Often, patients who are readmitted after being sent home from the hospital return through the emergency room. Photo shows nurses rushing a patient on a gurney into a doorway.
Often, patients who are readmitted after being sent home from the hospital return through the emergency room. Image courtesy Trust for America's Health

North Carolina’s injury rate has fallen, with overdose deaths leading the drop.

By Rose Hoban

North Carolina is one of only nine states that have seen a drop in the rate of injury-related deaths over the past few years, an annual report found.

The state had an injury death rate of 62.1 deaths per 100,000 residents, higher than the national average of 58.2 per 100,000, according to the report, published Wednesday by the Trust for America’s Health and the Robert Wood Johnson Foundation.

North Carolina ranked 26th highest in the country among states for the rate of injury deaths, which include, among other things, drug overdoses, motor vehicle crashes and homicides.

Injuries are the leading cause of death for Americans aged 1 to 44.

North Carolina injury deaths have decreased over the past four years, while 17 other states increased and another 24 states had stable rates. The state’s injury death rate was 66 per 100,000 in 2013, when North Carolina ranked 19th for injury deaths in the country in the same report.

The injury rates are based on three-year averages of the most recent data, from 2011 to 2013.

“The average injury-related death in the U.S. costs over $1 million in medical costs and lost wages,” said Amber Williams, head of the Safe States Alliance, during a telephone press conference Wednesday. “Preventing these injuries will allow for investments in other critical areas, including education and infrastructure.”

Accidental overdose

One of the largest causes of injury death came from accidental drug overdose, which has been the focus of intense attention in North Carolina over the past few years.

Overdose was a main focus of the press call Wednesday morning, with Williams and others noting that it takes time for policies to result in a drop in the overdose death rate.

In North Carolina, opioid overdose deaths have been trending downward from a total of 836 in 2008 to 790 in 2013. However, as prescription painkiller overdose deaths have dropped, deaths from heroin overdose have increased sharply in recent years.

Image courtesy Trust for America's Health
Image courtesy Trust for America’s Health

“We know from the research in North Carolina over a decade that 60 percent of the people who died from an overdose, almost all these people had someone with them as they were dying who made the decision not to call for help,” said Kay Sanford, who was one of the earliest people in the state to work toward getting naloxone into the hands of drug users and their friends and families.

Sanford said the passage of North Carolina’s Good Samaritan law in 2013, which allows the companion of someone experiencing an overdose to call 911 without fear of prosecution, is an important tool in saving lives.

Another tool that’s saved lives is the wide distribution of the opiate-antidote naloxone by groups such as the North Carolina Harm Reduction Coalition.

Robert Childs from the coalition has said his group has documented hundreds of naloxone “saves” since the legislature allowed for wider prescription and distribution of the drug in 2013.

Drug overdoses are the leading cause of injury death in 36 states, including North Carolina. Nationwide, 44,000 people died from overdoses, making it the leading cause of injury death in the U.S., surpassing motor vehicle-related deaths.

North Carolina met seven of 10 key indicators of steps that states can take to prevent injuries. The state achieved these seven guidelines:

– having seat belt laws requiring everyone in the car to wear one;
– requiring booster seats for children up to 8 years old;
– having graduated driver’s licensing that restricts teens from driving after 10 p.m.;
– requiring bicycle helmets for children;
– having child-abuse and -neglect rates lower than the national average;
– requiring mandatory use of the state’s controlled-substances reporting system; and
– allowing access and use of naloxone to counteract overdoses.

Nationally, about 30 million Americans are medically treated for injuries each year, according to the 88-page report.

Nearly 193,000 Americans die, nearly 2.5 million are hospitalized and more than 27 million are treated in emergency departments for injuries annually.

More than 30 percent of emergency department visits are injury related, with falls being the leading cause and motor vehicle crashes the second-leading cause, according to the report.

Males account for more than 80 percent of all injury deaths.

Additional reporting for this story was done by Rachel Herzog.

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