Review of US mortality data from 1979 to 1986 identified 315,328 deaths associated with head injury, which represented 2% of all deaths, 26% of injury deaths, and an annualized head injury-associated death rate of 16.9 per 100,000 residents. Motor vehicles (57%), firearms (14%), and falls (12%) were the most frequent causes. Death rates peaked at 15 to 24 years of age and at 75 years or older, with the younger group most affected by motor vehicles (77%) and the older group by falls (43%). Although blacks and whites had similar death rates overall, age- and cause-specific rates varied considerably. The rate of head injury-associated death for males was three times that of females. Rates for head injury-associated death plateaued after declining in the early 1980s. Physicians can play an important role in primary prevention of head injury through careful prescribing of medications, patient counseling, and advocacy of proved interventions such as motor vehicle-occupant restraints. use, we observed 9827 children riding bicycles at sites in high-, middle-, and