Leading causes of injury deaths, hospital discharges, and emergency department visits, Maine, 2007-2011
Injury is an important public health issue in Maine. Every week, on average, during 2007-2011, there were 16 injury deaths, 154 injury hospital discharges, and 3,403 injury emergency department visits (that did not end in hospitalization) involving Maine residents. Identifying the most common causes of injury events in the state is a key step in planning injury prevention activities.
The leading causes of injury table shows causes that were responsible for at least 10% of injury deaths, hospital discharges, or emergency department visits among Maine residents in 2007-2011. The table shows the leading causes for the state as a whole, for females and males, and for specific age groups. For each leading cause, the average annual number of injury events due to that cause during 2007-2011 and the percentage of all injury events during 2007-2011 that were due to that cause also are shown. For example, looking at the emergency department visit column for the Maine total, we see that there were an average of 46,200 unintentional fall related injury emergency department visits among Maine residents each year during 2007-2011 and that 26% of all injury emergency department visits by Maine residents during this 5-year period were due to unintentional falls. Additional information about the table can be found in the footnotes.
|Leading causes* of injury deaths, hospital discharges, and emergency department visits by selected demographics, Maine, 2007-2011|
Cause (average annual #; % of injury deaths)
Cause (average annual #; % of injury discharges)
Emergency department visits§
Cause (average annual #; % of injury visits)
|Maine total||Suicide (196; 24%)
Unintentional motor vehicle traffic (153; 19%)
Unintentional poisoning (140; 17%)
Unintentional fall (94; 12%)
|Unintentional fall (4,208; 53%)||Unintentional fall (46,200; 26%)
Unintentional struck by, against (21,423; 12%)
Unintentional overexertion (19,595; 11%)
|(tie) Unintentional motor vehicle traffic (49; 18%)
(tie) Unintentional poisoning (49; 18%)
Unintentional fall (42; 16%)
Suicide (39; 15%)
|Unintentional fall (2,691; 61%)||Unintentional fall (25,399; 30%)
Unintentional overexertion (9,750; 12%)
Unintentional struck by, against (8,436; 10%)
|Male||Suicide (157; 29%)
Unintentional motor vehicle traffic (104; 19%)
Unintentional poisoning (91; 17%)
|Unintentional fall (1,517; 42%)
Unintentional motor vehicle traffic (482; 13%)
|Unintentional fall (20,799; 22%)
Unintentional struck by, against (12,986; 14%)
Unintentional overexertion (9,844; 11%)
|Unintentional suffocation (3; 60%)
Homicide (1; 24%)
|Unintentional fall (13; 29%)
Assault (12; 28%)
|Unintentional fall (447; 42%)|
|1-4||Homicide (1; 23%)
(tie) Unintentional drowning (1; 18%)
(tie) Unintentional pedestrian, other (1; 18%)
(tie) Unintentional motor vehicle traffic (1; 14%)
(tie) Unintentional suffocation (1; 14%)
|Unintentional poisoning (32; 30%)
Unintentional fall (27; 25%)
|Unintentional fall (3,020; 34%)
Unintentional struck by, against (1,217; 14%)
Unintentional natural/environmental (918; 10%)
|5-14||Unintentional motor vehicle traffic (3; 33%)
Unintentional drowning (1; 15%)
Homicide (1; 13%)
Suicide (1; 10%)
|Unintentional fall (56; 31%)
(tie) Unintentional motor vehicle traffic (21; 12%)
(tie) Unintentional transport, other (21; 12%)
|Unintentional fall (5,659; 27%)
Unintentional struck by, against (4,659; 22%)
|15-24||Unintentional motor vehicle traffic (34; 39%)
Suicide (22; 26%)
Unintentional poisoning (14; 16%)
|Unintentional motor vehicle traffic (169; 25%)
Self-inflicted (152; 23%)
Unintentional fall (86; 13%)
|Unintentional fall (5,666; 16%)
Unintentional struck by, against (5,601; 16%)
Unintentional overexertion (4,141; 12%)
|25-34||Unintentional poisoning (30; 33%)
Suicide (22; 25%)
Unintentional motor vehicle traffic (21; 24%)
|Self-inflicted (144; 25%)
Unintentional motor vehicle traffic (117; 20%)
Unintentional fall (93; 16%)
|Unintentional fall (4,793; 18%)
Unintentional overexertion (3,980; 15%)
Unintentional struck by, against (2,931; 11%)
|35-44||Suicide (36; 33%)
Unintentional poisoning (33; 30%)
Unintentional motor vehicle traffic (20; 18%)
|Self-inflicted (175; 25%)
Unintentional fall (155; 22%)
Unintentional motor vehicle traffic (105; 15%)
|Unintentional fall (4,762; 20%)
Unintentional overexertion (3,491; 15%)
Unintentional struck by, against (2,389; 10%)
|45-54||Suicide (48; 34%)
Unintentional poisoning (42; 29%)
Unintentional motor vehicle traffic (22; 15%)
|Unintentional fall (303; 33%)
Self-inflicted (149; 16%)
Unintentional motor vehicle traffic (121; 13%)
|Unintentional fall (5,396; 24%)
Unintentional overexertion (2,857; 13%)
|55-64||Suicide (30; 31%)
Unintentional motor vehicle traffic (20; 21%)
Unintentional poisoning (12; 13%)
|Unintentional fall (488; 52%)
Unintentional motor vehicle traffic (103; 11%)
|Unintentional fall (4,746; 31%)
Unintentional overexertion (1,553; 10%)
|65-74||Suicide (17; 27%)
(tie) Unintentional fall (12; 19%)
(tie) Unintentional motor vehicle traffic (12; 19%)
|Unintentional fall (599; 65%)||Unintentional fall (3,707; 39%)|
|75-84||Unintentional fall (28; 32%)
Unintentional motor vehicle traffic (13; 15%)
Suicide (12; 14%)
|Unintentional fall (1,136; 77%)||Unintentional fall (4,408; 52%)|
|85 and over||Unintentional fall (37; 32%)||Unintentional fall (1,252; 85%)||Unintentional fall (3,595; 66%)|
|Data sources: Deaths -- death certificate datasets from Maine Center for Disease Control and Prevention; Inpatient discharges -- hospital discharge datasets from Maine Health Data Organization; Outpatient emergency department visits -- hospital outpatient datasets from Maine Health Data Organization.
* Leading causes are defined as specific causes known to be responsible for 10% or more (before rounding) of that type of injury event; excludes non-specific causes such as unintentional unspecified or other specified. Average annual counts and percentages might be underestimates due to factors such as cause not being reported for some injury events or incomplete information about Maine residents who died out of state in 2010 and 2011.
† Deaths of Maine residents for which underlying cause of death was an injury cause (ICD-10 V01-Y36, Y85-Y87, Y89, or U01-U03).
‡ Inpatient discharges of Maine residents from Maine acute care hospitals for which principal diagnosis was injury (ICD-9-CM 800-909.2, 909.4, 909.9, 910-994.9, 995.5-995.59, or 995.80-995.85).
§ Emergency department visits by Maine residents at Maine acute care hospitals for which principal diagnosis was injury (ICD-9-CM 800-909.2, 909.4, 909.9, 910-994.9, 995.5-995.59, or 995.80-995.85) or an E800-E869, E880-E929, or E950-E999 external cause of injury code was present, and which did not end with patient being admitted to that hospital as an inpatient.
Why is the suicide rate higher in rural areas?
According to available national data, rural areas in the US experience higher suicide rates than urban areas. The rate of depression does not appear to be higher, nor are suicide attempts more prevalent. One possible explanation might be that people are more likely to die from their attempts because of their remoteness from emergency medical care. Also, household gun ownership is more prevalent in rural households and firearms have a higher fatality rate than other methods, leaving little to no opportunity for rescue. Studies that have examined the link between household gun ownership and suicide rates, even when controlling for other factors related to suicide, have found a relationship between gun availability and suicide rates. Easy access to guns is only one factor and further research is necessary to fully understand both the risk and protective factors for suicide in each state. (Harvard School of Public Health, August 2005) See www.hsph.harvard.edu/means-matter/index.html for more information.
What is the Maine Suicide Prevention Program?
The Maine Suicide Prevention Program (MSPP) is a collaboration among state agency leaders and staff and community service providers, schools and suicide survivors. The program is housed within and led by staff of the Maine Injury Prevention Program in the Maine Center for Disease Control and Prevention, Department of Health and Human Services. The MSPP provides resources such as a statewide crisis hotline and information resource center, mobile crisis outreach, training and education programs, and resource materials for suicide prevention and early intervention activities. Crisis services provide a variety of services including: telephone consultation, telephone support and referral, assessments, stabilization services, and crisis stabilization residential services. The toll free statewide crisis number (1-888-568-1112) is answered 7 days a week, 24 hours a day by trained clinicians.
Program goals are to:
- Provide leadership and coordination that guides suicide prevention among Maine citizens
- Promote access to suicide prevention and intervention services in health care settings across the state
- Implement effective suicide prevention initiatives within public and private organizations
- Promote professional competency in suicide prevention, intervention and postvention
- Support a culture of help seeking for people in need in Maine
Who should be involved in suicide prevention? Whose responsibility is it?
MSPP believes that suicide prevention is up to all of us! It is especially important that everyone who works with children and adults knows the early warning signs of suicidal behavior, how to intervene and when and how to access help.
What is the Federal Government doing?
The Federal Government supports efforts to implement the “National Strategy for Suicide Prevention” updated in 2012 by the U.S. Surgeon General. To read the National Strategy For Suicide Prevention go to: http://www.samhs.gov/prevention/ or for more information on suicide prevention, visit the nationally funded Suicide Prevention Resource Center at www.sprc.org.
What should everyone know about youth suicide?
Talking about suicide does NOT cause suicide. There are almost always some warning signs of suicide. Anyone can learn to intervene in suicidal behavior; and MANY suicides CAN be prevented when warning signs are recognized and people get the help and support they need. Removing lethal means (i.e. guns, ropes, pills & poisons etc.) from the presence of a suicidal individual is an important prevention strategy. For more information, visit: www.hsph.harvard.edu/means-matter/index.html
What causes suicide?
Suicidal behavior is one of the most complicated of human behaviors. This question cannot be answered briefly. There is no research that shows that a particular set of risk factors can accurately predict the likelihood of imminent danger of suicide for a specific individual. It is fair to say that suicidal people are experiencing varying degrees of external stress, internal conflicts and biological dysfunction and these factors together contribute to their state of mind. Depression, anxiety, conduct disorders, and substance abuse all contribute to the possibility of suicide, but they do not cause suicide. The exact reasons behind an individual suicide often remain a mystery though it is very helpful to know the warning signs and to get help for people showing these signs.
How do you know if someone is suicidal?
The best way to know whether or not someone is suicidal is to ASK! Whether or not you know the warning signs of suicide, if for ANY reason you think someone might be suicidal, it is perfectly OK to ask. You will not cause suicide by asking and you may very well save a life. Suicidal individuals are in a lot of pain, and the very fact that someone has noticed, has expressed concern and asked about suicide, can provide the relief and time needed to explore other options and get help.
How do you get a suicidal individual to talk?
- Take ALL talk/hints of suicide seriously
- LISTEN with concern, caring and respect
- Ask directly about suicidal thoughts and plans
- Do not judge, lecture, discount or criticize
- Offer hope in any way possible
- Never keep suicidal behavior a secret even if the person asks you to
- Assist in finding help and support
- Do not leave a suicidal person alone; be sure that firearms, pills, rope are not available
- Call mental health professional, or crisis services and for children and youth, contact parents and another adult trusted by the child if/when indicated
What are the warning signs of suicide?
- Talk of suicide, death
- Neglect of appearance, hygiene
- Dropping out of activities
- Isolating self from friends, family
- Feeling life is meaningless, feeling unloved
- Hopelessness, helplessness increases
- Perceived burdensomeness
- Refuses help, feels beyond help
- Puts life in order-may make a will
- Picks a fight, argues
- Gives away favorite possessions
- Verbal clues (see below)
- Sudden improvement in mood, behavior after being down or withdrawn*
*It is important to note that most suicidal people, no matter what their age, usually suffer from some degree of depression. In many people, the depression may be undiagnosed until a crisis occurs. Depression may leave a person feeling drained, “too tired” to carry out a suicide plan of action. When the depression begins to lift and you notice a sudden improvement, be warned that this could be a very dangerous time. Three months following a period of depression is a critical time of suicidal risk. The person has the energy to act, and may even appear cheerful and at peace with the world.
How can people help prevent a suicide?
- Encourage the person to talk about his/her feelings
- Stay calm and listen
- Take all threats seriously
- Be accepting, DO NOT judge or lecture
- Let the person know you care
- Ask about suicidal thoughts
- Ask if he/she has a plan
- Never promise secrecy-tell someone who can provide needed help
- Get help
- Stay with the person until help is arranged
Are Maine schools doing enough to prevent youth suicide?
The school role in suicide prevention and crisis intervention is a limited one, but school staff members play a crucial role in identifying and helping at-risk youth to access services. All Maine school administrators have received guidelines for development of school procedures. Using these guidelines to develop school protocols to respond to suicidal behavior prepares school staff to be better prepared to prevent suicide and intervene effectively in a crisis situation.
Most Maine schools have sent key people to the MSPP Gatekeeper Training. Sending key school staff to be trained is a really important step to learn the basics of youth suicide prevention. The one-day Gatekeeper training teaches risk factors, warning signs and, most importantly, how to recognize and respond to a suicidal youth. Training in how to conduct suicide prevention awareness education, Lifelines student lessons and other training programs are also available from the MSPP.
What should schools do to prevent suicide?
The MSPP recommends that schools integrate suicide prevention by:
- Developing procedures to follow to prevent youth suicide or to intervene in a suicide crisis
- Developing formal agreements between the school and local crisis service providers
- Sending several key staff to Gatekeeper training
- Offering ongoing awareness education for ALL school staff members
- Providing education and resources for parents and other community members
- Integrating student lessons that build help-seeking skills for all students within their Comprehensive School Health Education curriculum
- Providing or linking to services for youth at high risk
Suicide is the second leading cause of death for Maine’s young people and the 10th leading cause of death among Mainers of all ages. Suicide claims more lives of young people than cancer, heart disease, AIDS, birth defects, stroke, pneumonia and influenza, and chronic lung disease combined. For every homicide in Maine, there are seven suicides.
Suicide deaths, though very tragic, are the tip of the iceberg. Suicidal behavior among youth is thought to be far higher than in adult populations. It is estimated that there are 25 to 100 suicide attempts by adolescents and young adults for every youth suicide.