Unintentional Injury in San Diego County

County of San Diego Health and Human Services Agency Chronic Disease and Injury Prevention Emergency Medical Services Unintentional Injury in San Diego County County of San Diego Board of Supervisors Greg Cox, District 1 Dianne Jacob, District 2 Pam Slater, District 3 Ron Roberts, District 4 Bill Horn, District 5 Walter F. Ekard Chief Administrative Officer Rodger G. Lum, Ph.D., Director, Health and Human Services Agency July 1, 1999 through June 30, 2000 August 2002 Nancy L. Bowen, M.D., MPH Public Health Officer Gwen Jones, Chief Emergency Medical Services

Unintentional Injury in San Diego County July 1, 1999 through June 30, 2000

We acknowledge the contributions of the following individuals for their work in the preparation of this report: Nancy Bowen, MD; Public Health Officer Adrienne Collins Yancey; Acting Chief, Chronic Disease & Injury Prevention and Health Promotion Gwen S. Jones; Chief, Emergency Medical Services Patricia A. Murrin, RN, MPH; EMS Coordinator, Emergency Medical Services Leslie Upledger Ray, MA, MPPA; Senior Epidemiologist, Emergency Medical Services Edward M. Castillo, MPH; Biostatistician, Emergency Medical Services Alan M. Smith, MPH; Epidemiologist, Emergency Medical Services Barbara M. Stepanski, MPH; Biostatistician, Emergency Medical Services Bruce Even; Health Information Specialist, Chronic Disease and Injury Prevention Additionally, this report would not have been possible without the hard work and dedication of our community partners. In particular, we acknowledge the invaluable contributions of the San Diego County Trauma System, particularly the six trauma centers: Children s Hospital and Health Center Palomar Medical Center Scripps Memorial Hospital, La Jolla Scripps Mercy Hospital and Health Center Sharp Memorial Hospital University of California, San Diego Medical Center We extend our thanks and appreciation to the hundreds of nurses, paramedics and emergency medical technicians and their hospitals and agencies who provided the information on emergency patients.

TABLE OF CONTENTS Introduction...1 Table 1 National, State, and San Diego County Rates of Unintentional Injury (1998)...3 Table 2 San Diego County Incidents and Rates of Unintentional Injury (FY 1999/00)...4 Leading Causes of Unintentional Injury Paramedic/EMT Responses Table 3a. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Paramedic/EMT Responses...7 Table 3b. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Paramedic/EMT Responses...8 Table 3c. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by MSA: Paramedic/EMT Responses...9 Severe Injury Table 4a. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Severe Injury...10 Table 4b. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Severe Injury...11 Table 4c. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by MSA: Severe Injury...12 Deaths Table 5a. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Death...13 Table 5b. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Death...14 Table 5c. Leading Causes of Unintentional Injury (Number and Rate per 100,000) by MSA: Death...15 Transport Related Injuries Motor Vehicle Occupant (MVO) Table 6a Area by for Paramedic/EMT Responses: Motor Vehicle Occupant...17 Table 6b Area by Race/Ethnicity for Paramedic/EMT Responses: Motor Vehicle Occupant...21 Table 7a Area by for Severe Injury: Motor Vehicle Occupant...23 i

Table 7b Area by Race/Ethnicity for Severe Injury: Motor Vehicle Occupant...27 Table 8a Area by for Deaths: Motor Vehicle Occupant...29 Table 8b Area by Race/Ethnicity for Deaths: Motor Vehicle Occupant...33 Motorcycle Table 9a Area by for Paramedic/EMT Responses: Motorcycle...35 Table 9b Area by Race/Ethnicity for Paramedic/EMT Responses: Motorcycle...39 Table 10a Area by for Severe Injury: Motorcycle...41 Table 10b Area by Race/Ethnicity for Severe Injury: Motorcycle...45 Table 11a Area by for Deaths: Motorcycle...47 Table 11b Area by Race/Ethnicity for Deaths: Motorcycle...51 Pedalcycle Table 12a Area by for Paramedic/EMT Responses: Pedalcycle...53 Table 12b Area by Race/Ethnicity for Paramedic/EMT Responses: Pedalcycle...57 Table 13a Area by for Severe Injury: Pedalcycle...59 Table 13b Area by Race/Ethnicity for Severe Injury: Pedalcycle...63 Table 14a Area by for Deaths: Pedalcycle...65 Table 14b Area by Race/Ethnicity for Deaths: Pedalcycle...69 Pedestrian Table 15a Table 15b Table 16a Table 16b Table 17a Table 17b Area by for Paramedic/EMT Responses: Pedestrian...71 Area by Race/Ethnicity for Paramedic/EMT Responses: Pedestrian...75 Area by for Severe Injury: Pedestrian...77 Area by Race/Ethnicity for Severe Injury: Pedestrian...81 Area by for Deaths: Pedestrian...83 Area by Race/Ethnicity for Deaths: Pedestrian...87 Other Transportation Table 18a Area by for Paramedic/EMT Responses: Other Transportation...89 Table 18b Area by Race/Ethnicity for Paramedic/EMT Responses: Other Transportation...93 Table 19a Area by for Severe Injury: Other Transportation...96 Table 19b Area by Race/Ethnicity for Severe Injury: Other Transportation...99 Table 20a Area by for Deaths: Other Transportation...101 Table 20b Area by Race/Ethnicity for Deaths: Other Transportation...105 Non-Transport Related Unintentional Injuries Falls Table 21a Area by for Paramedic/EMT Responses: Falls...108 Table 21b Area by Race/Ethnicity for Paramedic/EMT Responses: Falls...112 Table 22a Area by for Severe Injury: Falls...114 Table 22b Area by Race/Ethnicity for Severe Injury: Falls...118 Table 23a Area by for Deaths: Falls...120 Table 23b Area by Race/Ethnicity for Deaths: Falls...124 ii

Fire-Burn-Scald Table 24a Area by for Paramedic/EMT Responses: Fire-Burn-Scald...127 Table 24b Area by Race/Ethnicity for Paramedic/EMT Responses: Fire-Burn-Scald...131 Table 25a Area by for Deaths: Fire-Burn-Scald...133 Table 25b Area by Race/Ethnicity for Deaths: Fire-Burn-Scald...137 Cut-Pierce Table 26a Area by for Paramedic/EMT Responses: Cut-Pierce...140 Table 26b Area by Race/Ethnicity for Paramedic/EMT Responses: Cut-Pierce...144 Table 27a Area by for Severe Injury: Cut-Pierce...146 Table 27b Area by Race/Ethnicity for Severe Injury: Cut-Pierce...150 Blunt Trauma Table 28a Area by for Paramedic/EMT Responses: Blunt Trauma...153 Table 28b Area by Race/Ethnicity for Paramedic/EMT Responses: Blunt Trauma...157 Poison-Bite-Sting Table 29a Area by for Paramedic/EMT Responses: Poison-Bite-Sting...160 Table 29b Area by Race/Ethnicity for Paramedic/EMT Responses: Poison-Bite-Sting...164 Table 30a Area by for Deaths: Poison-Bite-Sting...166 Table 30b Area by Race/Ethnicity for Deaths: Poison-Bite-Sting...170 Airway Obstruction-Suffocation Table 31a Area by for Paramedic/EMT Responses: Airway Obstruction-Suffocation...173 Table 31b Area by Race/Ethnicity for Paramedic/EMT Responses: Airway Obstruction-Suffocation...177 Table 32a Area by for Deaths: Airway Obstruction-Suffocation...179 Table 32b Area by Race/Ethnicity for Deaths: Airway Obstruction-Suffocation...183 Drown-Submersion Table 33a Area by for Paramedic/EMT Responses: Drown-Submersion...186 Table 33b Area by Race/Ethnicity for Paramedic/EMT Responses: Drown-Submersion...190 Table 34a Area by for Deaths: Drown-Submersion...192 Table 34b Area by Race/Ethnicity for Deaths: Drown-Submersion...196 Technical Notes...198 iii

INTRODUCTION The Division of Chronic Disease and Injury Prevention The County of San Diego Health and Human Services Agency s Chronic Disease & Injury Prevention Division (ChDIP) was established as part of the County Board of Supervisors Health and Wellness Initiative in its Strategic Plan for 2001-2005. ChDIP s mission is to promote the wellness, and prevention of illness, disability and premature death due to chronic diseases and unintentional injuries. ChDIP goals include increasing physical activity, healthy eating, safe behaviors and environments, and use of recommended preventive health care and quality of health care treatment, and reducing tobacco use and exposure. One component of the Division s efforts to promote physical activity and healthy eating is the Get Up San Diego initiative. The purpose is to increase knowledge, positive attitudes and healthy behaviors. ChDIP focuses on individuals, families, institutions (such as schools, healthcare systems, etc.), neighborhoods and communities. The Division of Emergency Medical Services The Division of Emergency Medical Services (EMS) is a component of the Health and Human Services Agency s Public Health Services group. It is the local EMS agency as defined in California law. EMS s purpose is to ensure that the quality of emergency medical services, which includes 9-1-1 ambulance services, trauma care services, and non-emergency ambulance services, are of the highest quality. As the regulatory agency for emergency services, EMS designates participants in the county wide EMS system (base hospitals, advanced life support providers, trauma centers, prehospital training programs, etc.); monitors system activity with a large data network; develops the medical standard of care for emergency patients; and provides the framework for medical quality improvement activities. Additionally, EMS provides services within two ambulance districts (County Service Areas 17 & 69), oversees the County s medical disaster plan and implements numerous community education, prevention and research grants/projects. PURPOSE The purpose of this publication is to provide community level information of where and why people access emergency medical services in San Diego County and to help health professionals identify problems within their communities. LAYOUT This document provides an overview of injuries by level of severity based on data routinely collected by the Division of Emergency Medical Services. The Paramedic/EMT tables contain Cause of Injury as reported by paramedics/emergency medical technicians-1s (EMT-1s). The Severe Injury tables are based on San Diego County Trauma Registry data, which are obtained from the six trauma centers in the San Diego County Trauma System. Death tables are based on San Diego County Medical Examiner s records. 1

Data is presented in tables with community area (MSA and SRA) incidence and rate by age group for each cause of injury and level of severity. All rates are calculated per 100,000 residents by area and age/ethnicity as defined by San Diego Association of Governments (SANDAG). Rates were not calculated for categories with less than five incidents. Complete annual reports on these databases are available from Emergency Medical Services. DATA SOURCES The Divisions of Chronic Disease and Injury Prevention and Emergency Medical Services used three population based data sources for the preparation of the Unintentional Injury in San Diego 1999/2000 report. Prehospital Database: EMS receives a prehospital patient record (PPR) for every patient seen by a paramedic or emergency medical technician. The PPR contains information including demographics, incident zip code location, chief complaint, patient status, injury event information, restraint use, contributing factors, times and outcomes. Trauma Registry: EMS receives an abbreviated Trauma Registry for every trauma patient admitted to any designated trauma center hospital trauma service. A detailed Trauma Registry is received for every trauma patients who meets one or more of the following criteria: length of hospitalization of at least 24 hours, admission to intensive or intermediate care unit, death due to traumatic injuries, and/or transfer to or from another acute care hospital. Medical Examiner s Data: EMS receives an Investigative Summary and Autopsy for every individual who dies in San Diego County from a traumatic injury. Medical Examiner s records contain injury related information including date and time of injury, incident location, patient home zip code, external cause of injury (ICD9 CM E-code), age, sex, race/ethnicity, vehicle make and type, law enforcement agency, mechanism of injury and detailed narrative of injuries sustained. DATA STATISTICS This publication contains two types of statistics: incident and rate. An incident answers the how many question while a rate is used to compare risk between groups. Incident: The number of occurrences for the specific injury type. Incidents should not be used to compare different racial/ethnic groups, age groups or geographic areas. For these comparisons, use rates, which take into account differences in population sizes. Rate: Calculated as incidents per 100,000 population. Rates were calculated using January 1999 population estimates provided by the San Diego Association of Governments (SANDAG). Rates were not calculated for categories with less than five occurrences due to instability. 2

National, State, and San Diego County Rates of Unintentional Injury (1998) Rates of unintentional fatal injuries in San Diego County were generally lower than those of the United States and generally similar or lower than the rates of California. However, non-fatal rates in San Diego County were higher than those of California for motor vehicle occupant (MVO) crashes, motorcycle, pedalcycle, pedestrian, falls, suffocation, and drown-submersion (United States data for non-fatal injuries were not comparable due to differences in data sources). Many of these differences can be explained by the temperate climate of San Diego in addition to the many recreational activities available to residents and visitors alike. Of these, the rate of falls were the highest of non-fatal injury (281.89/100,000) followed by MVO crashes (78.69/100,000) in San Diego County. Table 1. National, State, and San Diego County Rates of Unintentional Injury, 1998 National California San Diego Cause of Injury Fatal Non-Fatal Fatal Non-Fatal Fatal Non-Fatal Motor Vehicle Occupant (MVO) 9.17 --- 6.39 60.27 5.49 77.66 Motorcycle 0.63 --- 0.49 7.73 0.71 9.38 Pedalcycle 0.31 --- 0.34 12.73 0.25 16.61 Pedestrian 2.34 --- 2.15 15.24 2.80 16.18 Fire-Burn-Scalds 1.24 --- 0.69 9.74 0.50 12.15 Unintentional Firearm 0.32 --- 0.17 1.93 * 1.45 Cut-Pierce 0.04 --- 0.03 14.26 * 10.69 Fall 4.66 --- 3.30 276.23 3.75 277.94 Poison 4.00 --- 5.25 29.82 6.44 28.79 Suffocation 1.70 --- 0.60 3.83 0.46 4.28 Drown-Submersion 1.63 --- 1.43 1.79 1.31 1.84 Source: Center for Disease Control and Prevention, Web-based Injury Statistics Query and Reporting System (National), California Department of Health Services (State and Local) Note: National Non-fatal data is estimated from Emergency Department surveys and therefore is not comparable to State and Local hospital discharge data *Rates not calculated for incidents less than 5 Table 1 in the Unintentional Injury in San Diego Report 1999/2000 To ensure comparable rates for injury categories, 1998 data was used for Table 1 because it was the most recent data available using the ICD9 E-Code coding system. Injury grouping for the ICD10 is substantially different. As of 1999, all nationally reported death data utilize the ICD10 coding system. Presently, non-fatal data is still coded using the ICD9 coding system. The fatal injury rates for San Diego listed in Table 1 and Table 2 vary slightly because of this difference in reported years. 3

San Diego County Incidents and Rates of Unintentional Injury (FY 1999/00) Prehospital, trauma, and medical examiner patients predominantly suffered MVO crashes and fall injuries. The rate of prehospital pedalcycle and cut/pierce injuries were relatively high, however the rates for trauma and medical examiner data were lower than that of other injuries. This indicates that many pedalcycle injuries were not as severe as many other unintentional injuries. It is reasonable to suggest, based on the mechanism and sites of injuries sustained by pedalcyclists, that the most severe of these injuries are to the head and are in patients not wearing appropriate equipment such as helmets. The majority of cut/pierce injuries are to extremities, and although these injuries may require medical attention, they are less frequently life threatening. Table 2. San Diego County Incidents and Rates of Unintentional Injury, FY 1999/00 Prehospital Severe Injury Deaths Cause of Injury Incident Rate Incident Rate Incident Rate Motor Vehicle Occupant (MVO) 12,829 440.64 1,598 54.89 174 5.98 Motorcycle 763 26.21 281 9.65 22 0.76 Pedalcycle 1,178 40.46 247 8.48 10 0.34 Pedestrian 977 33.56 356 12.23 85 2.92 Other Transportation Related 919 31.56 281 9.65 17 0.58 Fire-Burn-Scald 461 15.83 ** - 16 0.55 Unintentional Firearm 38 1.31 23 0.79 1 * Cut-Pierce 686 23.56 18 0.62 0 - Blunt Trauma 531 18.24 ** - ** - Falls 12,440 427.28 1,064 36.55 156 5.36 Poison-Bite-Sting 1,447 49.70 6 0.21 255 8.76 Airway Obstruction-Suffocation 259 8.90 ** - 18 0.62 Drown-Submersion 72 2.47 ** - 24 0.82 Other 1,409 48.39 233 8.00 82 0.27 No Cause Indicated 4,430 152.16 44 1.51 20 0.48 Total 38,439 1320.26 4,158 142.81 880 16.76 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services Prehospital Database, Trauma Registry, Medical Examiner's Data, FY 1999/00 *Rates not calculated for less than 5 incidents **Not collected in Trauma Registry or Medical Examiner s Database Table 2 in the Unintentional Injury in San Diego Report 1999/2000 4

Motor vehicle crashes and falls result in significantly more deaths and injuries than other unintentional causes. While the death rate is significantly higher for poison/bite/sting injuries, this category includes all drug overdose deaths that are not specifically identified as suicides. Drug related overdose deaths are not typically considered unintentional injuries. However, bites, stings, and poisonings from toxic substances such as household chemicals are considered unintentional injuries. Leading Causes of Unintentional Injury (FY 1999/00) The leading causes of unintentional injury in San Diego were predominantly fall and MVO crashes. Falls were more prevalent among young children and older individuals, whereas MVO crashes occurred most often among young adult and middle age injury patients for prehospital, trauma, and those individuals who died. Overall, MVO crashes were the most common type of injury among all races. However, falls were more common among white prehospital patients and patients who died, which is primarily due to a higher proportion of older individuals in this category. Trauma patients were predominantly injured in MVO crashes. There were differences between the rates of MVO crashes and falls between major statistical areas (MSAs), but these differences were small. 5

LEADING CAUSES OF UNINTENTIONAL INJURY 6

Table 3a: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Paramedic/EMT Responses 0-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Overall 1 Fall 669 (285.22) MVO 409 (183.04) MVO 428 (209.22) MVO 1902 (985.21) MVO 1929 (862.16) MVO 2451 (555.44) MVO 2012 (426.37) MVO 1453 (404.97) Fall 917 (407.28) Fall 1399 (797.72) Fall 2813 (2442.86) Fall 2322 (5223.38) MVO 12829 (440.64) 2 MVO 342 (145.81) Fall 392 (175.43) Fall 405 (197.98) Fall 344 (178.19) Fall 362 (161.79) Fall 709 (160.67) Fall 991 (210.00) Fall 1069 (297.95) MVO 751 (333.55) MVO 536 (305.63) MVO 423 (367.34) MVO 114 (256.44) Fall 12440 (427.28) 3 Poison-Bite- Sting 84 (35.81) Pedalcycle 145 (64.89) Pedalcycle 252 (123.19) Poison-Bite- Sting 167 (85.50) Motorcycle 139 (62.13) Poison-Bite- Sting 270 (61.19) Poison-Bite- Sting 360 (78.20) Poison-Bite- Sting 223 (62.15) Poison-Bite- Sting 62 (27.54) Pedestrian 56 (31.93) Pedestrian 33 (28.66) Poison-Bite- Sting 17 (38.24) Poison-Bite- Sting 1447 (49.70) 4 Fire-Burn- Scald 71 (30.27) Pedestrian 119 (53.26) Other Trans 158 (77.24) Other Trans 139 (72.00) Poison-Bite- Sting 138 (61.68) Motorcycle 198 (44.87) Pedalcycle 169 (35.81) Pedalcycle 136 (37.91) Pedestrian 58 (25.76) Other Trans 36 (20.53) Poison-Bite- Sting 24 (20.84) Pedestrian 12 (26.99) Pedalcycle 1178 (40.46) 5 Pedestrian 63 (26.86) Other Trans 55 (24.61) Pedestrian 112 (54.75) Pedalcycle 133 (68.89) Other Trans 114 (50.95) Pedalcycle 156 (35.35) Motorcycle 144 (30.52) Motorcycle 109 (30.38) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 Pedalcycle 40 (17.77) Poison-Bite- Sting 32 (18.25) Cut-Pierce 23 (19.97) Other Trans 12 (26.99) Pedestrian 977 (33.56) 7

Table 3b: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Paramedic/EMT Responses White Black Hispanic Asian/Other Total 1 Fall 8540 (491.24) MVO 956 (550.85) MVO 2791 (386.36) MVO 1517 (547.90) MVO 12829 (440.64) 2 MVO 5791 (333.07) Fall 517 (297.90) Fall 1406 (194.64) Fall 500 (180.59) Fall 12440 (427.28) 3 Poison-Bite-Sting 745 (42.85) Pedestrian 112 (64.53) Pedestrian 284 (39.31) Pedestrian 71 (25.64) Poison-Bite-Sting 1447 (49.70) 4 Pedalcycle 648 (37.27) Poison-Bite-Sting 101 (58.20) Pedalcycle 221 (30.59) Poison-Bite-Sting 59 (21.31) Pedalcycle 1178 (40.46) 5 Other Trans 518 (29.79) Pedalcycle 84 (48.40) Poison-Bite-Sting 210 (29.07) Pedalcycle 56 (20.23) Pedestrian 977 (33.56) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 8

Table 3c: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Major Statistical Area: Paramedic/EMT Responses Central North City South Suburban East Suburban North County West North County East East County Total 1 Fall 2630 (417.86) MVO 3104 (441.07) MVO 1020 (325.63) Fall 2429 (495.46) Fall 1477 (392.16) Fall 2075 (552.03) Fall 182 (815.49) MVO 12829 (440.64) 2 MVO 2613 (415.16) Fall 2504 (355.81) Fall 904 (288.60) MVO 2091 (426.51) MVO 1345 (357.11) MVO 2073 (551.50) MVO 179 (802.04) Fall 12440 (427.28) 3 Pedestrian 284 (45.12) Pedalcycle 283 (40.21) Poison-Bite- Sting 191 (60.98) Poison-Bite- Sting 510 (104.03) Poison-Bite- Sting 240 (63.72) Poison-Bite- Sting 178 (47.35) Motorcycle 86 (385.34) Poison-Bite- Sting 1447 (49.70) 4 Pedalcycle 260 (41.31) Pedestrian 197 (27.99) Pedestrian 118 (37.67) Pedalcycle 200 (40.80) Other Trans 190 (50.45) Pedalcycle 155 (41.24) Poison-Bite- Sting 29 (129.94) Pedalcycle 1178 (40.46) 5 Cut-Pierce 199 (31.62) Blunt Trauma 181 (25.72) Pedalcycle 88 (28.09) Other Trans 183 (37.33) Pedalcycle 136 (36.11) Pedestrian 109 (29.00) Other Trans 26 (116.50) Pedestrian 977 (33.56) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 9

Table 4a: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Severe Injury 0-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Overall 1 Fall 130 (55.42) Fall 63 (28.19) Other Trans 51 (24.93) MVO 198 (102.56) MVO 254 (113.52) MVO 305 (69.12) MVO 229 (48.53) MVO 178 (49.61) MVO 102 (45.30) MVO 94 (53.60) Fall 133 (115.50) Fall 77 (173.21) MVO 1598 (54.89) 2 Pedestrian 41 (17.48) MVO 52 (23.27) Fall 49 (23.95) Fall 33 (17.09) Fall 43 (19.22) Fall 104 (23.57) Fall 141 (29.88) Fall 118 (32.89) Fall 79 (35.09) Fall 94 (53.60) MVO 76 (66.00) MVO 29 (65.24) Fall 1064 (36.55) 3 MVO 39 (16.63) Pedalcycle 46 (20.59) Pedalcycle 44 (21.51) Motorcycle 31 (16.06) Motorcycle 41 (18.32) Motorcycle 75 (17.00) Motorcycle 53 (11.23) Pedestrian 45 (12.54) Pedestrian 25 (11.10) Pedestrian 20 (11.40) Pedestrian 15 (13.03) Pedestrian 6 (13.50) Pedestrian 356 (12.23) 4 Pedalcycle 9 (3.84) Pedestrian 41 (18.35) MVO 40 (19.55) Other Trans 27 (13.99) Pedestrian 30 (13.41) Other Trans 62 (14.05) Pedestrian 52 (11.02) Motorcycle 36 (10.03) Motorcycle 21 (9.33) Other Trans 8 (4.56) Pedalcycle 4 (*) Other Trans 1 (*) Motorcycle 281 (9.65) 5 Other Trans 4 (*) Other Trans 15 (6.71) Pedestrian 22 (10.75) Pedalcycle 23 (11.91) Other Trans 30 (13.41) Pedestrian 39 (8.84) Other Trans 38 (8.05) Pedalcycle 30 (8.36) Other Trans 19 (8.44) Motorcycle 5 (2.85) Motorcycle 1 (*) Pedalcycle 1 (*) Other Trans 281 (9.65) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 10

Table 4b: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Severe Injury White Black Hispanic Asian/Other Total 1 MVO 804 (46.24) MVO 82 (47.25) MVO 505 (69.91) MVO 174 (62.84) MVO 1598 (54.89) 2 Fall 686 (39.46) Pedestrian 47 (27.08) Fall 259 (35.85) Fall 62 (22.39) Fall 1064 (36.55) 3 Motorcycle 220 (12.65) Fall 45 (25.93) Pedestrian 123 (17.03) Pedestrian 31 (11.20) Pedestrian 356 (12.23) 4 Other Trans 208 (11.96) Pedalcycle 14 (8.07) Pedalcycle 60 (8.31) Pedalcycle 23 (8.31) Motorcycle 281 (9.65) 5 Pedestrian 150 (8.63) Motorcycle 13 (7.49) Other Trans 42 (5.81) Other Trans 18 (6.50) Other Trans 281 (9.65) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 11

Table 4c: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Major Statisitical Area: Severe Injury 1 Central Fall 195 (30.98) North City Fall 125 (17.76) South Suburban MVO 67 (21.39) East Suburban MVO 120 (24.48) North County West MVO 83 (22.04) North County East East County Total MVO 159 (42.30) MVO 29 (129.94) MVO 1598 (54.89) 2 MVO 140 (22.24) MVO 120 (17.05) Fall 50 (15.96) Fall 59 (12.03) Fall 69 (18.32) Fall 106 (28.20) Motorcycle 19 (85.13) Fall 1064 (36.55) 3 Pedestrian 64 (10.17) Pedestrian 31 (4.40) Pedestrian 29 (9.26) Motorcycle 35 (7.14) Motorcycle 25 (6.64) Motorcycle 25 (6.65) Fall 9 (40.33) Pedestrian 356 (12.23) 4 Pedalcycle 35 (5.56) Other Trans 22 (3.13) Pedalcycle 15 (4.79) Pedestrian 33 (6.73) Pedestrian 24 (6.37) Pedestrian 20 (5.32) Other Trans 8 (35.85) Motorcycle 281 (9.65) 5 Motorcycle 14 (2.22) Pedalcycle 21 (2.98) Other Trans 9 (2.87) Pedalcycle 22 (4.49) Pedalcycle 18 (4.78) Pedalcycle 17 (4.52) Pedalcycle 1 (*) Other Trans 281 (9.65) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 12

Table 5a: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by : Deaths 0-4 5-9 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Overall 1 Pedestrian 4 (*) MVO 1 (*) Pedestrian 4 (*) MVO 36 (18.65) MVO 28 (12.51) MVO 21 (4.76) MVO 31 (6.57) Fall 20 (5.57) Fall 12 (5.33) Fall 25 (14.26) Fall 43 (37.34) Fall 43 (96.73) MVO 174 (5.98) 2 MVO 2 (*) Fall 1 (*) Other Trans 2 (*) Pedestrian 3 (*) Pedestrian 9 (4.02) Pedestrian 10 (2.27) Pedestrian 22 (4.66) MVO 15 (4.18) MVO 11 (4.8 9) MVO 12 (6.84) MVO 10 (8.68) MVO 6 (13.50) Fall 156 (5.36) 3 Other Trans 2 (*) Pedestrian 1 (*) Fall 1 (*) Motorcycle 2 (*) Motorcycle 9 (4.02) Fall 2 (*) Fall 8 (1.70) Pedestrian 9 (2.51) Pedestrian 7 (3.11) Pedestrian 5 (2.85) Pedestrian 5 (4.34) Pedestrian 3 (*) Pedestrian 85 (2.92) 4 Fall 1 (*) Pedalcycle 1 (*) --- Other Trans 1 (*) Other Trans 2 (*) Motorcycle 2 (*) Motorcycle 3 (*) Motorcycle 6 (1.67) Other Trans 2 (*) Other Trans 1 (*) --- --- Motorcycle 22 (0.76) 5 --- --- --- Pedalcycle 1 (*) --- Other Trans 1 (*) Other Trans 3 (*) Pedalcycle 4 (*) Pedalcycle 1 (*) Pedalcycle 1 (*) --- --- Other Trans 17 (0.58) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Medical Examiner s Data, FY 1999/00 13

Table 5b: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Race/Ethnicity: Deaths White Black Hispanic Asian/Other Total 1 Fall 129 (7.42) MVO 8 (4.61) MVO 55 (7.61) Pedestrian 7 (2.53) MVO 174 (5.98) 2 MVO 101 (5.81) Pedestrian 5 (2.88) Pedestrian 31 (4.29) MVO 6 (2.17) Fall 156 (5.36) 3 Pedestrian 41 (2.36) Fall 2 (*) Fall 18 (2.49) Fall 5 (1.81) Pedestrian 85 (2.92) 4 Motorcycle 20 (1.15) Motorcycle 2 (*) Pedalcycle 3 (*) Other Trans 1 (*) Motorcycle 22 (0.76) 5 Other Trans 16 (0.92) --- Fire-Burn-Scald 1 (*) --- Other Trans 17 (0.58) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Medical Examiner s Data, FY 1999/00 14

Table 5c: Leading Causes of Unintentional Injury (Number and Rate per 100,000) by Major Statisitical Area: Deaths Central North City South Suburban East Suburban North County West North County East East County Total 1 Fall 24 (3.81) MVO 45 (6.39) Pedestrian 17 (5.43) MVO 30 (6.12) Fall 22 (5.84) MVO 29 (7.72) MVO 9 (40.33) MVO 174 (5.98) 2 MVO 23 (3.65) Fall 37 (5.26) Fall 13 (4.15) Fall 24 (4.90) MVO 12 (3.19) Fall 18 (4.79) Other Trans 3 (*) Fall 156 (5.36) 3 Pedestrian 16 (2.54) Pedestrian 13 (1.85) MVO 10 (3.19) Pedestrian 12 (2.45) Pedestrian 11 (2.92) Pedestrian 11 (2.93) Motorcycle 2 (*) Pedestrian 85 (2.92) 4 Motorcycle 2 (*) Other Trans 3 (*) Pedalcycle 3 (*) Motorcycle 6 (1.22) Motorcycle 5 (1.33) Motorcycle 4 (*) Fall 1 (*) Motorcycle 22 (0.76) 5 Other Trans 1 (*) Motorcycle 2 (*) --- Other Trans 2 (*) Other Trans 5 (1.33) Other Trans 2 (*) --- Other Trans 17 (0.58) Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Medical Examiner s Data, FY 1999/00 15

TRANSPORT RELATED INJURIES 16

Table 6a: Area by for Paramedic/EMT Responses: Motor Vehicle Occupant 0-4 5-9 10-14 15-19 Area Number Rate Number Rate Number Rate Number Rate Central MSA 80 137.42 92 174.70 87 189.50 338 730.12 Central San Diego 26 186.07 27 212.26 26 249.33 102 1052.85 Peninsula 1 * 0-3 * 25 587.54 Coronado 3 * 3 * 2 * 10 523.83 National City 13 214.73 11 208.45 15 324.89 47 1017.76 Southeast San Diego 15 99.08 11 74.97 16 111.99 66 495.05 Mid-City 22 124.49 40 266.26 25 201.13 88 704.45 North City MSA 62 135.37 82 180.34 87 204.64 440 1052.23 Kearny Mesa 28 233.31 28 252.57 19 201.76 133 1494.55 Coastal 10 262.47 7 203.13 14 463.73 47 1619.01 University 4 * 5 226.45 6 315.79 28 613.36 Del Mar-Mira Mesa 13 141.04 9 92.39 17 177.43 61 696.19 North San Diego 2 * 14 231.21 14 230.95 54 999.81 Poway 1 * 9 168.67 12 214.48 76 1410.02 Miramar 0-1 * 1 * 3 * Elliott-Navajo 4 * 9 123.56 4 * 38 741.32 South Suburban MSA 30 99.98 38 141.44 39 159.57 146 662.40 Sweetwater 3 * 3 * 3 * 14 264.00 Chula Vista 19 176.20 14 147.23 20 243.37 72 1035.38 South Bay 8 58.98 21 176.23 16 148.55 60 613.25 East Suburban MSA 59 158.84 81 217.04 83 230.25 356 1119.00 Jamul 4 * 10 1222.49 5 544.66 16 1758.24 Spring Valley 10 150.53 9 135.32 16 244.91 50 857.63 Lemon Grove 6 234.10 13 526.10 4 * 13 608.90 La Mesa 5 119.39 3 * 8 228.57 49 1679.23 El Cajon 13 115.36 15 140.16 21 218.84 65 816.38 Santee 2 * 8 197.38 6 144.16 43 1115.72 Lakeside 4 * 9 217.92 10 236.85 37 977.80 Harbison Crest 4 * 4 * 3 * 31 3100.00 Alpine 9 1051.40 6 647.95 5 530.79 17 1969.87 Ramona 2 * 4 149.25 5 181.09 35 1368.26 N. County West MSA 37 124.00 40 139.28 39 152.12 182 721.51 San Dieguito 3 * 8 141.52 7 128.25 57 1166.84 Carlsbad 10 161.86 12 184.96 5 80.49 32 587.48 Oceanside 23 163.62 19 139.62 27 220.75 74 733.62 Pendleton 1 * 1 * 0-19 395.34 N. County East MSA 53 162.11 60 191.68 81 282.38 349 1425.36 Escondido 20 155.90 29 236.23 37 329.74 126 1320.89 San Marcos 7 118.32 12 216.53 10 201.37 54 1281.14 Vista 15 167.34 9 109.30 19 262.58 90 1516.43 Valley Center 4 * 1 * 4 * 29 2239.38 Pauma 2 * 0-3 * 12 2214.02 Fallbrook 5 133.55 9 246.17 8 235.36 38 1284.22 East County MSA 3 * 1 * 2 * 31 2246.38 Palomar-Julian 0-0 - 2 * 5 1269.04 Laguna-Pine Valley 0-0 - 0-2 * Mountain Empire 3 * 1 * 0-16 3493.45 Anza-Borrego Springs 0-0 - 0-8 4571.43 Out of County 0 --- 1 --- 0 --- 2 --- Unknown 18 --- 14 --- 10 --- 58 --- Total 342 145.81 409 183.04 428 209.22 1902 985.21 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 17

Table 6a: Area by for Paramedic/EMT Responses: Motor Vehicle Occupant (Continued) 20-24 25-34 35-44 45-54 Area Number Rate Number Rate Number Rate Number Rate Central MSA 408 735.72 578 585.18 424 421.16 281 400.09 Central San Diego 156 1188.39 254 954.31 148 488.16 109 528.43 Peninsula 34 681.77 17 158.33 15 131.16 15 183.46 Coronado 11 268.36 15 427.11 15 460.26 12 483.48 National City 50 810.90 62 730.79 58 780.30 33 661.59 Southeast San Diego 48 367.90 78 324.49 66 283.60 29 159.51 Mid-City 109 776.91 152 598.76 122 488.84 83 525.98 North City MSA 491 988.96 643 585.22 489 399.28 364 380.22 Kearny Mesa 189 1820.28 231 969.16 162 625.07 102 550.43 Coastal 65 1029.13 100 671.82 67 440.18 35 323.71 University 54 1179.30 67 660.68 45 440.05 43 647.59 Del Mar-Mira Mesa 69 711.34 93 418.54 68 253.67 61 277.36 North San Diego 35 623.55 64 536.15 56 369.22 54 415.51 Poway 33 553.23 37 339.01 50 397.17 34 263.77 Miramar 9 473.68 10 669.34 11 1684.53 4 * Elliott-Navajo 37 712.63 41 283.80 30 188.81 31 262.93 South Suburban MSA 161 702.11 178 372.67 158 333.01 106 291.73 Sweetwater 9 157.76 6 54.80 7 60.50 6 55.51 Chula Vista 81 1141.33 106 663.99 99 609.94 52 450.65 South Bay 71 700.96 66 316.55 52 264.71 48 343.18 East Suburban MSA 260 769.44 336 468.77 318 392.94 236 366.93 Jamul 14 1417.00 30 1756.44 18 894.19 10 469.26 Spring Valley 28 467.45 30 246.79 39 280.54 25 221.61 Lemon Grove 15 691.56 27 626.89 27 562.15 5 131.93 La Mesa 33 991.29 43 467.29 30 274.65 47 597.20 El Cajon 69 821.04 75 394.76 73 368.30 42 296.07 Santee 26 618.75 34 399.81 40 395.69 33 404.46 Lakeside 30 740.92 36 433.68 35 371.04 27 353.77 Harbison Crest 14 1315.79 24 1214.57 19 764.90 17 700.74 Alpine 11 1196.95 17 960.99 9 429.18 12 592.30 Ramona 20 747.10 20 420.61 28 523.95 18 373.68 N. County West MSA 238 677.60 241 429.28 190 318.79 137 298.46 San Dieguito 40 733.68 48 382.84 40 250.33 34 237.58 Carlsbad 53 909.09 51 391.16 57 338.50 39 264.91 Oceanside 110 1103.75 127 567.70 89 365.80 59 357.08 Pendleton 35 252.23 15 183.08 4 * 5 1440.92 N. County East MSA 285 1128.85 366 675.09 348 605.12 243 563.13 Escondido 91 929.33 145 687.04 132 579.23 108 627.58 San Marcos 57 1291.64 76 775.11 77 753.72 47 640.41 Vista 75 1248.75 96 710.58 80 545.37 44 428.52 Valley Center 13 931.90 11 447.52 12 442.48 8 298.95 Pauma 5 974.66 10 1068.38 7 813.01 3 * Fallbrook 44 1406.65 28 437.43 40 638.77 33 664.12 East County MSA 26 1683.94 39 1376.15 27 826.45 30 963.08 Palomar-Julian 6 1398.60 5 662.25 4 * 4 * Laguna-Pine Valley 1 * 2 * 2 * 7 736.84 Mountain Empire 13 2574.26 23 2590.09 14 1508.62 10 1219.51 Anza-Borrego Springs 6 2955.67 9 2368.42 7 1750.00 9 2233.25 Out of County 1 --- 3 --- 1 --- 3 --- Unknown 59 --- 67 --- 57 --- 53 --- Total 1929 862.16 2451 555.44 2012 426.37 1453 404.97 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 *Rates not calculat ed for fewer than five incidents 18

Table 6a: Area by for Paramedic/EMT Responses: Motor Vehicle Occupant (Continued) 55-64 65-74 75-84 85+ Area Number Rate Number Rate Number Rate Number Rate Central MSA 126 313.64 104 339.18 63 297.11 19 208.11 Central San Diego 45 407.42 35 443.77 31 531.00 10 299.85 Peninsula 8 166.32 5 119.90 8 250.86 1 * Coronado 6 328.23 3 * 4 * 0 - National City 18 606.67 14 581.88 2 * 0 - Southeast San Diego 18 163.61 16 212.51 4 * 1 * Mid-City 31 363.76 31 456.49 14 281.86 7 356.78 North City MSA 196 311.47 118 243.52 96 325.71 21 219.44 Kearny Mesa 62 480.69 37 315.51 29 415.12 8 406.50 Coastal 31 410.49 19 275.60 20 406.67 4 * University 18 423.13 10 304.88 4 * 2 * Del Mar-Mira Mesa 32 251.57 18 253.81 6 186.22 4 * North San Diego 20 255.13 13 224.60 13 312.65 1 * Poway 15 168.90 7 114.87 10 264.69 0 - Miramar 4 * 2 * 2 * 0 - Elliott-Navajo 14 159.73 12 158.69 12 265.84 2 * South Suburban MSA 86 361.69 34 192.17 34 331.29 3 * Sweetwater 6 78.00 3 * 2 * 0 - Chula Vista 48 625.81 15 221.80 20 425.99 3 * South Bay 32 380.27 16 279.97 12 399.07 0 - East Suburban MSA 145 356.74 112 365.28 79 421.99 20 278.36 Jamul 8 531.56 9 877.19 1 * 1 * Spring Valley 16 233.47 8 165.22 4 * 2 * Lemon Grove 9 378.47 3 * 15 1202.89 1 * La Mesa 17 333.33 19 395.26 17 458.22 6 306.28 El Cajon 34 370.73 29 409.37 19 449.17 5 379.08 Santee 19 407.99 12 401.47 6 352.73 2 * Lakeside 14 287.65 14 388.57 7 340.30 2 * Harbison Crest 10 593.12 11 832.07 2 * 1 * Alpine 10 697.84 3 * 2 * 0 - Ramona 8 267.02 4 * 6 539.08 0 - N. County West MSA 75 269.90 68 311.58 61 406.37 20 343.41 San Dieguito 13 147.18 17 285.76 13 362.22 2 * Carlsbad 21 223.38 15 196.34 12 243.90 3 * Oceanside 41 434.46 35 429.82 36 555.30 14 449.01 Pendleton 0-1 * 0-1 * N. County East MSA 92 1943.66 79 330.50 73 388.38 23 275.22 Escondido 39 358.79 25 302.85 23 409.11 10 407.00 San Marcos 17 378.20 16 363.64 13 301.69 6 261.55 Vista 22 361.37 19 343.89 20 440.24 2 * Valley Center 4 * 3 * 2 * 0 - Pauma 2 * 0-1 * 0 - Fallbrook 8 223.21 16 480.62 14 564.52 5 498.50 East County MSA 11 478.68 3 * 2 * 4 * Palomar-Julian 1 * 0-2 * 1 * Laguna-Pine Valley 1 * 0-0 - 0 - Mountain Empire 6 993.38 2 * 0-2 * Anza-Borrego Springs 3 * 1 * 0-1 * Out of County 2 --- 0 --- 0 --- 0 --- Unknown 18 --- 18 --- 15 --- 4 --- Total 751 333.55 536 305.63 423 367.34 114 256.44 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 19

Table 6a: Area by for Paramedic/EMT Responses: Motor Vehicle Occupant (Continued) Group Unknown Total Area Number Number Rate Central MSA 13 2613 415.16 Central San Diego 4 973 587.55 Peninsula 1 133 207.69 Coronado 0 84 340.45 National City 1 324 586.90 Southeast San Diego 2 370 231.45 Mid-City 5 729 455.59 North City MSA 15 3104 441.07 Kearny Mesa 4 1032 671.67 Coastal 5 424 519.02 University 1 287 542.82 Del Mar-Mira Mesa 1 452 318.53 North San Diego 1 341 385.94 Poway 2 286 341.02 Miramar 1 48 811.36 Elliott-Navajo 0 234 245.04 South Suburban MSA 7 1020 325.63 Sweetwater 1 63 81.74 Chula Vista 4 553 514.97 South Bay 2 404 313.72 East Suburban MSA 6 2091 426.51 Jamul 1 127 952.10 Spring Valley 0 237 281.36 Lemon Grove 0 138 450.16 La Mesa 2 279 454.11 El Cajon 1 461 375.58 Santee 0 231 406.20 Lakeside 1 226 399.53 Harbison Crest 0 140 882.45 Alpine 0 101 727.77 Ramona 1 151 435.62 N. County West MSA 17 1345 357.11 San Dieguito 3 285 319.07 Carlsbad 2 312 317.80 Oceanside 8 662 440.29 Pendleton 4 86 221.74 N. County East MSA 21 2073 551.50 Escondido 16 801 556.39 San Marcos 1 393 578.71 Vista 1 492 529.63 Valley Center 1 92 456.39 Pauma 0 45 744.29 Fallbrook 2 250 556.62 East County MSA 0 179 802.04 Palomar-Julian 0 30 464.25 Laguna-Pine Valley 0 15 263.99 Mountain Empire 0 90 1401.87 Anza-Borrego Springs 0 44 1172.08 Out of County 0 13 --- Unknown 0 391 --- Total 79 12829 440.64 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 20

Table 6b: Area by Race/Ethnicity for Paramedic/EMT Responses: Motor Vehicle Occupant Race/Ethnicity White Black Hispanic Area Number Rate Number Rate Number Rate Central MSA 916 378.45 453 499.37 708 327.18 Central San Diego 440 614.90 148 902.16 235 334.24 Peninsula 93 180.71 10 356.76 13 179.53 Coronado 48 238.64 8 652.53 6 262.35 National City 50 515.94 24 595.53 145 457.83 Southeast San Diego 48 186.88 114 288.95 129 221.90 Mid-City 237 373.06 149 556.03 180 385.02 North City MSA 1810 353.01 191 894.87 442 606.52 Kearny Mesa 552 537.88 93 1387.44 165 696.35 Coastal 289 417.34 18 2120.14 56 618.72 University 162 403.32 11 1156.68 50 1220.70 Del Mar-Mira Mesa 228 260.62 21 488.03 79 607.18 North San Diego 202 315.21 13 591.99 31 395.26 Poway 208 299.41 9 708.66 33 511.31 Miramar 24 619.35 2 * 7 1174.50 Elliott-Navajo 145 191.36 24 566.57 21 258.33 South Suburban MSA 256 234.24 59 397.25 491 324.47 Sweetwater 22 60.17 4 * 17 65.52 Chula Vista 140 341.95 33 583.35 229 432.25 South Bay 94 295.77 22 324.96 245 338.40 East Suburban MSA 967 259.30 101 583.58 259 332.08 Jamul 62 579.11 3 * 32 1530.37 Spring Valley 113 201.20 32 540.45 43 267.08 Lemon Grove 63 379.75 26 695.37 30 381.44 La Mesa 179 364.80 15 702.58 23 302.19 El Cajon 191 206.10 12 292.61 48 224.41 Santee 108 230.44 2 * 17 236.77 Lakeside 76 158.58 4 * 15 234.27 Harbison Crest 56 410.50 5 6329.11 7 411.76 Alpine 54 452.98 2 * 23 1622.00 Ramona 65 237.46 0-21 336.70 N. County West MSA 632 254.21 72 329.56 242 287.33 San Dieguito 170 245.22 9 2216.75 54 329.99 Carlsbad 105 139.28 5 370.64 19 111.23 Oceanside 306 379.44 47 359.91 151 333.85 Pendleton 51 219.28 11 156.41 18 324.32 N. County East MSA 1036 438.26 61 849.46 542 469.81 Escondido 449 488.08 21 1275.05 248 568.46 San Marcos 214 505.35 11 1060.75 114 519.39 Vista 218 387.06 24 641.20 107 376.18 Valley Center 47 320.97 2 * 26 570.80 Pauma 18 994.48 0-10 330.58 Fallbrook 90 307.47 3 * 37 268.76 East County MSA 73 437.70 8 2614.38 37 880.95 Palomar-Julian 16 311.53 1 * 5 676.59 Laguna-Pine Valley 9 191.57 1 * 1 * Mountain Empire 35 833.13 6 4225.35 30 1809.41 Anza-Borrego Springs 13 491.87 0-1 * Out of County 2 --- 2 --- 5 --- Unknown 99 --- 9 --- 65 --- Total 5791 333.07 956 550.85 2791 386.36 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 21

Table 6b: Area by Race/Ethnicity for Paramedic/EMT Responses: Motor Vehicle Occupant (Continued) Race/Ethnicity Asian/Other Unknown Total Area Number Rate Number Number Rate Central MSA 409 509.68 127 2613 415.16 Central San Diego 121 1650.30 29 973 587.55 Peninsula 10 395.57 7 133 207.69 Coronado 19 1816.44 3 84 340.45 National City 51 519.72 54 324 586.90 Southeast San Diego 70 191.30 9 370 231.45 Mid-City 138 601.67 25 729 455.59 North City MSA 562 580.58 99 3104 441.07 Kearny Mesa 191 926.06 31 1032 671.67 Coastal 52 2043.22 9 424 519.02 University 54 705.14 10 287 542.82 Del Mar-Mira Mesa 112 301.85 12 452 318.53 North San Diego 85 597.20 10 341 385.94 Poway 22 329.79 14 286 341.02 Miramar 12 1970.44 3 48 811.36 Elliott-Navajo 34 462.33 10 234 245.04 South Suburban MSA 98 259.46 116 1020 325.63 Sweetwater 11 90.64 9 63 81.74 Chula Vista 56 717.30 95 553 514.97 South Bay 31 173.88 12 404 313.72 East Suburban MSA 172 780.93 592 2091 426.51 Jamul 11 2375.81 19 127 952.10 Spring Valley 32 528.84 17 237 281.36 Lemon Grove 15 609.26 4 138 450.16 La Mesa 31 1180.95 31 279 454.11 El Cajon 47 1026.20 163 461 375.58 Santee 12 527.01 92 231 406.20 Lakeside 11 615.56 120 226 399.53 Harbison Crest 5 1126.13 67 140 882.45 Alpine 6 1219.51 16 101 727.77 Ramona 2 * 63 151 435.62 N. County West MSA 94 428.27 305 1345 357.11 San Dieguito 25 774.71 27 285 319.07 Carlsbad 20 458.82 163 312 317.80 Oceanside 44 385.29 114 662 440.29 Pendleton 5 169.89 1 86 221.74 N. County East MSA 148 873.05 286 2073 551.50 Escondido 63 940.86 20 801 556.39 San Marcos 32 1241.75 22 393 578.71 Vista 24 547.20 119 492 529.63 Valley Center 6 667.41 11 92 456.39 Pauma 11 918.96 6 45 744.29 Fallbrook 12 1002.51 108 250 556.62 East County MSA 16 1410.93 45 179 802.04 Palomar-Julian 4 * 4 30 464.25 Laguna-Pine Valley 1 * 3 15 263.99 Mountain Empire 6 1431.98 13 90 1401.87 Anza-Borrego Springs 5 13513.51 25 44 1172.08 Out of County 0 --- 4 13 --- Unknown 18 --- 200 391 --- Total 1517 547.90 1774 12829 440.64 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, Prehospital Database, FY 1999/00 22

Table 7a: Area by for Severe Injury: Motor Vehicle Occupant 0-4 5-9 10-14 15-19 Area Number Rate Number Rate Number Rate Number Rate Central MSA 0-4 * 2 * 18 38.88 Central San Diego 0-1 * 0-8 82.58 Peninsula 0-0 - 0-0 - Coronado 0-0 - 0-0 - National City 0-3 * 1 * 3 * Southeast San Diego 0-0 - 1 * 2 * Mid-City 0-0 - 0-5 40.03 North City MSA 2 * 5 11.00 2 * 12 28.70 Kearny Mesa 1 * 3 * 1 * 1 * Coastal 0-0 - 0-6 206.68 University 0-0 - 0-2 * Del Mar-Mira Mesa 0-0 - 0-1 * North San Diego 1 * 1 * 0-0 - Poway 0-1 * 0-2 * Miramar 0-0 - 0-0 - Elliott-Navajo 0-0 - 1 * 0 - South Suburban MSA 2 * 1 * 1 * 9 40.83 Sweetwater 0-0 - 0-1 * Chula Vista 2 * 1 * 1 * 7 100.66 South Bay 0-0 - 0-1 * East Suburban MSA 3 * 7 18.76 5 13.87 11 34.58 Jamul 0-2 * 1 * 0 - Spring Valley 1 * 1 * 0-1 * Lemon Grove 0-0 - 2 * 1 * La Mesa 1 * 0-0 - 0 - El Cajon 0-1 * 1 * 0 - Santee 0-0 - 1 * 2 * Lakeside 0-0 - 0-2 * Harbison Crest 1 * 2 * 0-2 * Alpine 0-0 - 0-1 * Ramona 0-1 * 0-2 * N. County West MSA 0-1 * 1 * 11 43.61 San Dieguito 0-0 - 0-3 * Carlsbad 0-1 * 0-0 - Oceanside 0-0 - 1 * 6 59.48 Pendleton 0-0 - 0-2 * N. County East MSA 4 * 2 * 3 * 27 110.27 Escondido 0-0 - 1 * 10 104.83 San Marcos 0-0 - 0-1 * Vista 2 * 2 * 1 * 7 117.94 Valley Center 1 * 0-1 * 3 * Pauma 0-0 - 0-1 * Fallbrook 1 * 0-0 - 5 168.98 East County MSA 1 * 2 * 1 * 5 362.32 Palomar-Julian 0-0 - 1 * 1 * Laguna-Pine Valley 0-0 - 0-0 - Mountain Empire 1 * 2 * 0-0 - Anza-Borrego Springs 0-0 - 0-4 * Out of County 3 --- 6 --- 5 --- 7 --- Unknown 24 --- 24 --- 20 --- 98 --- Total 39 16.63 52 23.27 40 19.55 198 102.56 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 23

Table 7a: Area by for Severe Injury: Motor Vehicle Occupant (Continued) 20-24 25-34 35-44 45-54 Area Number Rate Number Rate Number Rate Number Rate Central MSA 19 34.26 29 29.36 24 23.84 9 12.81 Central San Diego 5 38.09 11 41.33 10 32.98 2 * Peninsula 1 * 0-1 * 1 * Coronado 0-0 - 1 * 0 - National City 5 81.09 2 * 3 * 0 - Southeast San Diego 6 45.99 5 20.80 2 * 1 * Mid-City 2 * 11 43.33 7 28.05 5 31.69 North City MSA 21 42.30 27 24.57 13 10.61 10 10.45 Kearny Mesa 5 48.16 5 20.98 2 * 4 * Coastal 4 * 10 67.18 4 * 1 * University 2 * 2 * 1 * 1 * Del Mar-Mira Mesa 4 * 3 * 2 * 2 * North San Diego 0-1 * 1 * 0 - Poway 3 * 3 * 2 * 2 * Miramar 0-0 - 1 * 0 - Elliott-Navajo 3 * 3 * 0-0 - South Suburban MSA 11 47.97 13 27.22 6 12.65 10 27.52 Sweetwater 3 * 2 * 0-1 * Chula Vista 4 * 6 37.58 2 * 7 60.66 South Bay 4 * 5 23.98 4 * 2 * East Suburban MSA 10 29.59 20 27.90 21 25.95 16 24.88 Jamul 0-2 * 2 * 1 * Spring Valley 0-1 * 3 * 3 * Lemon Grove 0-2 * 0-1 * La Mesa 2 * 2 * 0-2 * El Cajon 2 * 2 * 5 25.23 2 * Santee 1 * 0-2 * 1 * Lakeside 2 * 2 * 3 * 0 - Harbison Crest 0-3 * 2 * 1 * Alpine 0-3 * 0-1 * Ramona 3 * 3 * 4 * 4 * N. County West MSA 18 51.25 13 23.16 10 16.78 14 30.50 San Dieguito 1 * 3 * 3 * 3 * Carlsbad 4 * 2 * 0-6 40.76 Oceanside 9 90.31 7 31.29 7 28.77 5 30.26 Pendleton 4 * 1 * 0-0 - N. County East MSA 24 95.06 29 53.49 20 34.78 19 44.03 Escondido 9 91.91 10 47.38 4 * 7 40.68 San Marcos 2 * 5 50.99 2 * 5 68.13 Vista 3 * 4 * 6 40.90 1 * Valley Center 3 * 4 * 1 * 3 * Pauma 2 * 2 * 3 * 0 - Fallbrook 5 159.85 4 * 4 * 3 * East County MSA 3 * 5 176.43 3 * 5 160.51 Palomar-Julian 1 * 1 * 0-0 - Laguna-Pine Valley 0-0 - 0-0 - Mountain Empire 2 * 3 * 2 * 3 * Anza-Borrego Springs 0-1 * 1 * 2 * Out of County 9 --- 8 --- 6 --- 10 --- Unknown 139 --- 161 --- 126 --- 85 --- Total 254 113.52 305 69.12 229 48.53 178 49.61 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 24

Table 7a: Area by for Severe Injury: Motor Vehicle Occupant (Continued) 55-64 65-74 75-84 85+ Area Number Rate Number Rate Number Rate Number Rate Central MSA 13 32.36 8 26.09 11 51.88 3 * Central San Diego 6 54.32 3 * 3 * 1 * Peninsula 0-0 - 4 * 0 - Coronado 0-1 * 0-0 - National City 3 * 1 * 0-0 - Southeast San Diego 0-0 - 1 * 0 - Mid-City 4 * 3 * 3 * 2 * North City MSA 9 14.30 7 14.45 8 27.14 3 * Kearny Mesa 3 * 2 * 1 * 0 - Coastal 1 * 1 * 3 * 0 - University 1 * 0-0 - 0 - Del Mar-Mira Mesa 1 * 0-0 - 0 - North San Diego 1 * 2 * 1 * 0 - Poway 1 * 2 * 2 * 0 - Miramar 0-0 - 0-0 - Elliott-Navajo 1 * 0-1 * 3 * South Suburban MSA 6 25.23 5 28.26 3 * 0 - Sweetwater 0-1 * 0-0 - Chula Vista 6 78.23 3 * 3 * 0 - South Bay 0-1 * 0-0 - East Suburban MSA 6 14.76 11 35.88 8 42.73 2 * Jamul 0-1 * 1 * 0 - Spring Valley 0-1 * 0-0 - Lemon Grove 0-1 * 3 * 0 - La Mesa 1 * 1 * 1 * 0 - El Cajon 1 * 3 * 1 * 0 - Santee 0-0 - 1 * 0 - Lakeside 0-4 * 1 * 1 * Harbison Crest 0-0 - 0-0 - Alpine 0-0 - 0-0 - Ramona 4 * 0-0 - 1 * N. County West MSA 3 * 4 * 3 * 4 * San Dieguito 0-2 * 0-0 - Carlsbad 1 * 1 * 2 * 0 - Oceanside 2 * 1 * 1 * 3 * Pendleton 0-0 0.00 0-1 * N. County East MSA 5 18.15 15 62.75 6 31.92 5 59.83 Escondido 3 * 7 84.80 2 * 1 * San Marcos 0-3 * 0-1 * Vista 1 * 2 * 2 * 0 - Valley Center 1 * 0-0 - 0 - Pauma 0-0 - 0-0 - Fallbrook 0-3 * 2 * 3 * East County MSA 2 * 2 * 0-0 - Palomar-Julian 0-0 - 0-0 - Laguna-Pine Valley 1 * 1 * 0-0 - Mountain Empire 0-0 - 0-0 - Anza-Borrego Springs 1 * 1 * 0-0 - Out of County 3 --- 2 --- 1 --- 0 --- Unknown 55 --- 40 --- 36 --- 12 --- Total 102 45.30 94 53.60 76 66.00 29 65.24 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 25

Table 7a: Area by for Severe Injury: Motor Vehicle Occupant (Continued) Unknown Total Area Number Number Rate Central MSA 0 140 22.24 Central San Diego 0 50 30.19 Peninsula 0 7 10.93 Coronado 0 2 * National City 0 21 38.04 Southeast San Diego 0 18 11.26 Mid-City 0 42 26.25 North City MSA 1 120 17.05 Kearny Mesa 1 29 18.87 Coastal 0 30 36.72 University 0 9 17.02 Del Mar-Mira Mesa 0 13 9.16 North San Diego 0 8 9.05 Poway 0 18 21.46 Miramar 0 1 * Elliott-Navajo 0 12 12.57 South Suburban MSA 0 67 21.39 Sweetwater 0 8 10.38 Chula Vista 0 42 39.11 South Bay 0 17 13.20 East Suburban MSA 0 120 24.48 Jamul 0 10 74.97 Spring Valley 0 11 13.06 Lemon Grove 0 10 32.62 La Mesa 0 10 16.28 El Cajon 0 18 14.66 Santee 0 8 14.07 Lakeside 0 15 26.52 Harbison Crest 0 11 69.34 Alpine 0 5 36.03 Ramona 0 22 63.47 N. County West MSA 1 83 22.04 San Dieguito 0 15 16.79 Carlsbad 0 17 17.32 Oceanside 1 43 28.60 Pendleton 0 8 20.63 N. County East MSA 0 159 42.30 Escondido 0 54 37.51 San Marcos 0 19 27.98 Vista 0 31 33.37 Valley Center 0 17 84.33 Pauma 0 8 132.32 Fallbrook 0 30 66.79 East County MSA 0 29 129.94 Palomar-Julian 0 4 * Laguna-Pine Valley 0 2 * Mountain Empire 0 13 202.49 Anza-Borrego Springs 0 10 266.38 Out of County 0 60 --- Unknown 0 820 --- Total 2 1598 54.89 Source: County of San Diego, Health and Human Services Agency, Division of Emergency Medical Services, San Diego Trauma Registry, FY 1999/00 26