2010 Middle District PSN Training (09-30-10)
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Transcript of 2010 Middle District PSN Training (09-30-10)
North Carolina’s Violent Death Reporting System (NC-VDRS)
Middle District PSN Training Workshop
September 30, 2010
Agenda
• Background and history of NC-VDRS
• Key findings from NC-VDRS– Overall Violent Death– Suicide – Homicide
• Q&A
Violent Deaths in the US• 50,000 Americans died from violence in 2002
– 40,000 MVTA, 14,000 HIV
– Suicide (32,000) > Assaults (18,000)
• Homicide and suicide affect young persons
– Homicide 2nd leading cause of death – persons 15-24 years
– Suicide 2nd leading cause of death – persons 15-34 years
• Elderly have high suicide rates
• Violence greater impact on some populations groups
…But We Didn’t Know Enough…• What % of women killed in DV assaults had a
restraining order against the offender?
• How many drug-related homicides are there in the US each year?
• How often do multiple homicides occur?
• What % of youth suicide victims are intoxicated at the time they kill themselves?
• How many homicides involves the use of an assault weapon?
• What life crisis commonly precedes a suicide?
• How many men kill themselves after killing their partner?
What is the National Violent Death Reporting System (NVDRS)?
1. Population-based, public health reporting system on deaths from violence managed by the CDC ● Funding through competitive application ● Ultimate goal to fund 50 states and territories
2. Data are collected by states and sent to CDC ● Data on homicides, suicides, and deaths from
unintentional firearm, legal intervention and undetermined intent obtained from multiple
sources ● Personal identifiers are removed
3. Provides timely and detailed data on incidents where someone is killed by violence, including victims, suspects, weapons, circumstances and their inter-relationships.
Introduction to NC-VDRS• North Carolina is one of 18 states funded by the
Centers for Disease Control and Prevention (CDC)
• Housed in the State Health Department
• Collect detailed information on deaths from violence– Suicide– Homicide– Unintentional Firearm– Deaths of undetermined intent– Legal Intervention
Data Sources
• Data are gathered from multiple sources– Death Certificates (SCHS)
– Medical Examiner (OCME)
– Law Enforcement (Local)
– NC-IBRS(SBI)
Types of information gathered
• Demographics (victim and suspect)
• Circumstances of the event
• Alcohol/drug use by the victim
• Type of location where the event happened
• Type of weapon used
• Relationship between the victim and suspect
Flow of Information for NVDRS
Occurrence of a violent death
Medical Examiner
State Health Dept
State agenciesOther Fed. agencies
General publicResearchers
Law enforcement
Case Info(- identifiers)
Death certificate
NVDRS (at CDC)
NC-VDRS
Analysis Files (+)
Data Re-release Policy
Certificate of Confidentiality IRB approval for research
No restrictions for aggregate data
Deaths by Manner/Intent: Resident and Occurrence DeathsNorth Carolina Violent Death Reporting System, 2004-2009*
6254
3549
80 94 297
6421
3677
86 97 306
0
1000
2000
3000
4000
5000
6000
7000
Suicide Homicide UnintentionalFirearm
LegalIntervention
UndeterminedIntent
Number of Deaths
Total resident deaths = 10,274
Total occurrence deaths = 10,587
Solid bars: resident deaths
Striped bars: occurrence deaths
*2009 data are provisional
Percent of Deaths Due to Violence by Manner/Intent: North Carolina Violent Death Reporting System, 2004-2008
Suicide: 61%
Homicide: 35%
Unintentional Firearm: 1%
Legal Intervention: 1%Undetermined Intent: 3%
Deaths Due to Violence by Manner/Intent and Age: North Carolina Violent Death Reporting System, 2004-2008
0
200
400
600
800
1000
1200
1400
<1 '1-4 '5-9'10-1415-1920-2425-3435-4445-5455-6465-7475-84
85+
Number of Deaths
Suicide
Homicide
Violent Death Rates by Manner/Intent and Age: North Carolina Violent Death Reporting System, 2004-2008
0
2
4
6
8
10
12
14
16
18
20
<1 '1-4 '5-9'10-1415-1920-2425-3435-4445-5455-6465-7475-84
85+
Rates Per 100,000
Suicide
Homicide
Percent of Deaths Due to Violence by Race and Gender: North Carolina Violent Death Reporting System, 2004-2008
55
41 40
60
90
6
92
8
0
10
20
30
40
50
60
70
80
90
100
Black Male White Male Black Female White Female
Percent of Deaths
Homicide
Suicide
Violent Death Rates by Manner/Intent Sex and Race: North Carolina Violent Death Reporting System, 2004-2008
0
5
10
15
20
25
30
35
40
Rates per 100,000
Homicide Suicide
American IndianMaleAmerican IndianFemaleBlack Male
Black Female
White Male
White Female
Other Male
Other Female
Percentage of Deaths From Suicides by Place of Injury : North Carolina Violent Death Reporting System, 2004-2008
82
1 25
14 4
1 00
10
20
30
40
50
60
70
80
90
Suicide
Percent of Deaths by Place of Injury
House/Apartment
ResidentialInstitutionHighway/Road
Motor Vehicle
Recreational Area
Commercial Area
Natural Area
Other
Unknown
Percentage of Deaths From HOMICIDES by Place of Injury : North Carolina Violent Death Reporting System, 2004-2008
62
1
16
6
1
9
31 2
0
10
20
30
40
50
60
70
Homicide
Percent of Deaths by Place of Injury
House/Apartment
ResidentialInstitutionHighway/Road
Motor Vehicle
Recreational Area
Commercial Area
Natural Area
Other
Unknown
Percent of Deaths by Manner and Method of Fatal Injury: North Carolina Violent Death Reporting System, 2004-2008
68%
14%
6%
0%
5%
3%4%
60%
1%
0%
17%
0%
3%
Firearm
SharpInstBlunt
Poison
Hanging
Unarmed
OtherHomicide Suicide
Precipitating Circumstances For Suicide
• Recent depressed mood• Current mental health problem/diagnosis
– If so, what was the diagnosis?– Was the person under treatment for his/her
MH problem?– Has the person ever been treated for a MH
problem?• Alcohol dependence• Substance abuse problem
Precipitating Circumstances For Suicide
• Did the person – leave a suicide note?– tell someone about his/her intent to commit
suicide?– have a history of suicide attempts?– experience some type of crisis in the past two
weeks?– have a physical health problem that was
relevant to the suicide?
Percent of Suicides By Mental Health Status and Gender: North Carolina Violent Death Reporting System, 2004-2008
4942
3641
47
6762
66
0102030405060708090
100
Reportedcurrent
depressedmood
MD Dx'dcurrent mental
illness
CurrentTreatment
Ever Treated
Percent of Deaths
Males
Females
Percent of Suicides by Suicide Markers and Gender: North Carolina Violent Death Reporting System, 2004-2008
12
2427
39
19
30
0
10
20
30
40
50
60
70
80
90
100
History Of attempts Disclosed Intent Left a note
Percent of Deaths
Males
Females
Percent of Suicides by Life Stressors and Gender: North Carolina Violent Death Reporting System, 2004-2008
38
2128
812
27
18 21
3 4
010
20
3040
50
6070
80
90100
Crisiswithin 2Weeks
PhysicalHealth
Problem
IntimatePartner
Problem
JobProblem
LegalProblem
Percent of Deaths
Males
Females
Percent of Suicides by History of Substance Abuse and Gender:
North Carolina Violent Death Reporting System, 2004-2008
151212
16
0
10
20
30
40
50
60
70
80
90
100
Alcohol Other Substance
Percent of Deaths
Males
Females
Precipitating Circumstances for homicide
• Did the homicide – result from an argument or conflict over money or
property?
– result from jealousy or distress over an intimate partner’s relationship or suspected relationship with another person?
– involve a conflict between current or former intimate partners?
– involve other interpersonal conflict, such as abuse, insult, grudge, or personal revenge?
Precipitating Circumstances for homicide
• Did the homicide – Did the homicide result from drug dealing or
illegal drug use?– Was the homicide gang-related?– Was the homicide precipitated by another
serious crime (e.g., drug dealing, robbery, rape)If so, what type of crime?
– Was the other crime in progress when the homicide occurred?
– Did the death involve justifiable self-defense?
Percent Homicides by Crime Related Circumstance and Gender: North Carolina Violent Death Reporting System, 2004-2008
3127
14
3
2622
9
00
10
20
30
40
50
60
70
80
90
100
Precipitated Byanother Crime
Crime InProgress
DrugInvolvement
Gang Related
Percent of Deaths
Males
Females
Percent Homicides by Conflict Related Circumstance and Gender: North Carolina Violent Death Reporting System, 2004-2008
61
104
12
31
52
2 2
0
1020
30
4050
6070
80
90100
Argument InitmatePartner
Violence
Jealousy Victim Used aWeapon
Percent
Males
Females
Percent of Homicides by Crime Related Circumstance: North Carolina Violent Death Reporting System, 2004-2008
39
16
84
0
10
20
30
40
50
60
70
80
90
100
Robbery Drug Trade Rape, SexualAssault
Motor VehicleTheft
Percent of Deaths
Percent of Homicides by Victim Characteristics: North Carolina Violent Death Reporting System, 2004-2008
10 104
12
010
20
3040
50
6070
80
90100
Victim Used aWeapon
Justifiable SelfDefense
Victim Was aBystander
Victim wasassisting crime
victim
Percent of Deaths
Number of Deaths and Incidents From Violence: North Carolina Violent Death Reporting System, 2004-2008
1271067
2873
5383
0
1000
2000
3000
4000
5000
6000
Single SuicideSingle HomicideMutiple Suicide
Multiple HomicideMurder/Suicide
Number of Deaths
Percent of Murder/Suicide Victims by Gender: North Carolina Violent Death Reporting System, 2004-2008
Female(78%)
Male (22%)
Percent of Murder/Suicide Perpetrators by Gender: North Carolina Violent Death Reporting System, 2004-2008
Female(5%)
Male (95%)
Percent Murder/Suicide Victims by Race: North Carolina Violent Death Reporting System, 2004-2008
63
26
38
0
10
20
30
40
50
60
70
White Black AmericanIndian
Hispanic
Percent of Deaths
Percent Murder/Suicide Perpetrators by Race: North Carolina Violent Death Reporting System, 2004-2008
66
21
2
11
0
10
20
30
40
50
60
70
White Black AmericanIndian
Hispanic
Percent of Deaths
Percent Murder/Suicide Victims/Perp by Race and Gender: North Carolina Violent Death Reporting System, 2004-2008
22
69
27
62
6 83 4
65
0
83
10
17
2 0
22
0
10
20
30
40
50
60
70
80
90
Black Male White Male BlackFemale
WhiteFemale
HispanicMale
HispanicFemale
AmericanIndian Male
AmericanIndianFemale
Percent of Deaths
Victim
Perp.
Suspected Alcohol Use by Manner of Death: North Carolina Violent Death Reporting System, 2004-2008
28
33
42
25
18
0
5
10
15
20
25
30
35
40
45
SuicideHomicide
Legal InterventionUndetermined IntentUnintentional Firearm
Percent of Deaths
Suspected Alcohol Use by Manner of Death and Gender: North Carolina Violent Death Reporting System, 2004-2008
2219
0
23
00
5
10
15
20
25
30
35
40
SuicideHomicide
Legal InterventionUndetermined IntentUnintentional Firearm
Percent of Deaths
30
3842
27
20
0
5
10
15
20
25
30
35
40
45
SuicideHomicide
Legal InterventionUndetermined IntentUnintentional Firearm
Percent of Deaths
Females Males
North Carolina Violent Death Reporting System (NC-VDRS)
Tammy Norwood, Program ManagerNC Injury & Violence Prevention Branch
1915 Mail Service CenterRaleigh, NC 27699-1915
http://www.injuryfreenc.ncdhhs.gov/