The

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The 1 Cause of Death Among Young People
Unintentional Injury
The Public Policy Analysis Education Center for
Middle Childhood, Adolescent Young
Adult Health and National Adolescent Health
Information Center, Department
of Pediatrics Institute for Health Policy
Studies,
University of California, San Francisco
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Healthy People 2010 21 Critical Objectives for
Adolescents Young Adults
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Leading Cause of Death

• Unintentional injuries are the leading cause of
  death for young people motor vehicle accidents
  make up the largest portion of unintentional
  injuries.
• Mortality caused by unintentional injuries peak
  at ages 18-19 and then decrease throughout the
  lifespan.
• Among 10-24 year-olds, motor vehicle accident
  mortality has decreased in the past two decades,
  from 31/100,000 in 1981 to 19/100,000 in 2003.

Source NCIPC, 2006
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Leading Causes of Death, Ages
10-24 Ages 25-44, 2003
Adolescents Young Adults
Adults
Source NCIPC, 2006
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Leading Cause of Death

• Male adolescents and young adults are more likely
  to die from unintentional injury than their
  female peers.
• American Indian/Alaskan Native males ages 10-24
  have the highest unintentional injury mortality.

Source NCIPC, 2006
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Unintentional Injury Mortality by Type, Gender
and Race/Ethnicity, Ages 10-24, 2003
Source NCIPC, 2006
Source NCIPC, 2006
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Young People - Driving Risks

• Development Lack of maturity in decision-making,
  higher sensation-seeking, and more risk- taking
  around peers.
• Lack of driving experience.
• Among all age groups, adolescents and young
  adults are most likely to drive after using
  alcohol and/or illicit drugs.
• Less likely than adults to use safety belts.

Sources Steinberg, 2005 Marin Brown, 2005
NHTSA, 2006 SAMHSA, 2006 YRBSS, 2006 BRFSS,
2006
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Young People - Driving Risks

• Among fatal crashes for 13-19 year-olds, a
  majority have same-age passengers in the vehicle
  62 in 2004.
• Many fatal crashes among young people are
  alcohol-related 55 for 21-24 year-olds and 35
  for 16-20 year-olds in 2004.
• Among all age groups, young adults are most
  likely to report driving under the influence of
  alcohol 28 for 21-25 year-olds and 10 for
  16-17 year-olds in 2004.
• Seat belt use is higher among adolescents than
  young adults 82 for high school students
  (school-administered survey) vs. 70 for 18-24
  year-olds (household telephone survey) in 2003.

Sources IIHS, 2006 NHTSA, 2006 SAMHSA, 2006
YRBSS, 2006 BRFSS, 2006
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Drinking Driving Behavior by Gender, High
School Students, 2003
Source YRBSS, 2006
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Rarely/Never Wear Seat Belts by Gender and
Grade Level, High School Students, 2003
Source YRBSS, 2006
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Other Unintentional Injury Issues

• Getting hit/crushed was the leading cause of
  non-fatal unintentional injury for adolescents
  and young adults in 2004 other causes include
  motor vehicle accidents, falls, cuts/pierces,
  poisoning, and fires/burns.
• Trauma-related disorders were the leading
  condition for provider or emergency room visits/
  hospitalizations among 15-24 year-olds in 2003.

Injury resulting from being hi) or crushed by a
human, animal, or
inanimate object or
force other than a vehicle or machinery Sources
YRBSS, 2006 NCIPC, 2006 MEPS, 2006
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Reducing RisksUnintentional Injury Mortality

• Individual Role Drinking and driving, Seatbelt
  use
• Family and Community Changing norms (e.g.,
  Friends Dont Let their Friends Drive Drunk)
• Policy Level States Graduated Licenses
• Provider Level Clinical Preventive Services
  (e.g., screening counseling for drinking
  driving behavior, seat belt use)

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Reducing RisksState Policies

• Focus on 3 classes of State policies that address
  driver behavior
• Young driver licensing,
• Enforcement of safety belt use,
• Driving while intoxicated (DWI).
• Broad laws enacted by States have been successful
  in reducing adolescent traffic fatalities.

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Reducing Risks Graduated Licensure

• A full 3-stage system includes
• Initial supervision at all times by an
  experienced older driver (learners permit)
• Intermediate stage of permitting driving alone,
  but not at night or carrying other
  adolescent passengers (provisional license)
• Final stage of full-fledged license (model
  legislation at age 17).
• To graduate to a higher stage, need to spend
  required time at lower stage, demonstrate
  proficiency in driving skills, and remain
  violation-free.

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Resources

• Maternal and Child Health Bureaus Injury
  Prevention Program http//www.mchb.hrsa.gov/
• Bright Futures Guidelines for Safety and Injury
  Prevention http//www.brightfutures.org/
• National Research Council, Institute of Medicine,
  Committee on Contributions from the Behavioral
  and Social Sciences in Reducing and Preventing
  Teen Motor Crashes (February 2006 Planning
  Meeting)
• Williams AF. Teenage drivers patterns of risk.
  Journal of Safety Research 2003345-15.
• Bingham CR, Shope JT. Adolescent predictors of
  traffic crash patterns from licensure into early
  young adulthood. Association for the Advancement
  of Automotive Medicine 2005 September
  12-14245-59.
• Marin PS Brown BV. Are Teens Driving Safer?
  Pub 2005-16. Child Trends Cross Currents,
  October 2005.

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Resources

• For more information about the 21 Critical Health
  Objectives and the National Initiative to Improve
  Adolescent Young Adult Health, visit
  http//nahic.ucsf.edu/nationalinitiati
  ve/ or http//www.cdc.gov/HealthyYouth/Adolesce
  ntHealth/NationalInitiative/
• For more resources on Unintentional Injury,
  visit
• Non-Federal Resources http//nahic.ucsf.edu/index.
  php/niiah/article/ non_federal_resources/
• Partner Resources Database http//nahic.ucsf.edu/i
  ndex.php/partner_resources/

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ReferencesIn order of appearance

• National Center for Injury Prevention and
  Control. Mortality Reports Database Online
  Database. Accessed March 2006 at
  http//www.cdc.gov/ncipc/wisqars/.
• Steinberg L. Cognitive and affective development
  in adolescence. Trends in Cognitive Sciences,
  20059(2)69-74.
• Marin PS Brown BV. Are Teens Driving Safer?
  Pub 2005-16. Child Trends Cross Currents,
  October 2005. Accessed March 2006 at
  http//www.childtrendsdatabank.org/PDF/teen20driv
  ing.pdf.
• National Highway Traffic Safety Administration.
  Alcohol involvement in fatal motor vehicle
  traffic crashes, 2004 (DOT HS 809 905). Accessed
  March 2006 at http//www-nrd.nhtsa.dot.gov/pdf/nr
  d-30/NCSA/TSF2004/809905.pdf.
• Substance Abuse and Mental Health Services
  Administration. Results from the 2004 National
  Survey on Drug Use and Health National Findings
  (DHHS Publication No. SMA 05-4062). Accessed
  March 2006 at http//www.drugabusestatistics.samh
  sa.gov/nsduh.htm.
• Centers for Disease Control and Prevention. Youth
  Risk Behavior Surveillance System Online
  Database. Accessed March 2006 at
  http//apps.nccd.cdc.gov/yrbss/.
• Centers for Disease Control and Prevention.
  Behavioral Risk Factor Surveillance System,
  Prevalence Data Online Database. Accessed March
  2006 at http//apps.nccd.cdc.gov/brfss/.
• Insurance Institute for Highway Safety. Fatality
  Facts 2004 - Teenagers. Accessed March 2006 at
  http//www.iihs.org/research/fatality_facts/teenag
  ers.html.
• Medical Expenditure Panel Survey. Medical
  Expenditures by Condition Online Tables
  Accessed March 2006 at http//www.meps.ahrq.gov/C
  ompendiumTables/TC_TOC.HTM.

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National Adolescent Health Information Center
and Public Policy Analysis Education Center
for Middle Childhood, Adolescent Young Adult
Health
WEB SITES http//nahic.ucsf.edu/ http//p
olicy.ucsf.edu/ EMAIL
nahic_at_ucsf.edu policycenter_at_ucsf.edu PHONE
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