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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.
Currently Funded NVDRS States, 2010
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
Key Findings to Date
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
Nu
mb
er
of
De
ath
s
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
Nu
mb
er o
f D
eath
s
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
Rat
es P
er 1
00,0
00
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
Per
cen
t o
f D
eath
s
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
Rate
s p
er
100,0
00
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
Pe
rce
nt
of
De
ath
s b
y P
lac
e o
f In
jury
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
Pe
rce
nt
of
De
ath
s b
y P
lac
e o
f In
jury
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
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
Per
cen
t o
f D
eath
s
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
Per
cen
t o
f D
eath
s
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
203040
50607080
90100
Crisiswithin 2Weeks
PhysicalHealth
Problem
IntimatePartnerProblem
JobProblem
LegalProblem
Per
cen
t o
f D
eath
s
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
Per
cen
t o
f D
eath
s
Males
Females
Homicide
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
Per
cen
t o
f D
eath
s
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
01020
3040506070
8090
100
Argument InitmatePartner
Violence
Jealousy Victim Used aWeapon
Per
cen
t
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
Per
cen
t o
f D
eath
s
Percent of Homicides by Victim Characteristics: North Carolina Violent Death Reporting System, 2004-2008
10 104
12
010
203040
50607080
90100
Victim Used aWeapon
Justifiable SelfDefense
Victim Was aBystander
Victim wasassisting crime
victim
Per
cen
t o
f D
eath
s
MURDER/SUICIDE
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
Singl
e Suic
ide
Singl
e Hom
icide
Mut
iple
Suic
ide
Mul
tiple
Hom
icid
e
Mur
der/S
uicid
e
Nu
mb
er o
f D
eath
s
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
Per
cen
t o
f D
eath
s
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
Per
cen
t o
f D
eath
s
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
Pe
rce
nt
of
De
ath
s
Victim
Perp.
ALCOHOL USE SUSPECTED
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
45P
erc
en
t o
f D
ea
ths
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
Pe
rce
nt
of
De
ath
s
30
3842
27
20
0
5
10
15
20
25
30
35
40
45
Per
cen
t of D
eath
s
Females Males
QUESTIONS
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/
