It turns out that the number of people who decide to take their all-terrain vehicles into places those vehicles were perhaps not designed to go correlates almost perfectly with the number of those same people who subsequently show up in emergency rooms wondering where it all went wrong, and this correlation is so tight (0.904, if you're keeping score) that you'd think ATV manufacturers had simply optimized their machines for maximum hospital admissions. One begins to suspect the universe has a sense of irony, though a fairly unsubtle one.
The most likely explanation is boring in the way that true explanations usually are: more ATVs exist now than in 2002, more people use them, and therefore both deaths and injuries have simply scaled upward together like a grim bicycle built for two. The period 2002-2021 also encompassed rising recreational spending and expanding ATV trail networks, plus seasonal clustering—summer months see more off-roading and more ER visits—so weather and calendar are doing most of the heavy lifting. To give this some physical weight: ATV registrations roughly tripled over this period, which means what you're really looking at is the difference between several thousand people doing dangerous things versus several hundred doing the same dangerous things.
The correlation tells us that ATVs don't mysteriously become more lethal as more people buy them, nor do hospitals suddenly decide to admit more corpses on a whim. Instead, we've simply found that when you multiply the number of humans operating motorized vehicles in uncontrolled environments, both the ambulances and the hearses fill up proportionally. Which is less a discovery about ATVs and more a discovery about ourselves. We contain multitudes, mostly in the trauma ward.
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Want to learn more about why correlations like “ATV off-highway vehicle deaths” vs “ATV ER injuries” don't prove causation? Read our guide to statistical thinking.