Where We've Been

All unintentional injury-related deaths are preventable but, historically, inadequate progress has been made in reducing these deaths. After overtaking stroke deaths in 2013 and chronic lower respiratory disease in 2016, unintentional injuries are currently the third leading cause of death behind heart disease and cancer. Unintentional injuries fell to fourth ranked in 2020 and 2021 behind COVID-19.

The historic increase in preventable injuries is even more shocking when compared to the decreasing overall fatality rate in the United States. Using 1900 as the baseline year, the overall age-adjusted fatality rate has decreased by 68%, while the preventable death rate has decreased by only about 26%. Even with the recent increases in the overall death rate in 2020 and 2021, the progress gap between overall and preventable death rate is expanding.

Progress in reducing the preventable death rate has always lagged behind progress in reducing the overall fatality rate, but we have come close. Starting in 1944, the rate of preventable injury-related death fell quickly, along with all causes of death, decreasing by 36% before a brief uptick in the early 1960s through the mid-1970s.

By 1992, the rate of preventable injury-related death was at the lowest point on record (33.96 per 100,000 population), 61% less than in 1900 and at near parity with the level of improvement achieved with all causes of death (which had fallen to 64% since 1900).

Since that time, the overall fatality rate has decreased 12%, while unintentional deaths have increased nearly 86%. As a result of both direct and indirect impacts of the COVID-19 pandemic, the trends have gotten even worse. Compared to 2019, the overall fatality rate increased 11.7%, while the preventable injury-related death rate increased 29.4%. The preventable injury death rate increase was driven by both an increase in drug overdoses and motor-vehicle crash deaths.

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Note: Percent changes are based on rates adjusted to the year 2000 standard population to remove the influence of changes in age distribution over time.
Source: National Safety Council (NSC) analysis of Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) National Vital Statistics System mortality data and NSC preventable death data.