Injury in Australia

This report series divides hospitalised injury cases and injury deaths into 10 categories, based on the main causes of injury in Australia (see Figure 1).

In 2017–18, falls was the most common cause of both injury hospitalisations and injury deaths. The next most common causes for injury hospitalisations were contact with objects (such as blunt or sharp objects) and transport accidents. The next most common causes for injury deaths were suicide and transport accidents.

These 10 main causes of injury are described in more detail in separate reports on this website.

Figure 1: Injury hospitalisation cases and deaths by cause, 2017–18

Since 2008–09, there has been:

• a 1.1% annual average increase in injury hospitalisation rates to 2016–17
• very little change (0.1% annual average decrease) in injury death rates to 2017–18
• an increase in hospitalisation rates of injury due to contact with living things, falls, drowning and submersion, intentional self-harm, contact with objects and accidental poisoning
• a decrease in hospitalisation rates of injury due to assault and thermal causes
• an increase in rates of deaths due to falls, suicide and accidental poisoning
• a decrease in rates of deaths due to drowning, assault, transport crashes and other unintentional causes (Figure 2).

Annual average rate changes are calculated using modelled age-standardised rates (see Technical notes for more details).

Annual average rate changes for deaths due to contact with living things, contact with objects, and burns and other thermal causes are not reported due to relatively low numbers.

Because of changes in data collection methods, hospitalisation rates for 2017–18 are not included and should not be compared with rates for previous years (see Technical notes for more details). Death rates for 2017–18 are comparable with previous years.

Figure 2: Average annual change in rate of injury hospitalisation cases and deaths, by cause of injury, 2008–09 to 2016–17 (hospitalisation cases) and 2008–09 to 2017–18 (deaths)

For more details see Data tables C1–4 and E1–4.

Injury hospitalisation and death rates differ for males and females, by age and by cause of injury. In this section, statistics are first presented by looking at age and sex together. Age and sex are then examined separately by cause of injury.

More detailed information about age and sex by the various causes of injury are included in the Injury by cause web reports.

Injury hospitalisations by age and sex

In 2017–18, using 5-year age groups:

• the number of male injury hospitalisation cases peaked in the 20–24 year age group, while the number of female cases peaked at 85–89 years
• rates for both males and females were relatively stable during childhood and the early and middle stages of adulthood, ranging from 1,258 per 100,000 for the 5–9 age group to 2,355 per 100,000 in the 15–19 age group
• from about the age of 65, injury hospitalisation rates begin a dramatic rise from 2,045 per 100,000 for the 65–69 age group to 17,993 per 100,000 in the 95-and-over age group (Figure 3).

Injury deaths by age and sex

In 2017–18, using life-stage age groups:

• both male and female injury death rates peaked in the 65-and-over age group, and were dramatically higher compared with younger age groups
• rates for males were higher than females across the life stages, with greater differences between the sexes between the ages of 15–64 (Figure 3).

Figure 3: Injury hospitalisation cases and deaths, by age group and sex, 2017–18

For more detailed data, see Data tables A1–3 and D1–3.

Injury hospitalisations by sex

In 2017–18:

• 55% of injury hospitalisations were for males (291,253 cases) and 45% were for females (241,285 cases)
• males were 1.4 times as likely as females to be hospitalised due to injury
• the age-standardised rate of injury hospitalisations for males was 2,353 per 100,000 males, compared with 1,727 per 100,000 females
• the causes of injury hospitalisation cases with the largest difference between sexes were contact with objects (with the male rate 2.8 times the female rate), followed by transport accidents (male rate 2.0 times the female rate)
• the cause with the most similar rates between sexes was falls (with the female rate 1.1 times the male rate) (Figure 4).

Injury deaths by sex

In 2017–18:

• 61% of injury deaths were for males (7,892 deaths) and 39% were for females (5,136 deaths)
• males were 1.8 times as likely to die due to injury as females
• the age-standardised rate of injury deaths for males was 61 cases per 100,000, compared with 35 per 100,000 females
• the cause of injury deaths with the largest difference between sexes was contact with objects, with the male rate 6.0 times the female rate (however, due to the relatively low numbers of deaths due to contact with objects, this statistic should be treated with caution)
• other causes of injury deaths with large differences between sexes were suicide (with the male age-standardised rate 3.3 times the female rate), transport accidents (male rate 3.0 times the female rate) and homicide (male rate 2.8 times the female rate); drowning, poisoning and thermal causes also show male rates at least twice that of female rates
• the cause with the most similar rates between sexes was falls (with the female rate 1.1 times the male rate) (Figure 4).

Figure 4: Cause of injury hospitalisation cases and deaths, by sex, 2017–18

For more detailed data, see Data tables A1–3, D1–3 and B1–24.

Injury hospitalisations by age group

In 2017–18:

• 1 in 3 (32%) hospitalised injury cases involved older Australians aged 65 and over
• among people aged under 65, the injury hospitalisation rate was highest for the 15–19 age group (2,355 per 100,000 population) and lowest for children aged 5–9 (1,258 per 100,000)
• unintentional falls was the cause of injury hospitalisation for which the 5-year age group rate varied most, ranging from 247 per 100,000 for people aged 30–34 to 16,459 per 100,000 for people aged 95 and over
• drowning and submersion was the cause of injury hospitalisation that varied least by age—using 5-year age groups, the rate ranged from <0.1 per 100,000 people for those aged 95 and over to 16.7 for those aged 0–4
• contact with objects, falls, and other unintentional causes all placed in the top 4 causes of injury hospitalisation across all life stages
• drowning and submersion was consistently among the lowest-ranked causes of injury hospitalisation across all life stages (Figure 5).

Figure 5: Causes of injury, ranked by rate of hospitalisation cases, by age group, 2017–18

For more detailed data, see Data tables A1–3 and B1–24.

Injury deaths by age group

In 2017–18 (using the life-stage age groups 0–4, 5–14, 15–24, 25–44, 45–64 and 65+):

• over 1 in 2 (54%) injury deaths were for older Australians aged 65 and over
• injury death rates were lowest in childhood, with the 5–14 age group (2.2 deaths per 100,000) being lower than the 0–4 year age group (4.6 deaths per 100,000)
• rates steadily increase with age from adolescence to the 45–64 age group, before rising more sharply in the 65-and-over age group
• falls was the cause of injury deaths for which the rate varied most across the life stages, ranging from <0.1 per 100,000 for people aged 5–14 to 127 per 100,000 for people aged 65 and over
• causes of injury death with the least variation in rates across the life stages were drowning, burns and other thermal causes, contact with objects, contact with living things and homicide (Figure 6).

Figure 6: Causes of injury, ranked by rate of deaths, by age group, 2017–18

For more detailed data, see Data tables D1–3.

Three measures that may indicate the severity of a hospitalised injury are:

• length of hospital stay
• percentage of cases with time in an intensive care unit
• percentage of cases involving continuous ventilator support.

Length of hospital stay

In 2017–18, the most severe injuries in terms of average number of days in hospital were due to burns and other thermal causes (4.9 days) and falls (4.6 days), followed by transport crashes (3.4 days) (Figure 7). The average length of stay partly reflects the age of those injured, with younger people staying fewer days in hospital than older people across all causes-of-injury categories. This particularly affects the statistics for causes with higher proportions of older people, such as falls.

Figure 7: Average number of days in hospital, by cause of injury, 2017–18

Note: Includes admissions that are transfers from 1 hospital to another or transfers from 1 admitted care type to another within the same hospital, except where care involves rehabilitation procedures. See About the data for more information.

Source: AIHW National Hospital Morbidity Database.

Intensive care cases

Almost 12,800 (2.4%) hospitalised injury cases involved a stay in an intensive care unit (ICU) in 2017–18. Intentional self-harm (11%) and drowning and submersion (11%) were the causes most likely to result in ICU time. Only 1.7% of unintentional falls cases, the most common cause of injury, required ICU time (Figure 8).

Ventilator cases

About 6,370 (1.2%) hospitalised injury cases involved continuous ventilator support in 2017–18. Drowning and submersion (7%), and accidental poisoning (5%) were the causes most likely to result in continuous ventilator support (Figure 8).

Figure 8: Percentage of hospitalised injury cases involving continuous ventilator support and time in an ICU, by cause of injury, 2017–18

Source: AIHW National Hospital Morbidity Database.

For more detailed data, see Data tables A12–13.

In 2017–18, the head and neck was the body part most frequently injured in hospitalised injury cases (Figure 9). In part, this may reflect the inherently serious nature of head and neck injuries.

Figure 9: Injury hospitalisation cases by body part injured, 2017–18

Note: Body part refers to the principal reason for hospitalisation. Number and percentage of injuries classified as Other, multiple and incompletely specified body regions and Injuries not described in terms of body region not shown—see Data table A11.

Source: AIHW National Hospital Morbidity Database.

For more detailed data, see Data table A11.

Table 1 shows how body part injured varied by cause of injury.

Notes:

1. Other, multiple and incompletely specified body regions not included.
2. Data not available or not published for burns and thermal causes, poisoning, drowning and submersion, and intentional self-harm.

Source: AIHW National Hospital Morbidity Database

For more details see Data table A11.

Fractures were the most common type of injury across many cause-of-injury categories. Open wounds, superficial injuries and soft-tissue injuries were more common overall than intracranial injuries, dislocations, and injuries to internal organs or vessels of the trunk. However, types of injury vary by cause. Figure 10 shows the top types of injures for hospitalisation cases by selected causes.

Figure 10: Top types of injuries for hospitalisation cases, by selected causes, 2017–18

Notes:

1. Other and unspecified’ injuries include dislocations, injuries to internal organs or vessels of the trunk, burns, poisoning and other and unspecified types of injuries.
2. Data not available or not published by cause for burns and thermal causes, poisoning, drowning and submersion, and intentional self-harm.

Source: AIHW National Hospital Morbidity Database.

For more detailed data, see Data table A12.

In 2017–18, among Aboriginal and Torres Strait Islander people, there were over 28,700 hospitalisations and over 430 deaths. Assault and falls were the 2 most common causes of injury hospitalisations (Table 2); intentional self-harm was the most common cause of injury deaths (Table 3).

Indigenous males, compared with Indigenous females, were:

• 1.1 times as likely to be hospitalised due to an injury
• 2.0 times as likely to die from an injury (Figure 11).

Injury hospitalisation rates among Indigenous Australians were highest for the 25–44 age group (Figure 11).

Note: All-external-causes total includes hospitalisations where the external cause has undetermined intent or is missing, or where the external cause is not elsewhere classified.

Source: AIHW National Hospital Morbidity Database.

Notes:

1. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.
2. The sum of the counts by cause may be greater than the total number of injury deaths because some deaths have multiple causes.

Source: AIHW National Mortality Database.

Indigenous and non-Indigenous Australians

In 2017–18, Indigenous Australians, compared with non-Indigenous Australians, using age-standardised rates, were:

• 2.0 times as likely to be hospitalised due to an injury (Table 4)
• 1.6 times as likely to die from an injury (Table 5).

The cause of injury hospitalisations with the largest difference in rates between Indigenous and non-Indigenous Australians was assault, which was 14 times as high in the Indigenous population. Rates of injury among Indigenous Australians for intentional self-harm, burns and other thermal causes, accidental poisoning and contact with living things were all 2 to 3 times as high as for non-Indigenous Australians (Table 4).

The cause of injury deaths with the largest difference in rates between Indigenous and non-Indigenous Australians was homicide, which was 5.6 times higher in the Indigenous population. Rates of death for accidental poisoning and transport accidents were more than twice as high for Indigenous Australians compared with non-Indigenous Australians (Table 5). Readers are advised to use caution when using these rates due to relatively low numbers of deaths in some categories.

n.p. Not publishable because of small numbers, confidentiality or other concerns about the quality of the data.

Note: Rates are age-standardised to the 2001 Australian population (per 100,000).

Source: AIHW National Hospital Mortality Database.

n.p. Not publishable because of small numbers, confidentiality or other concerns about the quality of the data.

Notes:

1. Rates are age-standardised to the 2001 Australian population (per 100,000).
2. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.

Source: AIHW National Mortality Database.

The age-specific rate of injury hospitalisation cases was highest among the 25–44 life-stage age group for Indigenous Australians and among the 65-and-over age group for non-Indigenous Australians (Figure 11).

Figure11: Injury hospitalisation cases and deaths, by Indigenous status, sex and age group, 2017–18

For more detailed data, see Data tables A4–A6 and D4–D8.

People living in more remote areas of Australia tend to have higher rates of injury hospitalisation and injury death compared with people living in less remote areas. In 2017–18, people living in Very remote areas, compared with people living in Major cities, were:

• 2.3 times as likely to be hospitalised due to an injury
• 1.7 times as likely to die from an injury (Table 6).

Note: Rates are age-standardised per 100,000 population.

Source: AIHW National Hospital Morbidity Database; AIHW National Mortality Database.

Cause of injury by remoteness

The cause of injury with the largest difference in hospitalisation rates between remoteness areas was assault, with the rate for Very remote areas 19 times that of Major cities (Table 7). Burns and other thermal causes showed the next highest difference—the rate for Very remote areas was 5 times that of Major cities.

The rate of deaths due to transport crashes for people living in Very remote areas was 4.7 times that of those living in Major cities. Suicide rates for people living in Very remote areas was 2.1 times that of those living in Major cities. Readers are, however, advised to use caution when using these rates due to relatively low numbers of deaths in some categories. Comparisons between remoteness categories for other causes of injury death are limited due to small numbers (see Data tables A7–9).

n.p. Not publishable because of small numbers, confidentiality or other concerns about the quality of the data.

Note: Rates are age-standardised to the 2001 Australian population (per 100,000).

Source: AIHW National Mortality Database; AIHW National Hospital Mortality Database.

The highest age-specific rate of injury hospitalisation cases was among the 15–24 life-stage age group living in Very remote areas of Australia. (Figure 12).

Figure 12: Injury hospitalisation cases and deaths, by remoteness, by age group and sex, 2017–18

For more detailed data, see Data tables A7–A9 and D9–D10.

For information on how statistics by remoteness are calculated, see Technical notes.

Technical notes—read about how the data were calculated.

Data tables—download full data tables.

Glossary

Trends in hospitalised injury, Australia, 2007–08 to 2016–17

Trends in injury deaths, Australia, 1999–00 to 2016–17