Injury Demographics

The rising cost of health care in the U.S. is unsustainable. There is considerable evidence regarding the association between lower socioeconomic status and increased risk of morbidity and mortality (Brownell et al., 2010, Ziller et al., 2020). Factors associated with this risk include socioeconomic status for a specific geographic region (Messner et al., 2010, Harper et al., 2015).

Analyzing the Data

The purpose of this analysis is to identify a potential association between homicides, motor vehicle accidents, and injuries based on poverty rates for each county and state.

This data is also available in a text-based table format.

Tutorial: Using the Data

Data Sources

County Health Ranking (data released 2020)

Note: Because the number of events for an indicator may be too small to report for a county for any single year, data were aggregated over several years (3, 5 or 10 years depending on county population) for the measures of birth and death to increase the number of counties with available data. Data was aggregated for counties that have a population size less than 25,000 from years 1996-2005. Counties with a population between 25,000 and 99,999 include data that was aggregated from years 2001-2005. Finally, counties that have a population size greater than 100,000 include data that was aggregated from years 2003-2005. Death rates were age-adjusted to the year 2000 standard calculated by the Health Resources and Services Administration. Mortality data were from the National Center for Health Statistics, National Vital Statistics System, 1996–2005 for the ICD-9/ICD-10 codes listed after each variable.

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviated name of the state where the county is located.

County: The name of the county where the information was collected. County names are listed as provided on the U.S. Census Bureau's list of 2019 FIPS Codes for Counties and County Equivalent Entities.

Population Size: The total number of individuals residing in the county. The data is derived from the Census Population Estimates from 2018.

Motor Vehicle Accidents: Motor vehicle crash deaths are the number of deaths due to traffic accidents involving a motor vehicle per 100,000 population from the Centers for Disease Control and Preventioni Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) mortality data from 2012 through 2018.

Injury Deaths:  The number of deaths from intentional and unintentional injuries per 100,000 population. Deaths included are those with an underlying cause of injury (ICD-10 codes *U01-*U03, V01-Y36, Y85-Y87, Y89) from CDC WONDER mortality data from 2014 through 2018.

Homicides: An estimate of the number deaths due to homicide per 100,000 population from CDC WONDER mortality data from 2012 through 2018.

Drug Overdose Deaths: The number of deaths due to drug poisoning per 100,000 population from CDC WONDER mortality data from 2016 through 2018.

Alcohol-Impaired Driving Death Rate: The percentage of motor vehicle crash deaths with alcohol involvement from the Fatality Analysis Reporting System from 2014 through 2018.

Premature Deaths: The number of deaths under age 75 from the National Center for Health Statistics - Mortality files from 2016 through 2018.

Uninsured Rate: The estimated number of individuals in the county under age 65 without health insurance. Data is from the Small Area Health Insurance Estimates (SAHIE) Program from 2017.

Children in Poverty Rate: The percentage of children under age 18 living in poverty. Poverty status is defined by family; either everyone in the family is in poverty or no one in the family is in poverty. Data is from the Small Area Income Poverty Estimates (SAIPE) in 2018.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.