A Health Surveillance Update on Canadian Children and Youth

Injury Mortality

For every injury-related death, there are 40 hospitalizations and an estimated 670 emergency room visits for treatment of injuries.

Injuries are the leading cause of death among Canadian children and youth less than 20 years old.⁽¹⁾ Many of these deaths are preventable. Fatalities account for only a part of the health and economic burden associated with injury. Recent data on young people show that for every injury-related death there are 40 hospitalizations and an estimated 670 emergency room visits for treatment of injuries.⁽²⁾ Injury mortality statistics include deaths due to unintentional injuries, such as motor vehicle crashes and falls, as well as deaths due to suicide and assault, which includes child maltreatment. Adverse events occurring during medical treatment are not included in this report. Injury mortality rates are expressed as the number of deaths per 100,000 population per year.

In Canada in 1996, 1,280 (16.0/100,000) people under the age of 20 died from injuries – 30.5% of all deaths in this age group. Injury mortality rates were much higher among males (21.5/100,000) than females (10.2/100,000), and rates were highest in the 15-19 year age group (39.0/100,000), in which injuries accounted for 74.8% of all deaths. Unintentional injuries (11.1/100,000) accounted for 69.6% of the injury-related deaths among children and youth less then 20 years of age. Of these, 60.9% were associated with motor vehicle crashes, which were the leading cause of unintentional injury-related death at all ages except less than one year; in infants, suffocation predominated. Suicide and homicide accounted for 21.2% and 7.4% of the injury deaths respectively. The suicide rate was highest among 15-19 year olds (11.5/100,000); the highest homicide rate (4.2/100,000) was seen among children less than one year old.

The age-standardized rates in Figure 1 show that the rate of death due to unintentional injury fell by close to two thirds between 1980 and 1996. This decline is likely due to the combined effects of prevention of injury-producing events, reduction in injury severity, and improved emergency response and trauma care. In contrast, the mortality rate for intentional injuries, particularly suicide, has remained constant.

Note: Rates are standardized to the age distribution of the 1991 Canadian population.
Source: Bureau of Reproductive and Child Health, LCDC, based on Statistics Canada data⁽¹⁾

Figure 2 compares injury mortality rates for Canada and nine other developed countries.⁽³⁾

Note: Time periods for individual country rates differ.
Source: Fingerhut et al. 1998⁽³⁾

Data limitations
Canadian mortality data are generally strong.  However, it should be noted that these data can only be as good as the information that is provided on death certificates.  Furthermore, since coroners' and medical examiners' findings are not always available in time for inclusion in Statistics Canada publications, the numbers of suicides, homicides and unintentional injuries may be underestimated.⁽⁴⁾ Differences in international injury data must be interpreted with caution since some variation may be due to between-country differences in death registration, certification, classification and population enumeration.

Summary
Injury is an important cause of preventable mortality among Canadian children and youth. Despite the dramatic fall in the rate of death due to unintentional injury since 1980, 1,280 young people died of injuries in 1996. International comparisons of injury mortality in a group of developed countries also suggest that Canadians should not feel complacent about injuries.

Unless referenced otherwise, injury mortality statistics are the product of the Bureau of Reproductive and Child Health, LCDC⁽¹⁾

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