TY - JOUR
T1 - International comparisons of injury mortality in the elderly
T2 - Issues and differences between New Zealand and the United States
AU - Langlois, Jean Ann
AU - Smith, Gordon S.
AU - Baker, Susan P.
AU - Langley, John D.
N1 - Funding Information:
ACKNOWLEDGEMENTS The authors thank Sandra Brinsdon and Geraldine Whyte, NZ Health Information Service, for providing NZ data, Guohua Li, Johns Hopkins Injury Prevention Center, for providing the US data, Josephine Cruz for technical support, and David Chalmers and Robyn Norton for their comments on earlier versions of this manuscript. This work was supported by the Health Research Council of NZ through a postdoctoral fellowship awarded to Dr Langlois, by grants to the Injury Prevention Research Unit from the Accident Compensation Corporation and the Health Research Council of NZ, and by USPHS Centers for Disease Control Grant #R49/CCR302486-06 to the Johns Hopkins Injury Prevention Center and a First Award #R29AA077OO to Dr Smith from the National Institute on Alcohol Abuse and Alcoholism.
PY - 1995/2
Y1 - 1995/2
N2 - Background. International comparisons of mortality rates for injury, as for other conditions, can suggest priorities for further research and intervention. However, variability in the assignment of underlying cause, especially among the elderly, may lead to difficulty in interpreting cross-national differences in death rates. Despite similarities between the two countries, the injury death rate for ages >65 in New Zealand is substantially higher than the United States rate. The objective of this study was to investigate possible reasons for this differenceMethods. We used data not previously reported for New Zealand to calculate the cause-specific injury death rates for ages >65, compared them with US rates, and examined other injury rates that could help explain the observed difference.Results. The New Zealand death rate from falls for ages >65 was nearly three times the US rate (92 versus 32 per 100 000), causing the death rate for all injuries in this age group to be 34% higher in New Zealand (153 versus 114 per 100 000). However, hospitalization rates for both falls and hip fractures are similar for the two countries.Conclusions. The substantially higher fall injury death rates for older New Zealanders are not fully explained by differences in the incidence of falls resulting in injury nor the case fatality rate for fall-related injury. US injury death rates based on underlying cause of death might be similar to New Zealand rates, and thus substantially higher, if subjected to comparable procedures for the completion and coding of death certificates. As in studies of other conditions, international comparisons of injury death rates based on underlying cause, especially in studies of the elderly, must consider variation between countries in death certification and coding practices.
AB - Background. International comparisons of mortality rates for injury, as for other conditions, can suggest priorities for further research and intervention. However, variability in the assignment of underlying cause, especially among the elderly, may lead to difficulty in interpreting cross-national differences in death rates. Despite similarities between the two countries, the injury death rate for ages >65 in New Zealand is substantially higher than the United States rate. The objective of this study was to investigate possible reasons for this differenceMethods. We used data not previously reported for New Zealand to calculate the cause-specific injury death rates for ages >65, compared them with US rates, and examined other injury rates that could help explain the observed difference.Results. The New Zealand death rate from falls for ages >65 was nearly three times the US rate (92 versus 32 per 100 000), causing the death rate for all injuries in this age group to be 34% higher in New Zealand (153 versus 114 per 100 000). However, hospitalization rates for both falls and hip fractures are similar for the two countries.Conclusions. The substantially higher fall injury death rates for older New Zealanders are not fully explained by differences in the incidence of falls resulting in injury nor the case fatality rate for fall-related injury. US injury death rates based on underlying cause of death might be similar to New Zealand rates, and thus substantially higher, if subjected to comparable procedures for the completion and coding of death certificates. As in studies of other conditions, international comparisons of injury death rates based on underlying cause, especially in studies of the elderly, must consider variation between countries in death certification and coding practices.
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U2 - 10.1093/ije/24.1.136
DO - 10.1093/ije/24.1.136
M3 - Article
C2 - 7797335
AN - SCOPUS:0028960433
SN - 0300-5771
VL - 24
SP - 136
EP - 143
JO - International journal of epidemiology
JF - International journal of epidemiology
IS - 1
ER -