The high rate of injury for individuals 15 to 24 years of age may be caused by experimentation with drugs and alcohol in combination with poor judgment and risk-taking behaviors. The risk for MVC is higher among 16- to 19-year-olds than any other age-group. Drivers in this age-group are four times more likely than older drivers to crash, based on number of miles driven. ¹⁸ Teens are at risk because of the following:

The 65 and older age-group is the fastest growing segment of the U.S. population. As the U.S. population grows older, more and more people become vulnerable and are dependent on others to meet their most basic needs. Individuals more than 75 years of age have the highest death rate from injuries, which is attributed to multiple factors, including their frailer state of health and preexisting medical conditions. Age has been shown to be independently associated with increased mortality after trauma. Falls continue to be the most common cause of nonfatal and fatal injuries in adults ages 65 and older. ⁵ Drivers who are 65 and older have the highest death rate per mile driven except for teenage drivers. Older drivers drive less, but they are more likely to crash and die in the collision. ^{10. and 13.} Estimates indicate that more than 40 million older adults will be licensed drivers in 2020. ^{4. and 22.} In addition, age is a major factor in determining the risk for a cervical spine injury in auto-pedestrian injuries. Those over the age of 65 years are 12 to 14 times more likely to sustain a cervical spine injury than pediatric patients. ³²

Of the 11 million people age 65 years and older who are hospitalized annually, a significant percentage (52%) of injury-related admissions are due to fractures. ^{4. and 22.} Of interest is that medical costs for the geriatric population are 2.5 times greater than for younger patients with similar injuries; this is due to longer lengths of stay, higher incidence of complications, and more intensive care unit days. ^{22. and 23.}

Gender, along with age variances, is related to the incidence and type of injury incurred. Males are 2.5 times more likely to be injured than females. This statistic is significant because of their participation in more hazardous activities and greater risk taking. This fact continues throughout the life span, as rates for motor vehicle (MV)–related injuries are twice as high for older men than women. ⁵ The pedestrian fatality rate is also more than twice as high for men as for women. ⁵

Injury and death rates vary with race and income. The reasons for these variations are multifactorial and not completely understood. However, knowledge of the differences observed has been used to target prevention programs toward specific populations or geographic areas. For African Americans and whites, no matter what the MOI, the higher the income, the lower the death rate. The number of MVCs decreases in a depressed economy, whereas homicides and suicides increase. The highest homicide rate occurs in the African American population, the highest suicide rate is seen in whites and Native Americans and the lowest death rate occurs in Asian Americans.

African Americans have a pedestrian death rate that is 1.7 times that of whites. ⁵ African American men age 65 and older have one of the highest MV-related death rates when sorted by age, sex, and race. ⁵ Homicide is the leading cause of death for African Americans age 10 to 24 years of age. ⁵ The drowning rate for 5- to 14-year-old African Americans is 3.2 times higher than that of whites. ^{3. and 11.}

Asian-Pacific and Native American women age 65 years and older have the highest death rates when sorted by age, sex, and race. ⁵ Homicide is the second leading cause of death for Asian-Pacific Islanders for those age 10 to 24 years. ⁵

Hispanics have a mortality rate 1.8 times higher than non-Hispanics if they are a pedestrian who has been injured. ⁵ Homicide is the second leading cause of death for Hispanics among people age 10 to 24 years. ⁵

Native Americans 19 years or age and younger are at greater risk for preventable injury-related deaths than are all other children and youth in the United States. They have twice the average rate of traumatic deaths than their counterparts in any other racial group. Injuries and violence account for 75% of all deaths among Native Americans in this age-group. MVCs are the leading cause of fatality followed by homicide, drowning, and fires. ⁴ The rates for pedestrian deaths in auto-pedestrian injuries are three times higher for Native Americans and Alaska Natives than whites. ⁵ The drowning rate overall for Native Americans and Alaska Natives is 1.8 times higher than that for whites; in children age 5 to 14 years the drowning rate is 2.6 times higher. ^{3. and 11.} Native American men age 20 years and older are (1) twice as likely to die from an MVC, (2) nearly twice as likely to die from fire and burn injuries, and (3) five times more likely to drown than their counterparts in other races. They are also four times more likely to commit suicide and three times more likely to be murdered. ⁹

The CDC began tracking firearm injuries in the early 1960s. Firearm violence and firearm-related deaths have been increasing at a steady rate for over 40 years. ⁵ Firearm injury disproportionately affects young people, resulting in lives cut short or forever affected as a result of their use. Firearms (especially handguns) are effective lethal weapons with the capability to escalate often-impulsive acts of interpersonal violence or suicidal thoughts into death. The United States has wrestled with firearms and the consequences of their use and misuse for years. Compared with other industrialized countries, the firearm death rate in the United States is eight times the average rate of its economic counterparts. ²¹ Among all industrialized countries, more men are killed by firearms than women; however, women in the United States die at a much higher rate from firearm injuries then their counterparts in other high-income countries. ²¹

Alcohol plays a significant role in all types of trauma, including MVCs, family violence, suicides, homicides, and altercations. Alcohol alters judgment and coordination, so it frequently contributes to injury-producing events.

An alcohol-related MVC kills someone every 31 minutes and nonfatally injures someone every 2 minutes. ^{8. and 26.} The CDC’s research has found that about 68% of the children killed in alcohol-related crashes were riding in cars driven by drivers who had been drinking. ⁵ One study demonstrated that child passenger restraint use decreased as the BAC of the child’s driver increased. ²⁹

Geographic differences exist in injury mortality. Physical environment or geographic area also characterizes injury rates. Homicides and suicides occur more often in urban areas, whereas unintentional injuries are more numerous in rural areas. Injury and death rates are greater on weekends with the peak on Saturday. More injuries are seen in July—probably as a result of summer recreational activities.