Humans cannot avoid death altogether, but data experts at the Centers for Disease Control and Prevention and across the country are helping communities find ways to prevent some lives from ending too soon.
CDC’s National Violent Death Reporting System is a surveillance tool that, since 2002, has compiled information on lives ended by violence across the U.S. It collects known data from 40 U.S. states, the District of Columbia and Puerto Rico on every homicide, suicide and death where a person was killed by law enforcement in the line of duty. The system also collects data on unintentional firearm injury deaths and deaths where the intent was unknown.
Data in the system come from death certificates, coroner or medical examiner reports, law enforcement reports and toxicology reports. From those sources, system users can find a host of information, including circumstances related to suicide, such as major life events or stresses and depression; the relationship between a perpetrator and a victim; other crimes, such as robbery, committed along with homicide; and if deaths were part of multiple homicides, or homicide followed by suicide.
Such information on violent deaths may appear grim, but its collection is a cause for hope: It can help communities create and implement prevention programs to reduce risks. The need is great, as CDC reported that more than 42,000 people died by suicide in 2014 in the U.S., and another 16,000 people died by homicide.
Community investment is key for making the National Violent Death Reporting System work well, starting with data collection, said Leroy Frazier Jr., MSPH, CHES, CDC’s Surveillance Branch deputy branch chief. But data alone will not lower the rates of violent deaths in participating states, he warned.
“A lot of people think that collection of the data is an automatic prevention program,” Frazier told The Nation’s Health. “We have to depend on getting that data out to (potential prevention partners). Hopefully, prevention specialists and others that have resources to implement programs will take that data and use it.”
Indeed, many communities already have. Janet Blair, PhD, MPH, CDC’s Mortality Surveillance Team lead, pointed to the Oklahoma Violent Death Reporting System, one of the 40 states currently in the national system.
Public health advocates in the state evaluating their data saw that among state domestic violence homicides, in many instances, law enforcement had previously been called to the same location before victims were killed. The state secured funding from the National Institute of Justice to implement a lethality assessment prevention tool, in which law enforcement can connect survivors of intimate partner violence with a domestic violence advocate at the scene of an incident.
A 2014 report by the National Criminal Justice Reference Service said the system was shown to increase survivors’ use of formal and informal protective strategies and decrease the frequency and severity of physical violence. However, the assessment did not show a decrease in the presence of domestic violence in the state or among the couples who had received assessments.
Violence prevention is public health
Part of the issue could lie in perceptions. Paul Bonta, MA, associate executive director for policy, advocacy and external affairs at the American College of Preventive Medicine, said even among public health experts, prevention is often viewed in terms of vaccines or behaviors linked to chronic health conditions. But violence is a public health issue that touches all corners of a community, and needs to be viewed and treated as such, Bonta said. And that is where the National Violent Death Reporting System comes in.
“The NVDRS is a program that’s really aimed at better understanding the circumstances that really lead to a death,” Bonta told The Nation’s Health. “There’s a lot of prevention that takes place in the public health setting. Once you identify the risk factors, you can work to prevent the onset of those risk factors. The same thing happens in violence.”
Of particular interest to public health advocates is suicide prevention. Using data from the National Violent Death Reporting System, public health advocates can determine which populations are at risk for suicide attempt. Such was the case in both Oregon and Virginia, where data showed the elderly were dying by suicide at a higher rate than other age groups.
Bonta said local and state public health departments created resources targeted toward seniors and made more resources available to them if they were contemplating suicide. They were also “far more proactive” in reaching out to senior centers and other places within communities where seniors congregated to talk directly to them about suicide prevention.
“That’s something that would have never happened if they had not instituted their violent death reporting systems programs,” Bonta added.
In Colorado, too, the system helped identify another group at particular risk for suicide: first responders. In a December 2015 Health Watch report from the Colorado Department of Public Health and Environment, experts found that the state itself had the seventh-highest suicide rate in the nation. The report showed that first responders were both likely to encounter suicidal people in their day-to-day work and at higher risk to contemplate suicide themselves, with nearly 200 first responder suicide deaths reported from 2004 to 2014. They were also almost 50 percent more likely to die by suicide with a firearm than the general population, the report noted, and more than twice as likely to be veterans.
The vast majority of first responders are men, according to a U.S. Department of Labor report.
In response to this population’s high risk, the department amended an existing program called Man Therapy to include information particularly for veterans and first responders. The program also included an online component, as the data showed men were not likely to pursue talk therapy.
Partnerships such as those in Colorado, where public health, state government and industry leaders collaborated both in collecting data and implementing prevention programs, are key to the National Violent Death Reporting System’s success, Frazier said.
“The system would not be successful if it wasn’t for the partners, who are the major data providers,” he said. “Without their interest, support and dedication to providing data, (NVDRS could not thrive).”
In the 15 years since the National Violent Death Reporting System was first launched, the system has grown from data in just a few states to covering nearly 80 percent of the U.S. But CDC experts hope to expand the system to cover all U.S. states and territories.
Public health workers, supporters and students can request data from participating states through CDC’s National Violent Death Reporting System website, as some of the data is under restricted access. But anyone who is interested in the information can access violent death data through CDC’s Web-based Injury Statistics Query and Reporting System.
Learn more about the National Violent Death Reporting System at www.cdc.gov/violenceprevention/nvdrs.
- Copyright The Nation’s Health, American Public Health Association