The most distinct type of injury-related death in Minnesota — the one with a death rate that most exceeds the national average — is suicide not caused by a drug overdose, according to a study published online recently in the journal Injury Prevention.

Specifically, Minnesotans are 1.6 times more likely to die from a non-drug suicide than the national average.

Two other states — Colorado and New Hampshire — also share that distinction. 

As a region, however, the Midwest tends to have higher rates of motor vehicle, machinery and natural/environmental deaths than elsewhere in the country, the study found.

Iowa residents, for example, die from machinery accidents at a rate more than three times higher than the national average, while North Dakota residents die from such accidents at a rate more than twice the national average, according to the study.

Conducted by researchers at the Johns Hopkins Bloomberg School of Public Health, the study is based on fatal injury data collected by the Centers for Disease Control and Prevention (CDC) between 2004 and 2013.

The inspiration behind the study, say its authors, was the popular social-media phenomenon of mapping the “most distinctive” characteristics of states. By using that technique to identify the most distinctive cause of injury in each state, the researchers hope to provide information that might help local public health officials — and the public — better understand how geography, physical environments, culture and policies contribute to preventable injuries and deaths. 

Accidental gun deaths

The most striking geographical pattern uncovered in the study involved gun deaths, both those that are unintentional and those involving police officers.

The researchers found a cluster of states across the Southeast and Appalachia — Alabama, Arkansas, Kentucky, Louisiana, South Carolina, Tennessee and West Virginia — where accidental firearm deaths were the most distinctive injury death.

All these states lack safe storage laws, sometimes referred to as child access prevention laws, the Johns Hopkins researchers point out. Nationally, about 25 percent of accidental gun deaths each year involve children or teenagers.

“A 2005 study of gun storage practices found that only 0.3% of households with children in Massachusetts had loaded, unlocked firearms in the house, the lowest of any state, whereas the percentage for Alabama was 7%,” they write. “This is consistent with our findings that unintentional firearm injury deaths were Alabama’s most distinct cause of injury at more than three times the national rate and that Massachusetts had the lowest calculated rate ratio for unintentional firearm injury deaths.”

“Restricting access for unauthorised individuals through safe storage of firearms might help to reduce the large disparity of unintentional firearm deaths occurring in these states,” they add. 

‘Legal intervention’ deaths

The study also identify five states on the West coast — California, Oregon, Nevada, New Mexico and Utah — with high relative rates of “legal intervention” deaths. These are deaths in which a suspect or bystander is killed by a police officer or when a police officer is killed in the line of duty.

The Johns Hopkins researchers acknowledge that there are many problems with the way the “legal intervention” deaths of citizens are reported, so their findings may not reflect the true level of those deaths. Yet, as they also point out, other data appears to support their findings. The non-profit group Fatal Encounters, which uses crowdsourcing information to track citizens killed by police officers, identified 3,112 such deaths between 2010 and 2014. Of those, almost 32 percent occurred in the five states identified in the current study. 

“This suggests that even though there are problems with the classification of legal intervention deaths on death certificates, these five states may still experience legal intervention deaths disproportionately more often than would be expected nationally,” write the Johns Hopkins researchers.

Warranting attention

“This study is the first to our knowledge that applies the ‘most distinctive’ map methodology to injury epidemiology and prevention,” the researchers claim.

They hope that their findings will “help policymakers and public health practitioners identify injuries that, while not necessarily the most burdensome, warrant attention as the most distinctive injury deaths in their states.”

“In states where injuries are distinctive due to differences in policy or culture,” they add, “the results could also be a useful tool for advocates who could assert, ‘Not only is this injury a problem, it is a problem that we as a state are distinctly bad at addressing.’”

FMI: Unfortunately, the study is behind a paywall, but you’ll find its abstract on the Injury Prevention website.