Objective To quantify how changes in reporting of specific causes of death and of selecting underlying cause from among multiple causes of death contribute to trends in mortality from unintentional injury in Americans aged 65 years or older. Methods We extracted age-standardized unintentional injury mortality data in the United States Centers for Disease Control and Prevention online databases from 1999 to 2016. We used an attribution method to calculate two indicators: the proportion of mortality with specific codes out of all mortality; and the proportion of mortality with underlying cause of death selected from multiple causes of death. We conducted a linear regression to examine the changes over time in these proportions and in reported and age-adjusted mortality. Findings From 1999 through 2016, the proportion of cause-specific unintentional injury mortality in this age group increased from 74% in 1999 (136.9 out of 185.0 per 100 000 population) to 85% in 2016 (143.0 out of 169.1 per 100 000 population) based on multiple causes of death codes. The proportions of mortality with underlying cause of death selected out of multiple causes of death rose in all specific causes of unintentional injury except motor vehicle crash. Age-standardized mortality attributed to reporting changes increased steadily between 1999 and 2016. The increases for overall unintentional injury, fall, motor vehicle crash, suffocation, poisoning and fire or hot object were 24.2, 13.5, 2.1, 2.3, 1.6 and 0.4 deaths per 100 000 persons, respectively. Conclusion Changes in data reporting affect trends in overall and specific unintentional injury mortality over time for older Americans.
|Translated title of the contribution||Changes in reporting of unintentional injury deaths, United States of America|
|Number of pages||10|
|Journal||Bulletin of the World Health Organization|
|State||Published - Mar 2019|
Bibliographical noteFunding Information:
Injury mortality data reporting in the United States has changed significantly over 1999–2016 in both the reporting of the specific causes of death and in the selection of underlying cause of death from multiple causes of death. These changes created an apparent contribution to increasing unintentional injury mortality for Americans aged 65 years and older and significantly altered trends in overall and specific unintentional injury mortality. The potential impact of changes in data reporting should be considered by researchers, policy-makers and other stakeholders who interpret and use the data. ■ Funding: This study was supported by the Natural Science Foundation of China (No. 81573260).
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