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State-level lifetime medical and work-loss costs of fatal injuries--United States, 2014.

Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas.

The numbers of injury-associated deaths in each of the 50 states and DC in 2014 were obtained from the National Vital Statistics System, and state-level lifetime costs were obtained from the Web-based Injury Statistics Query and Reporting System database (3). Injury death rates were calculated using the U.S. Census Bureau's bridged race population estimates for 2014. Lifetime costs, which include lifetime medical and work-loss costs, were computed by multiplying the number of injury deaths by average costs of treating injuries and earnings in 2010, adjusted to 2014 prices. Medical costs were derived from various sources that measure the costs of transport, health care in multiple settings, including emergency departments, hospitals, and nursing homes, and examination by a coroner or medical examiner (4). Work-loss costs were developed using earnings data from the U.S. Census Bureau's Current Population Survey and life expectancy data from CDC's National Center for Health Statistics. Numbers of deaths, rates, lifetime costs, and lifetime costs per capita (lifetime costs divided by the state population) were examined for each state and DC. Lifetime costs per capita were used for comparisons across states. Four intents of fatal injuries were considered: all intents, * unintentional, suicide, and homicide. For each intent, state-level lifetime costs were estimated for the total population, for males and females, and for all intents. State-level lifetime costs were also estimated for three age groups: young (0-24 years), middle (25-64 years), and older (>65 years). State-level lifetime costs per capita were provided for the total population for each intent. In some state-intent-population combinations, average medical costs were statistically unstable, but these costs accounted for <1% or <5% of average lifetime costs. When both average medical costs and average work-loss costs were statistically unstable or when the mortality rates were unstable or missing, lifetime costs or lifetime costs per capita were not presented.

Injuries from All Intents

Injury mortality rates (per 100,000), lifetime costs (in 2014 U.S. dollars), and lifetime costs per capita (in 2014 U.S. dollars) varied widely among the 50 states and DC for each of the four intents. Overall, total injury-related mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 and $491 (New York) (Table 1). The rates of overall male and female injury mortality were highest in New Mexico (141.1 and 63.7, respectively), and lowest in New York (58.9 and 23.1, respectively). New York also had the lowest injury mortality rate among persons aged >65 years (87.1). The states with the highest and lowest lifetime fatal injury costs were California ($20.9 billion) and Vermont ($406 million), respectively. California had the highest number of injury deaths (18,152) and DC the lowest number of injury deaths (385). The lifetime costs per capita for injuries of all intents ranged from $491 to $1,233 (Figure). The five states with the highest lifetime fatal injury costs per capita were New Mexico ($1,233), West Virginia ($1,162), Alaska ($1,091), Louisiana ($1,041), and Oklahoma ($1,040); states with the lowest lifetime costs per capita were New York ($491), New Jersey ($533), California ($538), Massachusetts ($550), and Minnesota ($557).

Unintentional Injuries

West Virginia had the highest lifetime costs per capita for fatal unintentional injuries ($815), the highest unintentional injury mortality rate among males (95.2), and the highest unintentional injury mortality rate among persons aged 25--64 years (88.5) (Table 1). Maryland had the lowest lifetime costs per capita for fatal unintentional injuries ($261), the lowest total unintentional injury mortality rate (26.4), the lowest male unintentional injury mortality rate (36.9), and the lowest unintentional injury mortality rate among persons aged 25-64 years (23-3). New Mexico had the highest total unintentional injury mortality rate (71.9) and the highest female unintentional injury mortality rate (49.9). California had the highest lifetime costs for fatal unintentional injuries ($12.2 billion) and the highest number of unintentional injury deaths (11,804).

Suicides

Alaska and New Jersey had the highest and lowest lifetime suicide costs per capita ($338 and $107, respectively) (Table 2). Montana had the highest total suicide rate (23.8), the highest male suicide rate (36.8), and the highest female suicide rate (11.4). DC had the lowest number of suicides (52), total suicide rate (7.7), male suicide rate (12.3), and lifetime costs ($73 million). California had the highest lifetime costs ($4.9 billion) and the highest number of suicides (4,214).

Homicides

The highest and lowest lifetime homicide-related mortality costs per capita were in DC ($273) and Hawaii ($24), respectively (Table 2)4 DC had the highest total homicide rate (13.2), the highest male homicide rate (22.3), and the highest female homicide rate (4.8). New Hampshire, Maine, and Massachusetts had the lowest total homicide rate (1.3), the lowest male homicide rate (2.6), and the lowest female homicide rate (0.5), respectively. California had the highest lifetime homicide-related costs ($3.1 billion) and the highest number of homicides (1,813).

Discussion

Economic burdens of fatal injuries varied widely in the 50 states and DC for each of the four categories of intent. Across all the four fatal injury intents, some states consistently had lower lifetime costs per capita than most other states. For example, New York, New Jersey, and California ranked among the five lowest states in terms of lifetime costs per capita for injuries of all intents, unintentional injuries, and suicides. In contrast, New Mexico ranked among the five highest states in terms of lifetime costs per capita for injuries of all intents, unintentional injuries, and suicides. Varying economic burdens of fatal injuries in the 50 states and DC might be attributed to the different injury mortality rates, the different medical costs resulting from different medical procedures, and the different demographic characteristics of injury decedents, such as sex and age.

Implementation of effective injury prevention strategies is needed to help reduce the substantial lifetime medical and work-loss costs associated with fatal injuries. The differing state-level lifetime costs per capita for fatal injuries suggests an urgent need in some states to prevent injuries. States that consistently have lower lifetime costs per capita across different intents of injuries might have successful injury prevention experiences that could be shared with states with higher per capita costs.

The findings in this report are subject to at least four limitations. First, the costs account for medical and work-loss costs associated with decedents. Other societal costs, such as criminal justice costs and the pain and suffering of family members, were not considered. Second, work-loss costs, based on the mean earnings of the general population by sex and specific age groups, might be over- or underestimated because the mean earnings of decedents might differ from those of the general population. Third, intent of fatal injury, as determined from the manner of death assigned on death certificates by coroners or medical examiners, might differ across jurisdictions (5). Finally, unintentional fatal injuries were not broken down into more specific categories such as motor vehicle crashes, drug overdoses, traumatic brain injuries, and older adult falls, so that this report cannot indicate the economic burdens of those specific categories of unintentional injuries.

During 2005-2014, the number of unintentional fatal injuries increased 15%, from 117,809 to 136,053, and unintentional injury moved from the fifth to the fourth leading cause of death; the number of suicides rose 31%, from 32,637 to 42,773, and suicide moved from the eleventh to the tenth leading cause of death (2,6). The increasing incidence and economic burden of injuries, particularly unintentional injuries and suicides, call for effective prevention programs and strategies. For example, the CDC Guideline for Prescribing Opioids for Chronic Pain provides prescribing recommendations for opioid pain medication to patients aged [greater than or equal to] 18 years with chronic pain in primary care settings (7), which could be adopted by states and might reduce the number of persons who overdose prescribed opioid medications. To reduce motor vehicle crash fatalities, states could increase seatbelt use with primary enforcement seatbelt laws that cover everyone in the vehicle (8) or consider requiring car seats and booster seats for children through at least age 8 years or until seatbelts fit properly (9). The 2012 Surgeon General's National Strategy for Suicide Prevention suggests that strategies enhancing social support, community connectedness, and access to mental health and preventive services and measures to reduce stigma and barriers associated with seeking help might alleviate suicide risk across the lifespan (10). The estimates of state-level economic burdens of fatal injuries will permit policy makers to compare the costs of implementing prevention programs and strategies with the cost savings garnered from the aversion of fatal injuries.

Summary

What is already known about this topic?

Injuries are a leading cause of death in the United States. Injury-associated deaths result in a substantial economic burden to the United States: the total estimated lifetime medical and work-loss costs were $214 billion in 2013. Injury and violence prevention strategies can save lives and reduce costs.

What is added by this report?

Lifetime costs and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for each of four injury intent categories (all intents, unintentional, suicide, and homicide) for 2014. Economic burdens varied widely among the states and DC. Lifetime costs per capita ranged from $1,233 (New Mexico) to $491 (New York) among fatal injuries of all intents, from $815 (West Virginia) to $261 (Maryland) among unintentional injuries, from $338 (Alaska) to $107 (New Jersey) among suicides, and from $273 (DC) to $24 (Hawaii) for homicides.

What are the implications for public health practice?

States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas. States that consistently have lower lifetime costs per capita across different intents of injuries might have successful injury prevention experiences that could be shared with states with higher per capita costs.

References

(1.) Florence C, Simon T, Haegerich T, Luo F, Zhou C. Estimated lifetime medical and work-loss costs of fatal injuries--United States, 2013. MMWR Morb Mortal Wkly Rep 2015;64:1074-7. http://dx.doi.org/10.15585/mmwr.mm6438a4

(2.) Kochanek KD, Murphy SL, Xu JQ, Tejada-Vera B. Deaths: final data for 2014. National Vital Statistics Reports, Vol. 65, No. 4. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2016. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf

(3.) CDC. Web-Based Injury Statistics Query and Reporting System (WISQARS). Atlanta, GA: US Department of Health and Human Services; 2016. https://www.cdc.gov/injury/wisqars

(4.) Lawrence BA, Miller TA. Medical and work loss cost estimation methods for the WISQARS cost of injury module. Calverton, MD: Pacific Institute for Research & Evaluation; 2014. http://www.pire.org/documents/WisqarsCostMethods.pdf

(5.) Breiding MJ, Wiersema B. Variability of undetermined manner of death classification in the US. Inj Prev 2006;12(Suppl 2):ii49-54. http://dx.doi.org/10.1136/ip.2006.012591

(6.) Kung HC, Hoyert DL, Xu JQ, Murphy SL. Deaths: final data for 2005. National Vital Statistics Reports, vol. 52, no. 10. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2008. https://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf

(7.) Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain--United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1). http://dx.doi.org/10.15585/mmwr.rr6501e1

(8.) CDC. Prevention status reports: motor vehicle injuries. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://wwwn.cdc.gov/psr/NationalSummary/NSMVI.aspx

(9.) CDC. Buckle up: restraint use state fact sheets. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://www.cdc.gov/motorvehiclesafety/seatbelts/states.html

(10.) Office of the Surgeon General. National Action Alliance for Suicide Prevention. 2012 national strategy for suicide prevention: goals and objectives for action. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2012. https://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full-report.pdf

* All intents category includes legal intervention and undetermined intent of injury, in addition to unintentional, suicide, and homicide.

([dagger]) Lifetime costs or lifetime costs per capita of homicides were not presented for New Hampshire, North Dakota, South Dakota, Vermont, and Wyoming because those states had unstable average medical and work loss costs or unstable homicide rates.

Feijun Luo, PhD [1]; Curtis Florence, PhD [1]

[1] Division of Analysis, Research and Practice Integration, National Center for Injury Prevention and Control, CDC.

Corresponding author: Feijun Luo, fluo@cdc.gov, 770-488-3896.

Caption: FIGURE. Costs per capita * of fatal injuries of all intents--United States, 2014
TABLE 1. Deaths from injuries of all intents and unintentional
injuries, rates per 100,000 population, lifetime medical and
work-loss costs, and lifetime medical and work-loss costs per
capita, by state--United States, 2014

                                All intents

                                              Sex

State                 Total           Male           Female

Alabama

No. of            3,625 (73.2)    2,440 (105.3)   1,185 (44.1)
deaths (rate)

Costs, million     4,372 (902)        3,317          1,038
USD (per
capita, USD *)

Alaska

No. of             615 (85.8)      441 (119.9)     174 (50.4)
deaths (rate)

Costs, million     804 (1,091)         634            170
USD (per
capita, USD *)

Arizona

No. of            5,079 (72.6)    3,387 (100.4)   1,692 (45.5)
deaths (rate)

Costs, million     5,604 (832)        4,326          1,259
USD (per
capita, USD *)

Arkansas

No. of            2,280 (75.2)    1,522 (105.7)    758 (46.4)
deaths (rate)

Costs, million     2,719 (917)        2,052           642
USD (per
capita, USD *)

California
No. of            18,152 (44.9)   12,820 (66.0)   5,332 (25.0)
deaths (rate)

Costs, million    20,894 (538)       16,746          4,209
USD (per
capita, USD *)

Colorado
No. of            3,883 (72.2)    2,543 (98.1)    1,340 (46.9)
deaths (rate)

Costs, million     4,175 (779)        3,202           989
USD (per
capita, USD *)

Connecticut
No. of            2,140 (53.9)    1,373 (76.7)     767 (33.0)
deaths (rate)

Costs, million     2,186 (608)        1,682           464
USD (per
capita, USD *)

Delaware

No. of             629 (65.8)      433 (97.0)      196 (37.4)
deaths (rate)

Costs, million      775 (829)          592            184
USD (per
capita, USD *)

District of
Columbia

No. of             385 (56.2)      264 (81.7)      121 (33.7)
deaths (rate)

Costs, million      479 (726)          370             97
USD (per
capita, USD *)

Florida

No. of            13,673 (61.5)   9,216 (88.4)    4,457 (35.8)
deaths (rate)

Costs, million    14,763 (742)       11,411          3,326
USD (per
capita, USD *)

Georgia

No. of            6,002 (60.1)    4,061 (85.8)    1,941 (36.5)
deaths (rate)

Costs, million     7,055 (699)        5,452          1,582
USD (per
capita, USD *)

Hawaii

No. of             733 (47.3)      527 (70.6)      206 (24.0)
deaths (rate)

Costs, million      825 (581)          684            148
USD (per
capita, USD *)

Idaho

No. of            1,156 (71.2)     742 (95.2)      414 (48.4)
deaths (rate)

Costs, million     1,274 (780)         916            350
USD (per
capita, USD *)

Illinois

No. of            6,983 (52.0)    4,808 (75.9)    2,175 (29.6)
deaths (rate)

Costs, million     8,297 (644)        6,550          1,697
USD (per
capita, USD *)

Indiana

No. of            4,462 (66.5)    3,007 (94.1)    1,455 (40.1)
deaths (rate)

Costs, million     5,240 (794)        4,059          1,190
USD (per
capita, USD *)

Iowa

No. of            2,045 (58.4)    1,300 (81.2)     745 (37.4)
deaths (rate)

Costs, million     1,987 (639)        1,493           479
USD (per
capita, USD *)

Kansas

No. of            1,987 (65.2)    1,292 (89.8)     695 (41.7)
deaths (rate)

Costs, million     2,223 (765)        1,697           505
USD (per
capita, USD *)

Kentucky

No. of            3,634 (80.7)    2,466 (114.5)   1,168 (48.8)
deaths (rate)

Costs, million     4,296 (973)        3,300          1,010
USD (per
capita, USD *)

Louisiana

No. of            3,654 (77.5)    2,576 (113.8)   1,078 (43.7)
deaths (rate)

Costs, million    4,839 (1,041)       3,805          1,008
USD (per
capita, USD *)

Maine

No. of             952 (65.0)      633 (93.4)      319 (38.5)
deaths (rate)

Costs, million      960 (722)          736            215
USD (per
capita, USD *)

Maryland

No. of            3,482 (56.1)    2,426 (83.7)    1,056 (31.0)
deaths (rate)

Costs, million     4,233 (708)        3,376           838
USD (per
capita, USD *)

Massachusetts

No. of            3,452 (47.4)    2,361 (70.4)    1,091 (26.4)
deaths (rate)

Costs, million     3,707 (550)        3,032           711
USD (per
capita, USD *)

Michigan

No. of            6,652 (63.8)    4,392 (89.2)    2,260 (39.9)
deaths (rate)

Costs, million     7,539 (761)        5,766          1,749
USD (per
capita, USD *)

Minnesota

No. of            3,226 (54.3)    1,956 (71.6)    1,270 (37.4)
deaths (rate)

Costs, million     3,041 (557)        2,227           771
USD (per
capita, USD *)

Mississippi

No. of            2,477 (81.8)    1,702 (120.0)    775 (47.4)
deaths (rate)

Costs, million     2,872 (959)        2,306           601
USD (per
capita, USD *)

Missouri

No. of            4,672 (74.1)    3,142 (105.9)   1,530 (43.9)
deaths (rate)

Costs, million     5,371 (886)        4,213          1,159
USD (per
capita, USD *)

Montana

No. of             902 (83.1)      586 (110.5)     316 (56.2)
deaths (rate)

Costs, million      973 (950)          729            239
USD (per
capita, USD *)

Nebraska

No. of            1,116 (56.0)     752 (80.6)      364 (32.9)
deaths (rate)

Costs, million     1,139 (605)         913            245
USD (per
capita, USD *)

Nevada

No. of            1,948 (67.0)    1,359 (94.6)     589 (39.7)
deaths (rate)

Costs, million     2,294 (808)        1,781           534
USD (per
capita, USD *)

New Hampshire

No. of            1,001 (70.8)     645 (97.9)      356 (44.6)
deaths (rate)

Costs, million     1,022 (771)         800            226
USD (per
capita, USD *)

New Jersey

No. of            4,210 (44.4)    2,881 (65.2)    1,329 (25.4)
deaths (rate)

Costs, million     4,765 (533)        3,806           961
USD (per
capita, USD *)

New Mexico

No. of            2,163 (101.9)   1,443 (141.1)    720 (63.7)
deaths (rate)

Costs, million    2,573 (1,233)       1,965           603
USD (per
capita, USD *)

New York

No. of            8,585 (40.2)    5,801 (58.9)    2,784 (23.1)
deaths (rate)

Costs, million     9,689 (491)        7,594          1,987
USD (per
capita, USD *)

North Carolina

No. of            6,541 (63.7)    4,358 (90.8)    2,183 (39.2)
deaths (rate)

Costs, million     7,310 (735)        5,674          1,607
USD (per
capita, USD *)

North Dakota

No. of             514 (64.1)      353 (89.5)      161 (38.6)
deaths (rate)

Costs, million      545 (737)          447            100
USD (per
capita, USD *)

Ohio

No. of            8,366 (69.4)    5,541 (97.9)    2,825 (42.9)
deaths (rate)

Costs, million     9,370 (808)        7,217          2,143
USD (per
capita, USD *)

Oklahoma

No. of            3,522 (88.8)    2,277 (119.9)   1,245 (59.6)
deaths (rate)

Costs, million    4,035 (1,040)       3,024           981
USD (per
capita, USD *)

Oregon

No. of            2,773 (64.1)    1,805 (88.6)     968 (40.8)
deaths (rate)

Costs, million     2,704 (681)        2,075           624
USD (per
capita, USD *)

Pennsylvania

No. of            9,224 (66.1)    6,111 (94.1)    3,113 (40.0)
deaths (rate)

Costs, million    10,089 (789)        7,874          2,229
USD (per
capita, USD *)

Rhode Island

No. of             748 (62.8)      475 (88.8)      273 (40.0)
deaths (rate)

Costs, million      771 (731)          576            179
USD (per
capita, USD *)

South Carolina

No. of            3,608 (72.0)    2,422 (103.1)   1,186 (44.0)
deaths (rate)

Costs, million     4,279 (885)        3,309           962
USD (per
capita, USD *)

South Dakota

No. of             642 (71.1)      415 (97.4)      227 (45.9)
deaths (rate)

Costs, million      687 (805)          505            172
USD (per
capita, USD *)

Tennessee

No. of            5,237 (77.4)    3,489 (110.5)   1,748 (47.2)
deaths (rate)

Costs, million     5,947 (908)        4,556          1,396
USD (per
capita, USD *)

Texas

No. of            14,652 (55.6)   10,164 (79.8)   4,488 (32.8)
deaths (rate)

Costs, million    17,522 (650)       13,869          3,740
USD (per
capita, USD *)

Utah

No. of            1,924 (73.0)    1,265 (97.1)     659 (49.7)
deaths (rate)

Costs, million     2,362 (803)        1,794           564
USD (per
capita, USD *)

Vermont

No. of             478 (68.2)      291 (91.0)      187 (45.4)
deaths (rate)

Costs, million      406 (648)          314             88
USD (per
capita, USD *)

Virginia

No. of            4,701 (54.7)    3,141 (77.2)    1,560 (33.7)
deaths (rate)

Costs, million     5,166 (620)        3,996          1,128
USD (per
capita, USD *)

Washington

No. of            4,428 (59.6)    2,909 (81.9)    1,519 (38.2)
deaths (rate)

Costs, million     4,600 (651)        3,550          1,052
USD (per
capita, USD *)

West Virginia

No. of            1,897 (98.0)    1,253 (134.8)    644 (62.6)
deaths (rate)

Costs, million    2,149 (1,162)       1,599           530
USD (per
capita, USD *)

Wisconsin

No. of            4,032 (64.2)    2,463 (85.0)    1,569 (43.7)
deaths (rate)

Costs, million     3,934 (683)        2,895           967
USD (per
capita, USD *)

Wyoming

No. of             514 (86.6)      355 (119.2)     159 (52.2)
deaths (rate)

Costs, million      581 (995)          454            134
USD (per
capita, USD *)

                                 All intents

                                Age group (yrs)

State                  0-24            25-64       [greater than
                                                   or equal to] 65

Alabama

No. of              534 (31.6)     2,224 (89.6)     867 (121.9)
deaths (rate)

Costs, million         983             3,138            163
USD (per
capita, USD *)

Alaska

No. of              105 (36.3)      427 (106.1)      83 (141.0)
deaths (rate)

Costs, million         193              592              17
USD (per
capita, USD *)

Arizona

No. of              603 (25.1)     2,900 (85.4)    1,575 (152.7)
deaths (rate)

Costs, million        1,129            3,942            260
USD (per
capita, USD *)

Arkansas

No. of              316 (30.7)     1,330 (89.6)     634 (140.9)
deaths (rate)

Costs, million         587             1,904            117
USD (per
capita, USD *)

California
No. of             2,495 (17.6)    11,109 (52.5)    4,544 (90.2)
deaths (rate)

Costs, million        4,760           14,766            803
USD (per
capita, USD *)

Colorado
No. of              471 (25.3)     2,168 (74.5)    1,243 (193.4)
deaths (rate)

Costs, million         873             2,915            194
USD (per
capita, USD *)

Connecticut
No. of              205 (16.6)     1,152 (60.8)     783 (129.5)
deaths (rate)

Costs, million         405             1,584            117
USD (per
capita, USD *)

Delaware

No. of              79 (25.0)       383 (81.5)      167 (114.8)
deaths (rate)

Costs, million         146              549              31
USD (per
capita, USD *)

District of
Columbia

No. of              50 (19.8)       250 (67.6)       85 (111.1)
deaths (rate)

Costs, million          97              357              13
USD (per
capita, USD *)

Florida

No. of             1,672 (26.7)     7,363 (71)     4,636 (119.5)
deaths (rate)

Costs, million        3,111            9,992            773
USD (per
capita, USD *)

Georgia

No. of              946 (25.8)     3,589 (66.8)    1,467 (128.1)
deaths (rate)

Costs, million        1,755            4,910            271
USD (per
capita, USD *)

Hawaii

No. of              79 (16.1)       428 (57.5)       226 (92.5)
deaths (rate)

Costs, million         149              588              39
USD (per
capita, USD *)

Idaho

No. of              172 (29.4)      607 (75.0)      377 (172.7)
deaths (rate)

Costs, million         311              814              63
USD (per
capita, USD *)

Illinois

No. of             1,123 (25.0)    4,006 (58.3)    1,853 (101.7)
deaths (rate)

Costs, million        2,104            5,759            311
USD (per
capita, USD *)

Indiana

No. of              687 (29.0)     2,685 (79.9)    1,088 (115.6)
deaths (rate)

Costs, million        1,288            3,718            196
USD (per
capita, USD *)

Iowa

No. of              237 (21.5)      936 (58.4)      872 (161.7)
deaths (rate)

Costs, million         435             1,242            140
USD (per
capita, USD *)

Kansas

No. of              266 (24.7)     1,046 (71.2)      675 (154)
deaths (rate)

Costs, million         491             1,438            115
USD (per
capita, USD *)

Kentucky

No. of              427 (27.8)     2,343 (102.7)    864 (138.4)
deaths (rate)

Costs, million         767             3,314            164
USD (per
capita, USD *)

Louisiana

No. of              659 (39.6)     2,334 (95.9)     659 (107.8)
deaths (rate)

Costs, million        1,233            3,430            127
USD (per
capita, USD *)

Maine

No. of              105 (26.5)      492 (71.3)      354 (146.8)
deaths (rate)

Costs, million       200 (a)            649              60
USD (per
capita, USD *)

Maryland

No. of              462 (22.6)     2,129 (65.9)     891 (109.3)
deaths (rate)

Costs, million         888             3,049            149
USD (per
capita, USD *)

Massachusetts

No. of              335 (13.8)     2,132 (59.4)      984 (92.1)
deaths (rate)

Costs, million         648             2,936            158
USD (per
capita, USD *)

Michigan

No. of              967 (27.6)     3,807 (74.2)    1,878 (122.5)
deaths (rate)

Costs, million        1,780            5,194            322
USD (per
capita, USD *)

Minnesota

No. of              361 (19.6)     1,465 (50.0)    1,400 (168.8)
deaths (rate)

Costs, million         670             1,953            210
USD (per
capita, USD *)

Mississippi

No. of              443 (40.7)     1,421 (93.4)      612 (149)
deaths (rate)

Costs, million         807             1,963            110
USD (per
capita, USD *)

Missouri

No. of              675 (32.2)     2,658 (85.7)    1,339 (143.6)
deaths (rate)

Costs, million        1,249            3,767            230
USD (per
capita, USD *)

Montana

No. of              121 (34.9)      475 (91.4)      306 (183.8)
deaths (rate)

Costs, million         219              653              55
USD (per
capita, USD *)

Nebraska

No. of              161 (23.7)      563 (58.9)      392 (134.7)
deaths (rate)

Costs, million         296              754              61
USD (per
capita, USD *)

Nevada

No. of              251 (26.6)      1251 (81.2)     446 (121.7)
deaths (rate)

Costs, million         464             1,665             85
USD (per
capita, USD *)

New Hampshire

No. of              92 (20.1)       584 (84.9)      325 (154.8)
deaths (rate)

Costs, million         174              798              55
USD (per
capita, USD *)

New Jersey

No. of              555 (18.8)     2,454 (51.1)     1,200 (88.4)
deaths (rate)

Costs, million        1,074            3,465            201
USD (per
capita, USD *)

New Mexico

No. of              291 (38.5)     1,303 (124.7)    569 (185.9)
deaths (rate)

Costs, million         542             1,844            101
USD (per
capita, USD *)

New York

No. of             1,046 (15.1)    4,934 (45.9)     2,600 (87.1)
deaths (rate)

Costs, million        1,987            6,858            436
USD (per
capita, USD *)

North Carolina

No. of              890 (25.6)     3,709 (71.0)    1,940 (140.2)
deaths (rate)

Costs, million        1,681            5,148            334
USD (per
capita, USD *)

North Dakota

No. of              82 (27.0)       258 (68.6)      174 (149.1)
deaths (rate)

Costs, million    158 ([dagger])        367              30
USD (per
capita, USD *)

Ohio

No. of              984 (24.8)     5,062 (85.5)    2,320 (128.0)
deaths (rate)

Costs, million        1,820            7,038            403
USD (per
capita, USD *)

Oklahoma

No. of              485 (34.6)     2,069 (104.3)    968 (176.8)
deaths (rate)

Costs, million         893             2,841            171
USD (per
capita, USD *)

Oregon

No. of              286 (22.1)     1,477 (69.0)    1,010 (161.8)
deaths (rate)

Costs, million         530             1,932            159
USD (per
capita, USD *)

Pennsylvania

No. of             1,102 (25.4)    5,245 (78.8)    2,875 (127.4)
deaths (rate)

Costs, million        2,085            7,225            477
USD (per
capita, USD *)

Rhode Island

No. of              59 (15.2)       422 (75.6)      267 (143.4)
deaths (rate)

Costs, million         113              578              41
USD (per
capita, USD *)

South Carolina

No. of              564 (33.8)     2,111 (83.4)     933 (132.2)
deaths (rate)

Costs, million        1,054            2,925            169
USD (per
capita, USD *)

South Dakota

No. of              110 (35.9)      320 (75.8)      212 (149.9)
deaths (rate)

Costs, million         197              448              35
USD (per
capita, USD *)

Tennessee

No. of              631 (27.9)     3,093 (90.2)    1,512 (163.1)
deaths (rate)

Costs, million        1,162            4,262            273
USD (per
capita, USD *)

Texas

No. of             2,454 (24.4)    8,777 (62.2)    3,419 (115.9)
deaths (rate)

Costs, million        4,549           12,340            615
USD (per
capita, USD *)

Utah

No. of              286 (23.5)     1,190 (85.7)     446 (158.9)
deaths (rate)

Costs, million         525             1,726             78
USD (per
capita, USD *)

Vermont

No. of              54 (24.6)       208 (64.2)      216 (207.0)
deaths (rate)

Costs, million    102 ([dagger])        265              32
USD (per
capita, USD *)

Virginia

No. of              634 (21.9)     2,618 (57.9)    1,449 (132.9)
deaths (rate)

Costs, million        1,196            3,655            244
USD (per
capita, USD *)

Washington

No. of              530 (22.0)     2,446 (63.3)    1,451 (149.5)
deaths (rate)

Costs, million        1,004            3,262            240
USD (per
capita, USD *)

West Virginia

No. of              201 (33.9)     1,170 (125.0)    526 (166.2)
deaths (rate)

Costs, million         369             1,618             94
USD (per
capita, USD *)

Wisconsin

No. of              480 (24.1)     1,965 (64.8)    1,587 (174.2)
deaths (rate)

Costs, million         906             2,617            229
USD (per
capita, USD *)

Wyoming

No. of              81 (39.6)       322 (105.3)     111 (141.4)
deaths (rate)

Costs, million    149 ([dagger])        415              21
USD (per
capita, USD *)

                           Unintentional injuries

                                              Sex

State                 Total           Male          Female

Alabama

No. of            2,463 (49.2)    1,525 (65.9)    938 (34.4)
deaths (rate)

Costs, million     2,767 (571)       1,967           784
USD (per
capita, USD *)

Alaska

No. of             379 (54.9)      260 (74.2)     119 (35.6)
deaths (rate)

Costs, million      448 (608)         341            109
USD (per
capita, USD *)

Arizona

No. of            3,322 (46.8)    2,077 (61.5)   1,245 (32.5)
deaths (rate)

Costs, million     3,226 (479)       2,425           816
USD (per
capita, USD *)

Arkansas

No. of            1,458 (47.2)     907 (62.8)     551 (32.6)
deaths (rate)

Costs, million     1,623 (547)       1,180           420
USD (per
capita, USD *)

California
No. of            11,804 (29.1)   7,847 (40.6)   3,957 (18.3)
deaths (rate)

Costs, million    12,171 (314)       9,450          2,808
USD (per
capita, USD *)

Colorado
No. of            2,517 (47.1)    1,513 (60.1)   1,004 (34.4)
deaths (rate)

Costs, million     2,317 (433)       1,691           640
USD (per
capita, USD *)

Connecticut
No. of            1,642 (40.8)    1,005 (56.8)    637 (26.4)
deaths (rate)

Costs, million     1,446 (402)       1,100           330
USD (per
capita, USD *)

Delaware

No. of             425 (43.9)      270 (60.2)     155 (29.1)
deaths (rate)

Costs, million      472 (505)         334            139
USD (per
capita, USD *)

District of
Columbia

No. of             217 (32.7)      130 (42.4)     87 (24.0)
deaths (rate)

Costs, million      194 (294)         130             61
USD (per
capita, USD *)

Florida

No. of            9,433 (41.2)    5,932 (56.2)    3,501 (27)
deaths (rate)

Costs, million     9,478 (476)       7,055          2,386
USD (per
capita, USD *)

Georgia

No. of            3,964 (40.1)    2,491 (53.8)   1,473 (27.6)
deaths (rate)

Costs, million     4,232 (419)       3,117          1,104
USD (per
capita, USD *)

Hawaii

No. of             476 (29.9)      327 (43.9)     149 (16.3)
deaths (rate)

Costs, million      482 (340)         389             86
USD (per
capita, USD *)

Idaho

No. of             765 (46.5)      457 (58.8)     308 (35.0)
deaths (rate)

Costs, million      785 (480)         547            238
USD (per
capita, USD *)

Illinois

No. of            4,644 (34.2)    2,918 (46.5)   1,726 (22.9)
deaths (rate)

Costs, million     4,833 (375)       3,579          1,206
USD (per
capita, USD *)

Indiana

No. of            2,974 (43.8)    1,853 (58.3)   1,121 (30.0)
deaths (rate)

Costs, million     3,166 (480)       2,339           823
USD (per
capita, USD *)

Iowa

No. of            1,517 (41.9)     898 (55.8)     619 (29.3)
deaths (rate)

Costs, million     1,292 (416)        937            343
USD (per
capita, USD *)

Kansas

No. of            1,377 (44.1)     829 (57.4)     548 (31.5)
deaths (rate)

Costs, million     1,367 (471)       1,004           339
USD (per
capita, USD *)

Kentucky

No. of            2,622 (58.3)    1,677 (78.8)    945 (39.1)
deaths (rate)

Costs, million     2,966 (672)       2,196           775
USD (per
capita, USD *)

Louisiana

No. of            2,344 (49.6)    1,584 (70.5)    760 (30.4)
deaths (rate)

Costs, million     2,855 (614)       2,203           666
USD (per
capita, USD *)

Maine

No. of             690 (45.9)      429 (63.1)     261 (30.0)
deaths (rate)

Costs, million      626 (470)         467            152
USD (per
capita, USD *)

Maryland

No. of            1,674 (26.4)    1,046 (36.9)    628 (17.3)
deaths (rate)

Costs, million     1,560 (261)       1,183           363
USD (per
capita, USD *)

Massachusetts

No. of            2,692 (36.8)    1,767 (53.2)    925 (21.9)
deaths (rate)

Costs, million     2,508 (372)       2,059           503
USD (per
capita, USD *)

Michigan

No. of            4,422 (41.5)    2,714 (55.0)   1,708 (28.9)
deaths (rate)

Costs, million     4,338 (438)       3,168          1,172
USD (per
capita, USD *)

Minnesota

No. of            2,385 (39.2)    1,327 (49.0)   1,058 (29.8)
deaths (rate)

Costs, million     1,855 (340)       1,296           526
USD (per
capita, USD *)

Mississippi

No. of            1,712 (56.2)    1,085 (77.0)    627 (37.8)
deaths (rate)

Costs, million     1,816 (607)       1,379           447
USD (per
capita, USD *)

Missouri

No. of            3,110 (48.5)    1,911 (64.3)   1,199 (33.4)
deaths (rate)

Costs, million     3,203 (528)       2,379           830
USD (per
capita, USD *)

Montana

No. of             581 (52.6)      343 (64.8)     238 (40.5)
deaths (rate)

Costs, million      579 (566)         411            160
USD (per
capita, USD *)

Nebraska

No. of             781 (38.2)      492 (52.8)     289 (24.7)
deaths (rate)

Costs, million      697 (370)         543            169
USD (per
capita, USD *)

Nevada

No. of            1,166 (40.1)     750 (52.1)     416 (28.1)
deaths (rate)

Costs, million     1,319 (465)        975            359
USD (per
capita, USD *)

New Hampshire

No. of             716 (50.4)      435 (67.2)     281 (34.2)
deaths (rate)

Costs, million      664 (500)         515            156
USD (per
capita, USD *)

New Jersey

No. of            2,970 (30.8)    1,935 (43.9)   1,035 (19.1)
deaths (rate)

Costs, million     2,991 (335)       2,368           657
USD (per
capita, USD *)

New Mexico

No. of            1,534 (71.9)     958 (94.3)     576 (49.9)
deaths (rate)

Costs, million     1,659 (796)       1,214           445
USD (per
capita, USD *)

New York

No. of            5,945 (27.5)    3,799 (38.8)   2,146 (17.2)
deaths (rate)

Costs, million     5,772 (292)       4,443          1,302
USD (per
capita, USD *)

North Carolina

No. of            4,558 (44.3)    2,881 (60.9)   1,677 (29.5)
deaths (rate)

Costs, million     4,620 (465)       3,517          1,093
USD (per
capita, USD *)

North Dakota

No. of             349 (42.8)      219 (56.8)     130 (29.4)
deaths (rate)

Costs, million      312 (422)         245             69
USD (per
capita, USD *)

Ohio

No. of            6,178 (50.6)    3,828 (68.0)   2,350 (34.6)
deaths (rate)

Costs, million     6,200 (535)       4,607          1,609
USD (per
capita, USD *)

Oklahoma

No. of            2,421 (60.3)    1,465 (77.3)    956 (44.5)
deaths (rate)

Costs, million     2,508 (647)       1,812           686
USD (per
capita, USD *)

Oregon

No. of            1,803 (40.8)    1,072 (52.7)    731 (29.5)
deaths (rate)

Costs, million     1,504 (379)       1,111           383
USD (per
capita, USD *)

Pennsylvania

No. of            6,640 (46.6)    4,091 (63.0)   2,549 (31.5)
deaths (rate)

Costs, million     6,420 (502)       4,820          1,633
USD (per
capita, USD *)

Rhode Island

No. of             592 (49.0)      360 (67.9)     232 (32.7)
deaths (rate)

Costs, million      526 (498)         387            134
USD (per
capita, USD *)

South Carolina

No. of            2,436 (48.2)    1,519 (65.0)    917 (33.4)
deaths (rate)

Costs, million     2,693 (557)       1,984           695
USD (per
capita, USD *)

South Dakota

No. of             462 (49.2)      282 (65.6)     180 (34.3)
deaths (rate)

Costs, million      422 (495)         302            111
USD (per
capita, USD *)

Tennessee

No. of            3,781 (55.5)    2,361 (75.3)   1,420 (37.6)
deaths (rate)

Costs, million     3,900 (595)       2,871          1,030
USD (per
capita, USD *)

Texas

No. of            9,723 (37.2)    6,398 (51.2)   3,325 (24.2)
deaths (rate)

Costs, million    10,648 (395)       8,237          2,512
USD (per
capita, USD *)

Utah

No. of            1,167 (45.3)     726 (57.5)     441 (33.5)
deaths (rate)

Costs, million     1,251 (425)        937            315
USD (per
capita, USD *)

Vermont

No. of             322 (44.4)      168 (53.3)     154 (34.9)
deaths (rate)

Costs, million      228 (365)         161             62
USD (per
capita, USD *)

Virginia

No. of            3,147 (36.7)    1,962 (49.2)   1,185 (25.2)
deaths (rate)

Costs, million     3,004 (361)       2,265           720
USD (per
capita, USD *)

Washington

No. of            2,997 (39.9)    1,821 (51.8)   1,176 (28.8)
deaths (rate)

Costs, million     2,727 (386)       2,020           708
USD (per
capita, USD *)

West Virginia

No. of            1,380 (71.1)     874 (95.2)     506 (47.9)
deaths (rate)

Costs, million     1,507 (815)       1,099           393
USD (per
capita, USD *)

Wisconsin

No. of            3,015 (46.7)    1,696 (58.4)   1,319 (35.1)
deaths (rate)

Costs, million     2,499 (434)       1,765           700
USD (per
capita, USD *)

Wyoming

No. of             361 (60.2)      234 (78.4)     127 (40.8)
deaths (rate)

Costs, million      384 (658)         286            103
USD (per
capita, USD *)

                              Unintentional injuries

                                  Age group (yrs)

State                  0-24            25-64       [greater than
                                                   or equal to] 65

Alabama

No. of              360 (21.5)      1,396 (55.6)    707 (100.5)
deaths (rate)

Costs, million          642            1,943            130
USD (per
capita, USD *)

Alaska

No. of               54 (18.5)       259 (64.7)      66 (116.2)
deaths (rate)

Costs, million         94 (a)           349              13
USD (per
capita, USD *)

Arizona

No. of              357 (14.9)      1,710 (50.0)   1,254 (122.9)
deaths (rate)

Costs, million          652            2,247            201
USD (per
capita, USD *)

Arkansas

No. of              189 (18.4)       757 (50.4)     512 (114.8)
deaths (rate)

Costs, million          347            1,080             91
USD (per
capita, USD *)

California
No. of             1,437 (10.2)     6,832 (32.0)    3,531 (69.8)
deaths (rate)

Costs, million         2,686           8,765            601
USD (per
capita, USD *)

Colorado
No. of              254 (13.6)      1,221 (41.7)   1,042 (163.2)
deaths (rate)

Costs, million          459            1,602            154
USD (per
capita, USD *)

Connecticut
No. of               120 (9.7)       824 (44.2)     698 (114.1)
deaths (rate)

Costs, million          234            1,126            100
USD (per
capita, USD *)

Delaware

No. of               50 (15.8)       239 (50.6)      136 (94.8)
deaths (rate)

Costs, million          88+             338              24
USD (per
capita, USD *)

District of
Columbia

No. of                12 (4.8        133 (36.8)      72 (94.0)
deaths (rate)      ([section]))

Costs, million    --([paragraph])       163              11
USD (per
capita, USD *)

Florida

No. of             1,025 (16.5)     4,610 (44.3)    3,796 (97.5)
deaths (rate)

Costs, million         1,859           6,301            608
USD (per
capita, USD *)

Georgia

No. of              561 (15.4)      2,197 (40.6)   1,206 (106.9)
deaths (rate)

Costs, million         1,009           2,927            214
USD (per
capita, USD *)

Hawaii

No. of               47 (9.6)        246 (32.9)      183 (73.8)
deaths (rate)

Costs, million          86              340              30
USD (per
capita, USD *)

Idaho

No. of              100 (17.1)       341 (41.6)     324 (149.2)
deaths (rate)

Costs, million          177             458              52
USD (per
capita, USD *)

Illinois

No. of              557 (12.4)      2,506 (36.3)    1,581 (86.5)
deaths (rate)

Costs, million         1,015           3,502            256
USD (per
capita, USD *)

Indiana

No. of              390 (16.6)      1,665 (49.2)     919 (97.3)
deaths (rate)

Costs, million          716            2,279            160
USD (per
capita, USD *)

Iowa

No. of              135 (12.4)       586 (36.3)     796 (146.9)
deaths (rate)

Costs, million          243             756             123
USD (per
capita, USD *)

Kansas

No. of              157 (14.6)       634 (42.7)     586 (132.3)
deaths (rate)

Costs, million          284             855              97
USD (per
capita, USD *)

Kentucky

No. of              296 (19.3)       1,616 (71)     710 (114.9)
deaths (rate)

Costs, million          523            2,293            131
USD (per
capita, USD *)

Louisiana

No. of              381 (22.9)      1,440 (58.9)     522 (86.1)
deaths (rate)

Costs, million          685            2,045             97
USD (per
capita, USD *)

Maine

No. of               63 (15.9)       320 (46.7)     306 (126.7)
deaths (rate)

Costs, million    117 ([dagger])        423              50
USD (per
capita, USD *)

Maryland

No. of                183 (9)        772 (23.3)      719 (88.3)
deaths (rate)

Costs, million          340            1,039            114
USD (per
capita, USD *)

Massachusetts

No. of               230 (9.4)      1,577 (44.3)     884 (82.4)
deaths (rate)

Costs, million          444            2,143            138
USD (per
capita, USD *)

Michigan

No. of              532 (15.4)      2,283 (43.9)   1,607 (104.6)
deaths (rate)

Costs, million          943            3,014            264
USD (per
capita, USD *)

Minnesota

No. of              197 (10.7)       888 (30.3)    1,300 (155.9)
deaths (rate)

Costs, million          358            1,137            190
USD (per
capita, USD *)

Mississippi

No. of              288 (26.9)       903 (58.7)     520 (127.4)
deaths (rate)

Costs, million          512            1,215             92
USD (per
capita, USD *)

Missouri

No. of              407 (19.6)      1,585 (50.9)   1,118 (119.7)
deaths (rate)

Costs, million          731            2,185            186
USD (per
capita, USD *)

Montana

No. of               75 (21.8)       253 (49.1)     253 (153.3)
deaths (rate)

Costs, million          133             359              44
USD (per
capita, USD *)

Nebraska

No. of               95 (13.9)       338 (35.1)     348 (118.5)
deaths (rate)

Costs, million          172             446              52
USD (per
capita, USD *)

Nevada

No. of              144 (15.3)       722 (46.4)      300 (83.6)
deaths (rate)

Costs, million          265             949              54
USD (per
capita, USD *)

New Hampshire

No. of               56 (12.1)       376 (55.7)     284 (135.6)
deaths (rate)

Costs, million          104             522              46
USD (per
capita, USD *)

New Jersey

No. of              319 (10.8)      1,597 (33.1)    1,053 (77.2)
deaths (rate)

Costs, million          607            2,238            171
USD (per
capita, USD *)

New Mexico

No. of              173 (22.8)       899 (85.7)     462 (152.4)
deaths (rate)

Costs, million          315            1,250             79
USD (per
capita, USD *)

New York

No. of               587 (8.5)      3,095 (28.7)    2,259 (75.5)
deaths (rate)

Costs, million         1,095           4,158            363
USD (per
capita, USD *)

North Carolina

No. of              552 (16.0)      2,378 (45.4)   1,626 (118.7)
deaths (rate)

Costs, million         1,021           3,255            270
USD (per
capita, USD *)

North Dakota

No. of               44 (14.6)       146 (39.3)     159 (135.8)
deaths (rate)

Costs, million          82+             205              26
USD (per
capita, USD *)

Ohio

No. of              576 (14.5)      3,595 (60.6)   2,007 (110.6)
deaths (rate)

Costs, million         1,041           4,874            338
USD (per
capita, USD *)

Oklahoma

No. of              283 (20.3)      1,308 (65.0)    830 (152.5)
deaths (rate)

Costs, million          511            1,747            141
USD (per
capita, USD *)

Oregon

No. of              156 (12.1)       826 (38.3)     821 (131.8)
deaths (rate)

Costs, million          285            1,068            122
USD (per
capita, USD *)

Pennsylvania

No. of              683 (15.8)      3,454 (52.1)   2,503 (109.7)
deaths (rate)

Costs, million         1,256           4,687            404
USD (per
capita, USD *)

Rhode Island

No. of               33 (8.6)        316 (57.0)     243 (129.3)
deaths (rate)

Costs, million     62 ([dagger])        420              36
USD (per
capita, USD *)

South Carolina

No. of              334 (20.3)      1,333 (52.1)    769 (110.0)
deaths (rate)

Costs, million          615            1,821            136
USD (per
capita, USD *)

South Dakota

No. of               67 (22.1)       195 (45.6)     200 (139.9)
deaths (rate)

Costs, million    119 ([dagger])        270              31
USD (per
capita, USD *)

Tennessee

No. of              361 (16.0)      2,116 (61.4)   1,304 (141.7)
deaths (rate)

Costs, million          650            2,843            228
USD (per
capita, USD *)

Texas

No. of             1,498 (14.9)     5,434 (38.3)    2,789 (95.4)
deaths (rate)

Costs, million         2,720           7,485            486
USD (per
capita, USD *)

Utah

No. of              141 (11.5)       662 (47.6)     364 (130.0)
deaths (rate)

Costs, million          250             942              61
USD (per
capita, USD *)

Vermont

No. of               25 (10.9)       112 (34.5)     185 (179.2)
deaths (rate)

Costs, million          46+             140              27
USD (per
capita, USD *)

Virginia

No. of              362 (12.5)      1,577 (34.9)   1,208 (111.6)
deaths (rate)

Costs, million          671            2,163            194
USD (per
capita, USD *)

Washington

No. of              304 (12.6)      1,451 (37.0)   1,242 (128.6)
deaths (rate)

Costs, million          564            1,873            197
USD (per
capita, USD *)

West Virginia

No. of              122 (20.6)       818 (88.5)     440 (140.5)
deaths (rate)

Costs, million          225            1,133             77
USD (per
capita, USD *)

Wisconsin

No. of              275 (13.8)      1,279 (41.6)   1,461 (159.6)
deaths (rate)

Costs, million          508            1,665            203
USD (per
capita, USD *)

Wyoming

No. of               46 (22.3)       225 (72.4)      90 (116.0)
deaths (rate)

Costs, million          83+             291              17
USD (per
capita, USD *)

* Costs per capita calculated only for totals.

([dagger]) Average medical cost was statistically unstable;
however, it accounted for less than 1% of combined average
cost.

([section]) Rates based on <20 deaths might be unstable.

([paragraph]) Both average medical cost and average work loss cost
were statistically unstable.

TABLE 2. Suicide and homicide deaths, rates per 100,000
population, lifetime medical and work-loss costs,
and lifetime medical and work-loss
costs per capita, by state--United States, 2014

                                         Suicides

                                                   Sex

State                      Total            Male           Female

Alabama

No. deaths (rate)        715 (14.5)      569 (24.3)      146 (5.6)

Costs, million USD       897 (185)          755             143
(per capita, USD *)

Alaska

No. deaths (rate)        167 (22.0)      138 (34.8)       29 (7.9)

Costs, million USD     249 ([dagger])       220        32 ([dagger])
(per capita, USD *)        (338)         ([dagger])

Arizona

No. deaths (rate)       1,244 (18.0)     945 (27.7)      299 (8.7)

Costs, million USD      1,528 (227)        1,222            293
(per capita, USD *)

Arkansas

No. deaths (rate)        515 (17.2)      406 (27.9)      109 (7.2)

Costs, million USD       671 (226)          550        119 ([dagger])
(per capita, USD *)

California

No. deaths (rate)       4,214 (10.5)       3,234         980 (4.7)
                                           (16.7)

Costs, million USD      4,927 (127)        3,986            933
(per capita, USD *)

Colorado

No. deaths (rate)       1,083 (19.8)     843 (31.3)      240 (8.7)

Costs, million USD      1,421 (265)        1,174            252
(per capita, USD *)

Connecticut

No. deaths (rate)        379 (9.7)       276 (14.8)      103 (5.1)

Costs, million USD       475 (132)          368        98 ([dagger])
(per capita, USD *)

Delaware

No. deaths (rate)        126 (13.2)      100 (22.3)       26 (5.3)

Costs, million USD     168 ([dagger])       140            -- **
(per capita, USD *)        (179)         ([dagger])

District of
Columbia

No. deaths (rate)         52 (7.7)       39 (12.3)        13 (4.0)

Costs, million USD     73 ([dagger])         59            -- **
(per capita, USD *)        (110)         ([dagger])

Florida

No. deaths (rate)       3,035 (13.8)       2,328         707 (6.3)
                                           (21.9)

Costs, million USD      3,332 (167)        2,701            624
(per capita, USD *)

Georgia

No. deaths (rate)       1,294 (12.6)     998 (20.6)      296 (5.6)

Costs, million USD      1,622 (161)        1,323            292
(per capita, USD *)

Hawaii

No. deaths (rate)        204 (13.6)      163 (21.5)       41 (5.4)

Costs, million USD       283 (199)          243        43 ([dagger])
(per capita, USD *)

Idaho

No. deaths (rate)        320 (20.1)      240 (30.5)      80 (10.1)

Costs, million USD     391 ([dagger])       299        89 ([dagger])
(per capita, USD *)        (239)         ([dagger])

Illinois

No. deaths (rate)       1,398 (10.4)    1,110 (17.1)     288 (4.2)

Costs, million USD      1,780 (138)        1,474            304
(per capita, USD *)

Indiana

No. deaths (rate)        948 (14.3)      756 (23.4)      192 (5.6)

Costs, million USD      1,210 (183)        1,023            194
(per capita, USD *)

Iowa

No. deaths (rate)        407 (12.8)      327 (20.7)       80 (5.2)

Costs, million USD       520 (167)          437        81 ([dagger])
(per capita, USD *)

Kansas

No. deaths (rate)        455 (15.7)      356 (25.0)       99 (6.6)

Costs, million USD       624 (215)          511        111 ([dagger])
(per capita, USD *)

Kentucky

No. deaths (rate)        727 (15.9)      582 (26.2)      145 (6.2)

Costs, million USD       927 (210)          771             151
(per capita, USD *)

Louisiana

No. deaths (rate)        679 (14.3)      506 (22.2)      173 (7.0)

Costs, million USD       888 (191)          692             176
(per capita, USD*)

Maine

No. deaths (rate)        220 (15.7)      174 (25.5)       46 (6.7)

Costs, million USD     269 ([dagger])       219        49 ([dagger])
(per capita, USD *)        (202)         ([dagger])

Maryland

No. deaths (rate)        606 (9.8)       470 (16.1)      136 (4.2)

Costs, million USD       763 (128)          617        140 ([dagger])
(per capita, USD *)

Massachusetts

No. deaths (rate)        596 (8.3)       472 (13.6)      124 (3.4)

Costs, million USD       782 (116)          657             126
(per capita, USD *)

Michigan

No. deaths (rate)       1,354 (13.2)    1,062 (21.3)     292 (5.6)

Costs, million USD      1,735 (175)        1,461            276
(per capita, USD *)

Minnesota

No. deaths (rate)        686 (12.2)      525 (18.8)      161 (5.9)

Costs, million USD       914 (168)          741             172
(per capita, USD *)

Mississippi

No. deaths (rate)        380 (12.5)      299 (20.8)       81 (5.3)

Costs, million USD       481 (161)          406        74 ([dagger])
(per capita, USD *)

Missouri

No. deaths (rate)       1,017 (16.3)     817 (27.2)      200 (6.3)

Costs, million USD      1,302 (215)        1,091            205
(per capita, USD *)

Montana

No. deaths (rate)        251 (23.8)      197 (36.8)      54 (11.4)

Costs, million USD     302 ([dagger])       250        52 ([dagger])
(per capita, USD *)        (295)         ([dagger])

Nebraska

No. deaths (rate)        251 (13.4)      202 (21.7)       49 (5.4)

Costs, million USD       313 (166)          263        51 ([dagger])
(per capita, USD *)

Nevada

No. deaths (rate)        573 (19.5)      449 (31.2)      124 (8.2)

Costs, million USD       669 (236)          547        124 ([dagger])
(per capita, USD *)

New Hampshire

No. deaths (rate)        247 (17.6)      191 (27.5)       56 (8.1)

Costs, million USD     302 ([dagger])       251        49 ([dagger])
(per capita, USD *)        (228)         ([dagger])

New Jersey

No. deaths (rate)        786 (8.3)       590 (12.9)      196 (4.1)

Costs, million USD       958 (107)          748             203
(per capita, USD *)

New Mexico

No. deaths (rate)        449 (21.0)      350 (33.4)       99 (9.2)

Costs, million USD       594 (285)          501              98
(per capita, USD *)

New York

No. deaths (rate)       1,700 (8.1)        1,262         438 (4.0)
                                           (12.5)

Costs, million USD      2,139 (108)        1,674            435
(per capita, USD *)

North Carolina

No. deaths (rate)       1,351 (13.0)     984 (19.8)      367 (6.9)

Costs, million USD      1,685 (169)        1,296            369
(per capita, USD *)

North Dakota

No. deaths (rate)        137 (17.5)      113 (27.8)       24 (6.7)

Costs, million USD     195 ([dagger])       169            -- **
(per capita, USD *)        (264)         ([dagger])

Ohio

No. deaths (rate)       1,491 (12.6)    1,163 (20.1)     328 (5.7)

Costs, million USD      1,939 (167)        1,588            344
(per capita, USD *)

Oklahoma

No. deaths (rate)        736 (19.1)      561 (29.5)      175 (9.2)

Costs, million USD       999 (258)          801             186
(per capita, USD *)

Oregon

No. deaths (rate)        782 (18.7)      614 (30.1)      168 (7.9)

Costs, million USD       911 (229)          755        157 ([dagger])
(per capita, USD *)

Pennsylvania

No. deaths (rate)       1,817 (13.3)    1,440 (21.6)     377 (5.6)

Costs, million USD      2,307 (180)        1,928            378
(per capita, USD *)

Rhode Island

No. deaths (rate)        113 (10.0)      82 (14.9)        31 (5.4)

Costs, million USD     159 ([dagger])       120            -- **
(per capita, USD *)        (151)         ([dagger])

South Carolina

No. deaths (rate)        753 (15.1)      579 (24.4)      174 (6.8)

Costs, million USD       953 (197)          785             170
(per capita, USD *)

South Dakota

No. deaths (rate)        141 (17.0)      109 (25.9)       32 (7.9)

Costs, million USD     197 ([dagger])       162        37 ([dagger])
(per capita, USD *)        (231)         ([dagger])

Tennessee

No. deaths (rate)        948 (14.1)      746 (23.3)      202 (5.8)

Costs, million USD      1,241 (189)        1,032            214
(per capita, USD *)

Texas

No. deaths (rate)       3,254 (12.2)    2,528 (19.5)     726 (5.4)

Costs, million USD      4,264 (158)        3,490            754
(per capita, USD *)

Utah

No. deaths (rate)        559 (20.6)      418 (31.0)      141 (10.5)

Costs, million USD       802 (273)          634        158 ([dagger])
(per capita, USD *)

Vermont

No. deaths (rate)        124 (18.6)      102 (30.7)       22 (7.2)

Costs, million USD     148 ([dagger])       131            -- **
(per capita, USD *)        (237)         ([dagger])

Virginia

No. deaths (rate)       1,122 (12.9)     870 (20.7)      252 (5.7)

Costs, million USD      1,412 (170)        1,150            252
(per capita, USD *)

Washington

No. deaths (rate)       1,119 (15.2)     854 (23.5)      265 (7.2)

Costs, million USD      1,404 (199)        1,147            253
(per capita, USD *)

West Virginia

No. deaths (rate)        359 (18.1)      280 (28.6)       79 (8.1)

Costs, million USD       426 (230)          346        71 ([dagger])
(per capita, USD *)

Wisconsin

No. deaths (rate)        769 (13.1)      598 (20.6)      171 (5.9)

Costs, million USD       981 (170)          806             170
(per capita, USD *)

Wyoming

No. deaths (rate)        120 (20.7)      96 (32.3)        24 (8.7)

Costs, million USD     153 ([dagger])       131        21 ([dagger])
(per capita, USD *)        (262)         ([dagger])

                                        Homicides

                                                   Sex

State                      Total            Male          Female

Alabama

No. deaths (rate)        374 (8.0)       304 (13.4)      70 (2.8)

Costs, million USD       606 (125)          532             76
(per capita, USD *)                                     ([dagger])

Alaska

No. deaths (rate)        37 (4.7)         22 (5.3)       15 (4.1)

Costs, million USD          61               38            -- **
(per capita, USD *)     ([dagger])       ([dagger])
                           (83)
Arizona

No. deaths (rate)        322 (5.0)       249 (7.7)       73 (2.2)

Costs, million USD       538 (80)           448             82
(per capita, USD *)                                     ([dagger])

Arkansas

No. deaths (rate)        217 (7.6)       158 (11.3)      59 (4.1)

Costs, million USD       323 (109)          258             62
(per capita, USD *)                                     ([dagger])

California

No. deaths (rate)       1,813 (4.6)     1,514 (7.6)      299 (1.5)

Costs, million USD      3,103 (80)         2,794            337
(per capita, USD *)

Colorado

No. deaths (rate)        177 (3.3)       124 (4.5)       53 (2.1)

Costs, million USD       282 (53)           215             58
(per capita, USD *)                                     ([dagger])

Connecticut

No. deaths (rate)        99 (2.8)         75 (4.3)       24 (1.3)

Costs, million USD       170 (47)           142             25
(per capita, USD *)                                     ([dagger])

Delaware

No. deaths (rate)        57 (6.5)        47 (10.9)       10 (2.2)

Costs, million USD       98 (105)      87 ([dagger])       -- **
(per capita, USD *)

District of
Columbia

No. deaths (rate)        97 (13.2)       79 (22.3)       18 (4.8)

Costs, million USD       180 (273)          152            -- **
(per capita, USD *)

Florida

No. deaths (rate)       1,158 (6.2)      915 (9.8)       243 (2.5)

Costs, million USD      1,852 (93)         1,584            282
(per capita, USD *)

Georgia

No. deaths (rate)        658 (6.5)       518 (10.2)      140 (2.8)

Costs, million USD      1,087 (108)         933             155
(per capita, USD *)

Hawaii

No. deaths (rate)        30 (2.3)         21 (3.0)       ([dagger]
                                                         [dagger])

Costs, million USD          34             -- **           -- **
(per capita, USD *)     ([section])
                           (24)

Idaho

No. deaths (rate)        36 (2.4)         22 (3.0)       14 (1.7)

Costs, million USD          49             -- **           -- **
(per capita, USD *)     ([section])
                           (30)

Illinois

No. deaths (rate)        792 (6.2)       679 (10.6)      113 (1.8)

Costs, million USD      1,409 (109)        1,307            123
(per capita, USD *)

Indiana

No. deaths (rate)        364 (5.7)       290 (9.0)       74 (2.3)

Costs, million USD       597 (90)           515             86
(per capita, USD *)                                     ([dagger])

Iowa

No. deaths (rate)        78 (2.5)         50 (3.2)       28 (1.8)

Costs, million USD       114 (37)      87 ([dagger])        32
(per capita, USD *)                                     ([section])

Kansas

No. deaths (rate)        104 (3.6)        75 (5.2)       29 (2.1)

Costs, million USD       168 (58)           132             34
(per capita, USD *)

Kentucky

No. deaths (rate)        203 (4.7)       153 (7.1)       50 (2.3)

Costs, million USD       303 (69)           253             55
(per capita, USD *)                                     ([dagger])

Louisiana

No. deaths (rate)       538 (11.6)       428 (18.6)      110 (4.7)

Costs, million USD       941 (202)          796             135
(per capita, USD*)

Maine

No. deaths (rate)        23 (2.0)         15 (2.6)          --
                                                         ([dagger]
                                                         [dagger])

Costs, million USD          35             -- **           -- **
(per capita, USD *)     ([section])
                           (26)
Maryland

No. deaths (rate)        387 (6.6)       312 (10.8)      75 (2.4)

Costs, million USD       692 (116)          593             91
(per capita, USD *)                                     ([dagger])

Massachusetts

No. deaths (rate)        110 (1.6)        91 (2.7)       19 (0.5)

Costs, million USD       197 (29)           176             24
(per capita, USD *)                                     ([dagger])

Michigan

No. deaths (rate)        589 (6.2)       465 (9.8)       124 (2.6)

Costs, million USD       990 (100)          831             149
(per capita, USD *)

Minnesota

No. deaths (rate)        101 (1.9)        69 (2.6)       32 (1.2)

Costs, million USD       170 (31)           125             40
(per capita, USD *)                                     ([dagger])

Mississippi

No. deaths (rate)       332 (11.3)       277 (19.4)      55 (3.5)

Costs, million USD       530 (177)          484             62
(per capita, USD *)                                     ([dagger])

Missouri

No. deaths (rate)        441 (7.5)       357 (12.3)      84 (2.8)

Costs, million USD       745 (123)          650             94
(per capita, USD *)

Montana

No. deaths (rate)        30 (2.9)         23 (4.4)          --
                                                         ([dagger]
                                                         [dagger])

Costs, million USD          40             -- **           -- **
(per capita, USD *)     ([dagger])
                           (39)
Nebraska

No. deaths (rate)        63 (3.4)         47 (5.0)       16 (1.7)

Costs, million USD       108 (58)      91 ([dagger])       -- **
(per capita, USD *)

Nevada

No. deaths (rate)        176 (6.3)       138 (9.8)       38 (2.7)

Costs, million USD       266 (94)           235             41
(per capita, USD *)                                     ([section])

New Hampshire

No. deaths (rate)           17              --              --
                           (1.3)         ([dagger]       ([dagger]
                       ([paragraph])     [dagger])       [dagger])

Costs, million USD         -- **           -- **           -- **
(per capita, USD *)

New Jersey

No. deaths (rate)        372 (4.4)       302 (7.2)       70 (1.6)

Costs, million USD       654 (73)           568             80
(per capita, USD *)                                     ([dagger])

New Mexico

No. deaths (rate)        135 (6.8)       106 (10.5)      29 (2.9)

Costs, million USD       218 (105)          183             32
(per capita, USD *)                                     ([section])

New York

No. deaths (rate)        662 (3.3)       536 (5.5)       126 (1.2)

Costs, million USD      1,157 (59)         1,010            147
(per capita, USD *)

North Carolina

No. deaths (rate)        551 (5.6)       435 (8.9)       116 (2.3)

Costs, million USD       730 (73)           769             128
(per capita, USD *)

North Dakota

No. deaths (rate)           15            13 (3.0)          --
                           (2.0)                         ([dagger]
                       ([paragraph])                     [dagger])

Costs, million USD         -- **           -- **           -- **
(per capita, USD *)

Ohio

No. deaths (rate)        578 (5.2)       472 (8.4)       106 (1.9)

Costs, million USD       955 (82)           843             122
(per capita, USD *)

Oklahoma

No. deaths (rate)        250 (6.5)       183 (9.5)       67 (3.5)

Costs, million USD       409 (105)          316             83
(per capita, USD *)                                     ([dagger])

Oregon

No. deaths (rate)        99 (2.4)         65 (3.1)       34 (1.7)

Costs, million USD       131 (33)      104 ([dagger])       33
(per capita, USD *)                                     ([dagger])

Pennsylvania

No. deaths (rate)        620 (5.1)       492 (8.1)       128 (2.0)

Costs, million USD      1,059 (83)          901             149
(per capita, USD *)

Rhode Island

No. deaths (rate)        27 (2.5)         23 (4.2)          --
                                                         ([dagger]
                                                         [dagger])

Costs, million USD          45             -- **           -- **
(per capita, USD *)     ([dagger])
                           (43)

South Carolina

No. deaths (rate)        363 (7.5)       286 (12.1)      77 (3.1)

Costs, million USD       587 (121)          503             84
(per capita, USD *)                                     ([dagger])

South Dakota

No. deaths (rate)        26 (3.2)         15 (3.6)       11 (2.7)

Costs, million USD         -- **           -- **           -- **
(per capita, USD *)

Tennessee

No. deaths (rate)        379 (5.9)       309 (9.6)       70 (2.2)

Costs, million USD       595 (91)           523             82
(per capita, USD *)                                     ([dagger])

Texas

No. deaths (rate)       1,389 (5.1)     1,059 (7.8)      330 (2.5)

Costs, million USD      2,240 (83)         1,867            386
(per capita, USD *)

Utah

No. deaths (rate)        61 (2.1)         39 (2.7)       22 (1.4)

Costs, million USD          89         67 ([dagger])        25
(per capita, USD *)     ([dagger])                      ([dagger])
                           (30)

Vermont

No. deaths (rate)           16            13 (4.8)          --
                           (2.9)                         ([dagger]
                       ([paragraph])                     [dagger])

Costs, million USD         -- **           -- **           -- **
(per capita, USD *)

Virginia

No. deaths (rate)        339 (4.1)       249 (5.9)       90 (2.2)

Costs, million USD       555 (67)           449             105
(per capita, USD *)                                     ([dagger])

Washington

No. deaths (rate)        211 (3.0)       157 (4.4)       54 (1.6)

Costs, million USD       333 (47)           272             63
(per capita, USD *)                                     ([dagger])

West Virginia

No. deaths (rate)        103 (5.9)        70 (7.9)       33 (3.9)

Costs, million USD       156 (85)      113 ([dagger])       41
(per capita, USD *)                                     ([dagger])

Wisconsin

No. deaths (rate)        166 (3.0)       126 (4.5)       40 (1.4)

Costs, million USD       274 (48)           227             45
(per capita, USD *)                                     ([dagger])

Wyoming

No. deaths (rate)        24 (4.4)         16 (5.8)          --
                                                         ([dagger]
                                                         [dagger])

Costs, million USD         -- **           -- **           -- **
(per capita, USD *)

* Costs per capita calculated only for totals.

([dagger]) Average medical cost was statistically unstable;
however, it accounted for less than 1% of combined average cost.

([section]) Average medical cost was statistically unstable;
however, it accounted for less than 5% of combined average cost.

([paragraph]) Rates based on <20 deaths might be unstable.

** Both average medical cost and average work loss cost were
statistically unstable.

([dagger][dagger]) State-level counts and rates based on <10 deaths
have been suppressed.
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Author:Luo, Feijun; Florence, Curtis
Publication:Morbidity and Mortality Weekly Report
Geographic Code:1U9CA
Date:Jan 13, 2017
Words:10515
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