Brown study: Non-fatal injury costs U.S. $1.9 trillion in 2013

DR. MARK ZONFRILLO, a Brown University researcher, led a study showing the yearly cost of non-fatal injury in the U.S. was $1.9 trillion in 2013. / COURTESY BROWN UNIVERSITY
DR. MARK ZONFRILLO, a Brown University researcher, led a study showing the yearly cost of non-fatal injury in the U.S. was $1.9 trillion in 2013. / COURTESY BROWN UNIVERSITY

PROVIDENCE — Non-fatal injuries cost the United States $1.9 trillion in 2013, nearly all of it preventable, according to a Brown University and the Pacific Institute for Research and Evaluation study published Monday.

Study leader Dr. Mark Zonfrillo, associate professor at Brown University’s Warren Alpert Medical School and a pediatric emergency medicine physician at Hasbro Children’s Hospital, said that while the biggest cause of injuries was falls and being struck by objects accidentally, about 12 million incidents costing $808 billion, the area presenting the greatest opportunity for effective prevention is car-related injuries to occupants, pedestrians and cyclists. There were about 3 million of those in 2013, costing $207 billion.

Traffic-related incidents can be easily prevented with improved seat belt use and better traffic signs, Zonfrillo said. Injuries can be prevented though a combination of engineering, education, economics and enforcement, he said. A well-designed child car seat is of limited use if it’s not used consistently or properly, for instance.

Zonfrillo said the risk factors should be addressed, in order of importance: Primary prevention, reducing risk factors before they cause harm; secondary prevention, minimizing the extent of an injury that happens, such as with the use of seat belts; tertiary prevention, reducing the amount of time an injury impairs a person.

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Zonfrillo said a common reason people give for not using safety devices, such as a bicycle helmet, or not behaving safely, such as putting their cellphone away while driving, is “‘if it was important enough, it would be a law.’

“Laws are powerful — legislation has absolutely been shown to reduce deaths caused by injuries,”  Zonfrillo said.

“It’s important to know that even injuries that are not fatal and those that are not severe still can cause burden,” he said. That burden can be measured in medical costs, loss of work hours and in loss of quality of life, such as treatment for post traumatic stress disorder.

The study found that in 2013 about one in 10 people were treated for an injury at a hospital.

Zonfrillo’s team analyzed anonymized data from hospital-treated non-fatal injuries and determined three different costs for the 31,038,072 injuries: total medical spending, work lost, and decreased quality of life. Medical spending, including hospital and home care, emergency transportation, medicines and physical therapy – cost $168 billion. Future lost work from permanent disability cost $223 billion, and quality of life losses cost $1.5 trillion.

The findings were published Oct. 8, in the journal “Injury Epidemiology”.

“Having an economic analysis that focuses on the burden of injury from the perspective of not only acute medical costs, but also ongoing costs like quality of life, raises awareness around injury and the importance of injury-prevention efforts,” Zonfrillo said. “These injuries are preventable, and quantifying the costs is one strategy to encourage societal injury prevention efforts.”

Rob Borkowski is a PBN staff writer. Email him at