Medical, Work Loss Costs $671 Billion for Injury, Deaths; 2013 Key Findings

A CDC Study, released September 30, 2015, found the total cost of injuries and violence in the United States was $671 billion in 2013, according to two reports released recently by the CDC. The cost associated with fatal injuries was $214 billion. The cost associated with nonfatal injuries was $457 billion. Each year, more than three million people are hospitalized, 27 million people are treated in emergency departments (EDs) and released, and more than 192,000 die as a result of unintentional and violence related injuries.


“Injuries cost Americans far too much money, suffering, and preventable death,” said the CDC director Tom Frieden, M.D., M.P.H. “The doubling of deaths by drug poisoning, including prescription drug overdose and heroin, is particularly alarming.”


The two studies include lifetime medical and work loss costs for injury-related deaths and injuries treated in hospitals and emergency departments and break down costs by age, gender, and injury intent. Other key findings include:


  • Males accounted for a majority (78 percent) of costs for injury deaths ($166.7 billion) and nonfatal injury costs (63 percent; $287.5 billion);
  • More than half of the total medical and work-loss costs of injury deaths were from unintentional injuries ($129.7 billion), followed by suicide ($50.8 billion) and homicide ($26.4 billion);
  • Drug poisonings, which includes prescription drug overdoses, accounted for the largest share of fatal injury costs (27 percent), followed by transportation-related deaths (23 percent) and firearm-related deaths (22 percent);
  • The cost for hospitalized injuries was $289.7 billion in 2013; the cost for injuries treated and released in hospitals and emergency departments was $167.1 billion; and
  • Falls (37 percent) and transportation-related injuries (21 percent) accounted for a majority of the costs associated with emergency department treated non-fatal injuries.


“The magnitude of costs associated with injury underscores the need for effective prevention,” said Deb Houry, M.D., M.P.H., director of the CDC’s National Center for Injury Prevention and Control. “Communities and states must increase efforts to implement evidence-based programs and policies to prevent injuries and violence to reduce not only the pain and suffering of people, but the considerable costs to society.”


In 2013, unintentional injury was the fourth leading cause of death, suicide was the tenth, and homicide was the sixteenth; these three causes accounted for approximately 187,000 deaths in the United States. Costs from fatal injuries represent approximately one third of the total $671 billion medical and work-loss costs associated with all injuries in 2013. The magnitude of the economic burden associated with injury-associated deaths underscores the need for effective prevention.


Assault injuries and self-harm injuries accounted for $9.8 billion and $627 million in costs, respectively. Males accounted for about two thirds of assault costs ($6.4 billion), whereas females accounted for 60% of the self-harm costs ($377 million). Rates for nonfatal treated and released injuries from assaults and self-harm were highest among those aged 15–24 years, followed by those aged 25–44 years. Persons aged 15–44 years accounted for a large share of assault (83%) and self-harm costs (79%), whereas costs for unintentional treated and released injuries were more evenly distributed among age groups.


Although nonfatal injuries treated in EDs are common and costly, appropriate implementation of evidence-based strategies can reduce nonfatal injuries from the mechanisms that lead to the greatest cost burden. For example, primary seat belt laws, motorcycle helmet laws, sobriety checkpoints, and alcohol interlocks are effective in preventing motor vehicle–related injuries and can produce substantial economic benefits that greatly exceed the implementation costs.


The relatively high rate of injuries from assaults and self-harm among adolescents and young adults underscores the need for early prevention strategies that take advantage of the best available evidence to enhance youths' skills, family relationships, and social environments to reduce risk for violence-related injuries. One example is Life Skills Training, a middle school classroom-based program to reduce substance use, which is a risk factor for violent behavior.


Finally, the ED might also be a useful setting for implementing prevention. Studies of some screening and brief intervention programs for reducing excessive alcohol use, which is a risk factor for both unintentional and violent injuries, have shown that this intervention can reduce the likelihood of a subsequent visit to the ED for injury or violence-related causes. Expanded implementation of evidence-based programs and policies to prevent injuries and violence can reduce not only the pain and suffering of victims but also the considerable societal costs.


See the CDC Announcement


See the Non-Fatal Injuries CDC Report


See the Fatal Injuries CDC Report


See also Medical Law Perspectives, January 2014 Report: Prescription Painkillers: Risks for Patients, Pharmacists, and Physicians


See the Medical Law Perspectives October 8, 2014, Blog: Opioid Pain Pill Abusers Switch to Heroin; Heroin Overdose Deaths Double