Injury Center Priorities

Injury Center priorities are urgent, related, and preventable.

At a glance

  • The Injury Center's focus is on prevention—stopping injuries and violence before they happen.
  • Our work is growing and evolving, and our priorities reflect urgent public health issues: adverse childhood experiences (ACEs), overdose, and suicide.
  • We also address violence and leading causes of unintentional injuries—including drowning, motor vehicle crashes, older adult falls, and traumatic brain injury (TBI).
Suicide, ACES, overdose. Urgent, related, preventable.

ACEs prevention

Adverse childhood experiences (ACEs) are common and they can have lasting impacts on health opportunity and wellbeing. At least 5 out of the top 10 leading causes are death are associated with ACEs.1 Nearly two-thirds of US adults reported they had experienced at least one type of ACE before age 18. Experiencing adversity in childhood (0-17 years) can change the way the brain develops and functions.

When we prevent ACEs, we also prevent potential future involvement in violence, substance use, depression and suicidal behavior, along with other health challenges like cancer, diabetes, and heart disease.

The Injury Center has been a leader in ACEs prevention and mitigation efforts.

Overdose prevention

Drug overdose remains a leading cause of injury-related death in the United States. In 2022, there were about 296 overdoses each day. The Injury Center is at the forefront of tracking the complex and changing nature of the drug overdose epidemic and implementing proven prevention strategies.

Not all overdoses have to end in death. The Injury Center is working to advance overdose prevention in communities across the country. For the first time since 2018, U.S. overdose deaths decreased in 2023 compared to the previous year, according to new CDC data.

Suicide prevention

Suicide remains a leading cause of death in the United States and requires urgent public health action. Nearly 49,000 lives were lost to suicide in the United States in 2022—which is about 1 death every 11 minutes. Millions more Americans have suicidal thoughts or make a suicide attempt, and many suffer long-term mental and physical health consequences.

CDC's vision is "no lives lost to suicide." We use data, science, and partnerships to identify and implement effective suicide prevention strategies. We foster healthy and resilient communities across the United States as we work toward our vision.

Urgent and related

ACEs, overdose, and suicide are urgent and related public health challenges that have consequences for all of us. But these challenges are preventable if we adopt a coordinated approach that focuses on addressing today’s crises while preventing tomorrow’s.

  • ACEs increase the risk of opioid misuse and overdose and suicide later in life. ACEs are associated with younger age of opioid initiation, injection drug use, and likelihood of experiencing overdose.2
  • A CDC study examined the association between experiencing ACEs and recent opioid misuse. Study findings showed that the odds of opioid misuse increased as the number of adverse childhood experiences increased. Students experiencing 5 or more ACEs were 15 times more likely to report opioid misuse than those experiencing no ACEs.3
  • Losing a loved one to overdose or suicide during childhood is an ACE that can increase the risk of overdose or suicide.
  • ACEs are associated with lower educational attainment, unemployment, and poverty. These are risk factors for ACEs, suicide, and substance use that can impact future generations as well.4
  • Experiencing trauma before age 18 is associated with increased odds of opioid misuse; the odds of opioid misuse are approximately 3 times higher among adults with 4 or more different experiences of trauma.5
  • Having any ACE is associated with an increased risk for suicide. The odds of ever attempting suicide are 30 times higher for adults with 4 or more ACEs compared to adults with no ACEs.6

Why it matters

Injuries and violence affect everyone, regardless of age, race, or economic status. Americans ages 1-44 die from injuries and violence—such as motor vehicle crashes, suicide, or homicides—more than any other cause.

  • Suicide is now the second leading cause of death for people ages 1-44, and numbers of suicides continue to rise.
  • Homicide remains in the top five leading causes of death for the 1-44 age group.
  • Drowning is the number one cause of death for children ages 1–4.
  • Motor vehicle crashes are a leading cause of death in the United States among people ages 1–75 and the leading cause of death for children, youth, and young adults ages 5–24.
  • Falls are the leading cause of fatal and nonfatal injuries among adults ages 65 years and older.
  • People ages 75 years and older had the highest numbers and rates of TBI-related deaths. This age group accounts for about 28% of TBI-related deaths.

Top 10 leading causes of death in the U.S. for ages 1-44 from 1981-2022

1981

Download text version of the chart.

  1. Merrick MT, Ford DC, Ports KA, et al. Vital Signs: Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experiences and Implications for Prevention — 25 States, 2015–2017. MMWR Morb Mortal Wkly Rep 2019;68:999-1005. DOI: http://dx.doi.org/10.15585/mmwr.mm6844e1
  2. Stein MD, Conti MT, Kenney S, et al. Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder. Drug Alcohol Depend. 2017;179:325-329. doi:10.1016/j.drugalcdep.2017.07.007
  3. Swedo, E. A., Sumner, S. A., de Fijter, S., Werhan, L., Norris, K., Beauregard, J. L., Montgomery, M. P., Rose, E. B., Hillis, S. D., & Massetti, G. M. (2020). Adolescent Opioid Misuse Attributable to Adverse Childhood Experiences. The Journal of Pediatrics, 224, 102-109.e3. https://doi.org/10.1016/j.jpeds.2020.05.001
  4. Metzler M, Merrick MT, Klevens J, Ports KA, Ford DC. Adverse childhood experiences and life opportunities: Shifting the narrative. Children and Youth Services Review. 2017;72:141-149. and Maguire-Jack, K. Pathways from childhood abuse and other adversities to adult health risks: The role of adult socioeconomic conditions. Child Abuse Negl. 2016;51:390-399.
  5. Quinn K, Boone L, Scheidell JD, Mateu-Gelabert P, McGorray SP, Beharie N, et al. The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use. Drug and Alcohol Dependence. 2016;169:190-8.
  6. Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C, Jones L., Dunne MP. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet; 2017;2:e356-66.