Between 2019 and 2023, 23,510 children died from unintentional injuries, resulting in a fatal injury rate of 6.74 per 100,000. For every fatal case, around 22 children were hospitalized, and 873 were treated and released from emergency departments. These figures show that serious injuries are more common than many realize—and they’re often preventable.
Where a child lives can significantly affect their risk. Our analysis shows that Southern and rural states have disproportionately high fatal injury rates, while Northeastern states often report the lowest. These disparities reflect gaps in access to care, public health resources, and injury prevention programs.
Community-level factors like transportation infrastructure and socioeconomic stressors can contribute. We know that no single solution will eliminate injury risks, but regional disparities demonstrate that prevention must be local.
Urban centers may need stronger traffic safety measures and emergency response protocols, while rural areas might benefit from water safety education and expanded access to pediatric care.
The nearly threefold difference in injury rates between the highest and lowest states is not just a statistic—it’s a call for policymakers to take action rooted in community realities.
States With the Highest Fatal Injury Rates per 100,000 Children:
- Alabama: 11.05
- Mississippi: 10.87
- Arkansas: 10.76
- Louisiana: 10.65
- New Mexico: 10.54
States With the Lowest Fatal Injury Rates per 100,000 Children:
- Maryland: 3.25
- New Hampshire: 3.50
- Vermont: 3.75
- Massachusetts: 3.80
- Rhode Island: 3.90
Economic Cost of Preventable Injuries
Injuries don’t just impact individual families—they create a nationwide economic burden. In 2023, child injury costs totaled $334.53 billion. Fatal injuries accounted for $91.30 billion, while the remainder came from nonfatal injuries, including emergency care and long-term support.
These costs reflect the everyday toll of caregiving and extended hospitalizations. Parents may be unable to return to work while caring for an injured child, and families often require ongoing physical therapy and adaptive equipment costs long after the initial injury. The financial effect can be devastating, especially for families with limited resources or insurance coverage.
Falls, the most frequent nonfatal injury, cost over $3.58 billion, including $463.3 million in direct medical expenses. These incidents also led to $67.97 million in lost productivity and $3.05 billion in quality-of-life reductions. Other injury types—such as burns and poisonings—added hundreds of millions more in costs.
We see the financial toll these injuries take on families and communities every day. That’s why we advocate for stronger prevention efforts, improved public safety infrastructure, and greater access to affordable care.
Gender and Age Trends in Nonfatal Injuries
Understanding who is most at risk shapes effective solutions. Boys accounted for 60% of all nonfatal child injuries in 2023, with a crude injury rate of 8,500 per 100,000, compared to 5,670 for girls. This gender gap holds across nearly all injury categories and age groups.
Young children aged 0 to 4 were most frequently injured by falls and foreign objects. As children grow, their injury risks change. Among 5- to 9-year-olds, being struck by or against objects became more common, while adolescents aged 10 to 14 experienced more overexertion and bicycle-related injuries. These shifting patterns suggest that interventions need to evolve as children mature.
We also cannot overlook racial and ethnic disparities. Injury rates vary across groups, with Black children experiencing higher nonfatal injury rates than their white peers and children in Hispanic and Asian communities facing unique risk patterns. These differences reflect broader systemic inequities that must be addressed in any meaningful safety strategy.
Top Causes of Fatal and Nonfatal Injuries
Motor vehicle traffic incidents remain the deadliest type of unintentional injury, responsible for 25.6% of all child fatalities between 2019 and 2023. Drowning is the second leading cause, accounting for 16.6% of deaths. Together, these incidents led to more than 18,000 deaths in just five years.
In 2023, more than 4.2 million children aged 0 to 14 were treated for nonfatal injuries. Falls were the most common, followed by blunt trauma. Though these injuries often receive less attention, they can have long-term consequences for children and their families. Some children face repeat hospital visits, prolonged recovery periods, or trauma-related anxiety that affects their education and development.
Years of Potential Life Lost: A Human-Centered Perspective
Perhaps the most devastating statistic is the 1.28 million years of potential life lost before age 65 due to fatal injuries. That number doesn’t just reflect lost productivity—it reflects stolen futures, missed milestones, and the lasting impact on families and communities.
Each one of these injuries represents a moment that could have been prevented. At Anidjar & Levine, we are deeply committed to raising awareness around these issues, not only because of their legal implications but also due to the human stories behind the statistics. Many of the families we serve come to us after preventable tragedies—and we understand just how far-reaching the effects can be.
A Path Forward
We’ve seen firsthand the toll unintentional injuries can take on children and their families, and we know prevention is possible. The states with the lowest fatality rates have shown that consistent investment in public safety campaigns, injury prevention programs, and legislative support can save lives.
We’re sharing this data to help fuel a national conversation about child safety. By investing in smarter systems, better education, and community-focused policies, we can reduce the number of preventable injuries—and give every child a better chance at a full and healthy life.
