When reporting the cause of their injury, respondents are asked about six specific causes and an “other” cause. Approximately one-half of respondents reply with the “other” response, which includes accidents around the home and while conducting activities of daily living. In compiling data on the cause of injury, only three categories are used. “Falls” is one of the six specific causes; “vehicle or sports-related” injuries include being in a motor vehicle collision or as a pedestrian hit by a vehicle, accidents while in a boat, train or airplane, and accidents while on a scooter, bike, skateboard, horse, etc. Burns are included in the “other” cause category.

The cause of all injuries reported by male and female individuals is 11% each for vehicle or sports-related injuries. However, women report more falls than men (43% versus 30%) and fewer other causes (46%, 60%). (Reference Table 5A.1.1 PDF [1] CSV [2])

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By age, persons age 18 to 44 report higher incidence of vehicle and sport-related injuries (15.6%), while those age 65 and over report only 5% from this cause. However, the 65 and over population reports the highest incidence of falls (58.4%). (Reference Table 5A.1.2 PDF [5] CSV [6])

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Using race/ethnicity as the comparison variable, there is less variation between groups with only vehicle or sport-related injuries varying. Black non-Hispanics report vehicle or sport-related injuries as a cause 15.2% of the time while non-Hispanic whites report only 9.7% of injuries caused by vehicle or sport-related causes. (Reference Table 5A.1.3 PDF [7] CSV [8])

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Geographic regional areas report only minor differences by cause of injuries, with vehicle and sport-related accidents slightly higher in the South and West regions than in the Northwest and Midwest regions. (Reference Table 5A.1.4 PDF [9] CSV [10])

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It has long been known that most injuries occur in or around the home, in part because of the time spent at home versus other locations. In 2013-2015, persons self-reporting injuries reported one-half of the injuries for which they sought medical treatment occurred in the home (32%) or outside the home or farm (17%). Female individuals are more likely to report an injury occurring inside the home than are male individuals (37% versus 22%). Other common places of injuries to occur are public buildings (13%) and public streets (12%). Male individuals report injuries occurring in public buildings more than do female ones (22%, 13% respectively). Age is also a factor in where injuries occur, with 75% of injuries reported by persons age 65 and over occurring in or around the home while those age 18 or younger have more injuries at school (28%) or in a public facility (22%). Race/ethnicity and geographic region are not factors in where injuries occur. (Reference Table 5A.2.1 PDF [21] CSV [22])

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The type of activity engaged in does not differ significantly as a cause of musculoskeletal injuries. Sports, non-sport leisure activities, and working in and around the home or workplace are the cause of similar numbers of injuries for which medical care is sought. There are slight differences between male and female individuals, but age is a greater factor, with those age 65 and older reporting working at home (27%) or an “other” activity (42%) while young people under 18 are more likely to be injured during sport activities (41%). Race/ethnicity and geographic region are neither one a factor in the type of activity engaged in when injuries occur. (Reference Table 5A.2.1 PDF [21] CSV [22]; Table 5A.2.2 PDF [25] CSV [26]; Table 5A.2.3 PDF [27] CSV [28]; Table 5A.2.4 PDF [29] CSV [30])

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The type of self-reported injury reported showed small variations by demographic group, particularly with respect to age and race/ethnicity. Overall, the most common type of musculoskeletal injury for which medical attention was sought was a sprain or strain (37%). This was particularly true for non-Hispanic blacks (42%) and non-Hispanic others (43%), and persons age 18 to 44 (43%). Persons age 65 and older were most likely to report a scrape or bruise (contusion) for which they sought medical attention (28%). Fractures were most common among those 18 and younger (27%). (Reference Table 5A.3.1 PDF [33] CSV [34]; Table 5A.3.2 PDF [35] CSV [36]; Table 5A.3.3 PDF [37] CSV [38]; Table 5A.3.4 PDF [39] CSV [40])

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Injuries to the lower extremity were the most common injury site, accounting for 45% of all musculoskeletal injuries for which medical attention was sought. Female individuals reported lower extremity injuries more than male (52% and 39% of all injuries, respectively) while 42% of injuries reported by male individuals were to the upper extremity. Persons age 18 to 64 years were most likely to have a back injury, but injuries to the neck/back/spine accounted for only 13% of reported injuries. Spine injuries were reported in the West region (19%) more than other regions. Race/ethnicity was not a factor is anatomic site of injuries for which medical attention was sought. (Reference Table 5A.3.1 PDF [33] CSV [34]; Table 5A.3.2 PDF [35] CSV [36]; Table 5A.3.3 PDF [37] CSV [38]; Table 5A.3.4 PDF [39] CSV [40])

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Sprains and strains accounted for 64% of injuries for which medical attention was sought when the neck/back/spine were involved, and 41% of lower extremity injuries. Scrapes and bruises accounted to 49% of torso injuries. Injuries to the upper extremity were distributed across all types of injuries. Fractures occurred more frequently from a fall, while sprains and strains were more common with vehicle or sport-related injuries. Cuts and other types of injuries occurred from other causes. (Reference Table 5A.4.1 PDF [45] CSV [46]; Table 5A.4.2 PDF [47] CSV [48])

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Just over 6% of self-reported medically-consulted musculoskeletal injuries resulted in hospitalization of one night or longer. Fractures were most likely to result in hospitalization (16%), with sprains and strains least likely (2%). Injuries to the torso were more likely to result in hospitalization (10%) than injuries to other anatomic sites. Injuries resulting from falls (10%) also had a greater likelihood of hospitalization. (Reference Table 5A.4.3 PDF [51] CSV [52])

The annual National Health Interview Survey asks participants if they are limited in activities of daily living (ADL), such as the ability to dress oneself, to get in or out of bed or a chair, or to work, due to health issues. Depending on the NHIS dataset used, the specific limitation items are different. The Person file includes activities such as dressing, eating, and working. The Injury file focuses on ability to socialize, walk, and lift/carry items. Both include only persons age 18 and over, and both are based on a “yes” response to “fracture or bone/joint injury” as the cause of the limitation.

In the Injury file, one in four or five persons report limitations with all activities included unless special equipment is available. Reaching over the head is the most limited activity (30%), while grasping small objects the least limited (20%). (Reference Table 5A.5.1 PDF [53] CSV [54])

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Inability to work at all (52%) or limited in kind of work (27%) is the major limitation for adults in the Person file reporting a fracture or bone/joint injury. While one in three (31%) reported needing help with routine needs, the specific ADL varied. Women reported higher levels of need than men, and age was also a factor. One in four (25%) of persons age 65 and over reported needing help with personal care after a fracture or bone/joint injury. (Reference Table 5A.5.2 PDF [57] CSV [58])

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In addition to needing help with activities, persons suffering a fracture or bone/joint injury report high levels of bed days and lost work days. A bed day is defined as 1/2 or more days in bed due to injury or illness in past 12 months, excluding hospitalization. A mean of 28 bed days were reported by 4.5 million persons with a fracture or bone/joint injury, for a total of 122.6 million days. Mean bed days were slightly higher for women (28 days), persons aged 45 to 64 years (30 days), non-Hispanic whites (30 days), and persons living in the Midwest (35 days).

A missed work day is defined as absence from work due to illness or injury in the past 12 months, excluding maternity or family leave. A mean of 23 lost work days were reported by 2.5 million persons with a fracture or bone/joint injury, for a total of 55.9 million days. Mean lost work days were similar between sexes, by age, and regionally, but considerably higher for Hispanic persons with a fracture or bone/joint injury (33 days) and much lower for non-Hispanic others (10 days).

The share of bed days and lost work days reported by a demographic group is impacted by both the mean days reported and their share of the total population. However, variations can be seen. For example, non-Hispanic whites accounted for 80% of bed days but only 60% of lost work days, while Hispanics were 10% and 17%, respectively. Female injured had a higher share of bed days (59%), while lost work days were evenly split between female and male individuals. Persons age 45 to 64 reported half (49%) of total bed days, with the balance split between younger and older persons. However, due to a representing a small share of the workforce, persons age 65 and over accounted for only 4% of lost work days. (Reference Table 5A.5.3 PDF [61] CSV [62])

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