Head and spinal cord injury in North Carolina

              No. 57 June 1991
HEAD AND SPINAL CORD INJURY IN NORTH CAROLINA
by
Tena H. Ward
ABSTRACT
In recent years North Carolina has recognized the need to confront injury as one of the major,
preventable health problems in this state. Traditionally, injuries have been regarded as unavoidable
events. Injuries, however, have been found to be both predictable and preventable (1).
Head and spinal cord injuries are particularly devastating because the severe nature of many of these
injuries leads to death or permanent disability. Using the North Carolina death files, this study examines
resident head and spinal cord injury mortality from 1979 to 1988. Mortality data are then compared to
hospital discharge data from the Medical Database Commission. Head injury was involved in 11,317
deaths during this period, spinal cord injury in 493 deaths.
Head injury-associated death (HIAD) is most often related to motor vehicle collisions, falls, homicide,
and suicide. For both whites and nonwhites, males are at much greater risk of HIAD than females. Age
groups most affected are those 15-24 and 75 and older. By race, rates are generally higher for nonwhites
than whites. A comparison of the HIAD portion of this study to a national HIAD study reveals higher
state rates overall but similar age-specific rates. There are also differences in the proportion of HIADs by
cause, with an excess of motor-vehicle-related HIAD in North Carolina.
Spinal cord injury-associated death (SCIAD) is most often related to motor vehicle collisions and falls.
Again, males are at a much higher risk ofSCIAD than females. Rates increase at ages 15-24, level off, then
rise sharply after age 65. In general, rates are higher for nonwhites than whites, particularly nonwhite
males.
A comparison of 1 988 mortality and hospital discharge data reveals that, for every death from head
injury, another 4.4 persons were hospitalized with a head injury. The corresponding ratio for spinal cord
injury was 6.0. The relationship between HIADs or SCIADS and hospitalized survivors varies by age
group and sex group.