Recommended Framework for Presenting Injury Mortality Data

Injuries are a substantial and preventable public health problem and account for approximately 6% of deaths in the United States. Many injury epidemiology and injury control programs depend on injury mortality and morbidity data aggregated by external cause of injury codes (E codes) for program planning and evaluation. This report provides a framework for the uniform tabulation and analysis of injury mortality data classified by the Ninth Revision of the International Classification of Diseases (ICD-9) (a subsequent report will address the application of this framework to injury morbidity data). Standard ICD-9 E-code groupings are presented in the form of a matrix and are depicted as mechanism by intent of injury. All cells in the matrix are mutually exclusive. Injury mortality data from the National Center for Health Statistics (NCHS) are presented in the matrix for 1993 to illustrate numbers of deaths within each cell Justifications are given for assigning E codes to major categories and subcategories within the matrix. The groupings of external causes presented in this framework were developed by CDC (National Center for Injury Prevention and Control NCIPC and NCHS) in collaboration with members of the American Public Health Association's Injury Control and Emergency Health Services Section (ICEHS). These groupings are intended to assist persons involved in planning and evaluating injury control programs at national, state, and local levels and are relevant for all persons who collect, code, analyze, and report injury data. Public health researchers and other public health professionals are encouraged to adopt or adapt these groupings as a minimum framework for tabulating injury deaths and death rates. For historical continuity, vital statistics programs will continue to use tabulation standards based on both the guidelines of the World Health Organization and derivative lists developed by CDC (NCHS) for presentation of national mortality statistics. The proposed framework can be used to supplement these tabulation standards by providing more detailed presentations of injury deaths and death rates, which are useful for making policy decisions and planning injury prevention activities.