System that collects data on US violent deaths to cover all 50 states: Database expands ======================================================================================= * Kim Krisberg Fifteen years since its launch, the National Violent Death Reporting System will now begin collecting data from every state in the country — a major milestone for violence prevention and response. “This data will contribute greatly to public health activities and practice,” said Janet Blair, PhD, MPH, team lead for the Mortality Surveillance Team within the Centers for Disease Control and Prevention’s Division of Violence Prevention, which runs the national surveillance tool. “No other national database provides such comprehensive information on violent deaths.” In September, CDC announced funding for 10 new states to join the National Violent Death Reporting System: Arkansas, Florida, Idaho, Mississippi, Montana, North Dakota, South Dakota, Tennessee, Texas and Wyoming. The expansion means the system is now gathering key violence prevention data from all 50 states, as well as Washington, D.C., and Puerto Rico. First launched in 2003, the CDC surveillance tool covers a range of violent deaths, including homicides and suicides, and gathers hundreds of unique data points into one place where practitioners can learn more about the circumstances of such deaths, detect troubling trends in their early stages and pinpoint openings for intervention. The state data comes from a number of sources, such as law enforcement, medical examiners and toxicology reports, and often includes data that highlight the role of social determinants in violent death risk, such as information about employment, life stressors and income. According to CDC, suicide is among the top 10 leading causes of death in the U.S., and one of only three leading causes that are increasing. Homicide is currently the third-leading cause of death among teens and young people ages 15 to 34. Violence-related death and injury cost the U.S. about $107 billion in medical care and lost productivity every year. Data from the National Violent Death Reporting System has led to interventions and critical insights at the local, state and national levels, Blair said. For example, in Colorado, public health workers noticed that first responders who die by suicide were also more likely to be veterans, leading to enhanced outreach to first responders, active military, veterans and their families. In Connecticut, the data led to work by the state Department of Transportation to put up suicide prevention signs around a bridge where a number of suicides had occurred. At the national level, Blair said the data has revealed promising early intervention points that could lower the risk of death related to intimate partner violence. “Taking (the National Violent Death Reporting System) nationwide will provide more communities with vital information to better understand the preventable characteristics of violent deaths,” Blair told *The Nation’s Health.* A better understanding of suicide deaths is a top priority for Josh Clayton, PhD, MPH, and his public health colleagues in South Dakota, one of the newest states to join the reporting system. Clayton, state epidemiologist at the South Dakota Department of Health, said suicides account for 80% of all violent deaths in the state each year, with the state documenting record suicide rates in 2015 and 2017. Last year, a CDC Vital Signs report based in part on National Violent Death Reporting System data — published in CDC’s *Morbidity and Mortality Weekly Report* — found that suicides in South Dakota increased by more than 44% between 1999 and 2016. Clayton said he hopes joining the national system will help researchers more clearly reveal the many social and economic factors that contribute to the state’s high suicide rate. “It’ll allow us to have more focused collection on the context in which these suicides are occurring and really help us take it to the next level in terms of being able to provide helpful information to our community prevention partners,” Clayton told *The Nation’s Health.* As of May, Clayton said two of the state’s 66 counties were actively participating in the data system, with a goal of bringing every county on board by the start of 2020. He said the data-sharing effort not only builds on existing partnerships with local law enforcement, medical examiners and coroners, but helps strengthen those partnerships as well. “It gives us an opportunity to hear directly from the primary data collectors,” he said. “Strengthening that line of communication is a really helpful way to know what’s happening in communities — and not just what’s happening right now, but what’s coming up as a new threat.” The unique benefit of the National Violent Death Reporting System is its ability to build a “narrative” around violent deaths in a way that reveals both prevention opportunities as well as gaps in services and outreach, said Anna Fondario, MPH, program manager for the Violence and Injury Prevention Program at the Utah Department of Health, which joined the system in 2004 and participated in the pilot project that initially spurred the system launch. Over the years, Fondario said the surveillance data has detected trends and shaped public health response to a range of pressing problems, including suicide, domestic violence and overdose deaths. For example, a few years ago, practitioners studying the data noticed that many children who had witnessed a domestic violence homicide were not getting referred to services to help them cope with the traumatic experience. In response, a standardized practice was set up to make sure such children knew about and could access supportive services. Utah was also one of the first states to include overdose deaths in the reporting system, which Fondario said has helped public health workers target prescribing education, locate overdose hotspots and identify emerging overdose threats, such as fentanyl analogs. “It’s become foundational to our work,” Fondario said of the reporting system and its data. Learn more about the newly expanded National Violent Death Reporting System and how to access its data at [www.cdc.gov/violenceprevention/nvdrs](http://www.cdc.gov/violenceprevention/nvdrs). * Copyright The Nation’s Health, American Public Health Association