National Violent Death Reporting System NVDRS Overview and Update

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National Violent Death Reporting System
(NVDRS)Overview and Update

• Leroy Frazier, Jr., MSPH, CHES
• Etiology and Surveillance Branch
• Division of Violence Prevention
• National Center for Injury Prevention and Control
• Centers for Disease Control and Prevention

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What Do We Know About Violence?

• gt56,000 Americans died from violence in 2001
• Violence is a particular scourge of the young
• Homicide is the second leading cause of death in
  the 15-24 yrs. age group.
• Suicide is the second leading cause of death in
  the 25-34 yrs. age group.

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Homicide and Suicide as a Percent of All Deaths
by Age Group, US, 2000
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Suicide and Homicide Mortality Rates by Age
Group, US, 2000
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Violent Deaths by Mechanism and Manner, US, 2000
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But We Dont Know Enough

• Death certificates dont mention suspects and
  cant combine deaths in the same incident
• Supplementary Homicide Reports cover only
  homicides and carry little information
• The National Incident Based Reporting System has
  trouble getting law enforcement buy-in

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Why Not Just Go to the Original Sources?

• Law enforcement information describes what
  happened before death
• Medical examiner/coroner files contains
  information collected after death
• Death certificates describe the person, not what
  happened.
• In short, we need something new to compile
  multiple sources to get the full picture.

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The History of NVDRS 1999

• Key stimulus Institute of Medicine Report
  recommends the creation of a national fatal
  intentional injury surveillance system
• Early pilot Six foundations pool private money
  to start the National Violent Injury Statistics
  System (NVISS) in academic test tubes

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The History of NVDRS 2000

• 2000 NVISS gets under way at 12 sites,
  mostly universities
• 2000 Harvard and the Joyce Foundation convene
  an expert meeting that suggests the CDC direct
  a publicly funded system
• 2000 CDC starts planning

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NCIPCs Partners in Planning and Executing NVDRS

• Academic community NVISS
• State health departments CSTE, STIPDA, NAPHSIS
• Non-CDC Federal agencies Department of Justice
• Practitioners NAME
• Other CDC NCHS, EPO (MECISP), NIOSH

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Four Principal Data Sources

• Death certificates
• Police reports including Supplementary Homicide
  Reports (SHRs) or National Incident-Based
  Reporting System (NIBRS) records
• Coroner and medical examiner records
• Crime lab reports for firearms

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A Fifth Data Source Under Development Child
Fatality Review Teams (CFRT)

• CFRTs merge data on child deaths from the 4
  primary sources and multiple others
• They have a particular interest in uncovering
  violent deaths
• They offer unique information on the victims
  household, caregivers, supervision, and previous
  contacts with the system

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For NVDRS Surveillance Purposes, a Violent Death
Is One Classified As

• Suicide (including terrorism)
• Homicide (including terrorism)
• Legal intervention (excluding executions)
• Events of undetermined intent
• Unintentional firearm injury

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Scope of NVDRS
Intentional / Violent Deaths
Unintentional Injury Deaths
Undetermined Intent Deaths
Unintentional Firearm Deaths
NVDRS
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Flow of Information for NVDRS
CDC
State Health Dept
Completed Case
Med. Exam/ Coroner
Death certificate
State agencies Other Fed. agencies General
public Researchers
Crime Lab
Police
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NVDRS-Eligible Deaths in US in 2001
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NVDRS Funding 2002-2004

• Feb, 2002 Congresss first appropriation
  (1.5 million)
• Sept, 2002 CDC funds 6 of 17 applying MA,MD,
  NJ, OR, SC, and VA
• Feb, 2003 Second appropriation (1.5
  million)
• Aug., 2003 CDC funds 7 of 16 applying AK,
  CO, GA, NC, OK, RI, WI
• Feb, 2004 Third appropriation (725,000 million)

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NVDRS States as of May, 2004
FY 02 (6 states)
FY 03 (7 states)
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Progress to Date

• Implementation Working Group and Stakeholder
  Forum have met twice
• Software has been created and is being used by
  funded states.
• Users manuals have been created and are up on
  the web at www.cdc.gov/ncipc
• The first 6 states have collected most of their
  data from deaths in 2003.
• Announcement of third round of funded states in
  August.

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Involvement of Vital Records Office at the State
Level

• South Carolinas case initiation takes place in
  the vital statistics office by a full time staff
  person funded through the project.
• Maryland pays a clerk in the vital records office
  to pull all cases that meet the program case
  definition.
• Wisconsin pays the vital records office a yearly
  fee to run copies of all the records that meet
  the case definition.

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The Future for NVDRS

• Some results will become available in 2004
• Basic surveillance publications will follow.
• Incorporation into Public Health Information
  Network (NEDSS)
• Eventually all 50 states and territories will be
  incorporated, assuming funding is available.

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For Additional Information, Contact Leroy
Frazier, Jr., MSPH, CHES NVDRS Project
Officer [phone] Email Lfrazier1_at_cdc.gov