What kills us in Connecticut? You might be surprised by number four.

For some of us in Connecticut, falls can be deadly.

But whether they’re babies suffocating in bed with their parents, young people dying in car crashes or elderly people falling and suffering a brain bleed, people are dying in accidents or accidental ways in Connecticut.

In fact, accidents are the fourth leading cause of death in the state, according to the Centers for Disease Control and Prevention, following heart disease, cancer and COVID-19.

Dr. Manisha Juthani, commissioner of the state Department of Public Health said accidental deaths “generally relate to falls, motor vehicle traffic deaths and poisoning. Those are sort of the big categories. And poisoning, I’m thinking, is largely opioid overdoses.” 

She added that “in the less-than-1-year age group, unintentional suffocation is the predominant cause across the board,” while motor vehicle crashes are No. 1 for those 10 to 64. Then, for those over 65, falls are the leading cause.

Part of the reason so many deaths are caused by accidents in Connecticut may be that it is one of the states with the oldest population.

“This is a state where … by 2030 they’re expecting people 65 and older to be at least 30% of every town,” said Dr. Sowmya Kurtakoti, chief of geriatrics at Hartford Hospital.

She said 37% of people who fall have an injury, and in 2021 there were 460 deaths caused by a fall in Connecticut.

As people live longer, they have more health concerns, such as cardiac issues, “which makes these kinds of falls just that much more fatal,” Kurtakoti said. “So they end up with head injuries, internal bleeding, things like that, that can actually cause them to have a fatal death versus in the past.”

Another concern is chronic health issues, such as diabetes and high blood pressure, which cause “trouble with gait and balance, their ability to walk, and that itself results in falls,” especially in the snow and icy conditions of Connecticut’s winters, she said.

“One of the key things that should happen is I think primary care should be at the forefront to make sure that they’re screening people for falls,” Kurtakoti said. “I think some health systems do better than others in screening people and the screening needs to start not just once a year, because so much happens within a year.”

She said those who are at high risk for falls should be referred to physical therapy programs and community exercise programs “to help maintain their ability to maintain their balance and their gait,” she said.

Vision and hearing problems, such as trouble dealing with bifocals or having tinnitus, can also affect balance, Kurtakoti said. 

“Also, if they’re not able to maintain their balance and gait, they need to be provided with the right kind of walker or cane or support,” she said.

Tai chi for balance

One of those community programs is Tai Ji Quan at the Windsor Senior Center. Roy Duff, 78, is taking the class for the second time.

“I take several medications … and several of them affect my balance,” he said. “So when I took this program last season, I noticed an improvement. And I’m taking it again this season and I noticed a significant improvement.”

“And one of the things that I do now that I didn’t do before I took this program was walk, point my feet straight ahead instead of splayed out and walk, lift my feet and walk heel-ball-toe,” Duff said. “If I do that now, I don’t have to grab onto anything if I get up in the middle of the night to visit the restroom.”

He said it’s helping with his golf stance too.

Since she’s taken the class, Ann Dillon, 81, said, “I am steady on my feet. I can walk without wobbling. Anything that requires balance, I can do so much better. This class has been fantastic for me.”

Mary DiPace said it’s helped her with her balance as well. “Even if you have a cane or something to help you with walking, you can take this course because you can sit when you’re doing it, but you would have to do it long term to see real results,” she said.

Kurtakoti said it’s wise to have a geriatrician do a home evaluation to find the lurking dangers.

“They have a rug there that could put them at a higher risk for falls,” she said. “Do they have a very dim light at night? That can put them at a higher risk for falls. How far is it just going from the room to the bathroom?”

Accidents No. 1 for children

“For children, accidents or unintentional deaths is the leading cause of death,” said Dr. Jody Terranova, deputy commissioner of the state health department.  

For infants, “co-sleeping and … accidentally suffocating” is the No. 1 cause, she said. A baby might be “on the couch with the mom or dad and got squished or wedged and then suffocated,” she said.

Dr. Kirsten Bechtel, a pediatrician at Yale New Haven Children’s Hospital, said the number of deaths caused by suffocation is a stubborn problem.

“We’ve not really made any dent in the numbers despite pediatricians providing this anticipatory guidance to parents and caregivers,” she said. “So many times, parents don’t adhere to this advice because they’re so desperate to get sleep and they feel that their baby sleeps better with them in the bed.

“And then, unfortunately, in rare cases, they wake up to a tragedy where the baby is not breathing or unresponsive and then is later declared dead,” Bechtel said.

In the 1990s, she said, there was a big push to encourage parents to have their baby sleep on its back, not on its stomach and “we made a big dent in sleep-related deaths. But over the past 10 years, here in Connecticut and nationally, all those numbers have stagnated.”

“In Connecticut, every year we lose about 25 children or a future kindergarten class every year because of sleep-related deaths,” Bechtel said. “So it’s the leading cause of preventable deaths in infants.”

Older children die from motor vehicle crashes and poisonings. “We’ve seen also an increase in the number of children that have been unintentionally exposed to fentanyl and have passed away from that in our state,” Terranova said. That can happen if a teenager is experimenting with heroin that is laced with fentanyl. Drownings are another cause.

Accidental gun deaths increase

“We have seen, as the kids get older, the 5 to 10 and then the teenagers, that deaths from gun violence is actually one of the leading causes of accidental death in that age group of children,” Terranova said.

“A number of years ago (that) wasn’t really on the list as one of the top causes of accidental deaths, and that’s become another epidemic that we have seen,” she said.

Kevin Borrup, executive director of the Injury Prevention Center at Connecticut Children’s Medical Center, said overall there are not many deaths from injuries among children.

“If you are 14 and under, the numbers are very small of injury-based deaths,” he said. “It’s kids under 1 where the numbers are a little bit higher and a lot of those numbers are these unexplained or sleep-related deaths.”

He said the numbers start to rise at about 10 “and then at 15 to 24 is where you really see these numbers go up around unintentional injury, suicide and homicide. So luckily, for the state of Connecticut, we’re relatively safe.”

Prevention programs

Borrup said the Injury Prevention Center has several programs, including Safe Kids Connecticut, which “works throughout the state on child passenger safety issues, making sure our folks understand the need to keep children appropriately restrained.”

Another, Watch for Me CT, “is a pedestrian and bicycle safety campaign that works to educate folks around how to be safe on our roads, both drivers and pedestrians and cyclists,” Borrup said.

“We know that in many of our urban centers, there is a big issue with violence and firearm violence,” he said.

“So we also engage in programs like our hospital-based violence-intervention program, where we work with both Hartford Hospital, Trinity Health in the city of Hartford and Compass Youth Collaborative …,” Borrup said. “Mothers United Against Violence, to intervene with folks who are at risk or we’ve been shot, work to ensure that they’re not in danger again.”   

Ed Stannard can be reached at estannard@courant.com.