Injury Patterns

• Deaths: Major Causes
• Trends 1979-1993
• Changing rates at different ages.
• Different risks in different places
• Hospitalisations:Major Causes
• Changing rates at different ages.

Deaths: Major Causes

Table 2: External Causes (excluding medical misadventure) deaths: counts and rates for males aged 15-29 years, Australia 1993

Cause	No. deaths			Total	Rate (per 100,000)			Total
	15-19	20-24	25-29	15-29	15-19	20-24	25-29	15-29
Transportation	223	298	198	719	33.5	40.5	29.0	34.5
Drowning	24	17	21	62	3.6	2.3	3.1	3.0
Poisoning, pharmaceuticals	7	20	40	67	1.1	2.7	5.9	3.2
Poisoning, other substances	7	8	6	21	1.1	1.1	0.9	1.0
Falls	4	13	14	31	0.6	1.8	2.1	1.5
Fires/flame/scalds	2	5	5	12	0.3	0.7	0.7	0.6
Other unintentional	21	25	35	81	3.2	3.4	5.1	3.9
Self inflicted	111	234	200	545	16.7	31.8	29.3	26.1
Violence related	10	25	28	63	1.5	3.4	4.1	3.0
Undetermined intent	3	10	6	19	0.5	1.4	0.9	0.9
Total	412	655	553	1620	61.9	89.0	80.9	77.8

Trends 1979-1993

Since 1979 only transportation deaths have decreased for 15 to 29 year old males (Figure 2). Other non-intentional and violence related death rates have remained remarkably stable. The other non-intentional group is however very diverse and there may have been improvements in some specific causes which are not reflected at the broad level.

Changing rates at different ages.

It was noted earlier that the injury rate is not consistent across the three five-year age bands from 15 to 29. Figures 3a and 3b show how rates vary by single year of age. Figure 3a represents cumulative figures as an stacked column chart which reflects overall changes. Death rates are much higher for 18 year olds than 15 year olds. There is a high plateau with a slight upward trend between 18 and 23 and the commencement of the establishment of the middle adulthood pattern starting at age 24. It must be remembered that this study considers a cross section and does not compare the rates of different cohorts at a particular age.

The major causes show differing patterns. The transport related death rate rises rapidly between 15 and 18. Suicide also climbs, but not quite so steeply and peaks among age 23 year olds. The other non-intentional injury rate rises slowly and peaks at 25, while the violence related death rate increases slowly across the age range.

Different risks in different places

Injury death to young males is more likely to occur in rural and remote areas than in densely populated areas (Figure 4). This is consistent with a similar pattern for all age groups. The major component of the city-country differential in accidental injuries is transport. For further detail see Australian Injury Prevention Bulletin 8 [19]. Suicide rates for young males are higher in "rural other" and "remote other" areas but this is not the case for young females. Violence related death is more common in remote areas outside major centres.

Hospitalisations: Major Causes

At the inpatient level, a different pattern emerges. While transport and suicide are still important, other accidental causes including falls, and violence related injury can be seen as more prominent. Table 3 and Figures 5a and 5b show this in more detail. The pattern of transport related death is not simple. Australian Injury Prevention Bulletin 9 for example showed that among 20 to 24 year old males there were more admissions of motor cycle riders than motor vehicle drivers [20].

Table 3: External causes (excluding medical misadventure) hospital separations: counts and rates for males aged 15 to 29 years Australia (except NT) 1991-2 financial year

Cause	No. separations			Total	Rate (per 100,000)			Total
	15-19	20-24	25-29	15-29	15-19	20-24	25-29	15-29
Transportation	5351	4933	3321	13605	806.2	738.2	506.6	684.5
Drowning	29	40	11	80	4.4	6.0	1.7	4.0
Poisoning, pharmaceuticals	585	749	656	1990	88.1	112.1	100.1	100.1
Poisoning, other substances	201	192	183	576	30.3	28.7	27.9	29.0
Falls	3001	2740	2386	8127	452.1	410.0	364.0	408.9
Fires/flame/scalds	322	380	299	1001	48.5	56.9	45.6	50.4
Other unintentional	8686	10010	8402	27098	1308.6	1498.0	1281.6	1363.4
Intentional, self inflicted	760	1063	901	2724	114.5	159.1	137.4	137.1
Intentional, inflicted by another	1947	2884	2153	6984	293.3	431.6	328.4	351.4
Undetermined intent	105	143	128	376	15.8	21.4	19.5	18.9
Total	20987	23134	18440	62561	3161.9	3462.0	2812.8	3147.6

Note: rate calculations are based on Census 1991 populations. See data issues page.

Changing rates at different ages.

The differences between rates at each single year of age are not as marked as for deaths. The rise from 15 to 18 years is still apparent but not as steep as shown for deaths. The dominant feature of separations data is the importance of other non-intentional causes. A finer breakdown of external causes codes can provide a little more information but, the limitation of these codes still makes a clear understanding of the underlying patterns difficult. A review of emergency department data based on a different coding system is used to better understand the finer details.

19. Moller J. The spatial distribution of injury deaths in Australia: urban, rural and remote areas. Australian Injury Prevention Bulletin 8, 1994.

20. Dolinis J, O'Connor PJ, Trembath RF. Injury experience of Australia's unprotected road-users. Australian Injury Prevention Bulletin 9, 1995.