Newswise — Ann Arbor, MI, October 13, 2016 – Violence-related deaths, including homicides and suicides, are an urgent public health problem, according to Alex E. Crosby, MD, MPH, James A. Mercy, PhD, and Debra Houry, MD, MPH, from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Their commentary and contributions by other noted experts in the supplement to the November American Journal of Preventive Medicine provide valuable insights into new data from the National Violent Death Reporting System (NVDRS), which can help inform current debates about violence, prevention, and public policy.

Homicides and suicides account for the deaths of more than 160 people every day in the United States. Violence-related injuries claim more than 55,000 people per year. The suicide rate rose for 9 straight years from 2005 to 2014. While homicides have been declining over the long term, estimates of the economic impact stand at $26.4 billion.

The three main goals of the NVDRS are to:

1. Collect detailed information about violent deaths in the U.S., including when, where, and how they occurred2. Link information from vital statistics (death certificates), coroner/medical examiner reports, and law enforcement reports into the reporting system3. Provide information to help public health officials, violence prevention groups, law enforcement, and policymakers better understand the problems and guide national, state, and local actions to prevent violent deaths

Creation of the NVDRS was inspired by a 1999 Institute of Medicine report calling for a national fatal intentional injury system as well as efforts from the U.S. Public Health Service’s Surgeon General’s Office and others. Although the NVDRS does not cover all 50 states, it was the first multistate system to provide detailed information on circumstances precipitating violent deaths, the first to link multiple source documents on violence-related deaths to enable more complete understanding of each death, and the first to link multiple deaths that are related to one another (e.g., multiple homicides, multiple suicides, and cases of homicide followed by the suicide of the suspected perpetrator).

Using data from the NVDRS, two contributions to the issue can help inform the current national debate about policing. One article, by Janet M. Blair, PhD, MPH, and colleagues at the Division of Violence Prevention, CDC, examines the details of the 128 law enforcement officers (LEOs) killed between 2003 and 2013. Key findings showed that 21% of LEOs were killed during an ambush, 19.5% were killed during traffic stops or pursuits, and 15.6% were killed responding to domestic disturbances. 90% of LEO homicides were committed with a firearm. The authors explain, “Systems such as NVDRS are critical to ongoing surveillance of LEO homicides. The current study affords an opportunity to inform policy makers and individuals involved in training federal, tribal, state, and local law enforcement personnel about the circumstances surrounding LEO homicides in order to prevent deaths and serious injuries among this population.”

Sarah DeGue, PhD, and Katherine A. Fowler, PhD, CDC, and Cynthia Calkins, PhD, of the John Jay College of Criminal Justice, analyzed NVDRS data for 812 deaths resulting from the use of lethal force by law enforcement officers while on duty. Key findings showed that while the majority of victims were white (52%), a disproportionate number, compared with the U.S. population, were black (32%), and the fatality rate was 2.8 times higher among blacks than whites. Most victims were reported to be armed (83%); however, black victims were more likely to be unarmed (14.8%) than white (9.4%) or Hispanic (5.8%) victims. Fatality rates among military veterans/active duty service members were 1.4 times greater than among their civilian counterparts.

DeGue, Fowler, and Calkins discuss in detail how their findings could be applied to many of the current conversations about racial disparities and violence. They conclude, “The current study is one of the first to examine the nature and circumstances of deaths due to the use of lethal force by law enforcement in the U.S. using data from a multistate public health surveillance system. Findings reinforce concerns about racial/ethnic inequities in these cases and identify incident characteristics and scenarios with important implications for prevention.” They also note that, “Further research is also needed to examine the effectiveness of training programs and policy initiatives aimed at reducing the use of lethal force while maintaining the health and safety of officers and communities.”

The remaining articles in the supplement analyze multiple aspects of suicides, homicides, and other violent deaths using the NVDRS. This supplement will be a valuable resource for public health professionals, law enforcement officials, federal, state, and local governments, and the general public – anyone concerned with violence in society in the U.S.

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NOTES FOR EDITORSNational Violent Death Reporting System: Analyses and CommentaryAmerican Journal of Preventive Medicine, Supplement, Volume 50, Issue 11 (November 2016)Published by Elsevier, this supplement will be openly available at http://www.ajpmonline.org/issue/S0749-3797(16)X0016-5

Guest Editors: Janet M. Blair, PhD MPH, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, and Stephen W. Hargarten, MD, MPH, Professor and Chair, Emergency Medicine, Director, Injury Research Center, Associate Dean, Global Health, Medical College of Wisconsin

COMPLETE TABLE OF CONTENTS

INTRODUCTORY COMMENTARYThe National Violent Death Reporting System: Past, Present, and FutureAlex E. Crosby, MD, MPH, James A. Mercy, PhD, Debra Houry, MD, MPH

HOMICIDES BY AND OF U.S. LAW ENFORCEMENT OFFICERSDeaths Due to Use of Lethal Force by Law Enforcement: Findings from the National Violent Death Reporting System, 17 U.S. States, 2009-2012Sarah DeGue, PhD, Katherine A. Fowler, PhD, Cynthia Calkins, PhD

Occupational Homicides of Law Enforcement Officers in the United States, 2003-2013: Data from the National Violent Death Reporting SystemJanet M. Blair, PhD, MPH, Katherine A. Fowler, PhD, Carter J. Betz, MS, Jason L. Baumgardner, MSPH

SUICIDESuicide among Current Military Personnel and Veterans of Ages 18–35 Years by County—16 StatesJoseph E. Logan, PhD, Katherine A. Fowler, PhD, Nimeshkumar P. Patel, MA, Kristin M. Holland, PhD, MPH

Mixed Methods Analysis of Sex Differences in Life Stressors of Middle-Age SuicidesDeborah M. Stone, ScD, MSW, MPH, Kristin M. Holland, PhD, MPH, Lara B. Schiff, MPH, Wendy L. McIntosh, MPH

Identifying and Tracking Gas Suicides in the U.S. using the National Violent Death Reporting System, 2005-2012Deborah Azrael, PhD, Alexander Mukamal, Amy P. Cohen, EdM, David Gunnell, DSc, Catherine Barber, MPA, Matthew Miller, MD

Previous Suicide Attempt and its Association With Method Used in a Suicide DeathEthan C. Jamison, MPH, Kirk A. Bol, MSPH

VIOLENT DEATHSImproved Ascertainment of Pregnancy-Associated Suicides and Homicides in North CarolinaAnna E. Austin, MPH, Catherine J. Vladutiu, PhD, MPH, Kathleen A. Jones-Vessey, MS, Tammy S. Norwood, BS, Scott K. Proescholdbell, MPH, M. Kathryn Menard, MD, MPH

Violent Deaths Among Georgia Workers: An Examination of Suicides and Homicides by Occupation, 2006-2009Antionette Lavender, MPH, Viani Ramirez-Irizarry, MPH, A. Rana Bayakly, MPH, Carol Koplan, MD, J. Michael Bryan, MPH

Burden of Violent Death on Years of Life Lost in Rhode Island, 2006-2013Yongwen Jiang, PhD, Megan L. Ranney, MD, MPH, Beatriz Perez, MPH, Samara Viner-Brown, MS

Characteristics of Violent Deaths Among Homeless Persons in Maryland, 2003-2011Jennifer L. Stanley, MPH, Alexandra V. Jansson, MPP, Adebola A. Akinyemi, MPH, Clifford S. Mitchell, MD

Full text of these articles is available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734-936-1590 or [email protected]. The supplement will be openly available at www.ajpmonline.org/issue/S0749-3797(16)X0016-5 once the embargo has lifted. Journalists wishing to interview the authors should contact CDC Media Relations at +1 404-639-3286 or [email protected].

This Supplement edition of the American Journal of Preventive Medicine has been sponsored by the U.S. Centers for Disease Control and Prevention (CDC), an Agency of the Department of Health and Human Services, under the Cooperative Agreement CDC-RFA-CE14-1402: Collecting Violent Death Information Using the National Violent Death Reporting System. The ideas and opinions expressed in the articles are those of the authors and do not necessarily reflect the opinions or official positions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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