Injuries and Injury Prevention

In this section:

Leading Causes of Injury Data
Falls and Fall Prevention Data
Road Safety Data
Concussion and Head Injury Data
Violence Data
Injury, Injury Prevention, and Violence Reports

Leading Causes of Injury Data

Injury is one of the leading causes of premature death and disability in Ottawa. In 2014, 18% of Ottawa residents aged 12 years and older reported being injured in the past year. [1] Many factors often come into play when injuries occur:

environmental influences such as the design of everyday objects and structures,
the use of protective equipment,
underlying social factors or other intrinsic factors such as age, sex, substance use, health and fitness.

Most injuries are not “accidents” because they are preventable. Yet the prevention of injuries is far from straightforward. Injury prevention strategies often consist of multifaceted efforts that address behaviours, policy and environment, the social determinants of health, and involve multiple sectors.

For more information on injury prevention and safety, please refer to Ottawa Public Health's Injury Prevention and Safety webpage.

Leading Causes of Injury Deaths

In Ottawa:

In 2012, there were 319 injury deaths, representing 6% of all deaths. [2]
The top three causes of injury deaths were falls, suicide, and unintentional poisonings and overdose. [2]
In the past 10 years there have been changes in the pattern of the leading causes of injury deaths (counts and rates). Falls became the leading cause of injury-related death in 2008, surpassing suicide. [2] The number and rate of deaths related to unintentional poisonings and drug overdose rose from 2008 to 2012 (Figure 1).
The increase in fall-related deaths and death rates occurred primarily among older adults (80 years of age and older). [2]

Figure 1. The top three leading causes of injury death for Ottawa residents, all ages, from 2000 to 2012

Data Source and Notes for Figure 1

Data Table for Figure 1

**Table 1.** Number of deaths due to the top three leading causes of injury deaths for Ottawa residents, all ages, from 2000 to 2012
Year	Falls Deaths	Suicides	Unintentional Poisonings/ Overdose Deaths
2000	39	55	17
2001	33	70	15
2002	45	43	21
2003	61	38	17
2004	53	56	19
2005	64	55	22
2006	62	65	21
2007	61	65	23
2008	80	69	20
2009	95	63	28
2010	110	65	34
2011	104	72	37
2012	132	63	34

Leading Causes of Injury-related Emergency Department Visits and Hospitalizations

In Ottawa:

Unintentional and intentional injuries to residents accounted for over 92,200 emergency department (ED) visits in 2017. Approximately 6,600 of these visits were hospitalized. [3]
Falls were the leading cause of injury-related ED visits (28,367) (Figure 2), hospitalizations (2,749) (Figure 3), and deaths (132). [2,3]
Falls were the leading cause of injury-related hospitalization in all age groups, with the exception of 15 to 24 year olds (Table 4). Self-harm was the leading cause of injury-related hospitalization for 15 to 24 year olds. [3]

Figure 2. Leading causes of injury-related emergency department visits for Ottawa residents, all ages, 2017

Horizontal bar chart of the leading causes of injury-related emergency department visits for Ottawa residents, all ages, in 2017

Data Source and Notes for Figure 2

Unscheduled emergency department visits, National Ambulatory Care System (2017). Ontario Ministry of Health and Long-Term Care IntelliHealth Ontario. Extracted June 8, 2018.

MVTC = Motor vehicle traffic collisions.
Not all categories are mutually exclusive and unless stated, some of the injury categories (e.g. cycling, falls, drowning) may overlap with the sport & recreation category.
The counts provided include all Ottawa residents seen at emergency departments (ED) and subsequently hospitalized in Ontario. Please note that injury events may have taken place outside of Ottawa.
The approach to reporting leading causes of injury here is different from the way others have reported the leading causes of injury.
- It includes a sport and recreational injury category, utilizing Canadian-specific U99 activity codes for ED and hospitalization data, which are not mandatory in the hierarchy of coding sport and recreational injuries. The U99 activity codes are suggested for use in describing further, the activity of the injured person at the time the event occurred. For example, a person who fell while playing ice hockey would be coded as W00 (Fall on same level involving ice and snow) and U99.011 (Ice hockey). While we have used the U99 codes to tease out sport and recreation specific codes from categories where there is common (>5%) overlap (i.e., falls, overexertion), the categories are not all mutually exclusive. For example, a person who was bitten by a dog and fell while out for a run would be coded as W54 (Bitten or struck by dog), W01 (Fall on same level from slipping, tripping and stumbling) and U99.050 (Running) and would be counted in the sport and recreation and the natural environment categories, but would not be included in the falls, non-sports category.
- Another difference is that others have defined MVTC as a broader category, whereas we have separate categories for car/van/truck/motorcyclist occupants, pedestrians, public transit/bus/train occupants and cyclists injured in a transport collision.
- Due to these differences, the rankings should not be compared to other rankings of leading causes of injury morbidity and mortality.
The following ICD-10-CA codes were used to categorize the injuries:

ICD-10-CA Codes for External Causes of Injuries
External Cause of Injury	ICD10-CA
All Unintentional Injuries	V01-X59, Y85-Y86. Emergency department and hospitalizations with a code of W75-W84 not accompanied by a main diagnosis of ICD-10-CA S or T are excluded.
Burns	X00-X19, W85-W93
Choking or suffocation	W75-W84 accompanied by a main diagnosis of ICD-10-CA S or T
Cut/pierce	W25-W29, W45-W46
Drowning/near drowning	W65-W74, V90, V92
Falls	W00-W19
Foreign body entering the eye or other orifice	W44
Motor vehicle traffic collisions, car/van/truck/motorcyclist occupant	V20-V69, V83-V85
Natural environment – bitten by animals, reptiles, insects, plants, forces of nature, heat, cold, noise/vibration	W53-W64, W92-W99, W42, W43, W20-39, X51-X57
Overexertion, non-sports	X50. Emergency department visits and hospitalizations accompanied with a code of U99.00-U99.09 are excluded.
Pedestrian	V01-V09
Poisoning/overdose (unintentional)	X40-X49
Public transit (bus, train, streetcar)	V70-V79, V81-V82
Sport and recreational activities	Includes ICD10-CA Chapter XX codes for ATV or snowmobile, baseball, cycling, rollerskate, scooter or skateboard, football or rugby, hockey/ringette, ice skating, playground, including trampoline, pool & natural water swimming, diving/jumping, recreational boating, ski or snowboarding, soccer, tobogganing and all activities coded as U99.00-U99.09 accompanied with a main diagnosis in Chapter XIX (S or T codes) and an unintentional injury code (V01-X59, Y85-Y86).
ATV or Snowmobile	V68, U99.032^a, U99.045^a
Baseball	W22.05, W21.01, W51.05, U99.010^a
Cycling	V10-V19, U99.034^a, U99.035^a
Rollerskate, scooter or skateboard	W02.02, W02.03, W02.08, U99.036^a
Football or rugby	W22.03, W51.03, U99.003^a, U99.004^a
Hockey/Ringette	W21.02, W21.03, W22.02, W51.02, U99.011^a, U99.012^a, U99.013^a, U99.014^a, U99.016^a
Ice skating	W02.00, U99.041^a
Playground (excluding trampoline)	W09.0-W09.4, W09.6-W09.9
Toboggan	W22.01, W51.01, U99.043^a
Trampoline	W09.05, U99.062^a
Pool & natural water swimming, diving/jumping	W16, W67-W74, U99.020^a, U99.021^a, U99.024, U99.025^a, U99.028^a, U99.029^a
Recreational boating	V90.2-V90.8, V91.2-V91.8, V92.2-V92.9, U99.022^a, U99.030^a, U99.031^a, U99.085^a
Ski or snowboard	W02.01, W02.04, W22.00, W51.00, U99.040^a, U99.044^a
Soccer	W22.04, W51.04, U99.002^a
Struck/bumped by object/person, non-sports	W20.00, W22.08, W22.09, W50.00, W51.08, W51.09, W52
Intentional injuries
Self-harm	X60-X84, Y87.0
Assault	X85-X99, Y00-Y09, Y87.1

^a“U” codes included only if accompanied with a “S” or “T” code from Chapter XIX. U codes were available for ER visits and hospitalizations only.

Data Table for Figure 2

**Table 2.** Leading causes of injury-related emergency department visits for Ottawa residents, all ages, 2017
Injury Type	Number of Emergency Department Visits
Falls	28367
Sports & recreation	11898
Struck/bumped by object/person, non-sports	7643
Cut/pierce	6152
Overexertion	5802
Natural environment	3836
MVTC occupant/motorcyclist	3182
Foreign body in eye/orifice	2513
Assault	1978
Cycling	1619
Unintentional poisonings	1465
Self-harm	1270
Burns	872
Pedestrian	407
Public transit	237
Choking or suffocation	106
Non-fatal and fatal drowning	28

Figure 3. Leading causes of injury-related hospitalizations for Ottawa residents, all ages, 2017

Data Source and Notes for Figure 3

Hospitalizations resulting from unscheduled emergency department visits, National Ambulatory Care System (2017). Ontario Ministry of Health and Long-Term Care IntelliHealth Ontario. Extracted June 8, 2018

MVTC = Motor vehicle traffic collisions.
Not all categories are mutually exclusive and unless stated, some of the injury categories (e.g. cycling, falls, drowning) may overlap with the sport & recreation category.
The approach to reporting leading causes of injury here is different from the way others have reported the leading causes of injury.
- It includes a sport and recreational injury category, utilizing Canadian-specific U99 activity codes for ED and hospitalization data, which are not mandatory in the hierarchy of coding sport and recreational injuries. The U99 activity codes are suggested for use in describing further, the activity of the injured person at the time the event occurred. For example, a person who fell while playing ice hockey would be coded as W00 (Fall on same level involving ice and snow) and U99.011 (Ice hockey). While we have used the U99 codes to tease out sport and recreation specific codes from categories where there is common (>5%) overlap (i.e., falls, overexertion), the categories are not all mutually exclusive. For example, a person who was bitten by a dog and fell while out for a run would be coded as W54 (Bitten or struck by dog), W01 (Fall on same level from slipping, tripping and stumbling) and U99.050 (Running) and would be counted in the sport and recreation and the natural environment categories, but would not be included in the falls, non-sports category.
- Another difference is that others have defined MVTC as a broader category, whereas we have separate categories for car/van/truck/motorcyclist occupants, pedestrians, public transit/bus/train occupants and cyclists injured in a transport collision.
- Due to these differences, the rankings should not be compared to other rankings of leading causes of injury morbidity and mortality.
The following ICD-10-CA codes were used to categorize the injuries:

ICD-10-CA Codes for External Causes of Injuries
External Cause of Injury	ICD10-CA
All Unintentional Injuries	V01-X59, Y85-Y86. Emergency department and hospitalizations with a code of W75-W84 not accompanied by a main diagnosis of ICD-10-CA S or T are excluded.
Burns	X00-X19, W85-W93
Choking or suffocation	W75-W84 accompanied by a main diagnosis of ICD-10-CA S or T
Cut/pierce	W25-W29, W45-W46
Drowning/near drowning	W65-W74, V90, V92
Falls	W00-W19
Foreign body entering the eye or other orifice	W44
Motor vehicle traffic collisions, car/van/truck/motorcyclist occupant	V20-V69, V83-V85
Natural environment – bitten by animals, reptiles, insects, plants, forces of nature, heat, cold, noise/vibration	W53-W64, W92-W99, W42, W43, W20-39, X51-X57
Overexertion, non-sports	X50. Emergency department visits and hospitalizations accompanied with a code of U99.00-U99.09 are excluded.
Pedestrian	V01-V09
Poisoning/overdose (unintentional)	X40-X49
Public transit (bus, train, streetcar)	V70-V79, V81-V82
Sport and recreational activities	Includes ICD10-CA Chapter XX codes for ATV or snowmobile, baseball, cycling, rollerskate, scooter or skateboard, football or rugby, hockey/ringette, ice skating, playground, including trampoline, pool & natural water swimming, diving/jumping, recreational boating, ski or snowboarding, soccer, tobogganing and all activities coded as U99.00-U99.09 accompanied with a main diagnosis in Chapter XIX (S or T codes) and an unintentional injury code (V01-X59, Y85-Y86).
ATV or Snowmobile	V68, U99.032a, U99.045a
Baseball	W22.05, W21.01, W51.05, U99.010a
Cycling	V10-V19, U99.034a, U99.035a
Rollerskate, scooter or skateboard	W02.02, W02.03, W02.08, U99.036a
Football or rugby	W22.03, W51.03, U99.003 a, U99.004a
Hockey/Ringette	W21.02, W21.03, W22.02, W51.02, U99.011a, U99.012a, U99.013a, U99.014a, U99.016a
Ice skating	W02.00, U99.041a
Playground (excluding trampoline)	W09.0-W09.4, W09.6-W09.9
Toboggan	W22.01, W51.01, U99.043a
Trampoline	W09.05, U99.062a
Pool & natural water swimming, diving/jumping	W16, W67-W74, U99.020a, U99.021a, U99.024, U99.025a, U99.028a, U99.029a
Recreational boating	V90.2-V90.8, V91.2-V91.8, V92.2-V92.9, U99.022a, U99.030a, U99.031a, U99.085a
Ski or snowboard	W02.01, W02.04, W22.00, W51.00, U99.040a, U99.044a
Soccer	W22.04, W51.04, U99.002a
Struck/bumped by object/person, non-sports	W20.00, W22.08, W22.09, W50.00, W51.08, W51.09, W52
Intentional injuries
Self-harm	X60-X84, Y87.0
Assault	X85-X99, Y00-Y09, Y87.1

a “U” codes included only if accompanied with a “S” or “T” code from Chapter XIX. U codes were available for ER visits and hospitalizations only.

Data Table for Figure 3

**Table 3.** Leading causes of injury-related hospitalizations for Ottawa residents, all ages, 2017
Injury Type	Number of Hospitalizations
Falls	2749
Self-harm	429
Sports & recreation	286
MVTC occupant/motorcyclist	234
Unintentional poisonings	157
Assault	130
Cycling	93
Foreign body in eye/orifice	82
Overexertion	62
Cut/pierce	54
Pedestrian	48
Natural environment	43
Choking or suffocation	30
Burns	22
Non-fatal and fatal drowning	6

**Table 4.** Leading causes of injury-related hospitalizations, presented as counts with rates per 100,000 population in brackets, for Ottawa residents by age groups, 2017
Rank	0 to 4 Years Old	5 to 14 Years Old	15 to 24 Years Old	25 to 44 Years Old	45 to 64 Years Old	65+ Years Old
1	Falls 60 (113.0)	Falls 109 (104.1)	Self-harm 187 (143.1)	Falls 117 (40.3)	Falls 375 (140.5)	Falls 2030 (1342.6)
2	Sport & recreation 12 (22.6)	Sport & recreation 98 (93.6)	Falls 58 (44.4)	Self-harm 115 (39.6)	Self-harm 91 (34.1%)	MVTC, car/van/ truck/motorcycle occupant 57 (37.7)
3	Foreign body entering eye/orifice 10 (18.8)	Cycling 15 (14.3)	Sport & recreation 47 (36.0)	Assault 62 (21.4)	Sport & recreation 89 (33.3)	Struck/ bumped by object/person 37 (24.5)
4	Unintentional poisoning / overdose 8 (15.1)	Self-harm 13 (12.4)	MVTC, car/van/ truck/motorcycle occupant 40 (30.6)	MVTC, car/van/ truck/motorcycle occupant 62 (21.4)	MVTC, car/van/ truck/motorcycle occupant 73 (27.3)	Sport & recreation 32 (21.2)
5	Struck/ bumped by object/person 7 (13.2)	Foreign body entering eye/orifice 12 (11.5)	Assault 39 (29.9)	Unintentional poisoning / overdose 45 (15.5)	Unintentional poisoning / overdose 42 (15.7)	Unintentional poisoning / overdose 28 (18.5)
Total	All injuries 142 (267.4)	All injuries 241 (230.3)	All injuries 533 (408.0)	All injuries 840 (289.5)	All injuries 1487 (557.1)	All injuries 3358 (2221.0)

Data Source and Notes for Table 4

MVTC = Motor vehicle traffic collisions.
Not all categories are mutually exclusive and unless stated, some of the injury categories (e.g. cycling, falls, drowning) may overlap with the sport & recreation category.
The counts provided include all Ottawa residents seen at emergency departments and subsequently hospitalized in Ontario. Please note that injury events may have taken place outside of Ottawa.
The approach to reporting leading causes of injury here is different from the way others have reported the leading causes of injury.
- It includes a sport and recreational injury category, utilizing Canadian-specific U99 activity codes for ED and hospitalization data, which are not mandatory in the hierarchy of coding sport and recreational injuries. The U99 activity codes are suggested for use in describing further, the activity of the injured person at the time the event occurred. For example, a person who fell while playing ice hockey would be coded as W00 (Fall on same level involving ice and snow) and U99.011 (Ice hockey). While we have used the U99 codes to tease out sport and recreation specific codes from categories where there is common (>5%) overlap (i.e., falls, overexertion), the categories are not all mutually exclusive. For example, a person who was bitten by a dog and fell while out for a run would be coded as W54 (Bitten or struck by dog), W01 (Fall on same level from slipping, tripping and stumbling) and U99.050 (Running) and would be counted in the sport and recreation and the natural environment categories, but would not be included in the falls, non-sports category.
- Another difference is that others have defined MVTC as a broader category, whereas we have separate categories for car/van/truck/motorcyclist occupants, pedestrians, public transit/bus/train occupants and cyclists injured in a transport collision.
- Due to these differences, the rankings should not be compared to other rankings of leading causes of injury morbidity and mortality.
The following ICD-10-CA codes were used to categorize the injuries:

ICD-10-CA Codes for External Causes of Injuries
External Cause of Injury	ICD10-CA
All Unintentional Injuries	V01-X59, Y85-Y86. Emergency department and hospitalizations with a code of W75-W84 not accompanied by a main diagnosis of ICD-10-CA S or T are excluded.
Burns	X00-X19, W85-W93
Choking or suffocation	W75-W84 accompanied by a main diagnosis of ICD-10-CA S or T
Cut/pierce	W25-W29, W45-W46
Drowning/near drowning	W65-W74, V90, V92
Falls	W00-W19
Foreign body entering the eye or other orifice	W44
Motor vehicle traffic collisions, car/van/truck/motorcyclist occupant	V20-V69, V83-V85
Natural environment – bitten by animals, reptiles, insects, plants, forces of nature, heat, cold, noise/vibration	W53-W64, W92-W99, W42, W43, W20-39, X51-X57
Overexertion, non-sports	X50. Emergency department visits and hospitalizations accompanied with a code of U99.00-U99.09 are excluded.
Pedestrian	V01-V09
Poisoning/overdose (unintentional)	X40-X49
Public transit (bus, train, streetcar)	V70-V79, V81-V82
Sport and recreational activities	Includes ICD10-CA Chapter XX codes for ATV or snowmobile, baseball, cycling, rollerskate, scooter or skateboard, football or rugby, hockey/ringette, ice skating, playground, including trampoline, pool & natural water swimming, diving/jumping, recreational boating, ski or snowboarding, soccer, tobogganing and all activities coded as U99.00-U99.09 accompanied with a main diagnosis in Chapter XIX (S or T codes) and an unintentional injury code (V01-X59, Y85-Y86).
ATV or Snowmobile	V68, U99.032a, U99.045a
Baseball	W22.05, W21.01, W51.05, U99.010a
Cycling	V10-V19, U99.034a, U99.035a
Rollerskate, scooter or skateboard	W02.02, W02.03, W02.08, U99.036a
Football or rugby	W22.03, W51.03, U99.003 a, U99.004a
Hockey/Ringette	W21.02, W21.03, W22.02, W51.02, U99.011a, U99.012a, U99.013a, U99.014a, U99.016a
Ice skating	W02.00, U99.041a
Playground (excluding trampoline)	W09.0-W09.4, W09.6-W09.9
Toboggan	W22.01, W51.01, U99.043a
Trampoline	W09.05, U99.062a
Pool & natural water swimming, diving/jumping	W16, W67-W74, U99.020a, U99.021a, U99.024, U99.025a, U99.028a, U99.029a
Recreational boating	V90.2-V90.8, V91.2-V91.8, V92.2-V92.9, U99.022a, U99.030a, U99.031a, U99.085a
Ski or snowboard	W02.01, W02.04, W22.00, W51.00, U99.040a, U99.044a
Soccer	W22.04, W51.04, U99.002a
Struck/bumped by object/person, non-sports	W20.00, W22.08, W22.09, W50.00, W51.08, W51.09, W52
Intentional injuries
Self-harm	X60-X84, Y87.0
Assault	X85-X99, Y00-Y09, Y87.1

a “U” codes included only if accompanied with a “S” or “T” code from Chapter XIX. U codes were available for ER visits and hospitalizations only.

Falls and Fall Prevention Data

Falls

Although falls are largely preventable, they represent a tremendous health and economic burden.

In Ottawa:

The highest rates of fall-related injury hospitalization are among older adults aged 65+ years. [3]
Every year, approximately one fifth of older adults who live in private homes fall. [4]
In 2017, there were:

Over 2,700 fall-related hospitalizations, most of which were among residents aged 65+ years (2,030 hospitalizations). [3]
Over 28,000 fall-related emergency department visits, including close to 9,000 visits among adults aged 65+ years. [3]

Road Safety Data

Seat Belt Use

All Ontario motor vehicle drivers and passengers are required to wear a seat belt. Proper use of seat belts reduces the risk of death and serious injury in a collision.

Table 5. Seat belt use in Ottawa and Ontario-less-Ottawa, 2013-14 and 2017
Indicator	Measure	Ottawa Data	Ontario-less-Ottawa Data	Data Source
Youth	% of students in Grades 7 to 12 who always wear a seat belt when in a vehicle	71%	75%	2017 OSDUHS
Adult Drivers	% of drivers aged 16 years or older who always wear a seatbelt	98%	96%	2013-14 CCHS
Passengers	% of passengers aged 12 years or older who always wear a seatbelt	79%	82%	2013-14 CCHS
Taxi Passengers	% of taxi passengers aged 12 years or older who always wear a seatbelt	57%	61%	2013-14 CCHS

Data Sources and Notes for Table 5

Ottawa Public Health. Public Health Monitoring of Risk Factors in Ontario – Ontario Student Drug Use and Health Survey (OSDUHS) (2017), Centre for Addiction & Mental Health.

The 2017 data used in this section are from the Ontario Student Drug Use and Health Survey conducted by the Centre for Addiction and Mental Health and administered by the Institute for Social Research, York University. Its contents and interpretation are solely the responsibility of the authors and do not necessarily represent the official view of the Centre for Addiction and Mental Health.
The Ontario Student Drug Use and Health Survey (OSDUHS) is the longest ongoing biennial school survey in Canada, and the only province-wide survey of this population. The 2017 statistics are based on a random representative sample of over 1,400 Ottawa students enrolled in any of the four publicly funded school boards in Grades 7 through 12.

Ottawa Public Health. Canadian Community Health Survey (CCHS) 2013/14. Ontario Share File. Statistics Canada

The Canadian Community Health Survey (CCHS) is an annual national population health survey conducted by Statistics Canada.

Impaired Driving

Alcohol, cannabis, over-the-counter and prescription medications, and other drugs can affect reaction time, judgement, coordination, and motor skills. These substances can impair driving and increase the risk of collision and injury.

Table 6. Impaired driving behaviours in Ottawa and Ontario-less-Ottawa, 2013-14 and 2017
Indicator	Measure	Ottawa Data	Ontario-less-Ottawa Data	Data Source
Youth Passenger Drinking and Driving	% of students in Grades 7 to 12 who were passengers in a car (at least once in past year) driven by someone who had been drinking	16%	16%	2017 OSDUHS
Youth Passenger Drugs and Driving	% of students in Grades 7 to 12 who were passengers in a car (at least once in past year) driven by someone who had been using drugs other than alcohol	11%	10%	2017 OSDUHS
Youth Driver Cannabis Use	% of high school student drivers who drove within an hour of using cannabis	15%*	10%	2017 OSDUHS
Adult Drinking and Driving	% of drivers aged 16 years or older who had 2 or more drinks in the hour before driving (at least once in the past year)	4%*	4%	2013-14 CCHS

Data Sources and Notes for Table 6

Ottawa Public Health. Public Health Monitoring of Risk Factors in Ontario – Ontario Student Drug Use and Health Survey (OSDUHS) (2017), Centre for Addiction & Mental Health.

The 2017 data used in this section are from the Ontario Student Drug Use and Health Survey conducted by the Centre for Addiction and Mental Health and administered by the Institute for Social Research, York University. Its contents and interpretation are solely the responsibility of the authors and do not necessarily represent the official view of the Centre for Addiction and Mental Health.
The Ontario Student Drug Use and Health Survey (OSDUHS) is the longest ongoing biennial school survey in Canada, and the only province-wide survey of this population. The 2017 statistics are based on a random representative sample of over 1,400 Ottawa students enrolled in any of the four publicly funded school boards in grades 7 through 12.

Ottawa Public Health. Canadian Community Health Survey (CCHS) 2013/14. Ontario Share File. Statistics Canada

The Canadian Community Health Survey (CCHS) is an annual national population health survey conducted by Statistics Canada

*Interpret with caution – high sampling variability

Distracted Driving

Distracted driving (e.g., texting or using a cell phone, eating or drinking, tending to a child or pet, searching for music) increases the risk of collision, injury, and death.

Table 7. Distracted driving behaviours in Ottawa and Ontario-less-Ottawa, 2013-14 and 2017
Indicator	Measure	Ottawa Data	Ontario-less-Ottawa Data	Data Source
Youth Texting	% high school student drivers who did not send or read a text message/email while driving in the past year	71%	65%	2017 OSDUHS
Adult Cell Phone Use	% of drivers aged 16 years or older who never used a cell phone (excluding hands free) when driving	71%	74%	2013-14 CCHS
Adult Hands Free Cell Phone Use	% of drivers aged 16 years or older who use hands-free cell phone often or sometimes while driving	31%	30%	2013-14 CCHS

Data Sources and Notes for Table 7

Ottawa Public Health. Public Health Monitoring of Risk Factors in Ontario – Ontario Student Drug Use and Health Survey (OSDUHS) (2017), Centre for Addiction & Mental Health.

The 2017 data used in this section are from the Ontario Student Drug Use and Health Survey conducted by the Centre for Addiction and Mental Health and administered by the Institute for Social Research, York University. Its contents and interpretation are solely the responsibility of the authors and do not necessarily represent the official view of the Centre for Addiction and Mental Health.
The OSDUHS is the longest ongoing biennial school survey in Canada, and the only province-wide survey of this population. The 2017 statistics are based on a random representative sample of over 1,400 Ottawa students enrolled in any of the four publicly funded school boards in grades 7 through 12.

Ottawa Public Health. Canadian Community Health Survey (CCHS) 2013/14. Ontario Share File. Statistics Canada

The Canadian Community Health Survey (CCHS) is an annual national population health survey conducted by Statistics Canada

Concussion and Head Injury Data

A concussion is a brain injury that causes changes in the way the brain functions. It can lead to symptoms that can be physical, cognitive, emotional, behavioural and/or related to sleep. A concussion may be caused either by a direct blow to the head, face, or neck or by a blow to the body that transmits a force to the head that causes the brain to move rapidly within the skull.

Concussion-related Physician Visits

In 2016, 16,335 Ottawa residents visited a doctor in Ontario for a concussion or a head injury.
The rate of Ottawa patients visiting a doctor for a concussion or head injury more than doubled over the past 10 years from 691 per 100,000 population to 1710 per 100,000 population and is higher than the Ontario-less-Ottawa average rate (Figure 4).
Infants (aged 0 to <1 year), followed by youth aged 10-19 years have the highest rate of concussion or head injury-related physician visits, followed by children aged 1-9 years (Figure 5).

Figure 4. Rate of concussion and head injury-related doctor visits (all ages) in Ottawa and Ontario-less-Ottawa from 2003 to 2016

A line graph showing the rate of people seeking concussion and head injury-related care from doctors in Ottawa and Ontario-less-Ottawa from 2003 to 2016

Data Source and Notes for Figure 4

Patients of Ontario Physicians, Ontario Health Insurance Plan (OHIP) Approved Claim Files (2003-2016). Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted May 24, 2019.

Data include Ottawa and Ontario-less-Ottawa patients who visited a doctor in Ontario for a concussion or head injury.
OHIP diagnosis codes were used to categorize concussions (850) and head injuries (854).
Rates are age standardized to the 2011 Canadian population. The age standardized rate is not the actual rate (crude rate) in the population but a derived rate that is used for comparison with another population that might have a different age distribution.

Data Table for Figure 4

Year	Ottawa rate (age standardized) of patients seeking concussion and head injury-related care from doctors (per 100,000 population)	Ontario-less-Ottawa rate (age standardized) of patients seeking concussion and head injury-related care from doctors (per 100,000 population)
2003	708.4	876.3
2004	732.1	877.2
2005	716.3	864.5
2006	710.4	845.3
2007	680.9	843.5
2008	690.9	843.2
2009	859.7	934.6
2010	901.6	920.7
2011	1021.8	988.6
2012	1105.1	1055.3
2013	1287.8	1108.2
2014	1361.1	1171.0
2015	1498.8	1254.5
2016	1709.5	1373.0

Figure 5. Average rate of concussion-related physician visits by sex and age group in Ottawa from 2014 to 2016

A bar graph showing the average rate of concussion-related physician visits by gender and age group in Ottawa from 2014 to 2016

Data Source and Notes for Figure 5

Patients of Ontario Physicians, Ontario Health Insurance Plan (OHIP) Approved Claim Files (2014-2016). Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted May 24, 2019.

Data include Ottawa and Ontario-less-Ottawa patients who visited a doctor in Ontario for a concussion or head injury.
OHIP diagnosis codes were used to categorize concussions (850) and head injuries (854).

Data Table for Figure 5

Age group	Average female rate of concussion-related physician visits from 2014-2016 (per 100,000 females)	Average male rate of concussion-related physician visits from 2014-2016 (per 100,000 males)
<1 year	3796.1	4505.9
1-9 years	1774.8	2506.2
10-19 years	3559.1	3565.6
20-29 years	1309.1	1186.9
30-39 years	1103.7	857.2
40-64 years	1121.1	789.6
65+ years	1490.4	1142.8

Concussion-related Emergency Department Visits

In 2018, there were over 2,800 emergency department (ED) visits by Ottawa residents for concussions.
The rate of concussion-related ED visits among Ottawa residents nearly quadrupled in the past 15 years from 82 visits per 100,000 population in 2003 to a high of 324 visits per 100,000 population in 2016 (Figure 6).
The rate of concussion-related ED visits among Ottawa residents has consistently been higher than that of the Ontario-less-Ottawa average (Figure 6).
Youth aged 10-19 years have the highest rate of concussion-related ED visits, followed by adults aged 20-29 years and children aged 1-9 years (Figure 7).
Males aged 0-19 years had slightly higher rates of concussion-related ED visits compared to females, however this trend reversed for ages 20 years and older, where females had slightly higher concussion-related ED visits compared to males (Figure 7).
The most common cause for concussion-related ED visits were:
1. Falls: representing approximately 4 in 10 (38%) concussion-related ED visits
2. Motor vehicle traffic collisions: 1 in 10 (12%) of concussion related ED visits
3. Hockey/ringette (6%)
4. Rugby/football (4%)
5. Soccer (3%)
6. Cycling (3%)
7. Ski or snowboarding (2%)
8. Ice skating (2%)

Figure 6. Rate of concussion-related ED visits (all ages) in Ottawa and Ontario-less-Ottawa from 2003 to 2018

A line graph showing the rate of concussion-related emergency department visits in Ottawa and Ontario-less-Ottawa from 2003 to 2018

Data Source and Notes for Figure 6

Unscheduled emergency department visits, National Ambulatory Care System (2003-2018). Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted June 20, 2019.

Data include all Ottawa residents seen at an emergency department (ED) in Ontario. Injury events may have taken place outside of Ottawa.
The following ICD-10-CA code was used to categorize concussions: S06.0
Rates are age standardized to the 2011 Canadian population. The age standardized rate is not the actual rate (crude rate) in the population but a derived rate that is used for comparison with another population that might have a different age distribution.

Data Table for Figure 6

Year	Ottawa rate (age standardized) of ED visits for concussions (per 100,000 population)	Ontario-less-Ottawa rate (age standardized) of ED visits for concussions (per 100,000 population)
2003	82.4	69.8
2004	89.3	79.3
2005	93.9	81.8
2006	101.7	81.6
2007	110.7	88.9
2008	114.0	94.0
2009	138.5	111.5
2010	148.3	117.4
2011	191.3	142.7
2012	211.6	161.9
2013	257.7	181.0
2014	283.8	209.4
2015	303.4	235.3
2016	323.7	264.2
2017	301.8	272.6
2018	288.4	270.4

Figure 7. Average rate of concussion-related ED visits by sex and age group in Ottawa, from 2016 to 2018

A bar graph showing the average rate of concussion-related emergency department visits by gender and age group in Ottawa from 2016 to 2018

Data Source and Notes for Figure 7

Data Table for Figure 7

Age group	Average female rate of concussion-related ED visits from 2016-2018 (per 100,000 females)	Average male rate of concussion-related ED visits from 2016-2018 (per 100,000 males)
<1 year	6.3	6.0
1-9 years	258.9	338.2
10-19 years	950.9	982.9
20-29 years	399.2	330.0
30-39 years	263.4	181.6
40-64 years	220.7	130.7
65+ years	125.4	80.1

Head Injuries Among Children and Youth

Parent Reported Concussions Among Children and Youth

In 2018, one in four (25%) Ottawa parents report that at least one child (aged 5 to 17 years) has ever had a concussion. [5]

Lifetime Head Injury

35% of Ottawa students (grades 7-12) reported having a head injury at some point in their lifetime that resulted in a headache, dizziness, blurred vision, vomiting, feeling confused or “dazed”, or memory problems. [6]
- Boys were significantly more likely to report ever having a head injury compared to girls (boys: 39% vs. girls: 31%).
- Students in Grades 7 to 8 were significantly more likely to report ever having a head injury than those in Grades 9 to 12 (Grade 7-8: 42% vs. Grade 9-12: 32%).
- Non-immigrant students were significantly more likely to report ever having a head injury than immigrants (Canadian-born: 37% vs. immigrant: 29%).
- There were no significant differences in the prevalence of reported lifetime head injuries between students in Ottawa and Ontario-less-Ottawa or by socioeconomic status

Past Year Head Injury

16% of Ottawa students (Grades 7 to 12) reported having a head injury in the past year that resulted in a headache, dizziness, blurred vision, vomiting, feeling confused or “dazed”, or memory problems. [6]
- One fifth (20%) of students in Grades 7 to 8 reported having a head injury in the past year which was significantly higher than for those in grades 9-12 (14%).

Ever had Traumatic Brain Injury

Nearly one in ten (9%) Ottawa students in Grades 7 to 12 reported ever having a head injury that resulted in them being knocked unconscious for at least 5 minutes or resulted in a hospital stay for at least one night (traumatic brain injury). [6]
- Students in Grades 7 to 8 were more likely to report having a traumatic brain injury than those in Grades 9 to 12 (Grade 7-8: 11% vs. Grade 9-12: 8%).
- There were no significant differences in estimates for students in Ottawa compared to Ontario-less-Ottawa, or by sex, immigration status or socioeconomic status.

Reason for Head Injury in the Past Year

Playing hockey and other team sports (such as football, rugby) are among the most commonly reported causes of head injuries among Ontario students in Grades 7 to 12 (Ottawa data not available), followed by falling down, being hit by an object, playing soccer or from another sport (such as skiing, snowboarding or skateboarding) (Figure 8).

Figure 8. Main reason for a head injury in the past year among Ontario students in Grades 7 to 12, 2017

A bar graph showing the main causes of a head injury in the past year among Ontario students in 2017.

Data Source and Notes for Figure 8

Boak, A., Hamilton, H. A., Adlaf, E. M., Henderson, J. L., & Mann, R. E. (2018). The mental health and well-being of Ontario students, 1991-2017: Detailed findings from the Ontario Student Drug Use and Health Survey (OSDUHS). Toronto, ON: Centre for Addiction and Mental Health.

‘Another team sport’ includes football, rugby, basketball
‘Other sports injury’ includes skateboarding, skiing, snowboarding
‘Other vehicle’ includes snowmobile, ATV, tractor
Provincial data is presented as there was not enough sample to look at this detailed breakdown locally for Ottawa.

Data Table for Figure 8

Main reason for a head injury in the past year	Ontario Percentage (%)
Playing hockey	19
Playing another team sport	17
Fell down by accident	13
Object hit me/thrown at me	8
Playing soccer	7
Other sports injury	6
Bicycle accident	3
Car/truck/motorvehicle accident	2
Fight with someone	1
Other vehicle accident	1
Bullied (pushed) by someone	<1
Other cause not listed	13

Parent Awareness About Concussions and Head Injuries

Ability to recognize the signs and symptoms of a concussion:

35% of Ottawa parents were very confident and 52% were somewhat confident that they were able to recognize the signs and symptoms of a concussion in their child(ren). Thirteen percent were either not very or not at all confident that they were able to recognize the signs and symptoms of a concussion in their child(ren). [5]

Awareness about the importance of limiting certain cognitive activities following a concussion:

77% of Ottawa parents said that it was very important and 14%* said that it was somewhat important for their child to limit activities such as reading, watching TV, playing electronic games, or attending school if they were told their child had a concussion. [5]

Awareness of “Return to Play Protocol”

52% of Ottawa parents have heard of the “Return to Play Protocol” for children to safely return to activity or sport after having a concussion; 7%* thought that they might have heard of it and 41% said that they had not heard of the “Return to Play Protocol." [5]

Violence Data

Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation. [7] Exposure to violence is linked to poor mental and physical health outcomes, fear, social isolation, and risky behaviours, including criminal behaviour. [8,9,10,11,12,13]

Local data sources for estimates of violence are lacking, and the limited data that is available may underrepresent the violence experienced by Ottawa residents. For more information about violence and it’s impact on health, refer to Status of Mental Health in Ottawa Report 2018 and The Chief Public Health Officer’s Report on the State of Public Health in Canada 2016: A Focus on Family Violence in Canada.

Family Violence

From provincial reports, one-third (32%) of Ontario adults reported experiencing physical abuse, sexual abuse or exposure to intimate partner violence as a child. [14]
Nationally, 8% of community-dwelling older adults (55 years and older) reported mistreatment, most commonly reporting psychological and financial abuse. [15]
In 2015, 29 per 100,000 Ottawa older adults (65 to 89 years of age) were victims of police reported family violence, which was lower than the rates in Ontario (including Ottawa; 48 per 100,000) and Canada (60 per 100,000). [16]

Bullying

In 2017, one in five Ottawa students in Grades 7 to 12 (18%) were bullied at least once on school property in the current school year. [6]
Verbal or non-physical attacks were reported by 81% of bullied students and cyberbullying (bullied on the internet) was reported by 18% of Ottawa students. [6]
Bullying others at school was reported by 8% of Ottawa students and cyberbullying others by 8% of students. [6]

Physical and Sexual Assault

In 2017, 5% of Ottawa students in Grades 7 to 12 reported they had beat up or hurt someone on purpose in the past 12 months, and 10% reported they had been in a physical fight on school property in the past 12 months. [6]
In 2016, Ottawa residents made 1,900 visits to the emergency department (ED) due to assault, which includes physical and sexual assault. These assault-related ED visits resulted in 169 hospitalizations. [17]
Approximately 4% of Ontario adults reported being the victim of a physical or sexual assault in the past year – this was highest among young adults aged 18 to 24 years (9%) and higher for those born in Canada (4%) than for immigrants (2%). [14]

Injury, Injury Prevention, and Violence Reports

Results from the Older Adults Falls Prevention Survey

In 2012, OPH conducted the Older Adults Falls Prevention Survey by telephone with 1,050 Ottawa adults aged 65 years and older living at home. The fact sheets and infographics are intended to help service providers who work with older adults to tailor awareness and education campaigns on preventing falls, to support client education, and to inform program priorities and policy development. A description of OPH, partner and community falls prevention services are included at the end of each fact sheet.

Summary [ PDF 98 KB ]

Introduction [ PDF 101.81 KB ]

Annual Physical & Vision Exam and Medication Review

Full Report [ PDF 165.68 KB ]
Summary (Print version) [ PDF 197.5 KB ]

Falls Prevention Home Safety:

Full report [ PDF 213.71 KB ]
Summary (Print version) [ PDF 308.2 KB ]

Perception of Falls Risk and Prevention:

Full Report [ PDF 252.38 KB ]

Physical Activity:

Full Report [ PDF 256 KB ]
Summary (Print version) [ PDF 148.3 KB ]

Vitamin D and Calcium Intake:

Full Report [ PDF 245.12 KB ]
Summary (Print version) [ PDF 209.28 KB ]
Methodology [ PDF 220.13 KB ]

Burden of Injury Report, 2010

The Burden of Injury in Ottawa report 2010 provides an in-depth assessment of the type and frequency of injuries affecting children, youth and adults in Ottawa. Data from emergency department visits (ED visits), hospitalizations and deaths from 2001 to 2008 help paint a picture of the injuries most affecting Ottawa residents.

Burden of Injury Report, 2010 [PDF 12 MB]

Burden of Injury Report: Knowledge to Action Report [PDF 886 KB]

References

Ottawa Public Health. Canadian Community Health Survey Ontario Share File 2013/2014. Statistics Canada.
Ottawa Public Health. Ottawa Deaths, Ontario Mortality Data 2000-2012. Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted 2016.
Ottawa Public Health. Emergency department visits and resulting hospitalization. National Ambulatory Care Reporting System (NACRS), 2017. Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted June 2018.
Ottawa Public Health. Rapid Risk Factor Surveillance System, 2015.
Ottawa Public Health. Rapid Risk Factor Surveillance System, 2018.
Ottawa Public Health. Ontario Student Drug Use and Health Survey (OSDUHS), 2017. Centre for Addiction and Mental Health.
World Health Organization. World report on violence and health: summary. 2002.
Norman RE, Byambaa M, De R, Butchart A, Scott J, Vos T. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS medicine. 2012;9(11):e1001349.
Lagdon S, Armour C, Stringer M. Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review. European Journal of Psychotraumatology. 2014;5(1):24794.
Violence and Injury Prevention Program WROfE. The cycles of violence: The relationship between childhood maltreatment and the risk of later becoming a victim or perpetrator of violence: Key facts. Rome, Italy; 2007.
Public Health Agency of Canada. The Chief Public Health Officer's report on the state of public health in Canada 2016: A Focus on family violence in Canada. Ottawa, ON; 2016 2016.
Irish L, Kobayashi I, Delahanty DL. Long-term Physical Health Consequences of Childhood Sexual Abuse: A Meta-Analytic Review. Journal of Pediatric Psychology. 2010;35(5):450-61.
Leber B. Police-reported hate crime in Canada, 2015. Statistics Canada; 2017.
Centre for Chronic Disease Prevention, Public Health Agency of Canada (2016). Postive Mental Health Surveillance Indicator Framework, Public Health Infobase.
McDonald L. Into the light: National survey on the mistreatment of older Canadians 2015.
Burczycka M, Conroy S. Family violence in Canada: A statisitical profile, 2015. Statistics Canada; 2017 February 16, 2017.
Ottawa Public Health. Emergency department visits and resulting hospitalization. National Ambulatory Care Reporting System (NACRS), 2016. Ontario Ministry of Health and Long-Term Care IntelliHEALTH Ontario. Extracted 2017.

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Injuries and Injury Prevention

In this section:

Leading Causes of Injury Data

Leading Causes of Injury Deaths

Leading Causes of Injury-related Emergency Department Visits and Hospitalizations

Falls and Fall Prevention Data

Falls

Road Safety Data

Seat Belt Use

Impaired Driving

Distracted Driving

Concussion and Head Injury Data

Violence Data

Family Violence

Bullying

Physical and Sexual Assault

Injury, Injury Prevention, and Violence Reports

Results from the Older Adults Falls Prevention Survey

Burden of Injury Report, 2010

References

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