Injury in Australia

Most injuries, whether accidental or intentional, are preventable. This report divides injury hospitalisations and deaths into 15 categories, representing the main causes of injury in Australia (see Figure 1). These categories are based on the causes of injury listed in each hospital and death record.

In 2018–19, falls were the most common cause of both injury hospitalisations and injury deaths. The next most common causes for hospitalisations were contact with objects (including blunt or sharp objects) and transport accidents. For deaths, the next most common causes were suicide, accidental poisoning and transport accidents.

Each of these 15 main causes of injury is explored further on its own page.

Figure 1: Injury hospitalisations and deaths by cause, 2018–19

The age-standardised rate of injury hospitalisations in 2018–19 was 0.4% higher than a year earlier. Over the period from 2009–10 to 2016–17 there was an average annual increase of 1.5%.

There is a break in the time series for hospitalisations between 2016–17 and 2017–18 due to a change in data collection methods (see Technical notes for more details).

For injury deaths, the average annual increase in rate between 2009–10 and 2018–19 was 0.4% (Figure 2).

Figure 2: Age-standardised rate and number of injury hospitalisations and deaths, 2009–10 to 2018–19

For more detail, see Data tables C1–4 and E1–4.

Rates of injury vary between males and females. The extent of this variation changes over the course of life – some causes of injury tend to have the greatest impact on younger males, while other causes are more likely to impact older females.

The following sections explore these differences in age and sex, in general first of all, and then considering specific causes.

Overall, males had higher rates than females for both injury related hospitalisation and death. For hospitalisations, males had higher rates until around age 65, when female rates become more prominent. For deaths, male rates remained higher across all age groups.

Hospitalisations

In 2018–19, 55% of injury hospitalisations were for males (about 296,700 cases) and 45% were for females (247,400 cases). Correspondingly, the age-standardised rate of injury hospitalisation was higher for males at around 2,400 per 100,000, compared with 1,700 per 100,000 for females.

The age distribution of injuries differs between the sexes, as illustrated in figure 3. Comparing 5-year age brackets:

• the highest number of male cases was in the 20–24 year age group
• the highest number of female cases was in the 85–89 year age group
• rates of injury for both males and females were relatively stable during childhood and the early to middle stages of adulthood, with a small peak in the 15–19 age group
• from around age 65, rates per 100,000 rise dramatically

Deaths

In 2018–19, almost two thirds of injury deaths (62%) were for males (8,500 deaths) and 38% were for females (5,300 deaths). Correspondingly, the age-standardised rates of death were 65 per 100,000 males, and 32 per 100,000 females. Over half of injury deaths (53%) were for those aged 65 and over.

In 2018–19, comparing life-stage age groups:

• both male and female injury death rates peaked in the 65-and-over age group, and were dramatically higher than in younger age groups
• rates of death were higher for males than females across all life stages (Figure 3).

Figure 3: Injury hospitalisations and deaths, by age group and sex, 2018–19

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

Cause and sex

Some causes of injury affect one sex more. Males had higher rates of injury hospitalisation in all causes except falls and intentional self-harm. Some causes, such as accidental poisoning, showed a relatively small difference, while others displayed a large bias towards one sex (Figure 4).

The largest differences in hospitalisation rate in 2018–19 were from causes related to activities that are traditionally dominated by males:

• electricity and air pressure (the male rate was 2.9 times the female) and
• contact with objects (male rate 2.7 times the female).

Males had higher rates of injury death than females in every cause category. For males, the highest age-standardised rate was from suicide, while for females it was from falls.

Figure 4: Injury hospitalisations and deaths, by cause and sex, 2018–19

For more detail, see Data tables A1–3, D1–3 and B1–34.

Cause and age

Different age groups face different injury risk factors. As a result, injuries due to the various causes occur in different proportions in each age group.

For injury hospitalisations in 2018–19:

• unintentional falls placed in the top 3 causes across all age groups (Figure 5)
• falls caused 46% of all hospitalised injuries in the 0-4 year bracket, 14% in the 20-24 year bracket and 92% in the 95 and over bracket (Figure 6)
• contact with objects, transport accidents, contact with living things, and intentional self-harm also feature among the top causes across all ages.

For injury deaths in 2018–19:

• falls was the cause for which the rate varied most across the life stages, ranging from <0.1 per 100,000 for children aged 5–14 to 125 per 100,000 for people aged 65 and over (Figure 5).

Figures 5 and 6 illustrate, respectively, the rank and the proportion of injuries attributed to the cause categories, by age groups. Figure 5 uses stage-of-life age groups for simplicity, while Figure 6 uses 5-year age bands for more detail.

Figure 5: Top 5 causes of injury by age, 2018–19

Figure 6: Causes of injury as a percentage of total cases, by age, 2018–19

For more detail, see Data tables A1–3 and B1–34.

Each cause is discussed further on its own page.

There are many ways the severity, or seriousness, of an injury could be assessed. Using the available data, three measures of the severity of hospitalised injuries are:

• number of days in hospital
• time in an intensive care unit (ICU)
• time on a ventilator.

Average length of hospital stay

In 2018–19, the most severe injuries in terms of average number of days in hospital were due to falls (6.0 days), thermal causes (5.1 days), and transport accidents (4.4 days) (Figure 7).

The average length of stay may be influenced by the age of those injured, with younger people staying fewer days in hospital than older people across all cause categories. Older people recover more slowly and are more likely to have additional health problems or complications. 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, 2018–19

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.

Source: AIHW National Hospital Morbidity Database.

Intensive care

Over 13,700 injury hospitalisations (2.5% of all cases) involved a stay in an intensive care unit (ICU) in 2018–19. Intentional self-harm and drowning and submersion were the causes most likely to result in ICU time (Figure 8).

Continuous ventilatory support

About 6,800 injury hospitalisations (1.2% of all cases) involved continuous ventilatory support in 2018–19. Most patients needing this level of support will be in an ICU. Intentional self-harm and drowning and submersion were also the causes most likely to result in continuous ventilatory support (Figure 8).

Figure 8: Percentage of injury hospitalisations requiring continuous ventilatory support and time in an ICU, by cause of injury, 2018–19

Note: The Electricity and pressure category was not included because the underlying counts were suppressed.

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables A12–13.

This section provides summary statistics firstly about the parts of the body injured in hospitalised cases, and secondly about the types of injury commonly sustained.

Body part injured

In 2018–19, the head and neck was the body part most often identified as the principal site of injury in hospitalisations (Figure 9). To some extent this may reflect the inherently serious nature of head and neck injuries.

Figure 9: Injury hospitalisations by principal body part injured, 2018–19

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.

The various causes tend to lead to different types of injury outcomes. Figure 10 shows the three most common body parts injured for some of the most common cause categories.

Figure 10: Top 3 body parts injured as a proportion of hospitalised cases, for selected causes, 2018–19

For more detail, see Data table A11.

Types of injury

The type of injury that a person sustains also tends to vary by cause.

Fractures were the most common type of injury overall and across many cause categories. Open wounds and soft tissue injuries were the next most common overall. Figure 11 shows the most common types of injury in hospitalisations for selected causes.

Figure 11: Types of injury sustained in hospitalised cases as a proportion for selected causes, 2018–19

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 detail, see Data table A10.

In 2018–19, among Aboriginal and Torres Strait Islander people, there were over 29,600 injury hospitalisations and 500 deaths. Falls and assault were the two most common causes of injury hospitalisations (Table 1); suicide was the most common cause of injury deaths (Table 2).

Indigenous males, compared with Indigenous females (age-standardised) were:

• 1.1 times as likely to be hospitalised due to an injury
• 2.1 times as likely to die from an injury.

Injury hospitalisation rates among Indigenous Australians were highest for the 25–44 age group (Figure 12).

Note: All-causes total includes hospitalisations where the cause has undetermined intent or is missing, or where the 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.

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

Indigenous and other Australians

In 2018–19, Indigenous Australians, compared with other Australians, using age-standardised rates, were:

• 1.9 times as likely to be hospitalised due to an injury (Table 3)
• 1.8 times as likely to die from an injury (Table 4).

The cause of injury hospitalisations with the largest difference in rates between Indigenous and other Australians was assault, which was 13 times as high in the Indigenous population. Rates of injury among Indigenous Australians for intentional self-harm, thermal causes, accidental poisoning, contact with living things, and exposure to forces of nature were all 2 to 3 times as high as for other Australians (Table 3).

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

Source: AIHW National Hospital Mortality Database.

The cause of injury death with the largest difference in rates between Indigenous and non-Indigenous Australians was homicide, which was 4.3 times as high in the Indigenous population. Rates of death for accidental poisoning, transport accidents, and suicide were more than twice as high for Indigenous Australians (Table 4). Readers are advised to use caution when using the rates in categories with low numbers of deaths.

Notes

1. Age standardised rates for other categories not publishable because of small numbers, confidentiality or other concerns about the quality of the data.
2. Rates are age-standardised to the 2001 Australian population (per 100,000).
3. 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 hospitalisations was highest among the 25–44 life-stage age group for Indigenous Australians and among the 65-and-over age group for other Australians (Figure 12).

Figure12: Injury hospitalisations and deaths, by Indigenous status, sex and age group, 2018–19

For more detail, see Data tables A4–6 and D4–6.

Areas of Australia which are more remote tend to have higher rates of injury hospitalisation and death than less remote areas. In 2018–19, people living in Very remote areas, compared with people living in Major cities, were:

• 2.2 times as likely to be hospitalised due to an injury
• 1.7 times as likely to die from an injury (Table 5).

Note: Rates are age-standardised per to the 2001 Australian population (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 17 times that of Major cities (Table 6). Thermal causes showed the next highest difference—the rate for Very remote areas was 4.3 times that of Major cities.

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

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

Age-standardised rates of death by cause of injury in Remote and Very remote areas need to interpreted with caution because of low numbers of deaths in some categories. In the case of transport accidents, the rate for those living in Very remote areas was 5.6 times the rate for Major cities.

For further detail see Data tables A7–9 and D7–9.

Remoteness by age

The highest age-specific rate of injury hospitalisations was among the 15–24 life-stage age group living in Very remote areas of Australia. (Figure 13).

Figure 13: Injury hospitalisations and deaths, by remoteness, by age group and sex, 2018–19

For more detail, see Data tables A7–9 and D9–10.

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

MyHospitals

Life expectancy & deaths (topic)