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					   Children’s Safety Network (CSN) National Injury and Violence Prevention Resource Center works with State and Ter-
ritorial Title V, Maternal and Child Health (MCH) and Injury and Violence Prevention (IVP) programs to strengthen their
capacity to create healthy, safe and injury free communities for children and families. CSN works with a broad range
of partners, including federal agencies, national organizations and professional groups to increase awareness about the
importance of, extend the reach of, and share information on injury and violence prevention with state health agencies
and others. CSN is funded by the Health Resources and Services Administration’s, Maternal and Child Health Bureau and
provides services at no cost.

                               CSN partners with states and national organizations to build knowledge, expertise and leader-
                            ship to reduce unnecessary injury death, hospitalization and disability so all children and youth
                            have the opportunity to reach their potential. Our goal is to help states maximize their IVP capac-
                            ity, utilize data effectively and implement best practices.

                               CSN offers a full range of services to assist public health professionals and others in addressing
                            injuries to infants, children and adolescents and in developing a comprehensive system of IVP pro-
                            grams. CSN can provide an analysis of the incidence and costs of injuries and violence at the state
                            and national levels, as well as information about the cost benefits of effective interventions.


The Injury Problem
Injuries and violence are the leading cause of death and a leading cause of hospitalization among children and adoles-
cents in the United States. CSN can help address the following problems:
  √       injuries resulting from violence, including bullying, and child maltreatment
  √       traffic injuries, including injuries to pedestrians and cyclists
  √       injuries that take place in schools and in the home
  √       sports and recreational injuries, including drownings
  √       youth suicide
                                                                         Questions we can answer:
  √       injuries to teenaged workers
                                                                         ► How much could our state save in medical costs
                                                                             if we made booster seats available to low-income

         Causes of childhood deaths — ages 1-19, 2005                        families?
                                                                         ► How can we most effectively address our Title V
                                                                             Performance Measures?
                            Homicide                                     ► Where can I find model legislation about pool
      Injuries                       Suicide
                                                                             fencing?
      61%
                                                                         ► How can we improve collaboration between our
                          Other
                       unintentional                                         injury prevention program and our MCH agency?
                                                                         ► What can we contribute to our state’s bullying
                                Motor vechicle                               prevention initiative?
                                  related             All other
                                                      causes             ► How can we better advocate for injury preven-
                                                      39%
                                                                             tion?
 Source: www.cdc.gov/ncipc/wisqars
CSN works with states on injury and violence prevention to:
► Maximize capacity and prevention efforts
► Integrate injury and violence prevention into MCH activities
► Develop policy and set standards
► Build partnerships among MCH, injury prevention and other programs
► Implement effective strategies in a broad range of settings
► Achieve national and state performance measures
► Utilize surveillance and cost data
► Train and educate health professionals
► Demonstrate the value and effectiveness of programs

                   Contact us by phone, e-mail, web site or mail to:
                   ►    Obtain help with performance measures
                   ►    Obtain the names of people in your state and region who are involved in injury prevention
                   ►    Discuss ways you can collect and use injury data
                   ►    Get information on the cost of injuries in your state
                   ►    Find out what your peers are doing

Subscribe to CSN Discuss to:
► Learn about the latest federal and national initiatives
► Get abstracts of research articles
► Obtain a bibliography of recent injury-related research

Invite CSN Staff to visit your state to help you:
► Develop a strategic plan
► Convene key players and make the case for prevention
► Present information on specific issue(s)

Visit our web site at www.ChildrensSafetyNetwork.org to:
► Check on current developments
► Obtain information related to a specific injury
► Learn about best practices
► Access CSN and other key publications
► Link to other related organizations, agencies and resources

Contact our core site in Newton, MA for information about these and other services. We’ll make sure you get the help
you need!
                                                   Newton Office:
                                              Children’s Safety Network
                                          Education Development Center, Inc.
                                                   55 Chapel Street
                                               Newton, MA 02458-1060
                                                    (617) 618-2918
                                                     csn@edc.org
                                      Other sites: Washington, DC and Calverton, MD.
            Funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau (MCHB).
Injury and Violence-Related National Performance Measures and Health Status
                                  Indicators

The Maternal and Child Health Services (MCH) Block Grant (Title V of the Social Security Act of
1935), Health Resources and Services Administration’s Maternal and Child Health Bureau, funds
each State and Territory based on a formula to support MCH activities including direct health
care; enabling services (e.g., transportation); population-based services (e.g., SIDS counseling
and injury prevention); and infrastructure building (e.g., needs assessments, monitoring
program effectiveness). The Federal MCH Block Grant program requires State MCH programs to
report on 18 National Performance Measures (NPMs), two of which directly address injuries, as
well as seven to 10 State Performance Measures (SPMs). Each State is also required to report
on 12 Health Status Indicators, six of which directly address injuries.

Injury and Violence-Related National Performance Measures:

         NPM #10: The rate of deaths to children aged 14 years and younger caused by motor vehicle
         crashes per 100,000 children.

         NPM #16: The rate (per 100,000) of suicide deaths among youths aged 15 through 19.

Injury and Violence- Related Health Status Indicators:

         HSI 03A: The death rate per 100,000 due to unintentional injuries among children aged 14 years
         and younger.

         HSI 03B: The death rate per 100,000 for unintentional injuries among children aged 14 years and
         younger due to motor vehicle crashes.

         HSI 03C: The death rate per 100,000 from unintentional injuries due to motor vehicle crashes
         among youth aged 15 through 24 years.

         HSI 04A: The rate per 100,000 of all nonfatal injuries among children aged 14 years and younger.

         HSI 04B: The rate per 100,000 of nonfatal injuries due to motor vehicle crashes among children
         aged 14 years and younger.

         HSI 04C: The rate per 100,000 of nonfatal injuries due to motor vehicle crashes among youth
         aged 15 through 24 years.


CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health
                                 Bureau (U.S. Department of Health and Human Services).

                                      A project of the Education Development Center, Inc.
                                    CHILDREN’S SAFETY NETWORK
                                   A RESOURCE FOR CHILD AND ADOLESCENT INJURY AND VIOLENCE PREVENTION
                                                                                        United States Fact Sheet, 2008
National Performance Measures Related to Injury and Violence
The Federal Maternal and Child Health Bureau Block Grant program requires State MCH programs to report
on 18 National Performance Measures (NPM), two of which directly address injuries. Figure 1 (NPM #10)
shows the trend in the rate of deaths for children aged 14 years and younger caused by motor vehicle crashes.
In the United States, the average rate of unintentional motor vehicle (MV) deaths for children aged 0-14 during
2001-2005 is 3.51 per 100,000 population. Figure 2 (NPM #16) shows the trend in the rate of suicide deaths
among youths aged 15-19. In the United States, the average rate of suicide deaths among youths aged 15-19 for
this same period is 7.69 per 100,000 population. Figure 3 shows the costs per individual cases in the United
States for childhood MV traffic deaths and youth suicides.
                                     4                                                                            10
                                          3.70     3.53       3.53     3.55
                                                                                 3.21                                                           8.20
                                                                                                                  8    7.93                              7.66




                                                                                          Age-adjusted rate per
                                                                                                                              7.42
Age-adjusted rate per




                                                                                                                                       7.25




                                                                                           100,000 population
                                     3
 100,000 population




                                                                                                                  6
                                     2
                                                                                                                  4

                                     1
                                                                                                                  2

                                     0                                                                            0
                                          2001     2002       2003    2004     2005                                    2001   2002    2003    2004     2005

                                      Figure 1. The rate (per 100,000) of                                          Figure 2. The rate (per 100,000) of
                                      unintentional MVT deaths among children                                      suicide deaths among youths aged 15-19,
                                      aged 0-14, US, 2001-2005*                                                    US, 2001-2005*


                                    $2
                                                                        $1.8
Costs in millions (2005 dollars)




                                                                                            Definitions
                                   $1.5          $1.4
                                                                                                                  Medical costs include payments for
                                                                                                                  hospital and physician care, as well as
                                     $1
                                                                                                                  emergency medical transport,
                                                                                                                  rehabilitation, prescription drugs, allied
                                   $0.5                                                                           health services, medical devices, and
                                                                                                                  insurance claims processing. For fatalities,
                                                                                                                  coroner and premature burial expenses
                                    $0
                                           Unintentional             Completed                                    are included.
                                          MV Traffic Deaths           suicides
                                                                                                                  Productivity costs include immediate and
                                   Figure 3. Average individual costs per case                                    future work losses (e.g., wages, fringe
                                   of unintentional motor vehicle traffic deaths                                  benefits, schoolwork, and housework) due
                                   (aged 0-14) and completed suicides (aged                                       to a childhood injury.
                                   15-19) in the US, 2000-2004**

* Reference: Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) (2008). CDC WISQARS On-line Database,
compiled from Compressed Mortality File 2001-2005. Report retrieved March 10, 2008.
** Note: These estimated annual costs combine medical and productivity costs (see Definitions box above). Totals have been rounded and may not equal
previously published cost estimates.
Understanding injury rankings among other causes of death is important in determining their physical and
economic role in each state. Although, injuries are the leading cause of death for ages 1-34, knowing what
types of injuries cause the majority of deaths and hospitalizations can inform program planning and
development efforts. Table 1 shows the top 5 causes of death by age group in the state. Table 2 shows the top 5
causes of injury death by age group in the state.



                    Table 1. Leading Causes and Total 5-Year Incidence of Death by Age Group,
                                         The United States, 2000-2004
                                                                                                                         All Ages
   Rank              <1                  1-4                  5-9                10-14               15-24             (<1 to 65+)
     1          Congenital          Unintentional        Unintentional       Unintentional       Unintentional            Heart
                Anomalies              Injury               Injury              Injury               Injury              Disease
                 28,122                8,539                6,072               7,745               74,657              3,445,424
     2             Short             Congenital           Malignant           Malignant            Homicide            Malignant
                 Gestation           Anomalies            Neoplasms           Neoplasms             25,908             Neoplasms
                  22,935               2,692                2,561               2,628                                  2,774,920
     3              SIDS             Malignant            Congenital            Suicide             Suicide             Cerebro-
                   11,460            Neoplasms            Anomalies              1,359              20,279              vascular
                                       2,033                 964                                                        801,634
     4          Maternal              Homicide             Homicide            Homicide           Malignant           Chronic Low.
            Pregnancy Comp.            1,947                 661                1,045             Neoplasms           Respiratory
                 8,036                                                                              8,507               618,207
     5           Placenta              Heart                Heart             Congential             Heart            Unintentional
             Cord Membranes           Disease              Disease            Anomalies             Disease              Injury
                  5,249                 944                  483                1,003                5,223              527,468



                Table 2. Leading Causes and Total 5-Year Incidence of Injury Deaths by Age Group,
                                         The United States, 2000-2004
                                                                                                                         All Ages
   Rank              <1                  1-4                  5-9                10-14               15-19             (<1 to 65+)
     1         Unintentional        Unintentional        Unintentional       Unintentional       Unintentional        Unintentional
                Suffocation             MVT                  MVT                 MVT                 MVT                  MVT
                  3,120                2,676                3,193               4,507               26,035              215,141
     2         Unintentional        Unintentional        Unintentional         Suicide             Homicide           Unintentional
                   MVT               Drowning             Fire/Burn           Suffocation           Firearm            Poisoning
                   704                 2,291                 806                  841                7,806               84,751
     3           Homicide           Unintentional        Unintentional       Unintentional          Suicide              Suicide
                Unspecified           Fire/Burn           Drowning            Drowning              Firearm              Firearm
                   622                 1,210                 785                 782                 4,000               84,204
     4        Homicide Other         Homicide              Homicide            Homicide            Suicide            Unintentional
               Spec/Clasfbl         Unspecified             Firearm             Firearm           Suffocation             Fall
                   545                 738                    257                 686               2,858                80,624
     5         Unintentional        Unintentional        Unintentional       Unintentional       Unintentional          Homicide
                Drowning             Suffocation        OL       Suffoc       Fire/Burn           Poisoning              Firearm
                   326                  712            Trans       211           438                2,406                57,447
                                                        211



MVT = Motor Vehicle Traffic. Spec/Clasfbl = Specified/Classifiable. OL Trans = Other Land Transport. Suffoc = Suffocation.
Figures 4 and 5 compare the medical and productivity costs per individual case in the United States for youth
motor vehicle traffic (MVT) injuries and youth self-inflicted injuries for hospitalizations, respectively.




                                    $80                                                                                   $12                               $11.0
Costs in thousands (2005 dollars)




                                                                                      Costs in thousands (2005 dollars)
                                                                                                                          $10
                                    $60                              $57.9
                                                                                                                           $8           $6.7

                                    $40                                                                                    $6

                                                                                                                           $4
                                    $20          $18.0
                                                                                                                           $2

                                     $0                                                                                    $0
                                               Medical           Productivity                                                         Medical           Productivity

                                    Figure 4. Average individual costs per case                                           Figure 5. Average individual costs per case
                                    of nonfatal, unintentional hospital-admitted                                          of nonfatal, hospital-admitted self-inflicted
                                    MVT injuries, ages 0-15, in the United States                                         injuries, ages16-20, in the United States
                                    (Based on Year 2003 Incidence)                                                        (Based on Year 2003 Incidence)




                                                                     FOR MORE INFORMATION, PLEASE CONTACT:
                                                 CSN National Resource Center                CSN Economics and Data Analysis Resource Center
                                                 55 Chapel Street                            11720 Beltsville Drive, Suite 900
                                                 Newton, MA 02458                            Calverton, MD 20705
                                                 (617) 618-2230 | csn@edc.org                (301) 755-2728 | sheppard@pire.org
                                                 http://www.ChildrensSafetyNetwork.org       http://www.ChildrensSafetyNetwork.org


Children’s Safety Network is funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S.
Department of Health and Human Services.
CSN works closely with several key partners, including the National Child Death Review Resource and Policy Center, located at the
Michigan Public Health Institute, and the Suicide Prevention Resource Center, located at the Education Development Center, Inc.
State Rate Comparison to National Rate of Suicide Deaths among
Youth Ages 15-19 Years per 100,000 Population, 2005
The U.S. suicide death rate decreased from 7.93 for youth ages15-19 years per 100,000 population in
2001 to 7.66 per 100,000 population in 2005. In 2005, 25 States were below the national rate. Twelve
States that were above the national rate in 2001 fell below the national rate in 2005.
States below the national rate of 7.66 per 100,000 population for suicide deaths, 15-19 years, 2005

                       Alabama          Georgia         Massachusetts        New Hampshire            Pennsylvania
                       California       Hawaii          Maryland             New Jersey               Rhode Island
                       Connecticut      Illinois        Maine                New York                 South Carolina
                       Delaware         Indiana         Missouri             Oklahoma                 Virginia
                       Florida          Kansas          North Carolina       Oregon                   Vermont

In 2005, 25 States were above the national rate of 7.66 per 100,000 population. Of these 25 States, 7
have improved but remained above the 2005 national rate and in 12 States the rate was higher than in
2001. Six States that were below the 2001 national rate rose above the 2005 rate.

States above the 2005 national rate of 7.66 per 100,000 population but their State rate improved from 2001 to 2005.

                                                             Alaska          Tennessee
                                                             Idaho           Utah
                                                             Iowa            Wyoming
                                                             Michigan

States above the 2005 national rate of 7.66 per 100,000 population and their State 2005 rate increased above the State
2001 rate.

                                                   Arizona        Minnesota         New Mexico
                                                   Arkansas       Mississippi       South Dakota
                                                   Colorado       Montana           Washington
                                                   Louisiana      Nebraska          Wisconsin

States above the 2005 national rate of 7.66 per 100,000 population that were below the national rate in 2001.

                                           Kentucky                 Nevada              Texas
                                           North Dakota             Ohio                West Virginia




CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department
                                                            of Health and Human Services).
                                                 A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State Rate Comparison to National Rate of Unintentional Motor
Vehicle Deaths Ages 0-14 Years per 100,000 Population, 2005
The U.S. unintentional motor vehicle traffic death rate for children ages 0-14 years decreased from 3.70
per 100,000 population in 2001 to 3.21 per 100,000 population in 2005. In 2005, 20 States were below
the national rate, including one State that was above the national rate in 2001 but fell below in 2005.
States below the national rate of 3.21 per 100,000 population for unintentional motor vehicle deaths, 0 -14 years, 2005

                            California          Illinois               Minnesota                Pennsylvania
                            Colorado            Maine                  New Hampshire            Rhode Island
                             Connecticut        Maryland               New Jersey               Virginia
                             Delaware           Massachusetts          New York                 Washington
                            Hawaii              Michigan               Ohio                     Wisconsin

In 2005, 30 States were above the national rate of 3.21 per 100,000 population. Of these 30 States, 21
have improved but remained above the 2005 national rate. In 6 States, the 2005 rate was higher than
the 2001 rate. Three States that were below the 2001 national rate rose above the 2005 rate.

States above the 2005 national rate of 3.21 per 100,000 population, but their State rate improved from 2001 to 2005.

                                            Arizona              Louisiana             Oregon
                                            Arkansas             Missouri              South Carolina
                                            Georgia              Mississippi           South Dakota
                                            Idaho                Montana               Tennessee
                                            Iowa                 North Carolina        Texas
                                            Indiana              Nebraska              West Virginia
                                            Kansas               Oklahoma              Wyoming

States above the 2005 national rate of 3.21 per 100,000 population and the State 2005 rate increased above the State
2001 rate.

                                                       Alabama              Kentucky
                                                       Alaska               New Mexico
                                                       Florida              Utah

States above the national rate of 3.21 per 100,000 population in 2005 that were below the national rate of 3.70 per
100,000 population in 2001.

                                               North Dakota        Nevada              Vermont



CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department
                                                            of Health and Human Services).
                                                 A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State Rate Comparison to National Rate of Fatal
Unintentional Injuries Ages 15-18 Years per 100,000
Population, 2006
The U.S. fatal unintentional injury rate for youth ages 15 to 18 years decreased from 32.1 per
100,000 population in 2002 to 27.9 per 100,000 population in 2006. In 2006, 25 States were
below the national rate.
States below the national rate of 27.9 per 100,000 population for unintentional injuries, 15-18 years, 2006


 Alaska                 Hawaii                 Michigan                     Ohio               Utah
 California             Illinois               Minnesota                    Oregon             Vermont
 Connecticut            Iowa                   New Hampshire                Pennsylvania       Virginia
 Colorado               Maryland               New Jersey                   Rhode Island       Washington
 Delaware               Massachusetts          New York                     Texas              Wisconsin

In 2006, 25 States were above the national rate of 27.9 per 100,000 population. Of these 25
States, 15 have improved but remain above the 2006 national rate. In 10 States, the 2006 rate
was higher than the 2002 rate.
States above the 2006 national rate of 27.9 per 100,000 population but their State rate improved from 2002 to
2006.


 Florida          Indiana          Louisiana             Nevada                 South Carolina
 Georgia          Kansas           Maine                 New Mexico             South Dakota
 Idaho            Kentucky         Montana               North Carolina         Tennessee

States above the 2006 national rate of 27.9 per 100,000 population but the State 2006 rate increased above the
State 2002 rate.


 Alabama          Arkansas          Missouri        North Dakota             West Virginia
 Arizona          Mississippi       Nebraska        Oklahoma                 Wyoming




CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S.
                                               Department of Health and Human Services).
                                           A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State Rate Comparison to National Rate of Fatal Unintentional
Motor Vehicle Deaths Ages 15-18 Years per 100,000 Population,
2006
The U.S. unintentional motor vehicle traffic death rate for youth ages 15-18 years decreased from 25.23
per 100,000 population in 2002 to 20.52 per 100,000 population in 2006. In 2006, 23 States were below
the national rate.
States below the national rate of 20.52 per 100,000 population for unintentional motor vehicle deaths, 15-18 years, 2006

                   Alaska             District of Columbia         Michigan               Ohio                 Vermont
                   California         Hawaii                       Minnesota              Oregon               Virginia
                   Colorado           Illinois                     New Hampshire          Pennsylvania         Washington
                   Connecticut        Maryland                     New Jersey             Rhode Island
                   Delaware           Massachusetts                New York               Texas



In 2006, 28 States were above the national rate of 20.52 per 100,000 population. Of these 28 States, 19
have improved but remain above the 2006 national rate. In 7 States, the 2006 rate was higher than the
2002 rate. Two States that were below the 2002 national rate rose above the 2006 rate.
States above the 2006 national rate of 20.52 per 100,000 population but their State rate improved from 2002 to 2006.

                            Alabama                 Indiana                 Montana                 Oklahoma
                            Arkansas                Kansas                  Nebraska                South Carolina
                            Florida                 Kentucky                Nevada                  Tennessee
                            Georgia                 Louisiana               New Mexico              Wisconsin
                            Idaho                   Maine                   North Carolina

States above the 2006 national rate of 20.52 per 100,000 population but the State 2006 rate increased above the State
2002 rate.

                                                  Arizona                   South Dakota
                                                  Mississippi               West Virginia
                                                  Missouri                  Wyoming
                                                  North Dakota

States above the 2006 national rate of 20.52 per 100,000 population that were below the national rate (25.23) in 2002

                                                                Iowa        Utah

CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department
                                                            of Health and Human Services).
                                                 A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State Rate Comparison to National Rate of Fatal Unintentional
Motor Vehicle Deaths Ages 19-24 Years per 100,000 Population,
2006
The U.S. unintentional motor vehicle traffic death rate for young adults ages 19 - 24 years decreased
from 29.23 per 100,000 population in 2002 to 28.74 per 100,000 population in 2006. In 2006, 24 States
were below the national rate.
States below the national rate of 28.74 per 100,000 population for unintentional motor vehicle deaths, ages 19-24 years,
2006

                                Alaska                    Hawaii               Minnesota              Ohio
                                California                Illinois             Nebraska               Pennsylvania
                                Connecticut               Iowa                 New Hampshire          Rhode Island
                                Colorado                  Maryland             New Jersey             Utah
                                Delaware                  Massachusetts        New York               Washington
                                District of Columbia      Michigan             North Dakota           Vermont

In 2006, 28 States were above the national rate of 28.74 per 100,000 population. Of these 28 States, 9
have improved but remain above the 2006 national rate. In 12 States, the 2006 rate was higher than the
2002 rate. Six States that were below the 2002 national rate rose above the 2006 rate.

States above the 2006 national rate of 28.74 per 100,000 population but their State rate improved from 2002 to 2006.

                                             Idaho            New Mexico              Texas
                                             Kansas           North Carolina          West Virginia
                                             Missouri         Oklahoma                Wyoming

States above the 2006 national rate of 28.74 per 100,000 population but their State 2006 rate increased above the State
2002 rate.

                                    Alabama                    Kentucky                  Montana
                                    Arizona                    Louisiana                 South Carolina
                                    Arkansas                   Maine                     South Dakota
                                    Florida                    Mississippi               Tennessee

States above the 2006 national rate of 28.74 per 100,000 population that were below the national rate (29.23) in 2002.

                                                         Georgia           Virginia
                                                         Indiana           Wisconsin
                                                         Nevada            Oregon

CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department
                                                            of Health and Human Services).
                                                 A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State by State Rate Comparison for Nonfatal Injuries Among
Children Ages 14 Years and Younger per 100,000 Population,
2006
All state Title V Maternal and Child Health programs are required to report on 12 health status
indicators. This fact sheet provides information on Health Status Indicator Measure # 4A: the
rate per 100,000 of all nonfatal injuries among children aged 14 years and younger. The data
used for this comparison was reported by the state in their 2008 State Title V Block Grant
application and obtained from the Maternal and Child Health TVIS reports. As the majority of
the states indicated that the 2007 data was provisional 2006 data was used.

In comparing the 2003 rate to the 2006 rate, 19 states were determined to remain the same
with the same being defined as +/- 9 from their 2003 rate. In 18 States, their rate decreased
and in 10 States their rate increased from 2003 to 2006. Three states* did not provide data on
this health status indicator.

States status remained the same from 2003 to 2006.


 Alabama           Indiana                Minnesota               North Carolina             Virginia
 Georgia           Maryland               Maine                   Oklahoma                   Vermont
 Hawaii            Massachusetts          Missouri                South Carolina             Wyoming
 Illinois          Michigan               New York                Tennessee


States status decreased from 2003 to 2006.


 Alaska            Colorado              Nebraska                       New Mexico           Pennsylvania              Utah
 Arizona           Florida               New Hampshire                  Nevada               Rhode Island              West Virginia
 California        Kentucky              New Jersey                     Oregon               South Dakota              Wisconsin


States status increased from 2003 to 2006.


 Arkansas          Iowa                  Louisiana               North Dakota          Texas
 Connecticut       Kansas                Montana                 Ohio                  Washington


States data were not reported.


 Delaware          Idaho                 Mississippi

CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S.
                                               Department of Health and Human Services).
                                           A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State by State Rate Comparison for Nonfatal Injuries Due to
Motor Vehicle Crashes Among Children Ages 14 Years and
Younger per 100,000 Population, 2006
All state Title V Maternal and Child Health programs are required to report on 12 health status
indicators. This fact sheet provides information on Health Status Indicator Measure # 4B: the
rate per 100,000 of all nonfatal injuries due to motor vehicle crashes among children aged 14
years and younger. The data used for this comparison was reported by the state in their 2008
State Title V Block Grant application and obtained from the Maternal and Child Health TVIS
reports. As the majority of the states indicated that the 2007 data was provisional 2006 data
was used.

In comparing the 2003 rate to the 2006 rate, 8 states were determined to remain the same
with the same being defined as +/- 9 from their 2003 rate. In 36 States, their rate decreased
and in 4 States their rate increased from 2003 to 2006. Two states* did not provide data on
this health status indicator.

States status remained the same from 2003 to 2006.


 Colorado           Kentucky               Massachusetts         South Carolina
 Hawaii             Maryland               Nevada                Washington


States status decreased from 2003 to 2006.


 Alaska             Georgia                Louisiana             North Carolina              Oklahoma                   Texas
 Arizona            Idaho                  Michigan              North Dakota                Oregon                     Utah
 Arkansas           Illinois               Minnesota             Nebraska                    Pennsylvania               Virginia
 California         Indiana                Maine                 New Hampshire               Rhode Island               Wisconsin
 Connecticut        Iowa                   Missouri              New Jersey                  South Dakota               West Virginia
 Florida            Kansas                 Montana               New Mexico                  Tennessee                  Wyoming


States status increased from 2003 to 2006.


 Alabama            New York               Ohio                  Vermont


States data were not reported.


 Delaware           Mississippi
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S.
                                               Department of Health and Human Services).
                                           A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
State by State Rate Comparison for Nonfatal Injuries Due to
Motor Vehicle Children Ages 15-24 per 100,000 Population,
2006
All state Title V Maternal and Child Health programs are required to report on 12 health status
indicators. This fact sheet provides information on Health Status Indicator Measure # 4C: the
rate per 100,000 of all nonfatal injuries due to motor vehicle crashes among children aged 14
years and younger. The data used for this comparison was reported by the state in their 2008
State Title V Block Grant application and obtained from the Maternal and Child Health TVIS
reports. As the majority of the states indicated that the 2007 data was provisional 2006 data
was used.

In comparing the 2003 rate to the 2006 rate, 19 states were determined to remain the same
with the same being defined as +/- 9 from their 2003 rate. In 20 States, their rate decreased
and in 10 States their rate increased from 2003 to 2006. One state* did not provide data on
this health status indicator.

States status remained the same from 2003 to 2006.


 Arizona            Georgia                Maine                 Oklahoma                Tennessee
 Arkansas           Idaho                  Missouri              Pennsylvania            Washington
 Delaware           Louisiana              Montana               Rhode Island            Wyoming
 Florida            Maryland               North Carolina        South Carolina


States status decreased from 2003 to 2006.


 Alaska             Hawaii                 Michigan              New Hampshire                   Oregon
 California         Iowa                   Minnesota             New Jersey                      Utah
 Colorado           Kansas                 North Dakota          New Mexico                      Wisconsin
 Connecticut        Massachusetts          Nebraska              Ohio                            West Virginia


States status increased from 2003 to 2006.


 Alabama            Indiana                New York              South Dakota            Virginia
 Illinois           Kentucky               Nevada                Texas                   Vermont


State data was not reported.

Mississippi
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S.
                                               Department of Health and Human Services).
                                           A project of the Education Development Center, Inc.
CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
                                                                Cost of Child Abuse and Neglect in the United States
                                                                       (Year 2006 Incidence, Year 2007 Costs)
Abuse Type                  Future Earnings            Medical Care      Mental Health Property Damage            Public Programs                            Quality of Life                  Total
   Sexual Abuse                $485,312,100            $148,635,800     $1,731,994,600                    $0         $249,878,800                           $21,331,997,000         $23,947,818,300
  Physical Abuse             $1,378,911,000            $407,674,700     $1,392,055,000            $9,518,900         $763,706,400                           $23,491,251,100         $27,443,117,100

    Mental Abuse                $311,421,700                        $0        $1,171,959,400                           $0             $641,725,100            $7,263,304,600          $9,388,410,800

  Serious Neglect                $58,577,700              $9,264,400          $2,804,020,200                           $0           $1,830,681,700          $19,306,234,800         $24,008,778,800

              Fatal           $3,112,828,700             $62,642,700             $18,003,700                 $2,926,200                  $3,570,600           $7,885,620,900        $11,085,592,800


Total                         $5,347,051,200           $628,217,600           $7,118,032,900                $12,445,100             $3,489,562,600          $79,278,408,400         $95,873,717,800




Definitions:
Medical Care includes payments for hospital and physician care, as well as emergency medical transport, rehabilitation, prescriptions, allied health services, medical devices, and insurance
Mental Health Care includes payments for services by psychiatrists, psychologists, social workers, and pastoral counselors. Also includes insurance claims processing.
Future Earnings includes wages, fringe benefits, schoolwork, and housework lost by the injured. This estimate excludes earnings lost by family and friends caring for the injured.
Public Programs include police, fire, paramedic, ambulance, and helicopter transport costs. Social services and victim assistance costs are also included in this category. It excludes mental
Property Damage and Loss is the value of property damage and of property taken and not recovered.
Quality of Life places a dollar value on pain, suffering and lost quality of life to the victim and their family. The value is computed from jury awards for pain, suffering, and lost quality of life

Source:
Children's Safety Network-Economics and Data Analysis Resource Center, at the Pacific Institute for Research and Evaluation, Calverton, MD, 2009. All costs were calculated using incidents
reported in the Child Maltreatment 2006, National Center on Child Abuse and Neglect Data Set.

CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services).
                                                                 A project of the Education Development Center, Inc.
                                       Technical Assistance Teams




Regions 1 & 2                                              Region 7
Erica Streit-Kaplan, TA Specialist                         Lisa McCarthy, TA Specialist
Sally Fogerty, CSN Director                                Jennifer Allison, CSN Assistant Director, State Partners

Region 3                                                   Region 8
Malia Richmond-Crum, TA Specialist                         Erica Streit-Kaplan, TA Specialist
Ellen Schmidt, CSN Assistant Director, Nat’l Partners      Jennifer Allison, CSN Assistant Director, State Partners

Region 4                                                   Region 9
Malia Richmond-Crum, TA Specialist                         Malia Richmond-Crum, TA Specialist
Jennifer Allison, CSN Assistant Director, State Partners   Sally Fogerty, CSN Director

Region 5                                                   Region 10
Lisa McCarthy, TA Specialist                               Erica Streit-Kaplan, TA Specialist
Sally Fogerty, CSN Director                                Ellen Schmidt, CSN Assistant Director, Nat’l Partners

Region 6
Lisa McCarthy, TA Specialist
Ellen Schmidt, CSN Assistant Director, Nat’l Partners
                                                                                  Virginia

Unintentional injuries and violence are the leading cause of death, hospitalization, and disability for children ages
1-18. In 2005, the number of injury deaths for children ages 1-18 was 12,638, and the number of nonfatal injury
admissions to emergency departments and hospitals was 8.7 million.* The Children’s Safety Network National
Resource Center (CSN), funded by the Maternal and Child Health (MCH) Bureau, works with states to utilize
a science-based, public health approach for injury and violence prevention (IVP). CSN provides information
and technical assistance on injury surveillance and data; needs assessments; best practices; and the design,
implementation, and evaluation of programs to prevent child and adolescent injuries.

CSN has prepared this fact sheet to provide a state snapshot of injury and violence prevention data, resources,
and activities. The fact sheet is intended to be a helpful and easy-to-use tool for needs assessments, planning,
and presentations.

*Reference: Office of Statistics and Programming, National Center for Injury Prevention and Control, CDC.



Major Causes of Injury Hospitalizations National Performance Measures
and Deaths
                                                                     Virginia’s average rate of unintentional motor vehicle
Unintentional falls (491) were the leading cause of injury           deaths for children ages 0-14 was 2.68 per 100,000 in 2005
hospitalizations for children ages 0-12 in Virginia as of 2003.      as compared to the national average rate of 3.21.

Self-inflicted injuries (197) were the leading cause of injury        Virginia’s average rate of suicide deaths for teens ages
hospitalizations for teens ages 13-15 in Virginia as of 2003.        15-19 was 6.70 per 100,000 in 2005 as compared to the
                                                                     national average rate of 7.66.
Unintentional motor vehicle traffic crashes (616) were the
leading cause of injury hospitalizations for teens ages 16-20        The average cost per case of unintentional motor vehicle
in Virginia as of 2003.                                              traffic deaths for children ages 0-14 in Virginia was $1.5
                                                                     million in 2000-2004 (in 2005 dollars) as compared to the
Unintentional suffocation (57) was the leading cause of              national average cost per case of $1.4 million.
injury deaths for children under age 1 in Virginia during the
period 2000-2004, while homicide (34) other and unspeci-             The average cost per case of suicide deaths for teens ages
fied accounted for the second and third leading causes of             15-19 in Virginia was $1.9 million in 2000-2004 (in 2005
injury deaths for this age group.                                    dollars) as compared to the national average cost per case
                                                                     of $1.8 million.
Unintentional motor vehicle traffic crashes (790) were the
leading cause of injury deaths for children and teens ages
1-19 in Virginia during the period 2000-2004.
IVP Health Status Indicators

                                    Nonfatal Injury Health Status Indicators, Virginia 2003‐2007                                                                                       Fatal Injury Health Status Indicators, Virginia 2003‐2007
                              300                                                                                                                                 30

                                                                                  252.8                                                                                                                                                              25.4
                                                                                                                                                                  25                                                                                                       23.8
                              250
                                                                                                                                                                                21.7                       21.8                  22.3




                                                                                                                                     Rate per 100,00 population
            ,000 Population




                                                            203.3                                                         202.5
                                    189.4                                                             186.5                                                       20
                              200




                                                                                                                                                   00
                              150                                                                                                                                 15
Rate per 100,




                                                            106.8                 101.1               106.1
                                    95.1                                                                                   92.3
                              100                                                                                                                                 10
                                                                                                                                                                                 6.6                       7.1                     7                                        6.4
                                                                                                                                                                                                                                                       6

                               50                                                                                                                                  5             2.7
                                                                                                                                                                                                           1.9                    2.3                 1.7                   1.9
                                    17.1                    18.4                   14.4               15.2                 12.9

                                0                                                                                                                                  0
                                    2003                    2004                   2005               2006                 2007                                                2003                    2004                      2005                2006                  2007
                                                                                   Year                                                                                                                                          Year
                                      Injuries 0-14 years          Motor Vehicle Crashes 0-14 Years    Motor Vehicle Crashes 15-24                                     Unintentional Injuries 0-14 years         Motor Vehicle Crashes 0-14 years   Motor Vehicle Crashes 15-24 years




The Maternal and Child Health Bureau requires every state to report on 12 Health Status Indicators. Six of the indicators relate to IVP.



State Performance Measures                                                                                                           • The Virginia Department of Education should develop
                                                                                                                                     information which incorporates principles of child safety
Virginia adopted the following injury-related State Perfor-                                                                          and injury prevention into the appropriate curriculum,
mance Measure in the 2005 Maternal and Child Health                                                                                  including the dangers of shaking or striking a child and age
5-year Needs Assessment:                                                                                                             appropriate discipline strategies and child development
                                                                                                                                     markers.
The unintentional injury hospitalization rate for children
aged 1-14 per 100,000.                                                                                                               • The Department of Corrections should develop and
                                                                                                                                     implement a parenting and domestic violence curriculum
Priority Needs                                                                                                                       for persons incarcerated in Virginia’s prisons.

Virginia did not select any injury-related priority needs in                                                                         • [Health care providers should] be knowledgeable about
the 2005 Maternal and Child Health 5-year Needs                                                                                      the interpersonal dynamics of child abuse and neglect and
Assessment.                                                                                                                          the signs and indicators of child abuse and neglect. Objec-
                                                                                                                                     tively assess injury patterns among infants and children.
Child Death Review (CDR) Report                                                                                                      When appropriate, consult a colleague with expertise
                                                                                                                                     in child abuse and neglect-related injuries for a second
Recommendations
                                                                                                                                     opinion.
The Virginia State Child Fatality Review Team 2005 Report
includes the following injury-related recommendations:                                                                               • Develop collaborative initiatives with other agencies,
                                                                                                                                     such as schools, public health departments, churches, and
• The Virginia Department of Social Services (VDSS) and                                                                              domestic violence shelters, to address the impact of family
the Virginia Department of Health’s Office of Family Health                                                                           violence on infants and children.
Services (OFHS) should collaborate on the development
and promulgation of educational materials that encourage                                                                             • Caretakers should be educated that they should never
child protection and prevent child abuse and neglect.                                                                                shake a baby. Shaking a baby is not a safe way to calm
                                                                                                                                     infants, and can result in severe injury or death.
• Caretakers should follow age-appropriate safe sleeping       Examples of IVP Programs
practices with infants and children, such as placing infants
on their backs to sleep.                                       • Child Sexual Abuse Prevention -- The Virginia
                                                               Sexual Violence State Planning Advisory Board developed
• Caretakers should avoid high-risk co-sleeping arrange-       and oversees the implementation of the Virginia Sexual
ments, such as putting an infant or a child to bed in an       Violence State Plan. One of the objectives of this plan
adult bed and co-sleeping with adults who have abused          is to “provide a Statewide Hotline to provide options
alcohol or drugs.                                              for callers who suspect someone of being a perpetrator
                                                               or for callers who are perpetrators.” After investigat-
                                                               ing the options for meeting this objective, the Advisory
Injury Prevention Strategic Plan                               Board decided to contract for these services with Stop
                                                               It Now!, a national nonprofit organization that already
Virginia currently has three strategic plans for injury        had a helpline in place. The Virginia Department of
prevention:                                                    Health (VDH) – which is overseeing implementation of
                                                               the helpline - provided Stop It Now! with resources and
Commonwealth of Virginia’s Strategic Highway Safety            referrals specific to Virginia so the residents of the Com-
Plan 2006-2010                                                 monwealth will have access to local information, referrals,
http://www.vahealth.org/civp/VIPP/strategicplan.asp            and resources, in addition to the national information,
                                                               referrals, and resources that the typical helpline caller
Suicide Prevention Across the Life Span Plan for the           receives.*
Commonwealth of Virginia
                                                               *Excerpted from: Children’s Safety Network. (2005). Spotlight
http://www.vahealth.org/civp/VIPP/strategicplan.asp
                                                               on the states: Preventing child sexual abuse in Virginia. Newton, MA:
                                                               Education Development Center.
The Virginia Strategic Plan for Pedestrian Safety
2005-2010
                                                               • School Safety -- The Virginia Division of Injury and
http://www.vahealth.org/civp/VIPP/strategicplan.asp
                                                               Violence Prevention Program (DIVP), funded in part with
                                                               Title V grant dollars, partners with the Division of Child
                                                               and Adolescent Health and the State’s Department of
                                                               Education (DOE) to support school nurses. DIVP staff
                                                               participate in an annual summer institute that provides
                                                               training and resources to school nurses. In addition, DIVP
                                                               partners with school nurse consultants and the DOE on
                                                               the development, dissemination, and promotion of school
                                                               safety guidelines for all Virginia schools. The Virginia
                                                               Health Department also supports bullying prevention in
                                                               schools and uses bullying prevention resources from the
                                                               Stop Bullying Now Campaign. **
                                                               **Excerpted from: Children’s Safety Network. (2008). Weaving
                                                               a safety net: Integrating injury and violence prevention into Maternal
                                                               and Child Health programs. Newton, MA: Education Development
                                                               Center.
IVP Grants and Contacts                                       Contact Information

CDC Core Injury Prevention Grant                              MCH and IVP Contact Information
Grant Recipient: Virginia Department of Health
Contact Person: Erima S. Fobbs, erima.fobbs@                  MCH Director:
vdh.virginia.gov
                                                              Janice Hicks, janice.hicks@vdh.virginia.gov
CDC Rape Prevention and Education Grant
Grant Recipient: Center for Injury and Violence Prevention,   IVP Contact:
Virginia Department of Health                                 Erima Fobbs, erima.fobbs@vdh.virginia.gov
Contact Person: Rebecca Odor, becky.odor@vdh.virginia.gov
                                                              Other Contacts
Readiness and Emergency Management
for Schools Discretionary Grant Program                       The following programs may exist within your state
(FY2008)                                                      and can be important resources for you to work
Grant Recipient: Loudoun County Public Schools,               with in the development and implementation of
Ashburn, VA
                                                              IVP initiatives: Injury Free Coalition for Kids, Level I
Contact Person: Robert Burke
                                                              Trauma Center Pediatric Sites, and Safe Kids Coali-
Grant Recipient: Chesterfield County Public Schools,           tions. Call Jennifer Allison, CSN’s State Outreach
Chesterfield, VA                                               Coordinator, at 617-618-2918 to get the most recent
Contact Person: Timothy Mallory                               contact information for these programs.

Grant Recipient: Dinwiddie County Public Schools,
Dinwiddie, VA
Contact Person: Marie Grant

Grant Recipient: Russell County Public Schools, Lebanon, VA
Contact Person: Lorraine Turner

Grant Recipient: Roanoke City Public Schools, Roanoke, VA
Contact Person: Mac Westland

SAMHSA State,Tribal, and Territory Youth                      Children’s Safety Network is funded by the Maternal
Suicide Prevention and Early Intervention                     and Child Health Bureau, Health Resources and
Grant Program                                                 Services Administration, U.S. Department of Health
Grant Recipient: Virginia State Department of Health          and Human Services.
Contact Person: Calvin Nunnally, Sr., suicide prevention
program manager, calvin.nunnally@vdh.virginia.gov

                                                              Children’s Safety Network
                                                              55 Chapel Street
                                                              Newton, Massachusetts 02458

                                                              617.618.2918 (phone)
                                     CHILDREN’S SAFETY NETWORK
                                   A RESOURCE FOR CHILD AND ADOLESCENT INJURY AND VIOLENCE PREVENTION
                                                                                                                       Virginia Fact Sheet, 2008
National Performance Measures Related to Injury and Violence
The Federal Maternal and Child Health Bureau Block Grant program requires State MCH programs to report
on 18 National Performance Measures (NPM), two of which directly address injuries. Figure 1 (NPM #10)
shows the trend in the rate of deaths for children aged 14 years and younger caused by motor vehicle crashes.
In the United States, the average rate of unintentional motor vehicle (MV) deaths for children aged 0-14 during
2001-2005 is 3.51 per 100,000 population. Figure 2 (NPM #16) shows the trend in the rate of suicide deaths
among youths aged 15-19. In the United States, the average rate of suicide deaths among youths aged 15-19 for
this same period is 7.69 per 100,000 population. Figure 3 compares the cost per individual case between the
state and the United States for childhood MV traffic deaths and youth suicides.
                                     4                                                                                10
                                                                                                                                                   8.20




                                                                                        State age-adjusted rate per
                                                                                                                           7.93            7.91            7.66
State age-adjusted rate per




                                          3.70                                                                        8            7.42
                                                    3.53      3.53    3.55
                                     3




                                                                                            100,000 population
                                                                               3.21
    100,000 population




                                                                                                                           7.71            7.25    7.41    6.70
                                                              3.01                                                                 6.20
                                                                                 2.68                                 6
                                     2     2.26     2.30
                                                                      2.14
                                                                                                                      4
                                     1
                                                                                                                      2
                                             US                                                                               US
                                             VA                                                                               VA
                                     0                                                                                0
                                          2001      2002      2003   2004     2005                                         2001    2002   2003    2004     2005

                                      Figure 1. The rate (per 100,000) of                                              Figure 2. The rate (per 100,000) of
                                      unintentional motor vehicle traffic deaths                                       suicide deaths among youths aged 15-19,
                                      among children aged 0-14, VA and US,                                             VA and US, 2001-2005 *
                                      2001-2005*

                                    $2     US                        $1.9
Costs in millions (2005 dollars)




                                           VA
                                             $1.5
                                                                             $1.8
                                                                                             Definitions
                                   $1.5              $1.4
                                                                                                                      Medical costs include payments for
                                                                                                                      hospital and physician care, as well as
                                     $1
                                                                                                                      emergency medical transport,
                                                                                                                      rehabilitation, prescription drugs, allied
                                   $0.5                                                                               health services, medical devices, and
                                                                                                                      insurance claims processing. For fatalities,
                                                                                                                      coroner and premature burial expenses
                                    $0
                                           Unintentional             Completed                                        are included.
                                          MV traffic deaths           suicides
                                                                                                                      Productivity costs include immediate and
                                   Figure 3. Average individual costs per case                                        future work losses (e.g., wages, fringe
                                   of unintentional motor vehicle traffic deaths                                      benefits, schoolwork, and housework) due
                                   (aged 0-14) and completed suicides (aged                                           to a childhood injury.
                                   15-19) in VA and the US, 2000-2004**

* Reference: Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) (2008). CDC WISQARS On-line Database,
compiled from Compressed Mortality File 2001-2005. Report retrieved March 10, 2008.
** Note: These estimated annual costs combine medical and productivity costs (see Definitions box above). Totals have been rounded and may not equal
previously published cost estimates. For comparable hospital costs, see www.hsc.wvu.edu/icrc/AHRQFORM.asp.
Understanding injury rankings among other causes of death is important in determining their physical and
economic role in each state. Although, injuries are the leading cause of death for ages 1-34, knowing what
types of injuries cause the majority of deaths and hospitalizations can inform program planning and
development efforts. Table 1 shows the top 5 causes of death by age group in the state. Table 2 shows the top 5
causes of injury death by age group in the state.



          Table 1. Leading Causes and Total 5-Year Incidence of Death by Age Group, Virginia, 2000-2004

                                                                                                                                     All Ages
   Rank                <1                    1-4                     5-9                 10-14                  15-24              (<1 to 65+)
      1             Short              Unintentional           Unintentional         Unintentional         Unintentional              Heart
                   Gestation              Injury                  Injury                Injury                Injury                 Disease
                     728                   166                     122                   138                  1,719                  74,169
      2           Congenital             Congenital             Malignant             Malignant              Homicide              Malignant
                  Anomalies              Anomalies              Neoplasms             Neoplasms                642                 Neoplasms
                     655                    61                     53                    63                                         67,641
      3              SIDS                Malignant               Homicide              Homicide                Suicide               Cerebro-
                     363                 Neoplasms                 24                    34                     470                  vascular
                                            50                                                                                        19,919
      4           Maternal                Homicide              Congenital              Suicide             Malignant             Chronic Low.
              Pregnancy Comp.               44                  Anomalies                 32                Neoplasms             Respiratory
                    253                                            23                                          202                  14,029
      5           Placenta                 Heart            Heart          Septi-     Congenital               Heart              Unintentional
              Cord Membranes              Disease          Disease         cemia      Anomalies               Disease                 Injury
                    133                      36               10            10           28                     134                  12,581



    Table 2. Leading Causes and Total 5-Year Incidence of Injury Deaths by Age Group, Virginia, 2000-2004

                                                                                                                                     All Ages
   Rank                <1                    1-4                     5-9                 10-14                  15-19              (<1 to 65+)
      1          Unintentional         Unintentional           Unintentional         Unintentional         Unintentional          Unintentional
                  Suffocation              MVT                     MVT                   MVT                   MVT                    MVT
                      57                    45                      46                    77                   622                   4,787
      2        Homicide Other          Unintentional           Unintentional           Homicide              Homicide                Suicide
                Spec/Clasfbl            Fire/Burn               Drowning                Firearm               Firearm                Firearm
                    23                      37                      27                     28                   200                   2,388
      3           Homicide             Unintentional           Unintentional         Unintentional            Suicide             Unintentional
                 Unspecified            Drowning                Fire/Burn             Drowning                Firearm              Poisoning
                     11                     33                      23                    24                     97                  2,042
      4        Unintentional Uninten Homic                       Homicide              Suicide               Suicide              Unintentional
              Drown      MVT Suffoc Unspec                        Firearm             Suffocation           Suffocation               Fall
                8         8    20      20                            15                   17                    59                   1,712
      5          Unintentional        Homicide Other           Unintentional            Suicide            Unintentional            Homicide
                  Fire/Burn            Spec/Clasfbl             Other Land              Firearm             Poisoning                Firearm
                       7                    7                   Transport                  12                   47                    1,476
                                                                     8


MVT = Motor Vehicle Traffic. Spec/Clasfbl = Specified/Classifiable. Suffoc = Suffocation. Drown = Drowning. Unspec = Unspecified. Uninten =
Unintentional. Homic = Homicide.
Table 3 shows the top 5 causes of injury hospitalization by age group. Figures 4 and 5 compare the medical and
productivity costs per individual case between the state and the United States for youth motor vehicle traffic
(MVT) injuries and youth self-inflicted injuries for hospitalizations, respectively.


                                              Table 3. Leading Causes and Annual Incidence of Hospital-Admitted Injuries by Age Group,
                                                                             Virginia Residents, 2003
                                                                                                                                                                                         All Ages
                                    Rank               <1             1-4                 5-12                                                13-15               16-20                (<1 to 65+)
                                     1          Unintentional     Unintentional       Unintentional                                        Self-Inflicted     Unintentional        Unintentional
                                                    Fall              Fall                Fall                                                  197               MVT                  Fall
                                                     59               148                 284                                                                     616                 16,601
                                     2           Unspecified      Unintentional       Unspecified                                          Unspecified        Self-Inflicted           Unspecified
                                                     56            Poisoning             145                                                  154                  587                   8,143
                                                                      100
                                     3          Unintentional     Unspecified         Unintentional                                        Unintentional      Unspecified          Unintentional
                                                   Other              71                  MVT                                                  Fall              323                   MVT
                                                     41                                   102                                                  118                                    4,740
                                     4          Undetermined      Unintentional       Unintentional                                        Unintentional          Assault           Self-Inflicted
                                                     21            Fire/Burn        Struck By/Against                                          MVT                 241                 4,445
                                                                       55                  77                                                   99
                                     5               Assault      Unintentional       Unintentional                                        Unintentional      Unintentional        Unintentional
                                                       20            Other            Pedal Cyclist,                                         Struck By/           Fall                Other
                                                                       54                Other                                               Against              176                 2,144
                                                                                           58                                                   58


Spec/Clasfbl = Specified/Classifiable. OL Trans = Other Land Transport. Suffoc = Suffocation. Drown = Drowning. Unspec = Unspecified.




                                     $80                                                                                                   $12                                          $11.00
                                                                    $73.50
Costs in thousands (2005 dollars)




                                                                                                       Costs in thousands (2005 dollars)




                                                US                                                                                                    US
                                                VA                                                                                         $10        VA
                                                                             $57.90
                                     $60
                                                                                                                                            $8                                 $7.50
                                                                                                                                                              $6.70
                                     $40                                                                                                    $6
                                                $27.90                                                                                                $4.30
                                                                                                                                            $4
                                                         $18.00
                                     $20
                                                                                                                                            $2

                                         $0                                                                                                 $0
                                                  Medical            Productivity                                                                       Medical                Productivity

                                     Figure 4. Average individual costs per case                                                           Figure 5. Average individual costs per case
                                     of nonfatal, unintentional hospital-admitted                                                          of nonfatal, hospital-admitted self-inflicted
                                     MVT injuries, ages 0-15, in VA and the US                                                             injuries, ages16-20, in VA and the US
                                     (Based on Year 2003 Incidence)                                                                        (Based on Year 2003 Incidence)
                      State Performance Measures Related to Injury and Violence
The Virginia State MCH program reports on one State Performance Measure (SPM) that addresses injury and
violence. Figure 6 (SPM #4) shows the trend in the rate of unintentional injury hospitalizations among children
aged 1-14.


                                                                          140
                                                                                        135.2


                                            Rate per 100,000 population
                                                                          135

                                                                          130
                                                                                                        124.9
                                                                          125   125.0

                                                                          120                   121.4
                                                                                                                120.1

                                                                          115
                                                                                2003    2004    2005    2006    2007†
                                                                          Figure 6. The rate of unintentional injury
                                                                          hospitalizations among children aged 1-14
                                                                          (per 100,000), 2003-2007*


†2007 data are provisional since these data were unavailable at this time. This indicator is an estimate based on trend. *Reference: MCH Bureau (2008).
MCH Services Title V Block Grant: State Narrative for Virginia. Report retrieved March 10, 2008.




                                            FOR MORE INFORMATION, PLEASE CONTACT:
                        CSN National Resource Center                CSN Economics and Data Analysis Resource Center
                        55 Chapel Street                            11720 Beltsville Drive, Suite 900
                        Newton, MA 02458                            Calverton, MD 20705
                        (617) 618-2230 | csn@edc.org                (301) 755-2728 | sheppard@pire.org
                        http://www.ChildrensSafetyNetwork.org       http://www.ChildrensSafetyNetwork.org


Children’s Safety Network is funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S.
Department of Health and Human Services.
CSN works closely with several key partners, including the National Child Death Review Resource and Policy Center, located at the
Michigan Public Health Institute, and the Suicide Prevention Resource Center, located at the Education Development Center, Inc.
                                         Fatal Motor Vehicle Traffic Injury Rates, Ages 15‐18 and 19‐24 and Fatal Unintentional Injury 
                                                                      Rates, Ages 15‐18, Virginia2002‐2006
                                  35.0           32.0
                                                                                                                                                                              29.8
                                  30.0                                                                                                     28.3
                                                26.2                     27.0                          27.2
    Rate per 100,000 population




                                  25.0                                                                                                                                        27.1
                                                26.7                            24.7                    25.6                               24.7
                                  20.0
                                                                         21.8
              00,000




                                                                                                        20.1                               19.6                               19.6
                                  15.0
                                  15 0

                                  10.0

                                   5.0

                                   0.0
                                                 2002                    2003                           2004                               2005                               2006
                                                                                                        Year
                                    Unintentional Injuries 15-18 years       Motor Vehicle Crashes 15-18 years                               Motor Vehicle Crashes 19-24 years

SOURCE: Centers for Disease Control and Prevention. National Center for Injury Prevention and Control (NCIPC). Web-based Injury Statistics Query and Reporting System (WISQARS), Fatal Injury
Reports (2009). Available from: URL: http://www.cdc.gov/injury/wisqars/index.html. Accessed April 2009.


CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human Services). A project of the Education
                                                                                           Development Center, Inc.
                                                                 Cost of Child Abuse and Neglect in Virginia
                                                                   (Year 2006 Incidence, Year 2007 Costs)
Abuse Type                  Future Earnings           Medical Care    Mental Health Property Damage                           Public Programs            Quality of Life        Total
     Sexual Abuse                $6,303,700             $1,692,100       $19,717,800                     $0                         $2,773,800            $277,078,700   $307,566,100
   Physical Abuse               $19,672,900             $5,097,800       $17,407,200              $116,100                          $9,311,800            $335,148,600   $386,754,400
     Mental Abuse                  $465,700                     $0        $1,535,900                     $0                           $820,000             $10,860,500    $13,682,100
   Serious Neglect                 $469,000                $65,000       $19,679,000                     $0                        $12,527,600            $154,589,300   $187,329,900
             Fatal              $80,820,700             $1,425,500          $409,700               $64,900                             $79,200            $204,740,300   $287,540,300
Total                          $107,732,000             $8,280,400       $58,749,600              $181,000                         $25,512,400            $982,417,400 $1,182,872,800

Definitions:
Medical Care includes payments for hospital and physician care, as well as emergency medical transport, rehabilitation, prescriptions, allied health services, medical devices, and
insurance claims processing. For fatalities, also include coroner and premature burial costs.
Mental Health Care includes payments for services by psychiatrists, psychologists, social workers, and pastoral counselors. Also includes insurance claims processing.

Future Earnings includes wages, fringe benefits, schoolwork, and housework lost by the injured. This estimate excludes earnings lost by family and friends caring for the injured.

Public Programs include police, fire, paramedic, ambulance, and helicopter transport costs. Social services and victim assistance costs are also included in this category. It excludes
mental health services costs.
Property Damage and Loss is the value of property damage and of property taken and not recovered.
Quality of Life places a dollar value on pain, suffering and lost quality of life to the victim and their family. The value is computed from jury awards for pain, suffering, and lost quality
of life due to physical injuries and fear. For murders, this value is computed from the amount people routinely spend (in dollars or time) to reduce their risk of death.


Source:
Children's Safety Network-Economics and Data Analysis Resource Center, at the Pacific Institute for Research and Evaluation, Calverton, MD, 2009. The costs were adapted to
Virginia using a state-specific price adjusters. All costs were calculated using incidents reported in the Child Maltreatment 2006, National Center on Child Abuse and Neglect Data Set.
For more information contact Monique Sheppard at msheppard@pire.org.

 CSN (www.childrenssafetynetwork.org) is funded by the Health Resources and Services Administration's Maternal and Child Health Bureau (U.S. Department of Health and Human
                                                                                  Services).
                                                             A project of the Education Development Center, Inc.

				
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