1. 1 Trends in mechanism and manner of death from external causes across race and Hispanic origin categories -- U.S. 1999-2003 Arialdi M. Miniño Division of Vital Statistics / Mortality Statistics Branch Presented at the 2006 Data Users’ Conference of the National Center for Health Statistics July 10-12, 2006 Omni Shoreham Hotel Washington, DC

2. 2 Objectives Explore 5-year trend in mortality from external causes Identify noteworthy trends in specified race and Hispanic origin groups: – All races and origins – Hispanic – Non Hispanic White – Non Hispanic Black

3. 3

4. 4 Data and Methods Age-adjusted death rates from National Vital Statistics System (NVSS) Kendall’s Tau correlation coefficient to identify noteworthy trends Causes of death are coded and classified as per system of International Classification of Diseases, Tenth Revision (ICD-10) – Injury deaths limited to ICD-10 codes *U01-*U03, V01-Y36, Y85-Y87, or Y89.

5. 5 Data and Methods, continued Causes of death are further grouped following parameters of the External cause-of-injury mortality matrix (E.C. Matrix). – Jointly developed by the Injury Control and Emergency Health Services section of the American Public Health Association (APHA) and the International Collaborative Effort on Injury Statistics – E.C. Matrix shows injury data by both mechanism and intent of death.

6. 6 External cause-of-injury mortality matrix UnintentionalSuicideHomicideUndeterminedLegal intervention / war All injury Cut / pierce Drowning...... Suffocation Unspecified intent mechanism

7. 7 6.2% 6.5%6.6%6.7%

8. 8

9. 9 Noteworthy decreasing trend Noteworthy increasing trend

10. 10 Noteworthy decreasing trend

11. 11

12. 12 Noteworthy decreasing trend

13. 13

14. 14

15. 15

16. 16 Noteworthy increasing trend Noteworthy increasing trend

17. 17 Noteworthy decreasing trend

18. 18

19. 19

20. 20 Noteworthy decreasing trend

21. 21 Noteworthy increasing trend

22. 22 Noteworthy increasing trend Noteworthy increasing trend

23. 23 Noteworthy increasing trend

24. 24 Summary The following trends were identified as noteworthy (per race and origin category): Hispanic – decreasing unintentional injury mortality – decreasing firearm-related suicide Non Hispanic White – increasing unintentional injury mortality – increasing motorcycle-related injury mortality – decreasing unspecified role motor vehicle traffic mortality – increasing poisoning mortality – increasing mortality from falls Non Hispanic Black – decreasing unintentional injury mortality – decreasing suicide mortality – decreasing motor vehicle traffic mortality – decreasing firearm-related suicide – increasing firearm-related homicide mortality

25. 25 Concluding remarks More research needed to determine effect of decreases in unspecified role in MVT death upon other MVT trends identified (e.g. motorcycle- related mortality in nH white). More research needed to determine effect of decreases in certificates closed as “pending investigation” upon other trends identified (poisoning deaths comes to mind).