scales exist for use with trauma to determine the severity of injuries, which are used to determine the resources used and, for statistical collection. History The human remains discovered at the site of Nataruk in Turkana, Kenya, are claimed to show major trauma—both blunt and penetrating—caused by violent trauma to the head, neck, ribs, knees, and hands, which has been interpreted by some researchers as establishing the existence of warfare between two groups of hunter-gatherers 10,000 years ago. The evidence for blunt-force trauma at Nataruk has been challenged, however, and the interpretation that the site represents an early example of warfare has been questioned. Society and culture Economics The financial cost of trauma includes both the amount of money spent on treatment and the loss of potential economic gain through absence from work. The average financial cost for the treatment of traumatic injury in the United States is approximately per person, making it costlier than the treatment of cancer and cardiovascular diseases. One reason for the high cost of the treatment for trauma is the increased possibility of complications, which leads to the need for more interventions. Maintaining a trauma center is costly because they are open continuously and maintain a state of readiness to receive patients, even if there are none. In addition to the direct costs of the treatment, there also is a burden on the economy due to lost wages and productivity, which in 2009, accounted for approximately in the United States. Low- and middle-income countries Citizens of low- and middle-income countries (LMICs) often have higher mortality rates from injury. These countries accounted for 89% of all deaths from injury worldwide. Many of these countries do not have access to sufficient surgical care and many do not have a trauma system in place. In addition, most LMICs do not have a pre-hospital care system that treats injured persons initially and transports them to hospital quickly, resulting in most casualty patients being transported by private vehicles. Also, their hospitals lack the appropriate equipment, organizational resources, or trained staff. By 2020, the amount of trauma-related deaths is expected to decline in high-income countries, while in low- to middle-income countries it is expected to increase. Special populations Children Due to anatomical and physiological differences, injuries in children need to be approached differently from those in adults. Accidents are the leading cause of death in children between 1 and 14 years