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Deaths from violent and unintentional injuries surged in 2014-’16, after years of decline

“All injuries from gunshot wounds to car accidents have been going up,” said Dr. Angela Sauaia, the study’s senior author.

Dr. Angela Sauaia, the study’s senior author: “All injuries from gunshot wounds to car accidents have been going up.”
REUTERS/Ralph Freso

After declining for a more than a decade, the rate at which Americans are dying from violent and unintentional injuries jumped significantly between 2014 and 2016, according to a recent study published in JAMA Surgery.

“All injuries from gunshot wounds to car accidents have been going up,” said Dr. Angela Sauaia, the study’s senior author and a professor of public health, medicine and surgery at the University of Colorado, in a released statement.

Sauaia and her study co-authors call this sudden reversal of what had seemed like a promising downward trend “alarming,” particularly since the reasons for the turnaround are not clear.

Accidental injuries alone (without including homicides or suicides) are the fourth-leading cause of deaths in the United States, resulting in almost 150,000 deaths in 2016, according to the Centers for Disease Control and Prevention (CDC). 

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And among people under the age of 45, injuries are the leading cause of death.

Study details

For the study, Sauaia and her colleagues used the online WISQARS (Web-based Injury Statistics Query and Reporting System) database, which contains death certificate data and other information collected by the CDC’s National Vital Statistics System. The researchers focused on data from the years 2000-2016, looking to see what changes in the rates of fatal injuries had occurred during that 17-year period.

They separated the injuries into three main categories: homicides, suicides and unintentional. The unintentional category included different types of accidental deaths, including those caused by falls and motor vehicles. They also looked at the injuries by major racial/ethnic groups.

The analysis revealed that fatal injuries showed “large, significant increases from 2014 to 2016, reducing survival gains observed since 2001.” That trend was seen across all three categories of injuries and among all racial and ethnic groups.

Although specific numbers weren’t provided in the paper, Sauaia did cite them in an interview with a reporter for Harvard University’s Journalists Resource. She said that deaths resulting from violent injuries had climbed from 59,213 in 2014 to 64,876 in 2016 — an increase of 8 percent. 

Deaths due to nonviolent injuries rose from 135,928 in 2014 to 161,374 in 2016 — an increase of 15 percent.

Sauaia also said that these numbers are “certainly an underestimation of the problem,” given that most injuries do not result in death.

Additional findings

A deeper dive into the data revealed some additional findings: 

  • Blacks had the highest homicide rate of all the racial/ethnic groups throughout the entire period of the study, and they also experienced the biggest homicide-rate jump between 2014 and 2016. 
  • Two-thirds of the homicides were gun-related. 
  • The suicide rate was highest among whites throughout the study period. It increased steadily, however, for both whites and blacks during all 17 years of the study, with a small but significant acceleration starting in 2006. The suicide rate among Latinos began to increase starting in 2013. 
  • About half of the suicides were related to firearms, and these climbed significantly from 2006 to 2016 after a six-year decline.
  • Motor vehicle accidents also increased significantly from 2014 to 2016 following a decade of major declines.
  • Overall, motor vehicle accidents and other unintentional injuries spiked after 2014 among most age groups, except for children and teens aged 16 and under. Whites had the highest unintentional injury rate.

A major barrier to identifying solutions

“During the 1980s and 1990s, we saw much improvement in deaths due to most injury mechanisms, such as car accidents fatalities. Our study shows, however, that recent trends seem to be eroding these promising survival gains,” Sauaia told

“We are unclear about the causes of this recent increase in trauma-related deaths, but it is an alarming trend,” she added. 

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Sauaia also said she finds it disturbing “that we are talking about a major cause of death in our society and we have so little funding to do research for causes and solutions.”

“The funding for research in injury is dismal, especially for certain mechanisms, namely firearm-related injuries,” she explained. “It is one of the few such lethal conditions for which there is a single, known, avoidable cause. Yet, it is the only such lethal condition for which there is a controversial congressional ban on funding.” 

As I’ve noted in Second Opinion before, Congress has hampered researchers’ efforts to study the causes — and possible solutions — to gun violence with legislation known as the Dickey Amendment. Passed in 1996 under pressure from the National Rifle Association (NRA), it cut off CDC funding for gun violence research, a restriction that Congress extended to the National Institutes of Health (NIH) in 2011. 

After the shooting deaths of 20 children and six adults at the Sandy Hook Elementary School in 2012, President Obama launched a new NIH gun-research initiative, but that program was shelved within a few months of President Trump taking office.

What can be done now

Despite the barriers to research, Sauaia says that there are things that can be done now to reduce the number of Americans being killed by gun-related injuries. 

“Regardless of where you stand on guns, everyone agrees that children should not have access to loaded firearms,” she said. “And why not include as part of primary care, educating patients on firearm safety?” 

She also suggests that technology could be used to reduce injury-related deaths — through “smart guns” that unlock only for their owners and through apps that make it more difficult to text and drive.

“These growing rates [of injury-related deaths] warrant concerted, decisive efforts by academia, society and policy-makers to support trauma-focused research,” Sauaia and her co-authors conclude.

FMI: You’ll find an abstract of the study on the JAMA Surgery website, but the full study is behind a paywall.