Injury trends,
Northern Territory
Introduction
Injury is a leading cause of mortality and disability both nationally and in the Northern Territory (NT).1,2 It is also a major cause of health care costs.1,3,4 This fact sheet updates previously reported rates and trends in injury- related mortality and hospital admission in the NT.1
Since the release of two national reports in 2007, there have been changes in the
classification of injury-related events.5,6 In this fact sheet the earlier injury classification is used so that previously published rates and trends can be extended without adjustment for the change in definitions. Caution should be taken when comparing injury statistics in this fact sheet with recent national statistics.
A number of recent reports have highlighted aspects of injury-related deaths and
hospitalisation in the NT. In 2005 and 2006, Measey et al provided a detailed analysis of suicide including the association with alcohol and other drugs.7,8 More recently Jacob et al (2007) reported the surgical features of stabbing injuries.9
Data sources
Data on injury-related deaths were sourced from the Australian Bureau of Statistics (ABS) death dataset. This fact sheet reports all deaths of NT residents occurring in the NT for the 14- year period between 1991 and 2004. Deaths due to injury were identified by underlying cause of death, mechanism of injury and year of death.
Data on hospital admissions were sourced from the NT public hospital information system through the central departmental data
warehouse. Injury-related cases were identified by principal diagnosis and injury mechanism, and are presented for NT residents by year of separation for the 15-year period from
1992 to 2006. These data do not include the comparatively small proportion of injury-related admissions to the private hospital in the NT.
The ABS mid-year Estimated Resident Population (ERP) for the NT was used for population denominators. The 2001 Australian ERP, which is the national standard population, was used in the calculation of NT age-
standardised rates.
Injury-related deaths
The rates and trends in injury-related mortality are highlighted in Figures 1 and 2 and Table 1.
The data in Table 1 are aggregated into three- year periods. The graphs present annual rates while the dashed lines on the graphs highlight the limit of data (2000) presented in the previous report.1
Figure 1: Age-standardised death rates due to injury, NT 1991–2004
Persons
- 50 100 150 200 250 300
1991 1993 1995 1997 1999 2001 2003
Deaths per 100,000
Aboriginal Non-Aboriginal Australia
Male
- 50 100 150 200 250 300
1991 1993 1995 1997 1999 2001 2003
Deaths per 100,000
Female
- 50 100 150 200 250 300
1991 1993 1995 1997 1999 2001 2003
Year Deaths per
100,000
Table 1: Age-standardised rates of injury-related deaths for all and common injury mechanisms, NT residents by Aboriginality and three-year periods, 1991–2004
Years Non-
Aboriginal Aboriginal NT total Australia All-Injury
1991-93 59 148 80 43
1994-96 71 140 86 42
1997-99 58 127 75 44
2000-02 61 141 81 41
2003-04 55 145 78 39
Transportation
1991-93 17 61 28 13
1994-96 22 52 28 12
1997-99 17 41 22 11
2000-02 16 47 23 10
2003-04 12 43 19 9
Suicide
1991-93 16 9 14 13
1994-96 18 13 16 13
1997-99 17 19 18 14
2000-02 18 31 22 12
2003-04 17 41 24 11
Violence
1991-93 6 27 10 2
1994-96 7 25 11 2
1997-99 3 13 6 2
2000-02 2 29 9 2
2003-04 2 14 5 1
Falls
1991-93 5 2 4 3
1994-96 5 11 6 3
1997-99 4 3 4 3
2000-02 12 2 9 3
2003-04 7 2 6 4
Note: Rates are calculated as deaths per 100 000 population
Of particular note:
• During the 14-year period, injury-related death rates among Aboriginal males and females exceeded the rates among non-Aboriginal males and females.
• In 2004, the injury-related death rate for NT Aboriginal males was more than three times the rate among NT Aboriginal females and nearly four times the rate among NT non- Aboriginal males (Figure 1).
• During the 14-year period, the three most common injury mechanisms causing death among NT Aboriginal people were
‘transportation’, ‘suicide’ and ‘violence’. For NT non-Aboriginal people the leading mechanisms were ‘transportation’, ‘suicide’
and ‘falls’ (Table 1).
Figure 2: Trends of age-standardised injury- related deaths for the three most common injury mechanisms, NT Aboriginal and non-Aboriginal populations, 1991–2004
Non-Aboriginal
0 20 40 60 80
1991 1993 1995 1997 1999 2001 2003
Deaths per
100,000 Transportation
Suicide Falls
Aboriginal
0 20 40 60 80
1991 1993 1995 1997 1999 2001 2003
Year Deaths per
100,000 Transportation
Violence Suicide
• In the latest (two-year) period, 2003–2004, the most common injury mechanism among the NT population was ‘suicide’ with an
annualised rate of 24 per 100 000 population.
The suicide rate among the NT Aboriginal population was 2.4 times the NT non- Aboriginal rate (41 and 17 per 100 000 respectively) and nearly four times the national rate (11 per 100 000) (Table 1).
• For the NT non-Aboriginal population, the period after 2000 continued the long-term trend of decreasing death rates from transportation injuries. Fall-related deaths were more common after 2000 than during the 1990s (Figure 2).
• For the NT Aboriginal population, after fluctuating rates of violence-related deaths through the 1990s, there is suggestion of a recent decline. In the same population there was a decline in transportation-related deaths during the 1990s but more recently the rate has remained unchanged.
Injury-related hospital admissions
The rates and trends in injury-related hospital admissions are highlighted in Table 2 and in Figures 3 and 4. The table contains aggregated three-year data. The graphs highlight trends based on calendar year while the dashed line on the graphs highlight the limit of data (2001) presented in the previous report.1
Of particular note:
• The injury-related admission rate for the NT Aboriginal population was substantially higher than the non-Aboriginal population throughout the 15 years of reported data. The rate ratio has increased from 1.9 in 1992–1994 to 3.0 in 2004–2006 (Table 2, Figure 3).
Figure 3: Age-standardised hospital admission rates due to injury, NT 1992–2006, NT public hospitals
Male
- 2,000 4,000 6,000 8,000 10,000
1992 1994 1996 1998 2000 2002 2004 2006 Admissions
per 100,000
Female
- 2,000 4,000 6,000 8,000 10,000
1992 1994 1996 1998 2000 2002 2004 2006 Year
Admissions per 100,000
Persons
- 2,000 4,000 6,000 8,000 10,000
1992 1994 1996 1998 2000 2002 2004 2006 Admissions
per 100,000 Aboriginal
Non-Aboriginal
Table 2: Age-standardised hospital admission rates for the top five injury mechanisms by Aboriginality, NT public hospitals 1992–2006
Years Non-Aboriginal Aboriginal NT total All-injury
1992-94 2098 3972 2466
1995-97 2160 3952 2525
1998-00 1987 4571 2579
2001-03 2190 5421 2963
2004-06 2204 6638 3233
Violence
1992-94 142 1578 461
1995-97 127 1417 418
1998-00 97 1574 447
2001-03 139 2015 605
2004-06 119 2474 686
Transportation
1992-94 403 378 383
1995-97 533 649 540
1998-00 376 407 374
2001-03 356 360 350
2004-06 369 427 371
Falls
1992-94 640 514 589
1995-97 628 466 579
1998-00 615 604 612
2001-03 632 720 655
2004-06 656 860 704
Medical complications
1992-94 204 304 218
1995-97 198 427 243
1998-00 241 747 346
2001-03 356 923 469
2004-06 340 1187 503
Inanimate forces
1992-94 245 438 287
1995-97 235 340 259
1998-00 210 357 245
2001-03 212 311 240
2004-06 205 379 255
• Between the years 2001 and 2006, there was a 50% increase in the admission rate among the NT Aboriginal population. The increase occurred among both males and females (Figure 3).
• Over the same period, 2001–2006, there was also a 15% increase in admission rate among the NT non-Aboriginal population (Figure 3).
• Over the 15-year period (1992 to 2006), with the occasional exception of ‘transportation’
and ‘falls’, admission rates for injuries due to
‘transportation’, ‘falls’, ‘violence’, ‘medical complications’ and ‘inanimate forces’ were consistently higher among the NT Aboriginal
population than among the NT non-Aboriginal population (Table 2).
• From 1992 to 2006, injury-related admission rates among NT non-Aboriginal people were stable for ‘falls’ and decreased slightly for
‘transportation’. By contrast there was a 67%
increase in reported ‘medical complications’
among this group (Table 2).
• From 1992 to 2006, injury-related admission rates for the top three injury mechanisms among Aboriginal people increased. ’Medical complications’ had the greatest increase (290%), followed by ‘falls’ (67%) and ‘violence’
(57%) (Table 2).
• During the most recent three-year period of 2004–2006, the three most common injury mechanisms for non-Aboriginal people were
‘falls’, ‘transportation’ and ‘medical
complications’. For Aboriginal people the three most common injury mechanisms were
‘violence’, ‘medical complications’ and ‘falls’
(Table 2 and Figure 4)
Figure 4: Age-standardised hospital admission rates due to the top three injury mechanisms by Aboriginality, NT public hospitals, 1992–2006
Non-Aboriginal
- 500 1,000 1,500 2,000 2,500 3,000 3,500
1992 1994 1996 1998 2000 2002 2004 2006 Admissions
per 100,000
Falls Transportation Medical Complication
Aboriginal
- 500 1,000 1,500 2,000 2,500 3,000 3,500
1992 1994 1996 1998 2000 2002 2004 2006 Year
Admissions per 100,000
Violence
Medical Complication Falls
• From 1992 to 2006, the admission rate for
‘medical complications’ increased fastest among all injury mechanisms for both Aboriginal and non-Aboriginal population groups (Table 2). However, the number of
‘medical complications’ as a proportion of all separations, and the number of ‘surgical
complications’ as a proportion of all procedures was unchanged for non-Aboriginal patients, and decreased for Aboriginal patients (not presented here).
References
1. You JQ, Guthridge SL. Mortality, morbidity and health care costs of injury in the Northern Territory, 1991- 2001. Darwin: Northern Territory Department of Health and Community Services, 2005.
2. Zhao Y, Guthridge S, Magnus A, Vos T. Burden of disease and injury in Aboriginal and non-Aboriginal populations in the Northern Territory. Medical Journal of Australia. 2004;180(10):498-502.
3. Hendrie D, Hall SE, Arena G, Legge M. Health system costs of falls of older adults in Western Australia.
Australian Health Review. 2004;28(3):363-73.
4. Mathers C, Penm R, Carter R, Stevenson C. Health system costs of diseases and injury in Australia 1993- 94. Canberra: Australian Institute of Health and Welfare, Health and Welfare Expenditure Series no. 2, AIHW cat. no. HWE5, 1998
5. Berry J, Harrison JE. Hospital separations due to injury and poisoning, Australia 2003-04. Canberra: Australian Institute of Health and Welfare, Injury Research and Statistics Series no. 30, AIHW cat. no. INJCAT88, 2007.
6. Henley G, Kreisfeld R, Harrison JE. Injury deaths, Australia 2003-04. Canberra: Australian Institute of Health and Welfare, Injury Research and Statistics Series no. 31, AIHW cat. no. INJCAT89, 2007.
7. Measey M, Li SQ, Parker R. Suicide in the Northern Territory 1981-2002. Darwin: Northern Territory Department of Health and Community Services, 2005.
8. Measey ML, Li SQ, Parker R, Wang Z. Suicide in the Northern Territory, 1981-2002. Medical Journal of Australia. 2006;185(6):315-9.
9. Jacob AO, Boseto F, Ollapallil J. Epidemic of stab injuries: an Alice Springs dilemma. ANZ J Surg.
2007;77:621-5.
Information compiled by:
Jiqiong You and Steve Guthridge.
Enquiries to:
Director, Health Gains Planning Branch Department of Health
PO Box 40596, Casuarina, NT 0811 Email:
Health Gains Planning Information Sheet, July 2010.
