All Causes of Unintentional Injuries
There has been an increase in the rate of unintentional injuries seen in the emergency department in recent years after many years of declining rates. Death data is not yet available for this time period to confirm whether the rates of fatal injuries have also increased. The oldest and youngest were most affected as were those in the rural population.
Deaths due to unintentional injuries in Middlesex-London did not change significantly between 2005 and 2012. There has also been a stable trend in age-standardized death rates in Ontario and the Peer Group over the same timeframe. The rates in Middlesex-London, Ontario and the Peer Group were not significantly different from each other (Figure 4.1.1).
Seniors, aged 75 and older, experienced the greatest burden of death from unintentional injury (267.2 per 100,000). While the rate of death from injuries increases as age increases, the rate was nearly eight times higher in 75+ population compared to the next youngest age group 65-74 years (Figure 4.1.2).
Males (42.0 per 100,000) had higher rates of death due to unintentional injury than females (27.0 per 100,000) in Middlesex London but the difference was not statistically significant (not shown). Similarly, there was no significant difference between rural and urban areas (not shown).
Between 2005 and 2014 emergency department visits for unintentional injury significantly decreased in Middlesex-London, however they began to increase again in 2015. By 2017 the rates had increased to levels seen 10 years earlier. A similar trend was seen with an increase in the Ontario and Peer Group rates between 2013 and 2017 (Figure 4.1.3).
Middlesex-London’s rate was higher (11,359.2 per 100,000) than both geographic comparators for emergency department visits for all unintentional injuries in 2017: Ontario (9,916.3) and the Peer Group (10,679.8) (Figure 4.1.3).
Injuries were highest in the youngest and oldest age groups, as indicated by the U-shaped pattern for age-specific emergency department visit rates for unintended injuries in Middlesex-London (Figure 4.1.4).
Males had significantly higher age-standardized emergency department visit rates compared to females (not shown).
Rural areas had rates of emergency department visits that were 50% higher (17,471.9 per 100,000 people) than urban areas in Middlesex-London (10,922.1). (Figure 4.1.5).
Injury rates are on the rise as is the economic burden that injuries cause in Canada.1 Death rates represent the most severe form of injury and only present a picture of those injury causes with the direst consequences. Emergency department visits, on the other hand, are a good way to measure the many different types of injuries that people experience. They are not a perfect measure of all injuries as they only represent those severe enough to seek medical attention at an emergency department.
Rural populations tend to experience injuries at a higher rate than those in urban communities, particularly among children. Those in more remote rural areas have a higher risk of severe injuries.2
1. Parachute. The cost of injury in Canada [Internet]. Version 2.2. Toronto (ON): Parachute; 2015 [cited 2019 Feb 8]. 177 p. Available from: http://www.parachutecanada.org/downloads/research/Cost_of_Injury-2015.pdf
2. Kim K, Ozegovic D, Voaklander DC. Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev [Internet]. 2012 Aug [cited 2019 Feb 8];18(4):264–71. Available from: https://injuryprevention.bmj.com/content/18/4/264
Last modified on: March 15, 2019
Age-standardized rates may be used to compare different geographic areas or time frames to adjust for any differences in the age structure of the populations that could cause a difference in rates.
It reflects the number of events (e.g., deaths, hospitalizations) that would occur for a given population if that population had the same age distribution as the 2011 Canadian population.
Age-standardized rates have been used to make more valid comparisons than comparing crude rates. Standardization requires adjusting for the effects of varying age structures of different populations and over different periods of time. If one Population X has a higher proportion of elderly persons than Population Y, the death rate for Population X would be significantly higher solely because it has a higher proportion of elderly persons and the elderly have a much higher death rate than younger people. This concept also applies when comparing one population over different time periods if the age structure of the population changes over time. By standardizing the death rates for Population X, we can see what the death rate would be like if they had the same age structure as Population Y. The two different populations are now compared directly.