Overview of NVDRS data sources and data elements

Transcription

1 Overview of NVDRS data sources and data elements Shane Jack, PhD Katherine Fowler, PhD NVDRS Science Officers Surveillance Academy National Center for Injury Prevention and Control Division of Violence Prevention

2 Main Types of Data Elements in NVDRS Victim demographics Injury and death information Geographic information Toxicology Suspect variables Criminal activity Life stressors Mental health Weapon information Suicide circumstances Homicide circumstances* Undetermined death circumstances Unintentional firearm death circumstances Narrative from CME Narrative from LE For more info, view NVDRS coding manual at

3 Multiple Data Source Approach to NVDRS Blair, JM, Fowler, K.A., Jack, S.P.D., Crosby, A.E. (2015) The National Violent Death Reporting System: Overview and Future Directions. Injury Prevention, 0: 1-6. doi: /injuryprev

4 NVDRS Uses Many Data Sources Required Data Sources Death Certificates Law Enforcement Reports Coroner/ ME Reports NVDRS Dataset Optional Data & Data Sources Crime Lab Hospital/ ER records Intimate Partner Violence Module Child Fatality Review Drug Overdose Module

5 Death Certificate Main Data Elements 1. Birthplace 2. Veteran s status 3. Marital status 4. Place of death 5. Date pronounced dead 6. Date of death 7. State of death 8. Cause of death (text) 9. Cause of death (code) 10. Autopsy performed 11. Pregnancy status 12. Manner of death 13. Injury date/time 14. Incident location type 15. Injury address 16. Injured at work 17. Survival time 18. Education 19. Usual Occupation 20. Multiple Conditions For more info, view the NVDRS Implementation Manual and NVDRS Coding Manual located at

6 C/ME Main Data Elements 1. Incident occurred at home 2. Homeless status 3. Current occupation 4. Victim in custody, institutionalized 5. Suspected alcohol use (intoxication) 6. Location, Number of wounds and bullets 7. Circumstances of victim For more info, view the NVDRS implementation manual and NVDRS Coding Manual located at

7 C/ME Main Data Elements, cont d 9. Toxicology variables Date/time specimens drawn Alcohol test and result Blood alcohol level Drug tests and results Amphetamines Antidepressants Cocaine Opiates Marijuana Carbon Monoxide Other For more info, view the NVDRS Implementation Manual and NVDRS Coding Manual located at

8 LE Main Data Elements 1. Type and location of incident 2. Events leading up to incident 3. Weapons used, recovered 4. Circumstances of victim, suspect For more info, view the NVDRS implementation manual and NVDRS coding manual located at

9 Retrieving Data From Data Providers

10 What is Circumstance Data? Circumstances are events that preceded and were determined to be related to a victim s death Considered directly linked to the victim s death in the investigative process Exception: Mental health variables Specifically relate to victim For more info, view Coding Manual located at

11 3 Main Types of Circumstances 1) Manner specific Homicide Suicide/ Undetermined Unintentional firearm death 2) General/Non-manner specific Mental health, substance abuse, and other addictions Relationship and life stressors Crime and criminal activity 3) Crisis Subcomponent of other circumstances Current/acute event (within 2 weeks of death)

12 Manner Specific Circumstances: Suicide/Undetermined Circumstances Financial problem Job problem School problem Eviction or loss of home History of suicide attempts History of suicidal thoughts Criminal legal problem Civil legal problem Suicide of friend or family Other death of friend/family Disclosed intent to commit suicide Left a suicide note Physical health problem Disaster exposure Anniversary of a traumatic event For more info, view the Coding Manual located at nicalassist.html

13 General Circumstances/Non-manner specific Mental health, substance abuse, and other addictions Relationship and life stressors Crime and criminal activity For more info, view the Coding Manual located at nicalassist.html

14 General Circumstances: Mental health/substance abuse Circumstance Current diagnosed mental health problem Crisis? X Current depressed mood Current mental health treatment Ever treated for mental health/substance abuse Alcohol problem Other substance abuse problem Other addiction X X X Mental health diagnos(es)

15 General Circumstances: Relationship problems Circumstance Crisis? Manner Intimate partner violence Homicide Intimate partner problem X Suicide Family relationship problem Other relationship problem X X For more info, view the Coding Manual located at nicalassist.html

16 ABSTRACTORS WRITING NARRATIVES

17 CME NARRATIVE The victim, a 59 year old white male, with a history of depression sustained a self-inflicted gunshot wound while a Sheriff's Deputy was in the process of serving an eviction notice. The victim was pronounced at the scene. His medical history included chronic ethanol abuse, obesity, and hypertension. The manner of death is suicide; cause is a gunshot wound to the head.

18 LE NARRATIVE The victim, a 59 year old white male, and his mother had moved into an apartment 9 years ago. The mother died about 5 years ago, and the victim was an excellent tenant until 7 months ago when he stopped paying the rent. The manager notified Adult Protective Services (APS) who sent out a case worker to assist the victim. The only aid he would accept was Old Age Pension and food stamps, but he still did not pay rent. All of the other renters had moved out and the building was undergoing a major renovation. Since the victim had not paid rent, the manager called authorities to see if the victim could be held on a 72 hour hold, or be forced to use social services in some manner but she never received a return call. She started the eviction process. When the sheriff arrived to service the eviction notice, he spoke with the victim who appeared to be in ill health. The victim stated that he had no where to go. It was cold and snowing outside so the sheriff decided not to complete the eviction that day. While he was calling his supervisor the victim shot himself in the head.

19 Narrative The V, a 53 year old white male, was found in the motel room he had been living in for the past month. He always paid in cash and when paying 5 days before said he would be leaving after that. The staff found the door locked from the inside when they came to clean the room. During the past month he had visited the local emergency room on a regular basis complaining of suicidal thoughts and was thinking about jumping off the balcony or in front of a train. He admitted to abusing alcohol most of his life and intentionally over-medicating himself. He was admitted to a mental health treatment facility for several days and his release papers stated his discharge diagnoses as bipolar, depression, alcohol dependence, hypertension and hypercholesterolemia. His ex-wife revealed that he told he her he was going to kill himself three weeks ago when he was fired from his job for being intoxicated while at work. Without his job, he said he could not make the rent payment and had nowhere to live. Ex-wife stated V attempted suicide last year by overdosing on sleeping pills. The manner of death is suicide; cause severe brain injury due to GSW to the head. Codes from Coding Manual Disclosed intent Alcohol Dep. Other substance abuse Current tx for MI; Ever treated for MI Current MH Problem; 1st MI treated (Bipolar disorder); 2 nd MI treated (Depression/dysthymia) Job problem Financial problems Hx of suicide attempts

20 Acknowledgments NVDRS Grantees Coroners/Medical Examiners and Law Enforcement staff in NVDRS States Surveillance Branch Alex Crosby, MD MPH, Surveillance Branch Chief Leroy Frazier Jr., MSPH CHES, Surveillance Branch Deputy Chief Shae Pope, MPH, Training Coordinator Mortality Surveillance Team Jamar Barnes MPH, Project Officer Jason Baumgardner MPH, Mathematical Statistician Craig Bryant, Computer Scientist Katherine Fowler, PhD, Senior Science Officer Shane Jack PhD, Science Officer Asha Ivey-Stephenson PhD, Science Officer Michele LaLand, Project Officer Bridget Lyons MPH, Science Officer Emiko Petrosky, MD MPH, Science Officer Rebecca Wilson MPH, Project Officer

21 The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Thank You For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone: CDC-INFO ( )/TTY: Visit: Contact CDC at: CDC-INFO or National Center for Injury Prevention and Control Division of Violence Prevention, Surveillance Branch

22 Homicide Circumstances Precipitated by another crime Nature of precipitating crime/crime in progress Argument over money or property Other argument/abuse/conflict Jealousy (lover s triangle) Intimate partner related violence Drug or gang related Justifiable self defense/law enforcement Hate crime Brawl Victims was bystander/police officer on duty/intervener Mercy killing Victim used a weapon

23 Unintentional Firearm Circumstances Context of Injury Hunting Target shooting Celebratory firing Loading/unloading Cleaning gun Showing gun to others Playing with gun Mechanism of Injury Thought safety was engaged Thought it was unloaded Unintentionally pulled trigger Bullet ricochet Gun defect or malfunction Fired while holstering/unholstering Gun mistaken for a toy

24 Demographic Information in the National System All of this information is being provided to CDC today: Date of Injury Date of Death City, State and ZIP Code of Injury City, State and ZIP Code of Residence US Census Tract and Block Group Number (optional) Age Sex, Race and Ethnicity Relationship of Victim to Suspect

25 Crime/criminal activity Circumstance Crisis? Manner Precipitated by another crime First crime in progress Nature of first/second crime (CME/LE) Stalking X Hom/LI Prostitution or sex trafficking X Hom/LI Terrorist attack Walk-by assault Gang-related Homicide Hom/LI