mortality rate from falls is affected by the disproportionately high rate among the elderly. In 1984, rates for the elderly ranged from 10.2/100,000 for 65- to 74-year-olds to 147.0/100,000 for persons 85 years of age and older. The downward trend of the overall crude fatality rate from falls may plateau or begin to rise as the proportion of the U.S. population aged 65 years or older increases. In addition, National Center for Health Statistics, CDC, mortality data may undercount fatalities from falls more than other fatalities. Because the fatal events that often follow hip fractures (e.g., pneumonia or pulmonary embolism) occur long after the fall, deaths may be misclassified (5,6). Medical and behavioral factors that lead to falls include disorders of gait and balance and the use of certain prescription and nonprescription drugs (including alcohol). Environmental factors implicated as contributors to falls include items such as poor lighting and loose rugs. Survival after injury is greatly influenced by the immediate management of head trauma and hip fracture and by the subsequent prevention of venous thrombosis, pulmonary embolism, and pneumonia. Advances in knowledge about these factors and their roles in fall-related mortality could highlight opportunities to prevent falls and fatalities from falls. Focused. prevention efforts, based on clearly defined priorities, can help coordinate the activities of many governmental and nongovernmental entities in addressing this problem. By 1990, the home injury fatality rate for children under 15 years of age should be no greater than 5.0/100,000 children (baseline rate in 1978: 6.0/100,000). Status: The 1984 rate was 4.9/100,000. This objective has already been achieved. For nearly 50 years, home injury deaths and mortality rates for children under 15 years of age have steadily declined. In 1984, almost 40% of the injury deaths involving children under 5 years of age occurred in the home. The home injury fatality rate is highest for children under 1 year of age; however, the rate for this age group declined from 14.7/100,000 in 1979 to 11.9/100,000 in 1984. The causes of home injury deaths include fires, drowning, suffocation, falls, firearms, and poisoning. Since 1978, home injury deaths have decreased in every category except poisoning. Deaths in that category increased from a rate of 0.12/100,000 population in 1978 to 0.15/100,000 in 1984. For children under 1 year of age, suffocation is now the most prevalent cause of death, whereas, for children 10 to 14 years of age, deaths are most often due to fires and unintentional firearm injuries. By 1990, the death rate from drowning should be reduced to no more than 1.5/100,000 persons (baseline rate in 1978: 3.2/100,000). Status: The 1984 rate was 2.3/100,000. This objective is not expected to be met by 1990. During the last decade, boating activities, which have increased greatly, have exposed more people to the risk of drowning. Nonetheless, boating-related drownings declined from 1,242 to 944 between 1978 and 1984, and the rate decreased from 0.6/100,000 to 0.4/100,000 population, nearly a 29% reduction in the rate of such fatalities. Alcohol use by boat operators is increasingly recognized as contributing to boating fatalities (7). From 1978 to 1984, nonboating drownings decreased from 5,784 to 4,444, and the rate of such drownings decreased nearly 27%, from 2.6/100,000 to 1.9/100,000. Despite improved safety in residential swimming pools and spas, approximately 300 children under 5 years of age drown each year in this setting (8). Injury Prevention - Continued By 1990, residential fire deaths should be reduced to no more than 4,500 per year (baseline deaths in 1978: 5,401). Status: The number of deaths in 1984 was 4,466. This objective was reached in 1984. The overall annual mortality rate due to residential fires decreased 21%, from 2.4/100,000 persons in 1978 to 1.9 in 1984. For males, the mortality rate due to residential fires decreased 20%, from 3.0/100,000 in 1978 to 2.4/100,000 in 1984. For females, the rate decreased 26%, from 1.9/100,000 in 1978 to 1.4/100,000 in 1984. Mortality rates due to residential fires differ markedly for blacks and whites. In 1984, the rate among blacks was 4.8/100,000; it was 1.5/100,000 among whites. By region, the mortality rate due to residential fires was highest in the South and lowest in the West. By age group, it was highest for persons 65 years of age or older (4.6/100,000) and second highest for children under 5 years of age (4.1/100,000). TABLE II. Notifiable diseases of low frequency, United States *Four of the 53 reported cases for this week were imported from a foreign country or can be directly traceable to a known internationally imported case within two generations. TABLE III. Cases of specified notifiable diseases, United States, weeks ending |