The Facts Hurt: A State-By-State Injury Prevention Policy Report

Michigan had the 30th Highest Rate of Injury Deaths in U.S.

Michigan scored Four out of 10 on Key Indicators of Steps States can take to Prevent Injuries

Washington, D.C., June 17, 2015 – In a new report, The Facts Hurt: A State-By-State Injury Prevention Policy Report, Michigan ranked 30th highest for the number of injury-related deaths in the state, with a rate of 60.6 per 100,000 people. Overall, the national rate is 58.4 per 100,000.

Rates in Michigan increased over the past four years for injury deaths, which includes drug overdoses, motor vehicle crashes, homicides and others. Overall, 17 states increased, 24 remained stable and 9 decreased. Injuries are the leading cause of death for Americans ages 1 to 44 – and are responsible for nearly 193,000 deaths per year.

Drug overdoses have become the leading cause of injury death in 36 states, including Michigan, surpassing motor vehicle-related deaths.

Nationally, drug overdose deaths have more than doubled in the past 14 years – resulting in 44,000 deaths per year, and half of those deaths (22,000) are related to prescription drugs. Michigan ranked 18th highest for drug overdose deaths – at a rate of 14.6 per 100,000 people.

Michigan scored four out of 10 on key indicators of steps states can take to prevent injuries – nationally, 29 states and Washington, D.C. scored a five or lower. New York received the highest score of nine out of a possible 10 points, while four states scored the lowest, Florida, Iowa, Missouri and Montana, with two out of 10 points.

No. Indicator Michigan Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Seat Belts: Have primary seat belt laws
Source: Governors Highway Safety Association
Y 34 and Washington, D.C.
2 Drunk Driving: Mandatory ignition interlocks for all convicted drunk drivers, even first offenders
Source: Governors Highway Safety Association
N/A 21
3 Booster Seats: Require booster seats up to at least the age of eight–Meeting American Academy of Pediatrics standards
Source: Governors Highway Safety Association
Y 35 and Washington, D.C.
4 Driver Licensing for Teens: Restricts teens from nighttime driving after 10 p.m. (Most states have a Graduated Drivers License with some time and passenger restrictions, but this indicator requires a10 pm restriction)
Source: Governors Highway Safety Association
Y 11
5 Bicycle Helmet Use: Requires bicycle helmets for all children
Source: American Academy of Pediatrics
N/A 21 and Washington, D.C.
6 Preventing Homicide: Homicide rate at or below national goal of 5.5 per 100,000 people (2011-2013 data)
Source: Healthy People 2020
N/A 31
7 Child Abuse and Neglect: Rates at or below the National Rate of 9.1 per 1,000 Children (in 2013)
Source: Administration of Children, Youth and Families Children’s Bureau
N/A 25
8 Preventing Falls: Deaths from unintentional falls below national goal of 7.2 per 100,000 People (2011-2013 data)
Source: Healthy People 2020
N/A 13
9 Prescription Drug Monitoring Program (PDMP): State requires mandatory use of PDMP – to monitor for overprescribing or doctor shopping — by healthcare providers in at least some circumstances
Source: PDMP Center for Excellence at Brandeis University
N/A 25
10 Rescue Drug Laws: State law allows prescribing and access to naloxone – a drug used to counteract overdoses – for use by laypersons
Source: Network for Public Health Law
Y 34 and Washington, D.C.
Total Four

“Injuries are not just acts of fate. Research shows they are pretty predictable and preventable,” said Jeffrey Levi, PhD, executive director of TFAH. “This report illustrates how evidence-based strategies can actually help prevent and reduce motor vehicle crashes, head injuries, fires, falls, homicide, suicide, assaults, sexual violence, child abuse, drug misuse, overdoses and more. It’s not rocket science, but it does require common sense and investment in good public health practice.”

Some key findings include:

  • Drug abuse: More than 2 million Americans misuse prescription drugs. The prescription drug epidemic is also contributing to an increase in heroin use; the number of new heroin users has doubled in the past seven years.
  • Motor vehicle deaths: Rates have declined 25 percent in the past decade (to 33,000 per year).
  • Homicides: Rates have dropped 42 percent in the past 20 years (to 16,000 per year). The rate of Black male youth (ages 10 to 24) homicide victims is 10 times higher than for the overall population. One in three female homicide victims is killed by an intimate partner.
  • Suicides: Rates have remained stable for the past 20 years (41,000 per year). More than one million adults attempt suicide and 17 percent of teens seriously consider suicide each year. Seventy percent of suicides deaths are among White males.
  • Falls: One in three Americans over the age of 64 experiences a serious fall each year, falls are the most common nonfatal injuries, and the number of fall injuries and deaths are expected to increase as the Baby Boomer cohort ages.
  • Traumatic brain injuries (TBIs): from sports/recreation among children and youths have increased by 60 percent in the past decade.

Score Summary:

A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest.

9 out of 10: New York

8 out of 10: Delaware

7 out of 10: California, New Jersey, North Carolina, Tennessee, Washington and West Virginia

6 out of 10: Alaska, Colorado, Hawaii, Indiana, Kentucky, Louisiana, Maine, Minnesota, Nevada, New Mexico, Oregon, Rhode Island and Virginia

5 out of 10: Alabama, Arkansas, Connecticut, Georgia, Illinois, Kansas, Massachusetts, Oklahoma, Utah, Vermont and Wisconsin

4 out of 10: Arizona, District of Columbia, Idaho, Maryland, Michigan, Mississippi, New Hampshire, North Dakota and Pennsylvania

3 out of 10: Nebraska, Ohio, South Carolina, South Dakota, Texas and Wyoming

2 out of 10: Florida, Iowa, Missouri and Montana

The 10 indicators include:

  • Does the state have a primary seat belt law? (34 states and Washington, D.C. meet the indicator and 16 states do not.)
  • Does the state require mandatory ignition interlocks for all convicted drunk drivers, even first-time offenders? (21 states meet the indicator and 29 states and Washington, D.C. do not.)
  • Does the state require car seats or booster seats for children up to at least the age of 8? (35 states and Washington, D.C. meet the indicator and 15 do not.)
  • Does the state have Graduated Driver Licensing laws – restricting driving for teens starting at 10 pm? (11 states meet the indicator and 39 states and Washington, D.C. do not. Note a number of other states have restrictions starting at 11 pm or 12 pm.)
  • Does the state require bicycle helmets for all children? (21 states and Washington, D.C. meet the indicator and 29 states do not.)
  • Does the state have fewer homicides than the national goal of 5.5 per 100,000 people established by the U.S. Department of Health and Human Services (HHS) (2011-2013 data)? (31 states meet the indicator and 19 states and Washington, D.C. do not.)
  • Does the state have a child abuse and neglect victimization rate at or below the national rate of 9.1 per 1,000 children (2013 data)? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
  • Does the state have fewer deaths from unintentional falls than the national goal of 7.2 per 100,000 people established by HHS (2011-2013 data)? (13 states meet the indicator and 37 states and Washington, D.C. do not.)
  • Does the state require mandatory use of data from the prescription drug monitoring program by at least some healthcare providers? (25 states meet the indicator and 25 states and Washington, D.C. do not.)
  • Does the state have laws in place to expand access to, and use of, naloxone, an overdose rescue drug by laypersons? (34 states and D.C. meet the indicator and 16 states do not.)

State-by-State Injury Death Rankings

Note: Rates include all injury deaths for all ages for injuries caused by injuries and violence (intentional and unintentional). They are based on a methodology used to compare rates across all states – including using three-year averages of the most recent data (2011-2013). National data sources may differ from how some states calculate their data (because of use of different time frames, inclusion/exclusions, etc.). 1 = Highest rate of injury fatalities, 51 = lowest rate of injury fatalities. The 2011-2013 data are from the U.S. Centers for Disease Control and Prevention‘s Web-based Injury Statistics Query and Reporting System — age-adjusted using the year 2000 to standardize the data. This methodology, recommended by the CDC, compensates for any potential anomalies or unusual changes due to the specific sample in any given year in any given state. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**).

1. West Virginia (97.9*); 2. New Mexico (92.7**); 3. Oklahoma (88.4*); 4. Montana (85.1); 5. Wyoming (84.6); 6. Alaska (83.5); 7. Kentucky (81.7*); 8. Mississippi (81.0); 9. Tennessee (76.7); 10. Arkansas (75.3); 11. Louisiana (75.3**); 12. Arizona (73.4); 13. Alabama (73.3); 14. Utah (72.8*); 15. Missouri (72.4); 16. Colorado (70.7); 17. South Carolina (69.9); 18. Idaho (69.1); 19. (tie) Nevada (67.1**) and South Dakota (67.1*); 21. Vermont (66.0); 22. Kansas (65.0*); 23. Pennsylvania (64.3*); 24. Ohio (63.9*); 25. Indiana (63.7*); 26. North Carolina (62.1**); 27. Wisconsin (62.0*); 28. Oregon (61.8); 29. Florida (61.3**); 30. Michigan (60.6*); 31. Maine (60.1); 32. Delaware (60.0); 33. North Dakota (59.3); 34. Rhode Island (58.6*); 35. Georgia (58.1**); 36. Washington (57.1); 37. New Hampshire (56.6*); 38. Iowa (56.4*); 39. Texas (55.3**); 40. Minnesota (54.9*); 41. District of Columbia (53.7); 42. Maryland (53.4**); 43. Nebraska (52.5); 44. Virginia (52.0); 45. Illinois (50.0); 46. Connecticut (49.6); 47. Hawaii (48.8); 48. California (44.6**); 49. New Jersey (44.0*); 50. Massachusetts (42.9); 51. New York (40.3*).

State-by-State Drug Overdose Death Rankings

Note: Rates include drug overdose deaths, for 2011-2013, a three-year average. 1 = Highest rate of drug overdose fatalities, 51 = lowest rate of drug overdose fatalities. States with statistically significant (p<0.05) increases since 2007-2009 are noted with an asterisk (*), while states with a statistically significant decrease are noted with two asterisks (**). States with a § have an overdose death rate higher than the state‘s overall motor vehicle mortality rate for 2011 to 2013.

1. West Virginia (33.5*§); 2. (tie) Kentucky (24.6*§) and New Mexico (24.6§); 4. Nevada (21.6*§); 5. Utah (21.5§); 6. Oklahoma (20.0§); 7. Rhode Island (19.4*§); 8. Ohio (19.2*§); 9. Pennsylvania (18.9§); 10. Arizona (17.8*§); 11. Tennessee (17.7*§); 12. Delaware (17.1*§); 13. Wyoming (16.4*); 14. Missouri (16.2*§); 15. Indiana (16.0*§); 16. Colorado (15.5§); 17. Alaska (15.3§); 18. (tie) Michigan (14.6§) and New Hampshire (14.6§); 20. Louisiana (14.5§); 21. (tie) District of Columbia (13.8*§) and Massachusetts (13.8§); 23. (tie) Florida (13.7**§) and Washington (13.7**§); 25. Montana (13.6); 26. Maryland (13.3*§); 27. (tie) New Jersey (13.2*§) and North Carolina (13.2*§); 29. (tie) Connecticut (13.1*§) and Wisconsin (13.1*§); 31. Vermont (13.0§); 32. South Carolina (12.9§); 33. Idaho (12.7*); 34. Oregon (12.4§); 35. Arkansas (12.3**); 36. (tie) Alabama (12.2**) and Maine (12.2**§); 38. Illinois (11.8*§); 39. Hawaii (11.4*§); 40. Kansas (11.2); 41. (tie) California (10.7*§) and Georgia (10.7*) and Mississippi (10.7); 44. New York (10.4*§); 45. (tie) Texas (9.6) and Virginia (9.6*); 47. Minnesota (9.3*§); 48. Iowa (8.8*); 49. Nebraska (7.2*); 50. South Dakota (6.5); 51. North Dakota (2.6**).


Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

The Safe States Alliance is a national, non-profit organization and professional association whose mission is to strengthen the practice of injury and violence prevention.

SAVIR is a national professional organization dedicated to fostering excellence in the science of preventing and treating violence and injury. Our vision is a safer world through violence and injury research and its application to practice.