The Burden of Injury in Ottawa, 2010

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1 The Burden of Injury in Ottawa, 21

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3 Message from Ottawa Public Health s Medical Officer of Health Dear Colleague, I am pleased to introduce The Burden of Injury in Ottawa, 21 report, which serves as the first-ever analysis by Ottawa Public Health to measure and describe the type of injuries affecting Ottawa residents. Injury, both unintentional and intentional, is a major cause of death, disability and hospitalizations in Ottawa. The burden from injury brings high social and economic costs. The impact on individuals, families and our communities is real, often leading to lifelong disabilities, lost productivity and increased health care costs. Given that the vast majority of unintentional injuries are preventable, this report gives public health program planners, alongside our community partners, the opportunity to identify emerging trends, identify key priorities and establish targeted strategies based on the report s findings. Along with giving an unprecedented description of the occurrence of injuries among Ottawa residents, the report also highlights effective injury prevention programs and identifies areas for improvement in program planning and partnerships. The report also addresses the assessment and surveillance requirements of the Ontario Public Health Standards. With this report, Ottawa Public Health aims to engage community partners, policy-makers and Ottawa residents in making injury prevention an important priority in public health policy and planning. Isra Levy, MB BCh, MSc, FRCPC, FACPM ottawa.ca/health TTY: i

4 Acknowledgements Acknowledgements The report has been prepared through a collaborative effort between Ottawa Public Health and City of Ottawa partners. The report was written by: Amira Ali Senior Epidemiologist, Epidemiology Unit, Ottawa Public Health Donna Casey Program and Project Management Officer, Ottawa Public Health Nancy Langdon Supervisor, Injury Prevention Unit, Ottawa Public Health Robert Paiement (Primary Author) Project Officer, Injury Prevention Unit, Ottawa Public Health Katherine Russell (Primary Author) Epidemiologist, Epidemiology Unit, Ottawa Public Health Lindsay Whitmore Epidemiologist, Epidemiology Unit, Ottawa Public Health We would also like to thank the following Ottawa Public Health staff who contributed to the report: Ginette Asselin Public Health Nurse, Ottawa Public Health Kirsten Coupland-Tardif Public Health Nurse, Ottawa Public Health Lorrie Levesque Project Officer, Ottawa Public Health Terry-Lynne Marko Public Health Nurse, Ottawa Public Health Kuy Ngo Public Health Nurse, Ottawa Public Health Colleen O Mahony-Menton Project Officer, Ottawa Public Health In addition, we would like to thank the following organizations for their input: Safe Communities of Ottawa Plan-It Safe, Children s Hospital of Eastern Ontario Canadian Mental Health Association, Ottawa Branch Special thanks go to the following peer reviewers for their technical advice and review: Douglas Angus, BCom, MA, PhD Director, PhD Program in Population Health Professor, Telfer School of Management University of Ottawa Philip Groff, BA, MA, PhD President and CEO SMARTRISK Margaret Herbert, BSc, MSc Epidemiologist and Senior Advisor Health Promotion and Chronic Disease Prevention Public Health Agency of Canada Eoghan O Shea, BAO, MB BCh, LMCC, MICGP, CCFP, FCFP Vice-President, Academy of Medicine Ottawa Dania Versailles, RN, BSc, MScN Clinical Nurse Specialist Montfort Hospital Thank you as well to The Alder Group Inc. for their editing, graphic design and desktop publishing services. Please use the following citation when referencing this document: Ottawa Public Health. The Burden of Injury in Ottawa, 21. Ottawa (ON): Ottawa Public Health; 21. For additional copies of the report, please visit Ottawa.ca/health. For further information, please contact, Amira Ali at , extension 238 or ii Ottawa Public Health The Burden of Injury in Ottawa, 21

5 Table of Contents Message from Ottawa Public Health s Medical Officer of Health...i Acknowledgements...ii Executive Summary...1 Next Steps Introduction...3 Haddon Matrix A Framework for Injury Prevention... Best Practices in Injury Prevention... 5 The Injury Pyramid... 5 Injury Prevention Within Ottawa Public Health... 5 Data Sources... 6 Data Limitations/Considerations... 6 Abbreviations All Unintentional Injuries...9 Summary... 1 Introduction... 1 Self-Reported Injuries... 1 Emergency Room Visits and Hospitalizations for All Unintentional Injuries Diagnosis of Unintentional Injuries Emergency Room Visits Leading Causes of Unintentional Injuries Hospitalizations Leading Causes of Unintentional Injuries Unintentional Injury-Related Deaths Leading Causes of Unintentional Injury Death Potential Years of Life Lost Falls...19 Summary... 2 Introduction... 2 Self-Reported Falls Emergency Room Visits and Hospitalizations for Falls Diagnosis of Fall-Related Injuries Place of Occurrence of Falls... 2 Types of Falls Types of Falls Among Seniors Types of Falls Among Children Falls on Same Level Due to Slip, Trip or Stumble Falls On and From Stairs and Steps Falls Involving Snow and Ice Falls Involving a Bed, Chair or Other Furniture. 3 Falls On and From a Ladder or Scaffolding... 3 Falls Involving Wheelchairs, Strollers and Other Types of Walking Devices Fall-Related Deaths Motor Vehicle Traffic Collisions...33 Summary... 3 Introduction... 3 Reportable Collisions Emergency Room Visits and Hospitalizations for Motor Vehicle Traffic Collisions Diagnosis of Motor Vehicle Traffic Collision-Related Injuries Types of Collisions Car Occupants Pedestrians Motorcyclists Pedal Cyclists... Motor Vehicle Traffic Collision-Related Deaths... Collision Prevention Awareness and Behaviour.. 1 Seat Belts... 1 Impaired Driving... 2 Cell Phone Use While Driving... 3 Child Seats and Booster Seats ottawa.ca/health TTY: iii

6 Table of Contents 5. Unintentional Poisoning and Substance Misuse...5 Summary... 6 Introduction... 6 Emergency Room Visits and Hospitalizations for Unintentional Poisoning and Substance Misuse.. 7 Place of Occurrence of Unintentional Poisoning and Substance Misuse... 9 Types of Poisoning Substances... 5 Unintentional Poisoning and Substance Misuse Deaths Self-Harm and Suicide...53 Summary... 5 Introduction... 5 Emergency Room Visits for Self-Harm Types of Self-Harm Injuries Self-Harm by Drugs, Medications and Alcohol. 56 Suicide Deaths Sport and Recreation Injuries Summary... 6 Introduction... 6 Emergency Room Visits and Hospitalizations for Sport and Recreation Injuries Types of Sport and Recreation Injuries Cycling Injuries Hockey Injuries Skiing and Snowboarding Injuries Ice Skating Injuries... 6 Playground Equipment-Related Injuries... 6 All-Terrain Vehicle and Snowmobiling Injuries. 6 Tobogganing Injuries In-line Skating, Skateboarding and Scooter Fall Injuries Sport and Recreation Injury Deaths Pedestrian Injuries...67 Summary Introduction Emergency Room Visits and Hospitalizations for Pedestrian Injuries Diagnosis of Pedestrian Injuries Types of Pedestrian Injuries Pedestrian Deaths Cycling Injuries...73 Summary... 7 Introduction... 7 Emergency Room Visits and Hospitalizations for Cycling Injuries Diagnosis of Cycling Injuries Types of Cycling Injuries Cycling Deaths Cycling Injury Prevention Behaviour Burns...79 Summary... 8 Introduction... 8 Emergency Room Visits and Hospitalizations for Burns Place of Occurrence of Burn Types of Burns... 8 Scalds Hot Appliances Burn-Related Deaths Drowning...87 Summary Introduction Emergency Room Visits and Hospitalizations for Near-Drowning Place of Occurrence of Near-Drowning Types of Near-Drowning Events... 9 iv Ottawa Public Health The Burden of Injury in Ottawa, 21

7 Table of Contents Near-Drowning Involving Watercraft... 9 Swimming Pool-Related Near-Drowning Drowning Deaths Public Health Practices and Partners...91 Falls Public Health Practices and Programs Partners in Falls Prevention Road Safety... 9 Public Health Practices and Programs... 9 Partners in Road Safety... 9 Self-Harm and Suicide Prevention Public Health Practices and Programs Partners in Self-Harm and Suicide Prevention.. 95 Unintentional Poisoning and Substance Misuse.. 96 Public Health Practices and Programs Partners in Unintentional Poisoning and Substance Misuse Prevention Burns Public Health Practices and Programs Partners in Burns Prevention Drowning Public Health Practices and Programs Partners in Drowning Prevention Sports and Recreation Public Health Practices and Programs Partners in Safe Sports and Recreation References...99 Appendices...1 Appendix 1: Glossary of Terms... 1 Appendix 2: Data Sources Appendix 3: External Cause of Injury Codes Appendix : Nature of Injury Codes ottawa.ca/health TTY: v

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9 Executive Summary Executive Summary Despite popular belief, most injuries are not accidents. The vast majority of unintentional injuries are preventable. The first-ever Burden of Injury in Ottawa, 21 report outlines important trends to help Ottawa Public Health (OPH) and its partners address an important health care issue the increasing social and economic costs associated with preventable injuries. The report highlights the latest significant findings in injury surveillance in Ottawa and should be used to inform and guide program and policy planning in injury prevention, with major opportunities for OPH and its community partners to reduce disability and mortality rates among Ottawa residents. It is important to note that the total burden of lost productivity, health care costs, potential lifelong disabilities and years of life lost due to injury is larger than what is reported, with the majority of injuries falling outside the traditional health care system. For every injury death, there are many more injuries leading to emergency department visits and hospitalizations. This report measures these occurrences from data collected between 21 and 28. While approximately 156 Ottawa residents die each year due to an unintentional injury, the death and emergency room visit rate for unintentional injuries is lower in Ottawa than in Ontario. The most prevalent types of injuries are falls, motor vehicle traffic collisions, unintentional poisoning and substance misuse, and self-harm and suicide. These four injury groups should be an important focus for injury prevention in Ottawa. The following are specific trends noted from local data on these four types of injuries: Falls There is a high occurrence of falls among seniors, particularly among elderly women. In fact, an average of 51 people die annually from falls, with most of these being seniors. In 28, 251 per 1, Ottawa residents visited an emergency room (ER) because of falls, while 25 per 1, were hospitalized. For seniors, most falls happen at home, and the most common ones are those occurring from slips, trips or stumbles; falls from beds, chairs or other furniture; and falls involving stairs. For children under age five, falls leading to ER visits occur mostly from beds, chairs or other furniture. Motor Vehicle Traffic Collisions Young adults have the highest average rate of ER visits from motor vehicle traffic collisions (MVTCs). Distractions from passengers, hand-held devices and impairment account for many of these collisions. Young drivers and passengers are also the least likely of all age groups to wear seat belts. An average of 32 Ottawa residents die annually from MVTCs, with 61 residents per 1, visiting an ER and 36 people being hospitalized per 1,. Seniors are the age group most likely to be hospitalized from an MVTC. Overall, the hospitalization rate of MVTCs declined by 3 per cent from 1996 to 28 and has been lower than the provincial average. Unintentional Poisoning and Substance Misuse Every year, an average of 19 Ottawa residents die from unintentional poisoning and substance misuse, with the highest death rate being among men aged 35 to 6 years. In 28, 17 Ottawa residents per 1, visited the ER due to unintentional poisoning and substance misuse, while close to 11 people per 1, were hospitalized. Seniors had the highest rate of hospitalizations for unintentional poisoning and substance misuse, and children under age five had the highest number of ER visits. Self-Harm and Suicide Even though suicide rates have been decreasing in Ottawa and Ontario since 1988, an average of 52 Ottawa residents die from suicide every year. Adult males have a suicide rate that is double that of women, with the highest rate being among men aged 5 to 6 years. Girls aged 15 to 19 have the highest rates of ER visits for self-harm incidents, including suicide attempts with drugs, medication and alcohol. ottawa.ca/health TTY:

10 Executive Summary Although these four groups of injuries are the most common in Ottawa, important findings emerged from the other types of injuries. These include the following: Children under five years of age have the highest rate of burns. Burns in the home account for 5 per cent of the burn-related hospitalizations. Most burn injuries result from scalding (7 per cent of the burn-related ER visits and 38 per cent of the hospitalizations), followed by exposure to smoke, fire or flames. Swimming pools are the most common location for near-drowning incidents resulting in ER visits for children and youth. Children under age five have the highest rate of ER visits for near-drowning, with 55 per cent of these events occurring at home. Pedestrian injuries resulting in an ER visit are highest for youth aged 1 to 19 years. Senior women and young males have the highest pedestrian injury hospitalization rates. The majority of pedestrian injuries are due to a collision with a car, pickup truck or van. Young males aged 1 to 19 years have the highest rates of ER visits for cycling injuries, followed by children aged five to nine years. The most common type of cycling injury involves falling or being thrown from a bicycle, followed by a collision with a motor vehicle. The top three sport and recreation activities resulting in an ER visit are cycling, hockey and skiing/snowboarding. For sport and recreation injury hospitalizations, the top three activities are cycling, skiing/snowboarding and ice skating. Rates of all-terrain vehicle-related injury leading to an ER visit more than doubled from 22 to 27. The most common sport and recreation activity leading to injury in children aged five to nine is the use of playground equipment. Next Steps The Burden of Injury in Ottawa, 21 report provides the opportunity to adopt a co-ordinated, evidencebased approach to injury prevention in Ottawa. The report provides individuals, program planners and policy-makers with the information needed to address injury prevention priorities in our community, in particular in the areas of the most common injuries among Ottawa residents: falls, motor vehicle traffic collisions, unintentional poisoning and substance misuse, and self-harm and suicide. Many factors are involved when injuries occur. The design of everyday objects and structures, underlying social factors and mental health issues are just a few of the multiple and complex factors that lead to injuries. Age and sex also play key roles in how and why injuries occur. Socio-economic status is also an important factor in hospitalizations from injuries. Research strongly shows that people living in lower-income neighbourhoods have higher rates of hospitalizations and mortality from injuries. Under the mandatory health programs and services outlined in the Ontario Public Health Standards, OPH is required to promote safety and injury prevention through its programs and partnerships. This report serves as a guide for OPH and its new and current partners to collaborate on the design of injury prevention strategies involving advocacy and community action. The report calls for an investment in multiple interventions using best practices to promote healthy behaviours for individuals, families and communities. 2 Ottawa Public Health The Burden of Injury in Ottawa, 21

11 Chapter 1 Chapter 1 Introduction

12 Chapter 1 Introduction The purpose of this report is to outline important injury trends to help Ottawa Public Health (OPH) and its partners address an important health care issue the increasing social and economic costs associated with preventable injuries. This is the first public health report in Ottawa to quantify and describe injury, which is one of the leading causes of premature death and disability in Ottawa. In 2, injuries resulted in 13,667 deaths and 211,768 hospitalizations within Canada. Injury takes a heavy social and economic toll, costing an estimated 19.8 billion dollars in direct and indirect costs in Canada in 2. 1 Injury prevention strategies can reduce both the rate and severity of injuries, resulting in considerable economic savings to the health care system and reducing the burden on the health care system downstream. The report portrays a current view of the burden of injuries in Ottawa, providing crucial evidence to inform injury prevention programming and policies as well as addressing the assessment and surveillance requirements of the Ontario Public Health Standards. The report also highlights effective injury prevention programs and areas for improvement. OPH program staff, other City departments, community partners, members of Council and concerned citizens can benefit from the findings of this report. This report is divided into 12 chapters. An executive summary provides the key highlights and trends from the data collected and analyzed from injuries resulting in hospitalizations, emergency department visits and deaths in Ottawa and outlines potential next steps for OPH and its partners to set priorities and adopt a framework for action in injury prevention. The first chapter outlines the framework for injury prevention, best practices and the mandate of OPH s injury prevention programs based on the requirements of the Ontario Public Health Standards. The following chapters focus on nine injury categories, including what the data reveal about the four leading causes of injury in Ottawa: falls, motor vehicle traffic collisions (MVTCs), unintentional poisoning and substance misuse, and self-harm and suicide. The final chapter of the report profiles OPH s injury prevention programs and partnerships for the nine injury categories examined in the report. It s important to note that the burden of injury in terms of lost productivity, health care costs, potential lifelong disabilities and years of life lost is larger than what is reported, with the majority of injuries falling outside the traditional health care system. For every injury death, there are many more injuries leading to emergency department visits and hospitalizations, which this report measures from data collected between 21 and 28. A broad range of interconnected factors can affect how injuries occur. Attitudes toward safety are critical. Environmental and engineering design is also important in reducing all types of injury. Complex underlying social factors such as unemployment and poor living conditions can also play pivotal roles. Mental health issues may also be a critical factor leading some people to harm themselves. 2 Haddon Matrix A Framework for Injury Prevention William Haddon developed a matrix where host, agent and environment interact over a time period. According to Haddon, injuries can be understood in three phrases: pre-event, event and post-event. 3 This framework for analysis makes it possible to identify: interventions aimed at preventing the injury pre-event (e.g., road and highway signage) interventions aimed at minimizing the impact of the injury event (e.g., air bag) interventions aimed at minimizing the severity of injury outcomes (e.g., rapid emergency response) Haddon also suggested that the most effective way to control injury was to use multiple strategies within each phase. He emphasized the use of passive interventions and implementing strategies that most effectively reduce injury. Ottawa Public Health The Burden of Injury in Ottawa, 21

13 Introduction Chapter 1 Best Practices in Injury Prevention Current evidence suggests that injury prevention works best when it: addresses the multiple factors that contribute to injury; encourages environmental and behavioural change; engages the people who are most at risk; involves action across sectors (e.g., health, police, education); and is sustained and reinforced over time. Strategies to reduce injuries must therefore include a wide variety of interventions, address a variety of determinants of health and involve a variety of disciplines (health, education, labour, transportation, police, etc.). The Injury Pyramid The ultimate target for prevention efforts is to reduce deaths and disabilities from injury. However, deaths make up a very small part of the overall impact that injuries have on the population. For every injury death, there are many more hospitalizations, emergency department visits and injuries that are not accounted for, having been treated outside of the traditional health care system. (Figure1) Figure 1 The Injury Pyramid Death Major Trauma In-patient Hospitalization Injury Prevention Within Ottawa Public Health Under the mandatory health programs and services outlined in the Ontario Public Health Standards, OPH is required to promote safety and injury prevention. Through its programs and partnerships, OPH s injury prevention objectives and strategies include: increasing the number of children, youth and adults practising safety measures while cycling and operating motorized vehicles (specifically, the use of helmets and car restraints and the safe operation of all motorized vehicles) reducing misuse of prevalent drugs such as marijuana reducing harmful drinking among young people and the general population reducing the rate of fall-related injuries in the elderly reducing health hazards in the physical environment with emergency response protocols, including extreme heat warnings reducing drowning in pools, lakes, rivers and other recreational bodies of water inspecting public pools, public wading pools and public spas and ensuring safety-related operational procedures are used at these facilities conducting surveillance of health-related information that identifies priority populations and contributes to effective public health program planning, delivery and management conducting surveillance of public beaches and public beach water-related illnesses promoting the health and safety of children and youth in the home Emergency Department Visits Physician Office/Medi-centre Visits Treated at Home/School/Work Rate per 1, population ottawa.ca/health TTY: Ottawa number of visits Number of ER visits 5

14 Chapter 1 Introduction Data Sources This report provides a descriptive analysis of the burden of injuries in Ottawa and profiles current public health injury prevention programming. Only those injury incidents captured through emergency room (ER) visits, hospitalizations and deaths are included in this report. This report provides a current comparison between Ottawa and Ontario. Where detailed injury data could not be reported from one year of data, five years of data were pooled and presented as a five-year average. Multiple data sources were used in the report s preparation. The most recently available data files were used; however, the most recent data year available is not consistent across the available data sources. Mortality data ( ) came from the Vital Statistics database (from the Office of the Registrar General). ER visit data from the National Ambulatory Care Reporting System (Canadian Institute of Health Information) from fiscal years (March through April) 22/3 to 28/9 were used, as were hospitalization data from the Discharge Abstract Database (Canadian Institute of Health Information) from fiscal years 1996/97 to 28/9. Behavioural data were obtained from the Canadian Community Health Survey (CCHS 25, 27) of Statistics Canada and the Rapid Risk Factor Surveillance System (RRFSS 21-28) of the City of Ottawa. For further details on the data sources, see Appendix 2: Data Sources. To protect the confidentiality of all Ottawa residents, small numbers that would make it possible to identify any individual were suppressed. Data Limitations/Considerations The data captured in this report (ER, hospitalization and mortality) under-represent the true burden of injuries in Ottawa because many injuries go unreported. The data represent injuries sustained by Ottawa residents who visited an ER or were hospitalized within Ontario. The injury event may have taken place outside of the Ottawa area, but it is captured if the patient was a resident of Ottawa. ER and hospitalization data prepared for this report are counted as diagnoses rather than unique visits. A person may have multiple reasons (external causes of injury) for visiting the ER or being hospitalized. For example, a pedestrian involved in a motor vehicle collision also may have fallen. Instead of counting the person as one visit to the ER, the person is counted once for the MVTC and once for the fall. As the sequence of events leading to the ER visit cannot be distinguished, both external cause diagnoses have been counted. For simplicity of terminology, external cause diagnoses are referred to as visits for ER data and hospitalizations for hospital discharge data in this report. The coding used for these external causes of injury is outlined in Appendix 3. The types of data in this report should be considered separately. Persons who are admitted to hospital from the ER or who die in the ER are not removed from the ER data. Similarly, those who die while in hospital are not removed from the hospitalization data. Thus, it would not be appropriate to add together the ER, hospitalization and death data as presented in this report. Data on the place that the injury occurred are available for all injuries in the report, with the exception of MVTCs, pedestrian injuries and cycling injuries. Hospitalization data for self-harm acts, such as suicide attempts, are not included in this report because of changes in reporting mental disorders. Beginning in fiscal year 26/7, patients with mental disorders who occupy psychiatric beds in hospitals are no longer reported in the Discharge Abstract Database. Although not all patients hospitalized for self-harm are diagnosed with mental disorders, the data are incomplete and are therefore excluded from this report. 5 6 Ottawa Public Health The Burden of Injury in Ottawa, 21

15 Introduction Chapter 1 Abbreviations ATV all-terrain vehicle CCHS CMHA DAD ER ICD IRSP LHIN MOHLTC MVTC NACRS OPH OSDUHS PHPDB PYLL RRFSS Canadian Community Health Survey Canadian Mental Health Association Discharge Abstract Database emergency room International Classification of Diseases Integrated Road Safety Program Local Health Integration Network Ministry of Health and Long-Term Care (Ontario) motor vehicle traffic collision National Ambulatory Care Reporting System Ottawa Public Health Ontario Student Drug Use and Health Survey Provincial Health Planning Database (Ontario) potential years of life lost Rapid Risk Factor Surveillance System ottawa.ca/health TTY:

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17 Chapter 2 Chapter 2 All Unintentional Injuries

18 Chapter 2 All Unintentional Injuries Summary Approximately 156 Ottawa residents die each year due to an unintentional injury. The death rate for unintentional injuries has been lower in Ottawa than in Ontario and higher in males than in females. Motor vehicle traffic collisions (MVTCs) are the leading cause of unintentional injury death in those under age 2 and those aged 2 to years. Unintentional poisoning and substance misuse rank as the leading cause of death in adults aged 5 to 6, followed closely by MVTCs, and falls are the leading cause for seniors. The rates of emergency room (ER) visits and of hospitalizations for all unintentional injuries in Ottawa have been lower than the Ontario rates. The leading cause of unintentional injury ER visits and hospitalizations across all ages is falls. Introduction This chapter examines the issue of unintentional injuries and focuses on a selected number of cause-specific unintentional injuries. Unintentional injuries are those where there is no evidence of predetermined intent. Intentional injuries, self-harm and suicide are not included in this chapter. Please refer to Chapter 6 for data on self-harm and suicide. The types of injuries included in this chapter are not mutually exclusive; for example, cycling injuries are included and covered as a part of MVTCs and of sport and recreation injuries. Self-Reported Injuries According to the Canadian Community Health Survey, in 25, 126, (18.2 per cent per cent) * Ottawa residents aged 12 and older reported that they had suffered an injury serious enough to limit normal activities (for example a broken bone, a bad cut or burn, a sprain, or a poisoning) in the last year. * The + symbol followed by a numerical value represents the interval within which the true value of a variable such as a mean, proportion or rate is contained. This is called the confidence interval (CI) and is calculated to a 95 per cent probability in this report. 1 Ottawa Public Health The Burden of Injury in Ottawa, 21

19 All Unintentional Injuries Chapter 2 Death Death Emergency Room Major Trauma Visits and Hospitalizations for All Unintentional Injuries Unintentional injuries In-patient Major caused Hospitalization Trauma a substantial burden on Ottawa ERs, accounting for an average of over 61, visits per year from 22 to 28. This represents about 25 per cent of all emergency room visits. In 28, the rate of ER visits for unintentional injuries was 739 per 1, population. From 22 to 28, the number and rate of ER visits Emergency In-patient Department Hospitalization Visits due to unintentional injuries remained stable in Ottawa, and the rates were less than the Ontario rates. (Figure 2.1) Physician Emergency Office/Medi-centre Department Visits Visits In 28, close Physician Treated to Office/Medi-centre at hospitalizations Home/School/Work Visits occurred because of an unintentional injury. Hospitalization rates due to unintentional injuries in Ottawa were stable over the past few years. In 28, the hospitalization rate was 399 per 1, population compared Treated at with Home/School/Work a provincial rate of 3 per 1, Ontario residents. (Figure 2.2) Figure 2.1 All Unintentional 12 Injury ER Visits City of Ottawa and Ontario Rate per Rate 1, per 1, population population Ottawa number of visits Ottawa rate Ottawa number of visits Ontario rate Ottawa rate Source: National Ambulatory Care Reporting System - ER Visits 22-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: August, 29 Data Note: Ontario Rates rate are age standardized to the 1991 Canadian population Number Number of ER visits of ER visits Source: National Ambulatory Care Reporting System - ER Visits 22-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: August, 29 Figure 2.2 All Unintentional Injury Hospitalizations City of Ottawa and Ontario Rate per Rate 1, per 1, population population Ottawa Number of Hospitalizations Ottawa rate Ottawa Number of Hospitalizations Ontario rate Ottawa rate Source: Hospital In-patient Data , Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: July 23, 29 Data Note: Ontario Rates rate are age standardized to the 1991 Canadian 65. population Source: Hospital In-patient Data , Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: July 23, Number Number of Hospitalizations of Hospitalizations Males 28 Females 28 Males Average Females Average ottawa.ca/health TTY:

20 Chapter 2 Rate Rate per per 1, 1, population population All Unintentional Injuries For males, the highest rates 2 2 of all unintentional injury years and older (212.1 per 1, population) and 2 2 ER visits occurred in those 1 1 aged 1 to 19 years ( was double that of their senior male counterparts 1 1 per 1, population from 2 to 28), followed (995.6 per 1, population). (Figures 2. and 2.6) by those under age 1 ( per 1, population). Among females, those aged 65 years and older Diagnosis of Unintentional Injuries Ottawa Number of Hospitalizations Ottawa rate Number of Hospitalizations had the highest average unintentional injury ER visit Ontario Ottawa rate Approximately one-third of all unintentional injury rates Ontario (915.2 rate per 1, population from to ER visits 52.7 and 75. two-thirds of the 3.1 unintentional injury Source: Hospital In-patient Data , Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: July 23, 29 28), Data Source: Note: Hospital Rates followed In-patient are age standardized Data by , young to the Ontario 1991 women Canadian MOHLTC, aged population IntelliHEALTH 1 to ONTARIO, 19 and Extracted: July 23, 29 hospitalizations involved treatment for a musculoskeletal injury (i.e., fracture, dislocation, sprain or strain). those under 1. (Figures 2.3 and 2.5) The average hospitalization rate for all unintentional injuries from (Figures 2.7 and 2.8) 2 to 28 was highest in senior females aged Number Number of of Hospitalizations Figure 2.3 All Unintentional Injury ER Visits by Age. City of Ottawa 28 and 2-8 Average Males 28 Females Males Females 28 Average 2 28 Average Number of ER Visits Number of ER Visits Source: National Ambulatory Care Reporting System - ER Visits 2-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: August, Source: National Ambulatory Care Reporting System - ER Visits 2-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: August, 29 Figure 2. All Unintentional Injury Hospitalizations by Age. City of Ottawa 28 and 2-28 Average Males 28 Females Males Females 28 Average 2 28 Average Number of Hospitalizations Number of Hospitalizations Source: Hospital In-patient Data 2-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: July 23, Source: Hospital In-patient Data 2-28, Ontario MOHLTC, IntelliHEALTH ONTARIO, Extracted: July 23, r, 1, population population Ottawa Public Health The Burden of Injury in Ottawa, 21

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