title: State injury prevention policies and variation in death from injury.
abstract: OBJECTIVE
  Death from injury is frequently preventable, but injury remains a leading cause of death in the USA. While evidence-based strategies exist to prevent many types of injuries, effective policies for implementing these strategies at the population level are needed to reduce injury deaths. We identified promising injury prevention policies and evaluated their association with injury death rate (IDR).
  
  
  METHODS
  We identified 11 injury prevention policies and accessed data on 2013 state and county IDRs. States were divided into strong, moderate and weak tertiles based on total number of policies in place. Adjusted regression modelling compared the strength of state prevention policies with IDRs at the state level and then at the county level to account for variability within states.
  
  
  RESULTS
  The strength of state prevention policies (tertile) was not significantly associated with IDR in US states. However, counties in strong policy states had a 11.8-point lower IDR compared with those in weak policy states (p=0.001).
  
  
  CONCLUSIONS
  States with more injury prevention policies in place have lower rates of death from injury, particularly when evaluated at the county level. Implementing recommended prevention policies holds potential to prevent injury death in the USA.
authors.affiliation: Master of Science in Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Elinore J
authors.identifier: http://orcid.org/0000-0001-7550-0024
authors.initials: EJ
authors.lastname: Kaufman
authors.affiliation: Epidemiology in Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Wiebe
mesh_terms: D000056:Accident Prevention / Q000379:methods / Q000592:standards; D000059:Accidents / Q000401:mortality*; D001265:Athletic Injuries / Q000401:mortality* / Q000517:prevention & control; D040343:Behavioral Risk Factor Surveillance System; D002423:Cause of Death; D003430:Cross-Sectional Studies; D003644:Death Certificates; D055317:Evidence-Based Practice; D015438:Health Behavior; D006291:Health Policy; D006708:Homicide / Q000517:prevention & control* / Q000706:statistics & numerical data; D006801:Humans; D011050:Policy Making; D011322:Primary Prevention / Q000379:methods / Q000458:organization & administration; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control*