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Ohio County Injury Profiles

Purpose of the County Injury Profiles

Injury is the leading cause of death for Ohioans ages 1 to 44 and the 5th-leading cause of death overall.  In 2010, injuries were associated with approximately 7,000 deaths, 72,000 inpatient hospitalizations, and 1.4 million visits to emergency departments (EDs).  

Ohio is a diverse state geographically with 88 counties ranging from metropolitan cities and suburban areas to rural and Appalachian counties.  Along with this diversity, injuries are not uniformly distributed across the state.  Counties have varying degrees of injury burden and concerns that are unique to their population and environment.  The purpose of the injury profiles is to document the leading causes of injury death, hospitalization, and ED visits at the state and county level.  The profiles provide a starting point for the development and enhancement of injury prevention efforts. 

 

Questions About the Profiles

 

Available County Profiles1,2,3

Allen  Green Montgomery
Ashtabula Hamilton  Portage 
Butler Lake  Stark 
Clermont Licking  Summit 
Clark  Lorain  Trumbull
Columbiana Lucas Warren 
Cuyahoga Mahoning Wayne 
Delaware  Medina  Wood 
Franklin  Miami   

 

1. Data Sources:  ODH Office of Vital Statistics, Ohio Hospital Association and Centers for Disease Control and Prevention.
2. County data are presented based on county of residence, not location of treatment or death.
3. Complete Methods

 

Injury in Ohio

Injury is the leading cause of death for Ohioans ages 1 to 44 and the 5th-leading cause of death overall.  In 2010, injuries were associated with approximately 7,000 deaths, 72,000 inpatient hospitalizations, and 1.4 million visits to emergency departments (EDs).  In addition, injuries resulted in over $13 billion in preventable medical costs and losses in worker productivity. In addition to economic and work loss, injuries result in quality-of-life loss costs including significant physical, emotional and financial effects.

The leading causes of injury death in Ohio are unintentional poisoning, suicide, motor vehicle traffic crashes, falls and homicide.  Falls are the leading cause of non-fatal injury for both hospitalizations and ED visits.  For more detailed age-specific information on the leading causes of injury, please see:  Leading Causes of all Injury by Age Group, Ohio. A comprehensive Burden of Injury in Ohio Report is also available. 

 

How to use the profiles?

The profiles can be used in a variety of ways including:

  • Raise awareness among the public and media about the impact of injuries at the state and county level in Ohio.
  • Educate policymakers at the national, state, and local level.
  • Provide data for county health impact assessments or other community needs assessments.
  • Use as a guide for planning injury prevention efforts and allocating resources.
  • Collaborate with surrounding counties, counties with similar challenges or the state to maximize injury prevention strategies and resources.

 

What you will find in the county profiles?

The profiles present the burden of injury at the state and county level first for deaths, hospitalizations and ED visits over time (page 1), then for leading injury mechanisms by severity (page 2) and then by leading mechanism across age categories for children/youth, adults and older adults (page 3).  Finally, a page (page 4) is devoted to a comparison of unintentional drug poisoning deaths, hospitalizations and ED visits at the state and county level due to the growing epidemic of drug overdose in Ohio over the past decade.  The profiles provide a snapshot of the injury burden at the county level for various time periods from 2000-2010 for deaths and 2002-2010 for hospitalizations and ED visits.  Please note that data are reported by county of residence, not location of death or hospital treatment.

How was the information in the profiles calculated?

The profiles provide information about injury deaths, hospitalizations, and ED visits among county residents.  The number of injury deaths, hospitalizations, and ED visits were divided by the total number of people in the county to calculate rates.  Rates were used to document trends occurring in the county over time as well as make comparisons among age groups within the county and document differences between the county and the state as a whole.  The rates were reported as the number of deaths, hospitalizations or ED visits per 100,000 county residents and have been age adjusted to account for any difference between the age distribution of the county’s population and the state’s population.  Data are reported by county of residence, not location of death or hospital treatment.

The profiles also include information on the cost of injuries among county residents.  Total costs were calculated by multiplying the number of injury deaths, hospitalizations, and ED visits among county residents by average cost estimates.  The average costs was developed by the Centers for Disease Control and Prevention (CDC) and based on national averages.  The estimates include costs associated with medical care and losses in worker productivity.

A detailed methods section is available here.

 

What are the data sources for the profiles?

The county profiles utilize three primary data sources.  

  1. The source for injury deaths is death certificates housed and maintained by the Office of Vital Statistics at the Ohio Department of Health (ODH).  Death certificates provide limited information about injury circumstances or contributing factors.  
  2. Hospital inpatient and emergency department (ED) discharge records are collected and maintained by the Ohio Hospital Association (OHA) from information provided by member hospitals.  OHA represents 167 member hospitals and 19 health systems throughout the state.  
  3. The third data source for the profiles is the CDC’s cost estimates for injuries.  This information can be found on the following website:  http://wisqars.cdc.gov:8080/costT/

A detailed methods section is available here.

 

Why is information about my county missing?

Information reporting is based on a quality standard developed by the VIPP.  The standard was based on the percentage of injury hospitalizations and ED visits with a documented external cause of injury code (E-code).  Injury rates were suppressed if the percentage of injuries among county residents with a documented E-code was lower than the state average for any given year.  The state E-coding average for injury hospitalizations was 63 percent and state average for ED visits was 72 percent in 2010.  A profile for a county was developed if the percentage of injuries with a documented cause (E-code) met or exceeded the state average for one or more years since 2002. 

A detailed methods section is available here

 

What is an injury?

The National Safety Council defines INJURY as: “Physical harm or damage to the body resulting from an energy exchange, usually acute mechanical (e.g., motor vehicle crash, falls), chemical (e.g., poisoning), thermal (e.g., fire/burn) or other environmental energy (e.g., hyperthermia, suffocation, drowning) that exceeds the body’s tolerance.”

Injuries can further be classified by the intent or purposefulness of occurrence in two categories:  intentional and unintentional injuries.  Intentional injuries are purposely inflicted and often associated with violence.  These include child and elder maltreatment, domestic violence, sexual assault, aggravated assault, homicide, and suicide.  Unintentional injuries include those that occur without intent of harm and are not purposely inflicted.

How are the causes of injuries identified in injury surveillance?

The cause, or mechanism, describes the way in which the person sustained the injury; how the person was injured; or the process by which the injury occurred.

The cause of injury is the underlying cause, rather than the direct cause. The underlying cause is what starts the chain of events that leads to an injury and produces the actual physical harm. The underlying and direct causes can be the same or different. For example, if a person cuts his or her finger with a knife, the knife is both the underlying and direct cause.  However, if a child falls and hits his/her head on a coffee table, the fall is the underlying cause (the action that starts the injury event), and the contact with the table is the direct cause (the action that causes the actual physical harm).  If we can prevent the underlying cause we can stop the injury from occurring. In other words, without the underlying cause, there would be no direct cause.   

However, efforts to prevent the direct cause of injury (e.g,. bicycle helmets, child safety seats, energy-absorbing playground surfacing, seat belts, air bags, smoke detectors,  etc.) can also be very effective and are an important part of a comprehensive injury prevention effort.

Information on causes of injury death is documented on the death certificate while causes of non-fatal injuries are documented in hospital discharge diagnosis codes.  For the purposes of injury surveillance using hospital discharge data, the underlying cause is considered the external cause of injury and is captured in external cause of injury codes, or E-codes.  These codes are critical to understanding injury prevention needs.  Injury causes are typically grouped into the following categories: cuts or pierces, drowning, falls, fire or burn, firearm, foreign body, suffocation, machinery, natural environment, bite or sting, overexertion, poisoning, transportation, and struck by or against.  Information on the manner or intent of injuries is also included within death and hospital data codes.

 

Last Reviewed 7/24/2014