The Economic Burden of Injury in Canada Philip Groff, PhD Director, Research & Evaluation SMARTRISK BCIRPU Teleconference Series September 24, 2009

A New Report The Economic Burden of Injury in Canada, builds on and expands our original 1998 economic burden study, The Economic Burden of Unintentional Injury in Canada. Added provincial breakdowns of data Added intentional injuries Used ICD-10 coded data Released August 17, 2009

Our Partners

Methodology Human Capital approach from a societal perspective Focus is on injuries, not events Incidence Costing Costs were analyzed using the ERAT, which combined existing data with variables from literature

Methodology, cont. Direct Costs: value of resources used to treat individual Goods and services used for any treatment Indirect Costs: value lost to society as result of injury Costs to societal productivity (ex. value of time lost from work and homemaking)

The Human Cost of Injury

Total Burden of Injury, Canada, 2004 Injury deaths Hospitalized treatment Non- hospitalized treatment Permanent partial disability Permanent total disabilityTotal cost 13,667211,7683,134,02562,5635,023$19.8 billion

Direct and Indirect Costs The direct costs (health care costs arising from injuries) of injury in 2004 were 54% of total injury costs. The indirect costs (costs related to reduced productivity from hospitalization, disability and premature death) were 46% of total costs arising from injury.

Economic Burden by Intent Unintentional injuries (transportation, falls, drowning, fire/burns, unintentional poisoning, sport, and other unintentional causes) accounted for 81% of injury costs. Intentional injuries accounted for a further 17% of total costs. Injuries of undetermined intent for the remaining 2%

Total Burden of Injury, by Select Causes, 2004 DescriptionDeathsHospitalizations Non-hospital- izations Permanent partial disability Permanent total disability Total costs ($ Millions) Transport Incidents3,06730,932286,0867,738760$3,699 Falls2,225105,565883,67629,5762,500$6,155 Suicide/Self-Harm3,61618,21041,9303,879199$2,442 Violence5078,05090,4631,899201$ 871

Cause Age/sex standardized injury mortality rates (per 100,000 pop.) by cause, Canada, highest and lowest province, 2004 Lowest provincial rate National rate Highest provincial rate Transport incidents 7.6 Ontario Prince Edward island Falls 3.4 Newfoundland and Labrador Nova Scotia Suicide 6.0 Prince Edward Island Quebec Violence 0.0 Prince Edward Island Manitoba

Total Burden of Injury, British Columbia, 2004 Injury deaths Hospitalized treatment Non- hospitalized treatment Permanent partial disability Permanent total disabilityTotal cost 1,72132,667403,3409,161739$2,812 million

Direct and Indirect Costs, BC The direct costs (health care costs arising from injuries) of injury in 2004 were 56% of total injury costs. The indirect costs (costs related to reduced productivity from hospitalization, disability and premature death) were 44% of total costs arising from injury.

Economic Burden by Intent, BC Unintentional injuries (transportation, falls, drowning, fire/burns, unintentional poisoning, sport, and other unintentional causes) accounted for 81% of injury costs. Intentional injuries accounted for a further 17% of total costs. Injuries of undetermined intent for the remaining 2%

Burden of Injury, by Select Causes, BC, 2004 DescriptionDeathsHospitalizations Non-hospital- izations Permanent partial disability Permanent total disability Total costs ($ Millions) Transport Incidents4515,50036,3431,295131$575 Falls33315,496115,5084,254358$886 Suicide/Self-Harm4653,2335, $346 Violence521,53710, $132

Cause Age/sex standardized injury mortality rates (per 100,000 pop.) by cause, Canada, highest and lowest province, and BC, 2004 Lowest provincial rate National rate Highest provincial rate BC rate Transport incidents 7.6 Ontario Prince Edward island 10.7 Falls 3.4 Newfoundland and Labrador Nova Scotia 7.9 Suicide 6.0 Prince Edward Island Quebec 11.2 Violence 0.0 Prince Edward Island Manitoba 1.2

Top 10 Mortality Rates, by Injury Category, Ages 0-14, BC, 2004 DescriptionMortality Rate /100,000 Transport Incidents - Motor Vehicle2 Drowning1.8 Suicide/Self-Harm - Other1.5 Transport Incidents - Other1.5 Transport Incidents - Pedestrian1.3 Other Unintentional Injuries1.2 Transport Incidents - Pedal Cycle0.7 Falls - Other0.5 Transport Incidents - ATV, Snowmobile0.4 Unintentional Poisoning0.4

Top 10 Mortality Rates, by Injury Category, Ages 15-19, BC, 2004 DescriptionMortality Rate /100,000 Transport Incidents - Motor Vehicle7 Suicide/Self-Harm - Other5.7 Transport Incidents - Other4.8 Unintentional Poisoning1.4 Violence1.4 Transport Incidents - Pedestrian1.2 Drowning0.7 Other Unintentional Injuries0.7 Transport Incidents - ATV, Snowmobile0.7 Suicide/Self-Harm - Poisoning0.4

Top 10 Mortality Rates, by Injury Category, Ages 65+, BC, 2004 DescriptionMortality Rate /100,000 Falls - Other36.2 Suicide/Self-Harm - Other9.2 Other Unintentional Injuries7.5 Transport Incidents - Other5.4 Falls - On stairs4.9 Transport Incidents - Motor Vehicle4.5 Falls - On the same level4.4 Suicide/Self-Harm - Poisoning4.1 Transport Incidents - Pedestrian4 Falls - From furniture3.2

Top 10 Hospitalization Rates, by Injury Category, Ages 0-14, BC, 2004 Description Hospitalization Rate /100,000 Other Unintentional Injuries248 Falls - Other157.2 Falls - In playgrounds136.1 Transport Incidents - Pedal Cycle95.9 Unintentional Poisoning65.7 Falls - From skates, skis, boards, blades64.3 Falls - From furniture62.8 Falls - On the same level62.3 Transport Incidents - Motor Vehicle51.5 Transport Incidents - Pedestrian29.9

Top 10 Hospitalization Rates, by Injury Category, Ages 15-19, BC, 2004 Description Hospitalization Rate /100,000 Suicide/Self-Harm - Poisoning138 Other Unintentional Injuries135.1 Transport Incidents - Motor Vehicle116.1 Violence76.7 Transport Incidents - Pedal Cycle44.1 Falls - From skates, skis, boards, blades43.7 Falls - Other41.9 Suicide/Self-Harm - Other26.5 Unintentional Poisoning23.3 Undetermined Intent/Other22.9

Top 10 Hospitalization Rates, by Injury Category, Ages 65+, BC, 2004 Description Hospitalization Rate /100,000 Falls - Other649.9 Falls - On the same level639.5 Other Unintentional Injuries155.5 Falls - From furniture125 Falls - On stairs111.3 Transport Incidents - Motor Vehicle79.4 Unintentional Poisoning48.2 Falls - From ladders/scaffolding31.9 Transport Incidents - Pedestrian26.3 Suicide/Self-Harm - Poisoning18.6

Top 10 Total Costs, by Injury Category, Ages 0-14, BC, 2004 Description Total Cost ($ Millions) Other Unintentional Injuries$102.0 Falls - Other$49.5 Falls - In playgrounds$32.2 Transport Incidents - Pedal Cycle$24.9 Falls - On the same level$23.2 Falls - From skates, skis, boards, blades$20.2 Falls - From furniture$16.1 Transport Incidents - Motor Vehicle$15.2 Unintentional Poisoning$12.7 Falls - On stairs$9.0

Top 10 Total Costs, by Injury Category, Ages 15-19, BC, 2004 Description Total Cost ($ Millions) Other Unintentional Injuries$71.3 Transport Incidents - Motor Vehicle$45.2 Suicide/Self-Harm - Poisoning$27.5 Violence$22.5 Suicide/Self-Harm - Other$15.9 Falls - Other$14.6 Falls - From skates, skis, boards, blades$13.8 Transport Incidents - Other$12.9 Transport Incidents - Pedal Cycle$11.9 Unintentional Poisoning$8.1

Top 10 Total Costs, by Injury Category, Ages 65+, BC, 2004 Description Total Cost ($ Millions) Falls - Other$133.3 Falls - On the same level$117.0 Other Unintentional Injuries$48.0 Falls - From furniture$26.6 Falls - On stairs$20.3 Transport Incidents - Motor Vehicle$13.8 Unintentional Poisoning$6.4 Falls - From ladders/scaffolding$5.3 Transport Incidents - Pedestrian$5.1 Suicide/Self-Harm - Poisoning$2.6

Need a comprehensive national injury prevention strategy and complementary strategies at the provincial level. We have the capacity to develop, implement and demonstrate the positive impact such strategies would have. We need leadership Injury can be prevented, lives saved and a significant drain on our public resources stopped We can make a difference! Conclusion