Human Costs of Injury

The Human Costs of Injury

Injury in British Columbia in 2018 resulted in: 

• 2,669 deaths 
• 8,753 disabilities 
• 33,256 hospitalizations 
• 614,866 emergency department (ED) visits 

Each of these cases represents a person whose life was affected or taken by injury.

Unintentional injuries accounted for the majority of injury cases in 2018: 

• 79 per cent of deaths 
• 88 per cent of hospitalizations 
• 95 per cent of ED visits 
• 90 per cent of disabilities

Taking a closer look at the data:

• Individuals aged 85 years and older had the highest rate of unintentional injury across all injury outcomes in 2018, peaking at 20,006.2 per 100,000 emergency department visits. 

• The rates of intentional/inflicted injury were highest for emergency department visits among males aged 20-24 years, at 1,016.8 per 100,000.

The table below provides injury case numbers and rates per 100,000 for intent and outcome of injury, by age group and by sex, across BC and the Health Authorities. 

The leading causes of injury deaths in 2018 were:

• Unintentional poisonings (40.0%)
• Falls (21.8%)
•  Suicide/self-harm (19.7%)
•  Transport incidents (10.2%)

The leading causes of injury hospitalizations were:

•  Falls (56.8%)
•  Transport incidents (11.8%)
•  Suicide/self-harm (8.4%)
•  Unintentional poisoning (5.0%)

The leading causes of injury ED visits were:

•  Falls (32.3%)
•  Transport incidents (9.7%)

The leading causes of injury disability were:

• Falls (62.7%)
• Transport incidents (10.6%)
• Suicide/self-harm (7.5%)
• Unintentional poisoning (4.6%)

The leading causes of injury varied when examined by age group or sex. For example:

• Falls were the leading cause of injury hospitalization for children ages 0-14 years, whereas the leading cause among young adults 15-24 years was suicide/self-harm.

•  Transport incidents were the leading cause of injury hospitalizations among males ages 15-24 years, whereas the leading cause among females was suicide/self-harm.

The table below provides injury case numbers and rates per 100,000 for cause and outcome of injury, by age group and by sex, across BC and the Health Authorities. 

Injury deaths tend to be higher among older people, as the risk of death from injury increases with age. This can influence society to focus on those causes of death that predominantly affect older people. Potential Years of Life Lost (PYLL) emphasizes the loss of future contribution individuals have the potential to make to society, and draws attention to deaths affecting younger people.

The PYLL from injury in 2018 was 63,955 years. The rate of PYLL was highest among those aged 20-34 years, at 2,539.3 per 100,000 population. Despite the 75+ years age group having the highest death rate, these deaths did not contribute to the calculation of PYLL, as it was based on a conservative life expectancy of 75 years.

The figure below depicts comparisons of PYLL rate per 100,000 for each age group by cause of injury, across BC and the Health Authorities. 

The Preventable Years of Life Lost (PrYLL) is similar to PYLL, except it considers only preventable causes of death. Compared to PYLL, where injuries do not appear as the leading cause in comparison to other causes of death such as cancers and heart diseases, PrYLL demonstrates that while injuries comprised 15 per cent of total deaths in 2018, they accounted for 49 per cent of preventable years of life lost.

As almost all causes of injury deaths are considered to be preventable, with the notable exceptions being legal interventions and acts of war, the PrYLL value for injury is similar to the PYLL. It is not only a useful metric to highlight the preventability of injuries, but also that injuries make up the highest proportion of avoidable loss of human potential. 

The PrYLL from injury in 2018 was 63,106 years, by far the highest as compared to other causes of death.

The figure below depicts comparisons of the proportion of PrYLL for cause of death, across BC and the Health Authorities. 

Disability Adjusted Life Years (DALY) quantifies the human impact of deaths and disability. It is the sum of years of life lost (YLL) due to premature death and years of healthy life lost due to disability (YLD). Unlike PYLL, where the same average life expectancy is applied to each case (e.g., 75 years of age), the YLL assumes that everyone who has died has also lost years of life, even if they have exceeded the average life expectancy.

In injury prevention, DALY is used to determine the effectiveness of programs, interventions, and resource allocation. DALY should not be used to compare causes of injury that are age-specific; for example, comparing falls among older adults with self-harm among youth. 

The DALY from injury in 2018 was 20,606,212 years.

The DALY is driven by unintentional injuries, and accounted for:

•  79 per cent of deaths
•  88 per cent of hospitalizations
•  95 per cent of ED visits

The figure below depicts comparisons of DALY rate per 1,000 for each age group by sex and by cause of injury, across BC and the Health Authorities.