BY JANET S. COULTER, MSN, MS, RN, CCM, FCM
According to the Centers for Disease Control and Prevention (CDC), unintentional injury is the third leading cause of death and disability for males in the United States, particularly those between the ages of 1 and 44 (CDC, 2023). In 2021 alone, nearly 130,000 people died from unintentional injuries, and over 70% of them were male (CDC, 2023). It cuts across socioeconomic, racial and age boundaries. These injuries include motor vehicle accidents, falls, drowning, poisoning (including drug overdoses) and workplace accidents. While injuries may seem like a random event, the truth is that many unintentional injuries are preventable. Unintentional injuries are often dismissed as chance occurrences or unlucky accidents with unpredictable outcomes. But a closer look at the data reveals a different narrative where men across every age and demographic group are disproportionately affected. For men, they are part of a troubling and persistent trend that claims lives, compromises health and affects families and communities. Men are disproportionately affected compared to women, often due to greater risk-taking behaviors, occupational exposures and cultural expectations that reinforce stoicism and reluctance to seek help or acknowledge vulnerability. For case managers, the challenges and the opportunities are to recognize that this crisis is preventable.
Motor vehicle accidents continue to be one of the most significant contributors to unintentional injury-related deaths among men. The National Highway Traffic Safety Administration (NHTSA) reports that men are more likely than women to be involved in fatal car crashes. They are more likely to speed, drive under the influence and engage in reckless driving behavior. Young adult males aged 16 to 24 are at the highest risk. They represent a group with both the highest rates of motor vehicle fatalities and the lowest rates of seat belt use (NHTSA, 2022). These factors are not just behavioral. They are cultural. Masculine ideals often equate caution with weakness and reinforce invincibility, particularly in young adulthood. For case managers, this means that conversations around injury prevention must go beyond safety statistics and address cultural attitudes, peer influence and behavioral health support. In addition, addressing post-injury recovery, advocating for safe driving education, monitoring medications that may impair driving ability and collaborating with families and support systems to promote behavior change are key case management interventions.
Falls represent another significant area of concern, particularly among older men. While both older men and women are at risk for falls, men are more likely to die from fall-related injuries. This is partly due to the higher likelihood of delayed treatment among men and the presence of untreated or underdiagnosed conditions like osteoporosis. Unlike women, men are seldom screened for bone density or fall risk factors, and few see preventive care as a priority. Case managers working with older men must prioritize fall risk assessments. In long-term care, hospital and home health settings case managers have an essential role in home safety evaluations, care planning, and coordination of rehabilitation services. Simple interventions like medication reviews, strength training and vision checks can drastically reduce fall risk.
The opioid crisis has added a devastating new layer to the picture of unintentional injuries in men. Drug overdose deaths have increased dramatically, particularly among men between the ages of 25 and 54. In fact, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), men are more than twice as likely to die from overdose as women (SAMHSA, 2023). Many of these overdoses stem from prescription drug misuse following injury or surgery, underscoring the importance of responsible prescribing and comprehensive pain management plans. Others are tied to mental health issues such as depression and post-traumatic stress disorder. These are conditions that are often unrecognized or untreated in men. Unfortunately, stigma around mental health and addiction can prevent men from seeking help. Case managers can play a critical role in identifying at-risk individuals and intervening by ensuring access to behavioral healthcare, facilitating referrals to substance use treatment, coordinating medication reconciliation and engaging patients and families in open conversations about addiction and recovery.
The workplace is another high-risk environment where men endure the most unintentional injuries. The U.S. Bureau of Labor Statistics (BLS) reported that in 2022, men accounted for over 90% of all fatal occupational injuries (BLS, 2023). This is in part because men disproportionately work in high-risk sectors such as construction, agriculture, manufacturing and transportation. These injuries range from falls from heights to exposure to hazardous materials, machinery accidents and transportation-related incidents. Even with improved safety regulations and employer education, fatal and non-fatal injuries persist. Education and advocacy around workplace safety protocols, proper use of personal protective equipment and routine safety training can reduce injury rates. It is essential for case managers in occupational health or workers’ compensation settings to coordinate timely and appropriate medical care, facilitate communication between the injured worker, employer, and insurer and support return-to-work efforts that prioritize safety and long-term recovery. Case managers are the bridge between the injured worker, the employer, medical providers and insurers. They must balance cost management with advocacy for the injured worker’s full recovery including physical, emotional and financial concerns.
From a public health perspective, prevention remains the most powerful tool in reducing unintentional injuries among men. Case managers can support community-based prevention programs, collaborate with schools and employers on injury prevention initiatives and serve as educators within their spheres of influence. For example, teaching young men about safe driving practices, promoting mental health awareness and suicide prevention or supporting firearm safety programs can all have long-term, life-saving impacts. Technology also offers innovative tools for injury prevention and management. Case managers can evaluate and recommend such technologies as part of a comprehensive care plan. Wearable devices that monitor vital signs, detect falls or track medication adherence can enhance patient safety and independence, especially for older adults or those recovering from injury. Digital health apps that support medication adherence or provide mental health check-ins can bridge the gap between appointments. Telehealth can overcome transportation and scheduling barriers. Importantly, case managers must evaluate these tools not just for functionality, but for accessibility and acceptance among male patients.
Unintentional injuries in men are not just a clinical or public health issue. They are deeply personal. These injuries affect daily living, employment, relationships and long-term well-being. They disrupt lives. Unintentional injuries in men are not random. They follow patterns. They are shaped by culture as much as biology. Behind every injury is a man with a story. It is usually a story that involves risk, resilience and recovery. Beyond the statistics lies the human cost of unintentional injuries. Lost productivity, emotional trauma, financial hardship and long-term disability can result. These outcomes not only affect the injured men themselves but ripple across families, workplaces and communities. For example, a 32-year-old father who sustains a traumatic brain injury in a motorcycle crash may face a lifetime of cognitive and functional impairments that prevent him from returning to work or parenting as he once did. A 55-year-old male construction worker who falls from a roof on a job site may lose not only his mobility, but his sense of identity as a provider. He may also face chronic pain, depression and social isolation. These are the real-life scenarios that professional case managers encounter. Managing their care requires empathy, resource coordination, patient advocacy and creativity in developing solutions tailored to individual needs. For these individuals, recovery goes far beyond the hospital stay. It involves complex discharge planning, home adaptations, vocational rehabilitation, mental health counseling and, often, navigating systems that are ill-equipped to meet their needs. This is where case managers shine. Our work does not stop at triage or referral. It extends through the entire care continuum fostering continuity, safety, autonomy and quality of life. As case managers, we have the opportunity to be part of their story in meaningful ways.
Another unique challenge for case managers is building trust and addressing underlying attitudes about masculinity and health. One of the greatest barriers case managers face is engagement. Men are less likely than women to seek medical care, attend follow-up appointments or adhere to treatment recommendations. Men are also less likely to have strong social support networks, particularly if they are older, live alone or are estranged from family. For case managers, fostering trust and rapport is essential. This may mean adjusting communication styles, offering male-specific resources, involving peer support programs or working with employers to provide education tailored to male workers. It may mean listening more deeply to how men express fear, shame or grief. These are emotions they are often conditioned to hide. Motivational interviewing, culturally competent communication and family involvement can be helpful strategies to improve engagement and outcomes.
The good news is that unintentional injuries are largely preventable. Case managers are uniquely positioned to recognize risk factors, implement interventions and advocate for systemic changes. By taking a proactive approach, case managers can not only support recovery after injury but also contribute to a culture of prevention and resilience. Case managers can lead and support public health strategies aimed at reducing risk. This includes advocating for helmet use, fall prevention programs, safe driving campaigns, overdose education and safety training. In community health settings, they can help design outreach programs that resonate with male populations. In acute care, they can collaborate across disciplines to ensure comprehensive discharge planning. In every setting, case managers can elevate the conversation around injury prevention and recovery by including gender as a critical factor.
Unintentional injuries among men are not simply accidents. They are often the result of modifiable risk factors and systemic gaps in prevention, education and access to care. For professional case managers, understanding the patterns, root causes and outcomes associated with these injuries is critical to implementing effective interventions, promoting prevention strategies and supporting comprehensive recovery plans for affected individuals. It requires a multi-pronged approach that includes individualized care coordination, population-level prevention strategies and continuous advocacy for safer environments. By advocating for prevention, facilitating timely and appropriate care and addressing the broader social and behavioral contexts that contribute to male injury, we can change outcomes. When it comes to unintentional injuries in men, the crisis is real. But so is the opportunity to change the narrative.
Bringing awareness, advocacy and intervention to the overlooked issue of male unintentional injuries.
REFERENCES
Bureau of Labor Statistics. (2023). Census of Fatal Occupational Injuries Summary, 2022. U.S. Department of Labor. https://www.bls.gov/news.release/cfoi.nr0.htm
Centers for Disease Control and Prevention. (2023). Web-based Injury Statistics Query and Reporting System (WISQARS). https://www.cdc.gov/injury/wisqars
National Highway Traffic Safety Administration. (2022). Traffic Safety Facts Annual Report. https://rosap.ntl.bts.gov/view/dot/80056
Substance Abuse and Mental Health Services Administration. (2023). National Survey on Drug Use and Health. https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health
Janet S. Coulter, MSN, MS, RN, CCM, FCM, is the President of the Case Management Society of America (CMSA). She is a board-certified transplant case manager with extensive experience including nursing education, administration, team leadership, and case management.
Janet holds a Master of Science in Nursing from West Virginia University and a Master of Science in Adult Education from Marshall University. Her contributions to the field have been recognized with the CMSA National Award of Service Excellence and the Southern Ohio Valley CMSA Case Management Leadership Award. In 2022, she was honored as a Fellow of Case Management (FCM).
An active and dedicated member of CMSA at both the national and local levels, Janet continues to serve the Southern Ohio Valley Chapter, where she recently completed her fifth term as president. She has been a frequent presenter at CMSA Annual Conferences, delivering concurrent sessions and poster presentations on key topics in case management.
Janet is also a passionate writer and has contributed extensively to industry publications, including CMSA Today, CareManagement, and the Professional Case Management Journal. Her thought leadership extends to the CMSA blog, where several of her articles have ranked among the top five most-read blogs in 2022.
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