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Injury and Violence

Injury includes a wide range of health topics, from unintentional injuries, such as car crashes and falls, to intentional injuries, such as assault and suicide. The consequences of injury are not just physical. Many people who suffer an injury may also have disability, mental health and financial problems that can last a lifetime. The good news is that many injuries are preventable. From seat belts to violence prevention programs, injury prevention saves lives.

Injuries are the leading cause of death among persons aged 1-44 years, resulting in more than 187,000 deaths per year in the United States. An additional 31.7 million persons suffer a non-fatal injury requiring medical attention each year. On top of the immediate physical consequences, injuries impact health by contributing to:
  • Premature death
  • Disability
  • Poor mental health
  • High medical costs
  • Lost productivity

In Hawai'i injuries are the leading cause of death among children and adults aged 1-40 years - responsible for more deaths than all other causes combined. They are the third leading cause of death among residents of all ages. Mortality statistics do not convey the full extent of the problem, however, because fatal injuries represent less than 1% of all injuries requiring medical attention. In an average week in Hawai'i 13 residents die from an injury, another 109 are hospitalized and nearly 1,600 others are treated in emergency departments. Medical treatment for injuries generate nearly $390 million in hospital charges each year in Hawai'i.

Injury data cover a broad array of topics. Here are some injury-related statistics for the United States:
  • Each year, injuries are responsible for:
    • More than 187,000 deaths.
    • More than 31.7 million emergency department visits.
    • More than 2.8 million hospitalizations.
    • $406 billion in medical care and lost productivity.
  • Intentional injuries account for 7% of all non-fatal injuries and 33% of injury-related fatalities.
  • Injuries are the leading cause of disability, regardless of age, gender, race/ethnicity, or socioeconomic status.

The leading types of fatal injuries in Hawai'i from 2013-2017 were suicide, falls, poisoning (including accidental overdoses), motor vehicle related injuries (occupant, pedestrian and motorcyclist) and drowning. Types of fatal injuries varied by age, with suicide being the leading cause of injury-related death among those 15-44 years, poisoning was the leading cause among 45-64 year olds and falls were the leading cause among those 65 years and older. Additionally, falls comprised 53% of the non-fatal injury hospital admissions and 31% of the non-fatal injury emergency department visits from 2013-2017.

There are many factors that can affect the risk of injury and violence:
  • Individual characteristics, such as education, age, and sex
  • Individual behaviors, such as alcohol use or risk-taking
  • Physical environment, such as safe homes and roadways
  • Social environment, such as relationships and community cohesion
  • Societal factors, such as cultural beliefs, laws, and regulations

The risk of injury can be reduced in a large number of ways.

For unintentional injuries, prevention methods may include changes to the environment; improvements in technology and product safety; legislation and enforcement of safety laws; education and behavior change and technology and engineering.

For intentional injuries, prevention efforts may include changes in social norms surrounding violence, policy changes that address the social and economic conditions that are associated with violence, or improvements in skills such as conflict resolution and coping.

Injuries are tracked using a range of datasets, in addition to mortality statistics. Some examples include:
For more information on tracking injury and violence health objectives, please visit the Healthy People 2020 Injury and Violence Prevention page.

Hawai'i IBIS Health Indicator Reports

Hawai'i Health Matters Indicator Dashboards

Behavioral Risk Factor Surveillance System (BRFSS)


Pregnancy Risk Assessment Monitoring System (PRAMS)


Youth Risk Behavior Survey (YRBS) - Unsafe Driving


Youth Risk Behavior Survey (YRBS) - Physical Fighting and Weapons Carrying


Youth Risk Behavior Survey (YRBS) - Bullying


Youth Risk Behavior Survey (YRBS) - Self-Harm


Youth Risk Behavior Survey (YRBS) - Dating Violence


Youth Risk Behavior Survey (YRBS) - Sexual Violence