Injury & Violence in Bernalillo County Theresa Cruz, PhD February 26, 2013
If today should turn out to be an average day in the U.S. 493 people will die of injuries 7,700 people will be discharged from a hospital after nonfatal injuries 79,000+ people will visit a hospital emergency department for treatment of injuries Source: CDC Grand Rounds, 2012
Injury Pyramid (U.S., annual estimates) 1 (180,000 deaths) 15 (2.8 million hospitalized) 161 (29 million Emergency Dept visits) Source: CDC, WISQARS
Unintentional vs. Intentional Unintentional (accidental) injuries: motor vehicle crashes, falls, poisoning, burns, suffocation, drowning Intentional (violence-related) injuries: homicide, assault, suicide, suicide attempt
Compared to other states NM has the highest injury death rate State New Mexico 90.98 Alaska 89.98 West Virginia 87.51 Oklahoma 85.51 Wyoming 84.71 US Crude Rate 58.56 Bernalillo County 79.9 Age-Adjusted Injury Death Rate per 100,000 (2010) Source: CDC, WISQARS, 2013
Leading Mechanisms of Injury Death, Bernalillo County, 2007-2011 Rank Cause Number 1 Poisoning 1,034 2 Fall 559 3 Firearm 444 4 Motor Vehicle Traffic 363 5 Suffocation 194 6 Cut/Pierce 52 7 Drowning/Submersion 49 8 Other Transport 26 9 Fire/Burn 19 10 Natural/Environmental 16 Source: NM IBIS - New Mexico Bureau of Vital Records and Health Statistics via Office of Injury Prevention
Alcohol-Related Injury The rate of alcohol-related injury in NM is among the highest in the U.S., about 1.75 times the national rate. In NM, alcohol is involved in: 33% of motor vehicle crash deaths 32% of fall deaths 23% of suicides 47% of homicides Source: New Mexico Bureau of Vital Records and Health Statistics via Office of Injury Prevention
Cost* of Injuries in NM, 2005 The estimated economic cost of injury deaths is $1.8 billion annually. The estimated economic cost of homicide deaths in NM is $199 million annually. * Includes medical costs and lost work costs based on cost in 2005 dollars. Source: CDC, WISQARS
Data Source: NMDOH Indicator-based Information System (IBIS), 2013. NOTE: Data are suppressed where fewer than 8 cases were identified.
Bernalillo County Injury Deaths by Intent, 2007-2011 N=244 Homicide 8% Other 1% Undetermined 2% Suicide 22% Unintentional 67% N = 1,979 Source: New Mexico IBIS, 2013
Bernalillo County Homicide Deaths by Mechanism, 2007-2011 Other Injury 33% Cut/Pierce 13% N = 244 Firearm 54% Source: NM IBIS - New Mexico Bureau of Vital Records and Health Statistics via Office of Injury Prevention, 2013
Homicide Death Rate Race/Ethnicity (per 100,000) 2002-2011 African American 16.7 American Indian 12.0 Hispanic 10.5 White 3.7 Asian/Pacific Islander 4.7* Gender Male 12.4 Female 3.5 * Rate is based on less than 20 cases and may fluctuate greatly. Source: NM IBIS - New Mexico Bureau of Vital Records and Health Statistics via Office of Injury Prevention, 2013
Sexual Violence Sexual violence any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed against a person s sexuality using coercion, by any person regardless of their relationship to the victim, in any setting including but not limited to home and work. Source: Heise & Garcia-Moreno, World Report on Violence and Health, 2002.
Sexual Violence in New Mexico Completed Rapes and Attempted Rapes 15% lifetime prevalence in NM compared with an 11% lifetime prevalence in the US In NM 1 in 5 women and 1 in 25 men reported being raped in their lifetime Source: Caponera, B. Sex Crimes in New Mexico X: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
Number of Sex Crimes Bernalillo County Sex Crimes Reported to Law Enforcement 2007-2011 350 300 250 200 150 100 50 0 2007 2008 2009 2010 2011 12 and under 95 113 130 111 138 13-18 19 158 165 170 145 19+ 60 281 276 321 276 Source: Caponera, B. Sex Crimes in New Mexico X: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
CSP Victim Race/Ethnicity as Reported by Law Enforcement, Bernalillo County, 2011 Black 4% Asian 1% Native American 7% White 37% Hispanic 51% Source: Caponera, B. Sex Crimes in New Mexico X: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
CSP Incidents with Suspect Arrested, 2007-2011 2007 2008 2009 2010 2011 Bernalillo 10% 12% 10% 11% 11% NM 16% 14% 11% 15% 12% CSP = criminal sexual penetration Source: Caponera, B. Sex Crimes in New Mexico X: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
Domestic/Intimate Partner Violence Domestic Violence (DV) or Intimate Partner Violence (IPV) acts of physical, sexual and emotional abuse by a current or former partner. Source: Garcia-Moreno, et al. WHO Multi-country Study on Women s Health and Domestic Violence against Women, 2005.
Domestic Violence in New Mexico In NM 1 in 4 New Mexicans are victims of domestic violence in their lifetime ~ 70% of DV victims are female Hispanic and American Indian populations are at increased risk Source: Caponera, B. Incidence and Nature of Domestic Violence in New Mexico XI: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
Domestic Violence Rates per 1,000 Bernalillo County and NM, 2007-2011 16 14 12 10 8 6 Bernalillo NM 4 2 0 2007 2008 2009 2010 2011 Source: Caponera, B. Incidence and Nature of Domestic Violence in New Mexico XI: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
Domestic Violence in Bernalillo County, 2007-2011 2007 2008 2009 2010 2011 % Adult Victims Served 44% 45% 45% 41% 35% % Involving Alcohol/Drugs 38% 32% 35% 35% 34% % Involving Weapons 71% 86% 81% 83% 80% % Involving Injury 35% 35% 35% 34% 37% % with Suspect Arrest 41% 47% 46% 51% 47% Source: Caponera, B. Incidence and Nature of Domestic Violence in New Mexico XI: An analysis of 2011 data from the NM interpersonal violence data central repository, 2012.
How do we prevent violence?
Haddon Matrix Phases Human Factors Agent (Vehicle) Environment (Physical) Environment (Social) (Host) Pre-Crash Crash Post- Crash
Phases Human Factors (Host) Agent (Firearm) Environment (Physical) Environment (Social) Pre-Event Include firearm risk assessment and counseling by physicians Modify so guns are only operable by the owner Store firearms locked and unloaded with weapons separate from ammunition Restrict handgun purchases; improve mental health treatment/ insurance practices Event Teach individuals to seek cover when they hear gunfire Limit caliber of weapons/ lethality of bullets Station police in high risk areas to reduce response time Enforce firearm laws Post- Event Teach first aid skills Limit magazine capacity reduce capacity to continue firing Locate paramedics in proximity of high risk areas to reduce response times Provide high quality EMS services, trauma care and rehabilitation
Sexual Violence Prevention Level of Spectrum 1. Strengthening Individual Knowledge and Skills 2.Promoting Community Education 3.Educating Providers 4.Fostering Coalitions and Networks 5.Changing Organizational Practices 6.Influencing Policy and Legislation Definitions of Level Strengthen an individual s capacity to prevent sexual violence (e.g., teach youth about sexual health and communication). Conduct a community-wide campaign to raise awareness and build support for prevention policies. Train human services providers on how to involve men and boys in sexual violence prevention. Partner with and support the Rape Crisis Center of Central NM as well as other community partners to achieve broader goals. Encourage employers to implement environmental safety measures (e.g., lighting in parking areas). Advocate for coordinated primary prevention of sexual violence. Determine if a policy change is needed to reduce the percentage of sexual assault cases being dismissed. Reduce access to alcohol.
National Resources National Center for Injury Prevention and Control (Centers for Disease Control and Prevention-CDC) www.cdc.gov/ncipc CDC WISQARS http://www.cdc.gov/injury/wisqars/index.html National Violent Death Reporting System http://www.cdc.gov/violenceprevention/nvdrs Children s Safety Network www.childrenssafetynetwork.org Prevention Institute www.preventioninstitute.org
National Resources National MCH Center for Child Death Review http://depts.washington.edu/cdreview National Coalition Against Domestic Violence http://www.ncadv.org National Sexual Violence Resource Center http://www.nsvrc.org National Sexual Assault Hotline 1-800-656-HOPE Blueprints for Violence Prevention http://www.blueprintsprograms.com/allprograms.php Hopkins Center for Gun Policy and Research http://www.jhsph.edu/research/centers-andinstitutes/johns-hopkins-center-for-gun-policy-and-research/
New Mexico Resources New Mexico Indicator-Based Information System (for data) http://ibis.health.state.nm.us New Mexico DOH Office of Injury Prevention http://nmhealth.org/injury NM Coalition Against Domestic Violence http://www.nmcadv.org NM Coalition of Sexual Assault Programs http://www.nmcsap.org Albuquerque Family Advocacy Center http://www.abusestopshere.org/ Rape Crisis Center of Central New Mexico http://www.rapecrisiscnm.org
Theresa Cruz, PhD Research Assistant Professor UNM Prevention Research Center 505-272-8379 thcruz@salud.unm.edu