Injury mortality among children and teenagers in the United States, 1993.

Correspondence to: Ms Lois A Fingerhut, Special Assistant for Injury Epidemiology, Office of Analysis, Epidemiology and Health Promotion, US Public Health Service Centers for Disease Control and Prevention, 6525 Belcrest Road, Room 750, Hyattsville, MD 20782, USA. With this edition of Injury Prevention, we are pleased to begin the annual submission of injury mortality rates for children and teenagers in the United States. The 1993 cause specific mortality data are from the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention, and are based on information reported on death certificates and filed in the 50 states and the District of Columbia. The tabular data conventions we have adopted in the accompanying table were arrived at after long and significant deliberations, and are the product of a collaborative effort in the injury control community in the United States'2 with assistance from the National Center for Injury Prevention and Control and NCHS. Standard definitions of external causes of injury mortality (and morbidity) are crucial for improving comparability across populations. In addition, standardizing definitions will facilitate the dissemination of data and other resources needed for the effective implementation of injury prevention programs. The mortality data shown in the following table are presented by the two axes of the external cause of injury and poisoning codes in the International Classification of Diseases, 9th revision (ICD-9 E-codes): (1) mechanism or cause of death and (2) intent of injury or manner of death. This method of data presentation more effectively presents the impact of injury mortality on children by focusing primarily on the mechanism of the injury, and secondarily on the intent. In previous tabulations of data, many of the external causes of injury such as suffocation, poisoning, and firearms have often been shown only for the 'unintentional' category. As shown in the table, this can significantly underestimate the magnitude of the problem caused by these injuries.