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Physical health problems Slightly more than one-fifth of male Job problems were noted as a precipitating circumstance in a higher percentage of males than females In contrast, family nonintimate relationship problems were a precipitating circumstance in a higher percentage of females than males Although indicated in a relatively small percentage of suicides, among males being a perpetrator of interpersonal violence in the month before death was more common 3.

Among suicide decedents for whom a crisis in the previous or upcoming 2 weeks was reported, intimate partner problems These percentages are similar to those for the most common precipitating circumstances. Rates of homicides by month of death varied little throughout the year range: Overall, the crude homicide rate was 4.

In more than half The homicide rate for males was three and half times the rate for females 7. Non-Hispanic blacks accounted for more than half Age-specific homicide rates were highest Rates were lowest among persons aged 5—14 years and 65—84 years. Among males, the majority of homicide decedents Among females, the homicide rate was highest 5.

Firearms were used in No other method was used in more than 4. Firearms were the most common method used in homicides of males A house or apartment was the most common location of homicide Among those who had positive results for alcohol Marijuana, opiates, and cocaine were identified in Precipitating circumstances were identified for Approximately one in three of those homicides were precipitated by another crime Table 15 ; in Other common precipitating circumstances were an argument or conflict An argument or a conflict was a factor in more homicides among males Drug involvement accounted for Intimate partner violence was a precipitating factor in Male decedents also used a weapon during the incident in Information was collected on crises experienced by decedents within the previous or upcoming 2 weeks Table The most common crises precipitating homicides were family relationship problems The 17 NVDRS states included in this report collected data concerning legal intervention incidents, which included deaths in Table When analyzed separately from homicides, the majority of legal intervention deaths occurred among males Non-Hispanic white males accounted for the highest percentage of legal intervention deaths Firearms were used in almost all legal intervention deaths Legal intervention deaths occurred most frequently in a house or apartment Of legal intervention decedents who were tested for antidepressants, The decedent reportedly used a weapon in A recent crisis within the previous or upcoming 2 weeks was cited in The two most common crisis circumstances were family relationship problems The 17 NVDRS states included in this report collected data concerning 1, incidents involving 1, deaths in for which a determination of intent could not be made Table Rates of deaths of undetermined intent varied little by month of death range: Overall, the crude rate of deaths of undetermined intent was 1.

Rates were higher among males than among females 2. Non-Hispanic whites accounted for Non-Hispanic white males had the highest rate of death of undetermined intent 2. More than half Rates were highest 3. The most common method of injury in deaths of undetermined intent was poisoning The majority of deaths of undetermined intent occurred in a house or apartment A house or apartment was the most common place of injury for males and females Opiates, cocaine, marijuana, and antidepressants were identified in Precipitating circumstances were known in approximately Of those, substance abuse problems Although a current depressed mood was reported for only Other common circumstances were physical health problems Among decedents for whom intent of death was undetermined, a greater percentage of males than females was reported to have alcohol problems Mental health problems were reported for approximately half of females A higher percentage of females than of males was currently in treatment for a mental health problem A crisis within the previous or upcoming 2 weeks was experienced by For males and females, the most common recent crises were health problems The 17 NVDRS states included in this report collected data concerning incidents involving unintentional firearm deaths in Table Males accounted for Persons aged 15—29 years accounted for Handguns were involved in The majority of unintentional firearm deaths occurred in March, April, October, November, and December Of all unintentional firearm deaths, The context of the injury or associated circumstances were known for Overall, the most common context of injury was playing with a gun The most common associated circumstance was unintentionally pulling the trigger Violent deaths occur among males and females of all ages, races, and ethnicities.

NVDRS data can help identify populations particularly affected by violence. The system not only provides details on specific manners of violent deaths, but also identifies common factors for multiple types of violence. These details can increase knowledge about the circumstances associated with violence and can help public health authorities develop data-informed, effective approaches to violence prevention. In participating states, updating to a web-based platform has simplified system operation and management, improved timeliness of data entry and reporting, and enhanced flexibility to adapt quickly to changing information needs in violence surveillance 8.

Changes to the system have also improved its capacity for future expansion to additional states 8. NVDRS data continue to illustrate that relationship problems, specifically intimate partner problems, frequently precede suicides and homicides.

These findings underscore the importance of youth violence prevention programs that help improve communication skills, individual coping skills 11 , and nonviolent conflict resolution skills such as impulse control, empathy, anger management, and problem solving 12 — For example Safe Dates, which focuses on reducing dating violence among adolescents by enhancing awareness about abusive relationships, changing norms, and teaching skills to develop healthy relationships, has been reported to reduce long-term physical and sexual dating violence 16 and other types of youth violence Other school-based, family-focused, or community-based prevention programs also have been reported to reduce youth violence 18 , Alcohol use also frequently precedes suicidal and interpersonal violent behavior 4 , 7 , 11 , 20 — These findings suggest that comprehensive violence prevention efforts can benefit from strategies that address alcohol and other substance abuse.

For example, analysis of NVDRS data on precipitating circumstances indicates that when homicides involve females, almost half are related to intimate partner violence. It is important that screening and counseling about abuse be done in a culturally sensitive and supportive way to address concerns about health and safety An intervention with multiple counseling sessions to assess the risk for danger, discuss prevention options, develop a safety plan, and share appropriate community resources has been reported to reduce recurrence of partner violence among pregnant women At the state level, NVDRS data have been instrumental in planning, implementing, and evaluating public health policies and practices regarding violent deaths.

The data-informed policy change allows the Department of Children and Family Services to help these children receive an assessment and get access to interventions such as mental health care Current diagnosed mental health problems were a common precipitating circumstance for suicides. However, only one-third of suicide decedents were receiving mental health treatment, which suggests the need for strategies to enhance access to care; reduce stigma for those seeking help; and enhance social connections and support, particularly during times of crisis Other studies have indicated that on average, as many as Such findings suggest opportunities for suicide prevention.

Primary care providers have the potential to prevent suicides, connect patients to specialty care, and collaborate or formally partner with behavioral health care providers 30 , Colorado VDRS data on suicide among middle-aged men were used by the Colorado Department of Public Health and their partners to develop ManTherapy, a web-based suicide prevention initiative to engage and help connect men with appropriate resources 32 , The initiative was driven by continued observation that men of working age aged 25—64 years comprise the population with the highest rate of suicide in Colorado.

Some circumstances associated with suicide among working-aged men differed considerably from those associated with women K Bol, MSPH, Colorado Department of Public Health and Environment, personal communication, March , Among suicides in Colorado from to , These findings suggest reticence among men to seek mental health care or to discuss a mental health diagnosis or treatment with those closest them e. Initial web analytics indicate that the program had over , unique visits between mid and early , with Suicide data from the Rhode Island VDRS 27 identified working-age males as being at increased risk for suicide and suicide attempts.

Mental health and substance abuse problems, interpersonal problems, and employment-related stressors were identified as common circumstances preceding suicide in this population. As a result, a symposium with the two largest employers in the state was conducted to present these findings and increase awareness of factors precipitating suicide among working-age adults.

Strategies were provided for integrating suicide prevention into worksites One large employee assistance program in the state integrated suicide prevention into its mission statement and began providing training to their clinical staff and clients in early identification and referral of at-risk employees. The NSSP is a comprehensive national agenda for suicide prevention Unlike other sources of data, NVDRS allows changing patterns in circumstances and risk profiles to be examined, which can affect how the rates are interpreted, help guide prevention activities, and monitor progress toward objectives.

In addition to providing more detail than other surveillance systems regarding the circumstances of violent deaths, NVDRS collects more complete information than other data sources on manners of death such as legal intervention deaths 36 and unintentional firearm deaths In light of current calls for better data on legal intervention deaths in particular 38 , 39 , continued expansion of the NVDRS is critical to understanding the national picture of these deaths.

The findings from 17 states in provide preliminary evidence of racial disparities in rates of legal intervention deaths, but further analyses are needed.

The findings provided in this report are subject to at least eight limitations. First, NVDRS data are available from a limited number of states and therefore are not nationally representative. NVDRS incident data might be limited or incomplete for areas in which these data-sharing relations are not fully developed.

Third, toxicology data are not collected consistently across all states or for all alcohol and drug categories. Fourth, abstractors are limited to the data included in the investigative reports they receive. Reports might not fully reflect all information known about an incident, particularly for homicides and legal intervention deaths, when data are less readily available until after a full investigation and adjudication are completed.

Fifth, case definitions present challenges when a single death is classified differently in different documents e. NVDRS abstractors reconcile these discrepancies using standard NVDRS case definitions and select a single manner of death on the basis of all source documents; the manner of death assigned must be consistent with the manner of death noted in at least one source document. For this reason, CDC provides abstractor training and states conduct blinded reabstraction of cases to test consistency and identify training needs.

Seventh, medical and mental health information e. Therefore, the completeness and accuracy of this information are limited by the knowledge of the informant. Finally, protective factor data i. Public health surveillance is the foundation for public health practice.

Surveillance is essential to monitoring the prevalence and incidence of violence-related fatal injuries, defining priorities, and directing programmatic and violence prevention activities Development and expansion of NVDRS are crucial to public health efforts at the federal, state, and local levels to reduce violence and the personal, familial, and societal consequences and costs.

These 14 states did not report data until NVDRS tracks both resident and occurrent violent deaths in the overall data set, and the numbers in this report reflect both. Drug involvement includes drug use in addition to drug trade. Michigan did not collect data statewide during These two states are excluded from the analysis in this report. The incident type characteristic reports number of incidents; all other characteristics report number of deaths. Circumstances were unknown for 1, suicides 1, males, females; sex is unknown for two suicides.

Numbers do not equal the sums of the columns because more than one circumstance could have been present per decedent. Numbers do not equal the sums of the columns because decedents could have had more than one diagnosis. Numbers do not equal the sums of the columns because more than one crisis could have been experienced per decedent. Marital status is unknown for decedents; victim-suspect relationship is unknown for 2, decedents. Circumstances are unknown for 1, decedents males, females.

Numbers do not equal the sums of the columns because a death could have had more than one precipitating circumstance. Number will not equal the sum of the column because a death could have been precipitated by more than one other crime. Numbers do not equal the sums of the columns because a decedent could have experienced more than one crisis. Circumstances are unknown for four decedents four males, no females.

Number does not equal the sum of the column because a death could have been precipitated by more than one other crime. Circumstances were unknown for decedents males, 87 females. Numbers do not equal the sums of the columns because a decedent could have had more than one diagnosis. Circumstances were unknown for 28 deaths. Suggested citation for this article: Department of Health and Human Services.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U. CDC is not responsible for the content of pages found at these sites. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version https: Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content.

Recommend on Facebook Tweet Share Compartir. Introduction In , more than 57, persons died in the United States as a result of violence-related injuries 1.

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

Manner of Death A manner i. Circumstances Preceding Death The circumstances preceding death are defined as the precipitating events that contributed to the infliction of a fatal injury Box 3.

Coding Training and Quality Control Ongoing coding support for data abstractors is provided through an e-mail help desk, monthly conference calls with all states, and regular conference calls with individual states.

Time Frame States are required to report all deaths within 6 months of the end of each calendar year for the preceding January—December. Fatal Injuries in This report provides data concerning fatal injuries meeting the NVDRS case definition for violent deaths in for 17 participating states that were received by CDC as of October 5, Toxicology Results of Decedent Tests for alcohol were conducted for Method and Location of Injury Firearms were used in more than half of suicides Toxicology Results of Decedent and Precipitating Circumstances Tests for alcohol were conducted for Method and Location of Injury Firearms were used in Legal Intervention Deaths The 17 NVDRS states included in this report collected data concerning legal intervention incidents, which included deaths in Table Method and Location of Injury The most common method of injury in deaths of undetermined intent was poisoning Context of the Injury and Associated Circumstances The context of the injury or associated circumstances were known for Discussion Violent deaths occur among males and females of all ages, races, and ethnicities.

Limitations The findings provided in this report are subject to at least eight limitations. Decorate your home with our easy craft ideas, use our free stencils to decorate a pumpkin, or get started on a no-sew costume.

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