Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Linda Degutis

Second Advisor

Susan Busch



Introduction: In the United States (US), injury-related morbidity and mortality is a public health burden in terms of lives lost, healthcare costs, and lost productivity. In 2020, according to the Centers for Disease Control and Prevention (CDC), unintentional injuries were the fourth leading cause of death (200,955) behind heart disease, cancer, and COVID-19. Many of the studies of injury recidivism were limited to demographic data and often focus on a specific type of injury, such as motor vehicle crashes, interpersonal violence, or falls. The aim of this study is to present the descriptive characteristics of injury recidivism among adults in the United States, using a population-based dataset.Method: Using the Medical Expenditure Panel Survey (MEPS), an annual cross-sectional survey of non-institutionalized U.S. households, 13,284 adults (2012-2018) with injuries were followed up for two years. Injuries captured in the study were those associated with healthcare utilization, disability days or any effects on self-reported health. Descriptive characteristics were performed using SAS version 9.4. Results: Recurrent injuries were reported by 2885 which is representing over nine million individuals in the U.S. over a 2-year follow-up. These statistics imply that 21.72% of those injured experienced recidivism after accounting for sampling weights, clusters, and strata. Persons with repeat injuries were more likely to be Caucasian, unmarried, and have private insurance. Although they were more likely than persons reporting single occurrences of injuries to report diabetes (13.0 vs. 11.4%, p = 0.04), asthma (17.3 vs. 13.2%, p<0.01), stroke (7.2 vs 4.8%, p<0.01), and smoking (21.4 vs. 17.%, p<0.01), there was no difference in the prevalence of cardiovascular illnesses or emphysema. Persons with repeat injuries were also significantly more likely than persons with single injury occurrences to have a positive depression (15.3 vs 9.6% p<0.01). Conclusions and Implications: We identified a range of characteristics associated with higher recidivism rate among injured individuals. It is critical to identify evidence-based risk factors, preventative measures, and the role of many stakeholders in reducing the burden of injuries on population health. It is as important to also include policy makers in the evaluation and implementation of effective injury prevention strategies. Keywords: Injury burden, Recidivism, Repeated injuries, MEPS


This is an Open Access Thesis.

Open Access

This Article is Open Access