Cora Peterson

Background: Health utility values (0–1 scale) underpin quality-adjusted and disability-adjusted life years, used to quantify illness burden and evaluate intervention cost-effectiveness. This systematic review summarised available health utility estimates associated with non-fatal acute injuries and violence to support economic analysis. Methods: The authors identified peer-reviewed studies through December 2025 reporting diagnosis-specific health utilities (1=full health) or disability weights (0=full health) from generic preference-based instruments (eg, EQ-5D) among general population samples. The primary outcome was the range of utility values by injury diagnosis and instrument. Body region, mechanism, intent, time since injury, geography, sample size, respondent type and contact method are also reported. Results: The authors summarised 468 estimates from 54 articles. Fractures, burns and traumatic brain injuries were most frequently studied; mechanism and intent were rarely reported. Utilities by diagnosis varied by study population, body region and time since injury. EQ-5D utilities for fractures ranged from 0.990 (near-zero loss) among children 9 months after an upper extremity fracture in the Netherlands to 0.139 (substantial loss) among older adults with pre-treatment proximal femoral fracture in Colombia. Disability weights for fractures ranged from 0 (no loss) for rib fractures 1 year post-treatment to 0.431 (substantial loss) during the acute phase of a pelvic fracture, assessed by general population respondents based on health state descriptions. Conclusion: This review offers streamlined access to utility inputs for economic analyses informing injury and violence prevention decisions. Analysts can consider available evidence broadly, select values matching the analytic context and use sensitivity analyses to strengthen validity and interpretability.

Background: Non-fatal traumatic brain injuries (TBIs) are commonly caused by falls, motor vehicle crashes and assaults, affecting millions of Americans each year. Yet there is limited information on the costs that non-fatal TBIs impose on affected individuals, families, employers and communities. This study used new data opportunities in a nationally representative survey to estimate annual productivity losses due to non-fatal TBI among US adults. Methods: In 2025, authors combined survey response data from the 2023 National Health Interview Survey with supplementary information from previous studies and other nationwide data sources to estimate the cost of inability to work, absenteeism, presenteeism and household productivity loss from non-fatal TBI. Productivity losses were assessed using the human capital approach, which values lost time due to illness or injury using average observed wages in the population. Results: Non-fatal TBI causes productivity losses among US adults each year exceeding an estimated US$19.1 billion (95% prediction intervals 7.5 to 35.6 billion) (2023 US$). The cost of inability to work comprises the greatest productivity losses (US$8.7 billion), followed by presenteeism (US$6.7 billion), absenteeism (US$3.5 billion) and household productivity loss (US$168 million). Discussion and conclusions: The economic cost of lost productivity due to non-fatal TBI among adults is substantial. Public health strategies that prevent TBI have enormous potential to both alleviate suffering and create cost savings for the US economy by avoiding preventable work and personal time losses.

Numerous examples of global and country-specific data sources for analysing injuries and violence exist. One notable example is the Global Burden of Disease study (GBD), which includes information on 371 diseases and injuries from 204 countries/territories from 1990 to the present, and online data extraction and visualisation tools.1 The WHO Mortality Database offers downloadable raw data files and dashboards to visualise country, regional or global trends.2 Brazil’s DATASUS publishes administrative outpatient, inpatient and high-cost drug and procedure data from all facilities in the public health system.3 The US National Electronic Injury Surveillance System publishes hospital sample-weighted nationwide consumer product injury data, and the Centers for Disease Control and Prevention provides a free online data extraction and visualisation tool, WISQARS.4 5 Various multisite studies allow researchers free data access to analyse secondary research questions; an example is the NCAA-US Department of Defense CARE Consortium’s concussion data from over 50 000 collegiate athletes at 30 colleges/universities.6

Background Measuring the impact of non-fatal injuries and violence is essential for informed public health policy-making and communications. This study aimed to generate new health-related quality of life data for a prominent US non-fatal injury surveillance source using disability weights derived from general population survey estimates. Methods Disability weights reflecting severity as measured on a 0 (no disability) to 1 (death) scale, for 47 natures of injury from the Global Burden of Diseases, Risk Factors and Injuries Study (GBD) were mapped to 492 injury types in the US National Electronic Injury Surveillance System – All Injury Program (NEISS-AIP). The matching of GBD natures of injury to NEISS-AIP injury types was based on the underlying definitions for each injury diagnosis. Results The average disability value weighted by incidence for all NEISS-AIP types was 0.073 (95% uncertainty interval: 0.050–0.097), and the range by injured body part and diagnosis was 0.006–0.408. Injuries that impacted large or critical body parts (lower trunk, upper trunk, head and neck) had the highest disability weights. Internal injuries, crushing, burns, nerve damage and fractures had higher disability weight values than lacerations, avulsions and contusions. The three most common NEISS-AIP non-fatal injury types during 2015–2020 were poisoning, internal injuries of the head and face lacerations, with disability weights of 0.163 (0.109–0.227), 0.168 (0.112–0.232) and 0.018 (0.010–0.029), respectively. Conclusions Mapping of publicly available disability weights data to a prominent non-fatal injury surveillance source can improve opportunities to measure and communicate the health and economic impact of injuries and violence.

Background Drowning causes more than 4500 deaths annually and is the leading cause of death among children aged 1–4 years old in the USA. Isolation pool fencing (ie, four-sided fencing to limit access from all adjoining areas including residences and yards) and use of US Coast Guard-approved life jackets while boating can prevent drowning, but preventable deaths still occur. This study aimed to estimate the annual health and economic burden of drowning likely attributable to inadequate pool fencing and not wearing life jackets while boating to highlight the unrealised value of these known prevention strategies. Methods A simple mathematical model used the most recent annual number of drowning deaths by decedent age in combination with previous study data to estimate the number of drowning deaths that might have been prevented through: (1) adequate isolation fencing for swimming pools among children aged Results Proper use of swimming pool isolation fencing and always wearing a life jacket while boating could prevent an estimated 348 US drowning deaths and an economic cost of US$4.5 billion per year. Conclusions Highlighting the effectiveness of drowning prevention strategies can help inform public attention to this issue and support cost-effective public health decision-making.