Injury deaths are a leading cause of death in the U.S. These deaths result from acute injuries caused by exposure to harmful substances, such as drug overdoses, or deprivation of essential elements, like oxygen deprivation. Intentional or unintentional deaths are classified first by intent and then, secondarily, by techniques like firearms or drug overdose. The present data brief published by the Centers for Disease Control and Prevention (CDC) – National Center for Health Statistics (NCHS) examines trends in injury fatality rates from 2003 to 2023, both overall and by three main causes such as homicide, unintentional, and suicide. It also explores trends in suicide, homicide, and unintentional death rates through the top three techniques for each.
Death data from 2003 to 2020 were collected from the National Center for Health Statistics using bridged-race categories, whereas data from 2021 to 2023 were categorized using single-race classifications. The death rates were adjusted for age based on the U.S. population in 2000 and given per 100,000 people.
This report used the International Classification of Diseases, 10th Revision (ICD–10) codes for the classification of injury deaths by intent and method. The age-adjusted death rates were measured for three intents. Cases with missing details were classified under unspecific techniques.
Trends in death rates were analyzed using Joinpoint software with a weighted regression model, three joinpoints, and a 0.05 alpha level. Death rates were compared through z-test statistics with a significance level of p < 0.05.
The injury death rates remained stable between 2003 and 2013. The total age-adjusted injury death rate significantly rose by 21% from 2013 (58.8 per 100,000) to 2019 (71.2), then increased another 25% by 2021 (89). It later significantly dropped by 4% by 2023 (85.3). Unintentional injury death rates significantly increased by 25% from 2013 to 2019 (39.4 to 49.3) and 31% by 2021 (64.7). This rate decreased by 4% in 2023 (62.3) with p < 0.05. Suicide death rates increased by 31% from 2003 to 2018 (10.8 to 14.2), declined by 5% by 2020 (13.5), then rose 4% to 14.1 in 2021 (p < 0.05), remaining stable during 2023.
The unintentional drug overdose mortality rate significantly increased from 2003 to 2022, with varying rates of change over time. This rate was significantly lower in 2023 (4%) compared to 2022 (p < 0.05).
The mortality rate for motor vehicle traffic deaths significantly decreased by 31% from 2003 to 2014 and increased by 29% from 2014 to 2021, whereas the rate significantly decreased by 6% in 2023 compared to 2021 (p < 0.05). Death rates from falls significantly increased from 2003 to 2021, with varying rates of change over time. There was no statistically significant difference observed in this trend between 2021 and 2023, with p < 0.05.
Firearms, including suicide deaths, significantly decreased by 15% from 2003 to 2014 and significantly increased by 91% from 2014 to 2012, whereas this rate was significantly lower by 16% in 2023 compared to 2021 (p < 0.05). The death rates due to suffocation significantly increased from 2003 to 2018 and statically decreased from 2018 to 2023 with p < 0.05. Homicide death rates, including pierce or cut and unspecified methods, were significantly decreased from 2003 to 2023 with p < 0.05.
In conclusion, after stability from 2003 to 2013, injury death rates rose in 2019 and then declined in 2023. Overdoses were the top method of unintentional deaths, which increased in 2022. Firearm homicide rates dropped after 2021, while firearm suicide rates remained stable.
Reference: Curtin SC. Trends in death rates for leading methods of injury: United States, 2003–2023. NCHS Data Brief. 2025:526. doi:10.15620/cdc/174582
