Injury is the leading cause of premature mortality in the United States. This proposed study is an evaluation of the quality of mortality data available to local health agencies for planning and evaluating injury control programs. The study has two primary aims. The central focus of the study is examination of death certificates and coroner/ Medical Examiner records in urban and rural counties, to ascertain accuracy and completeness of data related to injury. The other primary aim is to determine how different methodological approaches to calculation of county-specific injury mortality rates affect comparisons over time and across counties. For the purposes of this study, injury is defined by ICD-9 codes E800-E999, which include trauma from motor-vehicles, firearms, falls, drowning, fires, asphyxia, and poisoning. The study will examine three years of death certificate data for the 39 counties of Washington state, and records in coroner and Medical Examiner (ME) offices in a sample of five urban counties and ten rural counties. Data elements to be examined are demographics, behavioral factors (such as alcohol use or seat belt use), physical environment, social environment (such as injury at work), type of event, emergency medical care, and outcomes. The two data sources will be separately evaluated for completeness, and death certificate data compared to coroner/ME data for accuracy. The study will also estimate """"""""out-migration"""""""" of fatally injured patients from rural counties and """"""""in-migration"""""""" to urban counties, in order to develop methods for adjustment of published vital statistics reports. Separate injury mortality rates will be calculated based on place of residence vs place of death vs place of occurrence of injury. The study aims to provide injury prevention workers with a scientific basis for choosing data sources and interpreting published reports when planning and evaluating injury control programs for traumatic fatalities.
