Surveillance for Violent Deaths — National Violent Death Reporting System, 16 States, 2009

Surveillance Summaries

September 14, 2012 / 61(ss06);1-43

Debra L. Karch, PhD

Joseph Logan, PhD

Dawn McDaniel, PhD

Sharyn Parks, PhD

Nimesh Patel, MS

Division of Violence Prevention, National Center for Injury Prevention and Control, CDC

Corresponding author: Joseph Logan, PhD, Division of Violence Prevention, National Center for Injury Prevention and Control, CDC, 4770 Buford Hwy, N.E., MS F-64, Atlanta, GA 30341-3724. Telephone: 770-488-1529; Fax: 770-488-4222; E-mail: jlogan@cdc.gov.

Abstract

Problem/Condition: An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2009. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics.
Reporting Period Covered: 2009.
Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS data collection began in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four (California, Kentucky, New Mexico, and Utah) in 2005, and two (Ohio and Michigan) in 2010, for a total of 19 states. This report includes data from 16 states that collected statewide data in 2009. California is excluded because data were collected in only four counties. Ohio and Michigan are excluded because data collection did not begin until 2010.
Results: For 2009, a total of 15,981 fatal incidents involving 16,418 deaths were captured by NVDRS in the 16 states included in this report. The majority (60.6%) of deaths were suicides, followed by homicides and deaths involving legal intervention (i.e., deaths caused by police and other persons with legal authority to use deadly force, excluding legal executions) (24.7%), deaths of undetermined intent (14.2%), and unintentional firearm deaths (0.5%). Suicides occurred at higher rates among males, non-Hispanic whites, American Indians/Alaska Natives, and persons aged 45–54 years. Suicides occurred most often in a house or apartment and involved the use of firearms. Suicides were preceded primarily by mental health, intimate partner, or physical health problems or by a crisis during the previous 2 weeks. Homicides occurred at higher rates among males and persons aged 20–24 years; rates were highest among non-Hispanic black males. The majority of homicides involved the use of a firearm and occurred in a house or apartment or on a street/highway. Homicides were preceded primarily by arguments and interpersonal conflicts or in conjunction with another crime. Characteristics associated with other manners of death, circumstances preceding death, and special populations also are highlighted in this report.
Interpretation: This report provides a detailed summary of data from NVDRS for 2009. The results indicate that violent deaths resulting from self-inflicted or interpersonal violence disproportionately affected adults aged <55 additional="additional" among="among" and="and" are="are" as="as" be="be" because="because" certain="certain" conflicts="conflicts" crises="crises" data="data" ethnic="ethnic" factors="factors" fatal="fatal" findings="findings" for="for" have="have" health="health" homicides="homicides" in="in" information="information" injuries.="injuries." interpersonal="interpersonal" males="males" mental="mental" might="might" minority="minority" p="p" participating="participating" populations.="populations." precipitated="precipitated" preliminary.="preliminary." primary="primary" problems="problems" provided="provided" racial="racial" recent="recent" relationship="relationship" report="report" reported="reported" states="states" subsequently="subsequently" suicides="suicides" that="that" the="the" their="their" this="this" update="update" were="were" years="years"> Public Health Action: For the occurrence of violent deaths in the United States to be better understood and ultimately prevented, accurate, timely, and comprehensive surveillance data are necessary. NVDRS data can be used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Additional efforts are needed to increase the number of states participating in NVDRS, with an ultimate goal of full national representation.

Introduction

An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. Homicide is the second leading cause of death for persons aged 15–24 years, the third leading cause for persons aged 1–4 and 25–34 years, and the fourth leading cause for persons aged 5–9 and 10–14 years. Suicide is the second leading cause of death for persons aged 25–34 years, the third leading cause for persons aged 10–14 years and 15–24 years, and the fourth leading cause for persons aged 35–44 and 45–54 years. Only unintentional injury in those aged 1–44 years and malignant neoplasms and congenital anomalies in children aged 1–14 years of age were more common (1).
Public health authorities require accurate, timely, and comprehensive surveillance data to better understand and ultimately prevent the occurrence of violent deaths in the United States (2). In 2000, CDC started planning to implement the National Violent Death Reporting System (NVDRS) (3,4). The goals of this system are to:

collect and analyze timely, high-quality data that monitor the magnitude and characteristics of violent death at the national, state, and local levels;
ensure that data are disseminated routinely and expeditiously to public health officials, law enforcement officials, policy makers, and the public;
ensure that data are used to develop, implement, and evaluate programs and strategies that are intended to reduce and prevent violent deaths and injuries at the national, state, and local levels; and
build and strengthen partnerships among organizations and communities at the national, state, and local levels to ensure that data are collected and used to reduce and prevent violent deaths and injuries.

NVDRS was conceived as a state-based active surveillance system that would collect risk-factor data concerning all violence-related deaths, including homicides, suicides, and legal intervention deaths (i.e., deaths caused by police and other persons with legal authority to use deadly force; excluding legal executions), as well as unintentional firearm deaths and deaths of undetermined intent. NVDRS data are used to assist the development, implementation, and evaluation of programs and strategies designed to reduce and prevent these deaths and injuries at the national, state, and local levels.
Before implementation of NVDRS, single data sources (e.g., death certificates or law enforcement data systems) provided only limited information and few circumstances from which to understand patterns of deaths collected by this system. NVDRS fills this gap in national surveillance; it is the first system to provide detailed information on circumstances precipitating violent deaths, the first to link multiple source documents to enable researchers to understand each death more completely, and the first to link multiple deaths that are related to one another (e.g., multiple homicides, suicide pacts, and cases of homicide followed by the suicide of the suspected perpetrator).
NVDRS began data collection in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004, four more (California, Kentucky, New Mexico, and Utah) in 2005; and two (Ohio and Michigan) in 2010 for a total of 19 states (Figure). CDC provides funding for state participation and anticipates that NVDRS will expand to include all 50 states, the District of Columbia, and U.S. territories.
This report summarizes data for 2009 for deaths meeting NVDRS inclusion criteria from 16 states that collected statewide data (approximately 26% of the U.S. population). California data are not included in this report because data were collected in only four counties. Ohio and Michigan were excluded because data collection did not begin until 2010. Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary. Annual updates of NVDRS data also are available through a web-based query system (WISQARS) at http://wisqars.cdc.gov:8080/nvdrs/nvdrsDisplay.jsp.