The Application of Time Series Analysis to Injury Epidemiology Data

Abstract

Introduction: Injury fatality rates in the United States (US) decreased throughout the majority of the 20th century, mostly due to declining rates of occupational and motor vehicle injuries. However, near the beginning of the 21st century, fatal injury rates in the US began to increase. This is principally due to the nation’s opioid epidemic, which has been characterized by different epidemic “waves”, each driven by overdoses associated with specific substances. Given the temporally dynamic nature of US injury trends, this study aimed to explore the application of time series analysis to injury data in the US. First, rates of non-fatal occupational injuries treated in US emergency departments were assessed to determine if non-fatal occupational injury rates mirror the historic decline of fatal occupational injuries in the 20th and 21st centuries. Next, we explored the temporal shift from prescription to illicit opioid overdose deaths in West Virginia (WV) to elucidate the transition between the opioid epidemic’s first and second waves in the state with the highest fatality rates in the nation. Finally, we compared the forecasting performance of three time series models when applied to national US opioid overdose data to explore what time series approaches best predict future rates of overdose.