Using NVDRS in Oregon Lisa Millet, MSH Injury Prevention & Epidemiology Section Manager Office of Disease Prevention & Epidemiology Oregon Public Health Division SAMHSA Grantee Conference Portland, December 10, 2007
Overview NVDRS sources and variables NVDRS data Flexibility of NVDRS
Violent death A death that results from intentional use of force or power, threatened or actual, against oneself, another person, or a group or community Suicide Homicide Legal intervention Undetermined death Unintentional firearm injury
Data sources Primary sources: Death certificates Medical examiner reports Police reports Crime lab reports Secondary sources: Child fatality review SHR DA press release
Variables Identity variables: Person type: victim, suspect, both Name SS# Age, DOB Sex Race Ethnicity Address of residence
Death certificate variables Birthplace Veteran s status Marital status Place of death Date of death State of death Cause of death Autopsy Pregnancy status Manner of death Injury date/time Incident location Injury address Injured at work Survival time Education Occupation
Medical examiner variables # bullets and wounds Location of wounds Injury occurred at home Homelessness status Current occupation Victim in custody Suspected intoxication Manner of death Underlying cause of death Demographics Narrative Circumstances
Some circumstances Ever treated for mental illness Hx of inpatient psych tx Physical health problem Current depressed mood Current mental health problem Current tx for mental illness Type of mental illness treated Taking psych meds at time of death Crisis in past 2 weeks Financial problem School problem Sex abuse, physical abuse, neglect IPV in victim s household Disability Contact with juvenile justice system HX of suicide attempts Disclosed intent to suicide Left suicide note Substance dependence or abuse Gun owner, storage Other suicide circumstance
Police report Narrative Victim demographics Suspect demographics Circumstances
Toxicology Alcohol test, result Blood alcohol level Drug tests, results: Amphetamines Antidepressants Cocaine Opiates Marijuana Others
Crime lab variables Ballistics report Firearm Bullet Casing Other weapons
Age-specific rate of suicide, OR, 2005 80.0 All Male Female Rate per 100,000 60.0 40.0 20.0 0.0 10-14 15-19 20-24 25-34 35-44 45-54 55-64 65-74 75-84 >=85 All 1.2 7.2 15.7 14.2 17.5 25.9 18.7 21.1 30.5 28.2 Male 2.4 12.6 29.1 21.5 25.9 35.9 29.0 40.7 63.4 67.9 Female 0.0 1.7 1.6 5.6 8.7 15.7 8.3 2.4 8.5 8.1 Age
Age-specific suicide rates among male veterans and nonveterans, OR 2000-2005 Rate per 100,000 140 120 100 80 60 40 20 0 Veterans Non-veterans Significantly high 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Age
Figure 7. Behavioral health status among suicide victims by age group, OR, 2005 % in group w/ behavioral health status 80 60 40 20 0 Current depressed mood Current mental illness Alcohol dependant Substance abuse All ages 52 30 17 9 10-24 48 21 11 18 25-44 49 33 20 14 45-64 62 38 23 9 65+ 43 18 5 0
Figure 8. Factors associated with suicide by age group, OR 2005 60 All ages 10-24 25-44 45-64 65+ % of the total in the group 50 40 30 20 10 0 A crisis in the past 2 weeks Problem with intimate partner Relation Problem other than intimate partner Recent criminal / legal problem Job / Financial Problem Physical health problems
Figure 9. Suicidal behavior by age group, OR 2005 All ages 10-24 25-44 45-64 65+ 40 % of the total in the group 30 20 10 0 Disclosed intent to die by suicide Suicide note Previous suicide attempt
Suicide deaths and rates by county, OR 2005 Less than 5 suicide deaths Lower than the state rate The state rate: 15.2 (95% CI: 13.9 16.5) Higher than the state rate
Use of data Testimony to legislature to demonstrate need for resources Develop prevention plan Media work Determining where to establish program Developing questions for further study and research
States funded to conduct Violent Death Reporting Surveillance http://www.cdc.gov/ncipc/profiles/nvdrs/state_profiles.htm
States funded to conduct Injury Surveillance http://www.cdc.gov/ncipc/profiles/core_state/default.htm
Oregon Injury Prevention & Epidemiology Program Lisa Millet: lisa.m.millet@state.or.us OVDRS report @ http://www.oregon.gov/dhs/ph/ipe/nvdrs/in dex.shtml http://www.cdc.gov/ncipc/profiles/nvdrs/defa ult.htm