Trends in Fatal and Nonfatal Injuries Among Older Americans, 2004–2017

Introduction: This study (1) provides annual population estimates of fatal and nonfatal injury incidence rates for older adults for 2004–2017; (2) determines if trends differ by whether the injury was fatal or nonfatal, a fall or nonfall injury, and for nonfatal injuries, minor or serious; and (3) investigates whether trends vary by age, sex, and race. Methods: This study used National Vital Statistics System and National Health Interview Survey data covering the population of adults aged ≥65 years for 2004–2017. Fatal injury incidence rates were estimated using negative binomial models; nonfatal injury incidence rates were estimated using Poisson models. All models compared overall risk and trend differences by year, age, sex, and race, and interactions between year and age, sex, and race. All analyses were conducted in 2019. Results: Fatal injury incidence was stable over time, but this apparent stability masked a 35% increase in fatal falls and a 17% decrease in fatal nonfall injuries. Increases in fall-related deaths were concentrated among those aged ≥85 years, men, and white older adults. The trend in fatal falls accelerated over time for those aged ≥85 years and white older adults. By contrast, there was a large increase in nonfatal injury incidence, occurring across all injury types. Nonfatal injury risk grew with age and was higher for women and white older adults, but trends did not vary by age, sex, or race. Conclusions: Large increases in fatal and nonfatal injuries underscore the urgency of national implementation of fall prevention programs and expanding fall prevention efforts to more general injury prevention.