 5.6 Coastal (Brunswick) 318 19.3 48 4.2 Northeast (Athens) 643 24.3 117 5.4 Fire Deaths 1994-2001 Total Number 70 26 53 46 119 13 30 44 73 38 85 88 70 30 93 46 93 35 44 Rate 2.0 1.1 1.7 1.1 2.2 0.9 0.9 1.1 1.7 3.7 2.5 2.9 2.6 1.8 3.5 2.3 4.0 2.5 1.8 Rate = Annual age-adjusted mortality rate Poisoning death rates 1994-2001 not shown because comparability ratio not available at time of analysis. 88 County and Health District Data Drown Deaths 1994-2001 Total Number 38 38 42 45 83 24 61 47 68 21 70 63 43 32 52 33 61 51 38 Rate 1.0 1.6 1.3 0.9 1.4 1.3 1.2 0.9 1.5 2.0 1.9 1.9 1.5 1.8 1.9 1.6 2.5 3.0 1.3 Suicide Deaths 1994-2001 Total Number 486 298 424 518 632 174 491 450 579 118 477 343 313 204 304 239 306 185 304 Rate 12.8 12.6 13.1 10.9 10.9 10.9 10.5 9.4 13.0 11.4 13.3 10.6 11.7 12.3 11.6 11.8 13.0 11.9 11.7 Homicide Deaths 1994-2001 Total Injury Deaths 1994-2001 Total Number Rate Average Total Annual Number Number Rate 209 5.4 2485 311 66.9 92 3.7 1409 176 63.0 160 4.9 2095 262 66.2 226 4.1 2250 281 51.5 1226 18.9 4113 514 70.2 169 9.5 888 111 57.4 212 4.1 2111 264 49.4 649 11.9 2717 340 58.9 278 6.1 2746 343 63.6 69 6.9 795 99 77.2 370 9.9 2479 310 69.8 324 9.6 2166 271 67.8 250 8.9 1811 226 67.6 169 9.9 1101 138 65.9 263 9.8 1882 235 70.7 285 13.4 1276 160 62.5 216 9.0 1832 229 77.7 126 7.1 962 120 62.1 197 7.2 1676 210 65.0 89 Profile of Injuries in Georgia Table 23. Injury hospitalizations by health district, Georgia, 1999-2001 Motor Vehicle 1999-2001 Health District Total No. Rate Fall 1999-2001 Total No. Rate Poisoning 1999-2001 Fire 1999-2001 Total No. Rate Total No. Rate Northwest (Rome) 1,457 96.6 3,252 239.8 267 North Georgia (Dalton) 779 82.7 1,825 242.7 132 North (Gainesville) 1,436 108.2 2,579 212.0 190 Cobb/Douglass 1,516 75.1 3,143 241.8 336 Fulton 2,440 101.7 4,586 236.8 730 Clayton County (Morrow) 523 75.8 810 213.8 55 East Metro (Lawrenceville) 1,412 69.2 2,361 196.7 207 Dekalb 1,414 72.3 2,703 194.5 257 LaGrange 1,889 104.9 3,925 260.6 261 South Central (Dublin) 500 124.5 977 234.2 95 North Central (Macon) 1,453 103.0 2,763 220.2 229 East Central (Augusta) 1,351 106.9 2,117 188.7 193 West Central (Columbus) 968 92.0 1,797 184.2 181 South (Valdosta) 822 122.5 1,623 268.3 143 Southwest (Albany) 998 95.8 2,171 214.3 157 East (Savannah) 719 89.3 1,471 194.5 112 Southeast (Waycross) 1,188 124.7 1,941 225.5 190 Coastal (Brunswick) 462 72.5 877 193.6 73 Northeast (Athens) 1,070 98.4 2,089 234.8 176 17.8 64 4.2 14.1 29 3.1 14.5 48 3.7 18.0 38 2.2 31.6 114 5.1 8.0 13 2.5 10.7 34 1.8 14.2 47 2.4 15.0 63 3.4 23.6 37 9.3 16.7 122 8.7 15.9 105 8.5 17.9 43 4.1 21.8 50 7.6 15.2 118 11.4 14.2 41 5.2 21.1 92 10.0 12.2 37 6.1 17.6 76 7.4 Rate = Annual age-adjusted hospitalization rate 90 County and Health District Data Near Drowning 1999-2001 Suicide Attempt 1999-2001 Assault 1999-2001 Total Total No. Rate No. Rate Total No. Rate Total Injury Hospitalizations* 1999-2001 Total Average Average No. Annual Rate Annual No. LOS Average Annual Total Charges 8 - 463 30.3 178 11.6 7,409 2,470 517.0 12,587 $42,185,549 2 - 265 26.6 89 9.2 4,007 1,336 476.0 6,636 $21,415,693 7 - 318 23.9 129 9.6 6,523 2,174 513.0 11,575 $39,663,775 11 0.5 427 19.3 281 12.7 7,410 2,470 459.1 12,858 $41,777,350 22 0.9 658 26.0 1,835 70.9 13,796 4,599 621.3 27,735 $90,180,877 8 - 137 19.5 138 18.9 2,167 722 419.5 4,395 $15,924,477 14 0.6 471 21.1 208 9.5 6,451 2,150 414.4 10,764 $40,125,568 18 1.0 455 21.7 559 26.2 7,166 2,389 428.7 14,157 $43,569,986 12 0.6 520 28.2 258 14.1 9,056 3,019 550.7 16,295 $52,679,984 3 - 161 40.8 71 18.1 2,301 767 564.7 4,232 $14,005,076 20 1.4 578 40.5 364 25.5 7,195 2,398 537.8 13,670 $42,006,606 12 0.9 437 34.3 363 28.5 5,990 1,997 498.6 10,556 $39,392,937 5 - 410 38.8 277 26.4 4,814 1,605 474.8 8,951 $26,951,439 5 - 197 29.0 156 23.3 4,121 1,374 645.6 6,718 $17,779,342 9 - 258 25.1 227 22.1 5,420 1,807 528.6 10,225 $30,934,730 8 - 217 26.9 320 39.5 3,591 1,197 459.2 6,668 $26,393,623 10 1.0 259 27.4 233 24.5 5,279 1,760 582.4 9,400 $34,872,812 8 - 155 23.8 101 14.6 2,302 767 425.0 4,199 $15,342,455 6 - 301 27.6 181 16.3 4,983 1,661 509.0 9,598 $33,023,700 *Total number includes injuries from undetermined causes as well as those injuries that were not E-coded. 91 Profile of Injuries in Georgia APPENDIX I DEFINITIONS AND ABBREVIATIONS Definitions Age-adjusted rate. A rate calculated in a manner that allows for the comparison of populations with different age structures. In this document, all age adjustments are performed using the direct method. The U.S. projected Year 2000 standard population was used as the standard. All rates are given per 100,000 population. Years of Potential Life Lost. A measure of premature death based on an expected life span of 75 years. Comparability ratio. A ratio used to measure the differences caused by coding changes in cause-ofdeath data under ICD-9 and ICD-10 Abbreviations AAHR AAMR CDC Chronic lung Chronic kidney DUI ED GA ICD-9 ICD-9-CM ICD-10 LBW IPS MV NCHS Other race OPD RDS SIDS STIPDA SPAN US YPLL 92 Age-adjusted hospitalization rate Age-adjusted mortality rate Centers for Disease Control and Prevention Chronic lower respiratory diseases Nephritis, nephritic syndrome, nephrosis Driving under the influence Emergency department Georgia International classification of diseases, 9th revision International classification of diseases, clinic modification, 9th revision International classification of diseases, 10th revision Low birth weight Injury Prevention Section Motor Vehicles National Center for Health Statistics Race other than black or white Outpatient department Respiratory distress syndrome Sudden infant death syndrome State and Territorial Injury Prevention Directors Association Suicide Prevention Action Network United States Years of potential life lost Appendix APPENDIX II METHODS Population data The source of the Georgia and US population estimates was the US Bureau of the Census website with the exception of 2001 Georgia population, which was not available from the Census Bureau at the time of analysis. The Georgia 2001 population was represented by the 2000 Georgia census population. Death data The source of the number of deaths among Georgia residents was vital statistics data provided by the Georgia Department of Human Resources, Division of Public Health, Office of Health Information and Policy. The source of the number of US deaths and death rates for 1999 through 2001 for each of the injury categories was the website of the National Center for Injury Prevention and Control, CDC. ICD-9 and ICD-10 codes for the injury categories are: Mechanism All Injury Unintentional Drowning Falls Fire, flame Motor Vehicle ICD-9-CM (Hospital) E800-E869, E880-E929, E950-E978, E980-989 E800-E869, E880-E929 E910, 994.1 E880-E888 E890-E899 E810-E825 Motor Vehicle E810-E825 Poisoning Other E850-E869, E924.1 E800-E807, E826-E848, E900-E909, E911-E929 Suicide Homicide Legal Intervention Undetermined Intent E950-E959 E960-E969 E970-E978 E980-E989 ICD-10 (Death) V01-Y35, Y85-Y87.2, Y89.0, Y89.9 V01-X59, Y85-Y86 W65-W74 W00-W19 X00-X09 V02-V049, V090, V092, V12-V149, V190-V192, V194-V196, V20-V799, V803-V805, V810-V811, V820-V821, V83-V869, V870-V878, V880-V888, V890, V892 V02-V049, V090, V092, V12-V149, V190-V192, V194-V196, V20-V799, V803-V805, V810-V811, V820-V821, V83-V869, V870-V878, V880-V888, V890, V892 X40-X49 V01, V05-V06, V09.1, VV09.3-V09.9, V10-V11, V15-V18, V19.3, V19.8-V19.9, V80.0-V80.2, V80.6-V80.9, V81.2-V81.9, V82.2-V82.9, V87.9, V88.9, V89.1, V89.3, V89.9, V90-V99, W20-W64, W75-W99, X10-X39, X50-X59, Y85-Y86 X60-X84, Y87.0 X85-Y09, Y87.1 Y35, Y89.0 Y10-Y34, Y87.2, Y89.9 93 Profile of Injuries in Georgia ICD-10 codes for death injury subcategories are: Mechanism Drowning Falls Fire Motor Vehicle Poisoning Homicide Suicide 94 Subcategory Open Water Bathtub Swimming Pool Other Unspecified Same level (stumbling/colliding) One level to another or into another Ladder/Scaffolding From Building Stairs/Steps Furniture Unspecified Building/Structure Not in building/structure Exposure to ignition/melting of clothing Exposure to ignition of highly inflammable material Other Unspecified Motorcycle Pedal Cyclist Pedestrian Occupant Unspecified Other Drugs Cocaine/Harcotics/ Hallucinogens Alcohol Gases/Vapors Sedatives/Tranquillizers Pesticides/Other Chemicals Firearm Hanging/Suffication Cutting Struck by/against Fire Other Unspecified Poisoning Hanging/Suffocation Firearm Cutting Jumping Other ICD-10 Code W69-W70 W65-W66 W67-W68 W73 W74 W00-W03, W18 W04-W05, W09, W14-W17 W11-W12 W13 W10 W06-W08 W19 X00, X02 X01, X03 X05-X06 X04 X08 X09 V20-V29 V12-V14, V19.0-V19.2, V19.4-V19.6 V02-V04, V09.0, V09.2 V30-V79, V83-V86 V80.3-V80.5, V81.0-V81.1, V82.0-V82.1, V87.0-V87.8, V88.0-V88.8 V89.0, V89.2 X40, X43, X44 X42 X45 X47 X41 X46, X48-X49 X93-X95 X91 X99 Y00, Y04 X97 X85-X90, X92, X96, X98, Y01-Y03, Y05-Y08 Y09, Y87.1 X60-X69 X70 X72-X74 X70 X80 X71, X75-X77, X79, X81-X83 Appendix All injury death rates were age-adjusted using the direct method; the US projected 2000 population was used as the standard (US Bureau of the Census, release date February 6, 1998). Years of potential life lost (YPLL) were calculated for 2001 by subtracting the age at death from 75 for Georgians ages less than 75 years and then summing these values. To convert this value to YPLL per 100,000 population, the YPLL was divided by the 2000 Georgia population and then multiplied by 100,000 (2001 population estimates were not yet available). Excess deaths were estimated by multiplying the excess death rate by the estimated average population of Georgia from 1999 through 2001. The excess death rate was calculated by subtracting the national rate for the year 2000 from the Georgia rate for the years 1999 through 2001. N17-N19, N25-N27; 8) Stroke: I60-I69; 9) Meningitis: G00, D03; 10) Septicemia: A40-A41. Death data were analyzed by age, sex, and race. The major race categories for deaths were white and black (including Hispanics). County death rates were calculated by combining 1994-2001 Georgia death data to achieve stable estimation. The comparability ratio for each injury mechanism was applied to the death numbers from 1994 through 1998 to adjust for the ICD coding system change from ICD-9 to ICD-10. The comparability ratio for those mechanisms are 1) Drowning: 0.9965; 2) Falls: 0.8409; 3) Fire: 0.9743; 4) MV accidents: 0.9975; 5) Homicide: 0.9983; 6) Suicide: 0.9962; 7) All Injuries: 1.0000. The poisoning death rate by county was not calculated because the comparability ratio for poisoning was not available. The leading causes of death were calculated based Statistical testing was performed with a z-test to on the NCHS list of ICD-10 codes for 113 causes compare rates. The significance level was 0.05. The of death and 130 causes of infant deaths. The ICD- source of the formula for the test and the standard 10 codes for the following top causes of death for error for an age-adjusted rate was the National all age groups are 1) Heart diseases: I00-I09, I11, Center for Health Statistics, CDC (Monthly Vital I13, I20-I51; 2) Cancer: C00-C97; 3) Stroke: I60- Statistics Report, volume 45, number 11 (S) 2, June I69; 4) Unintentional injury: V01-X59, Y85-Y86; 12, 1997, page 77). 5) Chronic lower respiratory diseases: J40-J47; 6) Diabetes mellitus: E10-E14; 7) Pneumonia and influenza: J10-J18; 8) Chronic kidney diseases: N00N07, N17-N19, N25-N27; 9) Septicemia: A40-A41; 10) Suicide: X60-X84, Y87.0; 11) Homicide: X85Y09, Y87.1; 12) Alzheimer's: G30; 13) Chronic liver diseases: K70, K73-K74; 14) HIV: B20-B24; 15) Congenital abnormalities: Q00-Q99; 16) Perinatal conditions: P00-P96; 17) Pregnancy, childbirth: O00O99; 18) Anemia: D50-D64; 19) Benign neoplasm: D00-D48. The ICD-10 codes for the top 10 causes of death for infants are 1) Perinatal conditions: P00-P96; 2) Congenital abnormalities: Q00-Q99; 3) Heart diseases: I00-I99; 4) Unintentional injury: V01-X59; 5) Homicide: X85-Y09; 6) Pneumonia and influenza: J10-J18; 7) Chronic kidney diseases: Hospital Discharge Data The source of the hospitalization statistics was the 1999-2001 Georgia Hospital Discharge Data System. The case definition for injury hospitalization, based on the State & Territorial Injury Prevention Directors Association (STIPDA) recommendations, is a hospital admission for a Georgia resident to a non-federal, acute-care, inpatient facility with principal diagnosis of injury, including late effects, but excluding adverse effects of therapeutic use of drugs and adverse effects of medical/surgical care and the late effects of those adverse effects. Readmissions, transfers, and deaths in the hospital are included. Records with the following ICD-9-CM 95 Profile of Injuries in Georgia codes in the principal diagnosis field were selected: 800-909.2, 909.4, 909.9-994.9, 995.5-995.59, 995.80-995. Once the injury hospitalizations were selected, we searched for valid external cause codes (E-codes) in the following manner: if more than one external cause code was listed for a given record, we used only the first valid E code. If the first Ecode was invalid, or if it was E849, E967, E869.4, E870-879, or E930-949, we used the next valid Ecode listed. If there were no other E codes listed, we reported E967, E869.4, E870-879, or E930-949 but not E849. Approximately 2,600 hospitalization records per year (7% of total injury hospitalizations) did not include the external cause of injury, leading to an underestimate of injury hospitalization by cause (Table 4). The ICD-9-CM codes used in hospital discharge data for mechanism were those listed as comparable category ICD-9 and ICD-10 codes by the National Center for Health Statistics, CDC (National Vital Statistics Report, volume 49, number 2 (S) 2, May 18, 2001, page 14). (See above tables for ICD-9-CM Mechanism codes). However, the subcategories for hospital data may be different from death data subcategories. The following table lists the subcategories of each mechanism and the corresponding e-codes. 96 Appendix Mechanism Near -Drowning Falls Fire Motor Vehicle Poisoning Subcategory Open Water Bathtub Swimming Pool Other Unspecified Same level (stumbling/colliding) One level to another or into another Ladder/Scaffolding From Building Stairs/Steps Furniture Unspecified Building/Structure Other and Unspecified building Not in building/structure Exposure to Ignition/melting of clothing Exposure to Ignition of highly inflammable material Other Unspecified Motorcycle Pedal Cyclist Pedestrian Occupant Other Unspecified Cocaine and other local anesthetics Opiates and other narcotics Sedatives/Tranquilizers Other Drugs/Medicine Alcohol Gases/Vapors Pesticides/Other Chemicals ICD-9-CM Code E910.0-E910.3 E910.4 E910.8 994.1 E910.9 E884.6, E885, E886 E883, E884.0-E884.1, E884.3, E884.9 E881 E882 E880 E884.2, E884.4-E884.5 E888, E887 E890, E895 E891, E896 E892, E897 E893 E894 E898 E899 E810-E825 (.2, .3) E810-E825 (.6 ) E810-E825 (.7 ) E810-E825 (.0, .1) E810-E825 (.9 ) E825 (.4, .5, .8) E855.2 E850 E851-E855.1 E855.3-E858 E860 E867-869 E860-E866, E924.1 97 Profile of Injuries in Georgia Assault Suicide Attempts Firearm Struck by/Against Cutting Other Assault Unarmed fight/brawl Rape Child/Adult Battering Unspecified Poisoning Hanging/Suffocation Firearm Cutting Jumping Other Unspecified E965.0-E965.4 E968.2 E966 E961-E964, E965.5-E965.9, E968.0-E968.1, E968.3-E968.8, E969 E960.0 E960.1 E967 E968.9 E950-E952 E953 E955 E956 E957 E954, E958.0-E958.8, E959 E958.9 Hospital charges include all charges for hospital services, but exclude physician charges, outpatient expenditures, lost wages, and lost family resources. All injury hospitalization rates except age-specific rates were age-adjusted using the direct method; the US projected 2000 population was used as the standard (the source was the US Bureau of the Census, release date: February 6, 1998). Data were analyzed by age, sex, and race/ ethnicity. The major race/ethnicity categories for hospitalizations were non-Hispanic white, nonHispanic black, and Hispanic. This is different from the death data categorization due to differences in coding practices. 98 References REFERENCES 1. Advance Data from Vital and Health Statistics: National Hospital Ambulatory Medical Care Survey: 2000 Outpatient Department Summary. Number 327, June 4, 2002. 2. Advance Data from Vital and Health Statistics: National Hospital Ambulatory Medical Care Survey: 2000 Emergency Department Summary. Number 326, April 22, 2002. 3. Advance Data from Vital and Health Statistics: National Ambulatory Medical Care Survey: 2000 Summary. Number 328, June 5, 2002. 4. Advance Data from Vital and Health Statistics: 2000 National Hospital Discharge Survey. Number 329, June 19, 2002. 5. Consensus recommendations for using hospital discharge data for injury surveillance. State and Territorial injury prevention directors association, 2003 6. 1999 Georgia Injury Profile. Georgia Department of Human Resources, Division of Public Health, December 1999. 7. Suicide in Georgia: 2000 State and County Statistics Strategic Plans. Georgia Department of Human Resources, Division of Public Health, June 2000. 8. National Vital Statistics Reports: Deaths: Final Data for 1998. Volume 48, Number 11. 9. National Vital Statistics Reports: Deaths: Final Data for 1999. Volume 49, Number 8. 10. National Vital Statistics Reports: Deaths: Final Data for 2000. Volume 50, Number 15. 99