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The Economic Costs of Injuries Among Children and Adolescents
Injury and violence are serious threats to the health and well-being of children and adolescents in the United States. Children and adolescents are at high risk for many injuries that can lead to death or disability. In addition to the human tragedy represented by these injuries, economic consequences occur. In 2000, the injuries incurred by children and adolescents age 14 and younger will have lasting impacts including total lifetime economic costs of more than $50 billion in medical expenses and lost productivity (Finkelstein 2006).
The Problem
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In the United States during 2004, 1,638 children ages 14 years and younger died as occupants in motor vehicle crashes, and approximately 214,000 were injured. That’s an average of 5 deaths and 586 injuries each day (NHTSA 2005).
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In 2003, 834 children ages 0 to 14 years died from drowning. Although drowning rates have slowly declined, drowning remains the second-leading cause of injury-related death for children ages 1 to 14 years (WISQARS 2006).
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906,000 children in the United States were confirmed by child protective service agencies as being maltreated. An estimated 1,500 children were confirmed to have died from maltreatment (DHHS 2005).
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Among children ages 0 to 14 years, traumatic brain injury (TBI) results in an estimated 2,685 deaths; 37,000 hospitalizations; and 435,000 emergency department visits annually (Langlois 2004).
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Children, especially those under age 6, are more likely to have unintentional poisonings than older children and adults. Adolescents are also at risk for poisonings, both intentional and unintentional. About half of all poisonings among teens are classified as suicide attempts (Litovitz 2001).
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Suicide is the third leading cause of death among young people ages 10 to 14. In 2003, 250 suicides were reported in this age group (WISQARS 2006).
The Cost
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Injuries among children and adolescents 5 to 14 years old account for $34.6 billion, 9% of the total lifetime costs of injuries in 2000 (Finkelstein 2006).
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A childhood injury-related death deprives the world of the child’s lifetime of potential contributions; therefore, productivity losses account for 77% of the total lifetime costs of injuries for persons aged 0 to 4 years who were injured in 2000 (Finkelstein 2006).
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In 2000, children colliding with objects (i.e. walls, trees, etc.) and objects colliding with children (balls, hands, etc.) resulted in the greatest total lifetime costs among children ages 0-4, more than $2.2 billion (Finkelstein 2006).
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In 2000, falls resulted in the greatest total lifetime costs among children and adolescents ages 5-14, more than $10 billion (Finkelstein 2006).
Preventing Injuries among Children and Adolescents
CDC is conducting research and programs to identify effective prevention strategies for reducing the burden of unintentional and violent injuries among children and adolescents. Information about CDC efforts to prevent injuries and violence can be found at www.cdc.gov/injury; a few of these interventions are highlighted here:
CDC Tool Kit on Concussion for High School Coaches
Concussions can happen to any athlete—male or female—in any sport. Concussions are a type of traumatic brain injury (TBI), caused by a blow or jolt to the head that can range from mild to severe and can disrupt the way the brain normally works. More than 300,000 people sustain sports- and recreation-related TBIs every year in the U.S. To reduce the number of this type of injury, the Centers for Disease Control and Prevention (CDC), with the support of partners and experts in the field, has developed a tool kit for coaches. This kit contains practical, easy-to-use information including a video and DVD
featuring a young athlete disabled by concussion, a guide, wallet card and clip board sticker for coaches, posters, fact sheets for parents and athletes in English and Spanish, and a CD-ROM with downloadable kit materials and additional concussion-related resources. The tool kit is available online at www.cdc.gov/ncipc/tbi/Coaches_Tool_Kit.htm.
Smoke alarm installation and fire-safety education
Since 1998, CDC has funded smoke alarm installation and fire safety education programs in high-risk communities—those with fire death rates higher than state and national averages and median household incomes below the poverty level. An informal sample of program homes found that
1,053 lives have been saved thus far. Program staff have canvassed more than
380,047 homes and installed almost 269,990 long-lasting smoke alarms in high-risk homes, targeting households with children ages five years and younger and adults ages 65 years and older. Fire safety messages have reached millions of people as a result
of these programs. CDC funded 14 states from 1998 to 2000. Based on the success of these programs, CDC awarded funding to 13 states in 2001 to install long-lasting, lithium-powered smoke alarms and to provide fire-safety education in homes in high-risk communities. In 2002, 3 additional states were funded for these activities, bringing the total number of CDC-funded states to 16. For more information about preventing residential fires visit www.cdc.gov/ncipc/factsheets/fire.htm.
Effectiveness Trial of Triple P-Positive Parenting Program
Child maltreatment is a serious public health problem with extensive short- and long-term health consequences. CDC is funding the University of South Carolina to examine the effectiveness of a multilevel parent training program. Triple P-Positive Parenting Program is a parenting and family support strategy to prevent severe behavioral, emotional, and developmental problems among children by enhancing the knowledge, skills, and confidence of parents. The project tests broad strategies aimed at preventing and reducing the risk of child maltreatment and promotes positive parenting to reduce stress and
child behavior problems. CDC is also supporting an economic evaluation of Triple P, focusing on training and implementation costs. For more information on the Triple-P-Positive Parenting Program visit www.triplep.net.
References
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. [cited 2006 Apr 5]. Available from URL: www.cdc.gov/ncipc/wisqars.
Department of Health and Human Services (DHHS) (US), Administration on Children, Youth, and Families (ACF). Child maltreatment 2003 [online]. Washington (DC): Government Printing Office; 2005. [cited 2005 April 5]. Available from: URL: www.acf.hhs.gov/programs/cb/pubs/cm03/index.htm.
Department of Transportation (US), National Highway Traffic Safety Administration (NHTSA), Traffic Safety Facts 2004: Children. Washington (DC): NHTSA; 2005. Available from URL: www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2004/809906.pdf. [cited 2005 Dec 30].
Finkelstein EA, Corso PS, Miller TR, Associates. Incidence and Economic Burden of Injuries in the United States. New York: Oxford University Press; 2006.
Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2004.
Litovitz TL, Klein-Schwartz W, White S, Cobaugh D, Youniss J, Omslaer J, Drab A, and Benson B. 2000 Annual Report of the American Association of Poison Control Centers Toxic Exposures Surveillance System. American Journal of Emergency Medicine, 19(5): 337 – 396; 2001.
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