firearm deaths and injuries among youth in north carolina · 2020-03-02 · firearm deaths and...
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![Page 1: Firearm Deaths and Injuries among Youth in North Carolina · 2020-03-02 · Firearm Deaths and Injuries among Youth in North Carolina Scott K. Proescholdbell, MPH North Carolina Division](https://reader033.vdocuments.us/reader033/viewer/2022050104/5f43100235789c27641f097c/html5/thumbnails/1.jpg)
NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 1
Firearm Deaths and Injuries among Youth in North Carolina
Scott K. Proescholdbell, MPH
North Carolina Division of Public Health
Chronic Disease and Injury Section
Injury and Violence Prevention Branch
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 2
Firearm-related Violence in US & NC
* 2018 data are provisional
Analysis by Injury Epidemiology and Surveillance Unit (as of Dec 2019)
NC Firearm-related deaths, 2018*
NC all ages= 1,345
NC ages 0-17= 61
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 3
North Carolina Violent Death Reporting System (NC-VDRS)
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 4
Data and Surveillance • Since 2004, abstract approximately 2,000 violent deaths per year
(homicides, suicides, firearm deaths)
• Data Sources and Collaborators
–Death certificate data- State Center for Health Statistics
–NC Office of the Chief Medical Examiner (OCME)
–NC-IBRS (SBI)
–Decentralized law enforcement
•More than 650 law enforcement agencies in NC
•~250 in a given year experience violent death
• Data can differ slightly due to case definition, data closeout dates, and other factors
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 5
North Carolina Violent Death Reporting System
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 6
Deaths by Manner/Intent: Resident and Occurrence Deaths
North Carolina Violent Death Reporting System, age 0-17, 2004-2018*
511
758
71
10
71
520
780
72
10
77
0
100
200
300
400
500
600
700
800
900
Suicide Homicide UnintentionalFirearm
LegalIntervention
UndeterminedIntent
Resident Occurrence
Total resident deaths = 1,421
Total occurrence deaths = 1,459
* 2018 data is provisional
Analysis by Injury Epidemiology and Surveillance Unit (as of Dec 2019)
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 7
Firearm Deaths in North Carolina:2014-2018*
NC all ages= 6,477
NC ages 0-17= 239
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 8
Firearm Death Counts/Rates by Race ages 0-17:NC-VDRS, 2014-2018*
Data Source: North Carolina Violent Death Reporting System, 2017 ; Analysis conducted by Injury Epidemiology and Surveillance Unit
*Technical Note: 239 violent deaths caused by firearms among 0-17: 2014 -2018- using May 2019 datafile
2018* data are provisional
16
100
76
40 22
19 18
0 1 10
20
40
60
80
100
120
Hispanic White NH Black NH AI/NA NH Asian NH Unknown
Male Female
White NH Rate: 2.1
Black NH Rate: 3.7
Hispanic Rate: 1.1Rates per 100,000 NC persons
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 9
Firearm Death Rates by Sex and Age (0-17): NC-VDRS, 2014-2018*
Data Source: North Carolina Violent Death Reporting System, 2017 ; Analysis conducted by Injury Epidemiology and Surveillance Unit
*Technical Note: 239 violent deaths caused by firearms among 0-17: 2014 -2018- using May 2019 datafile
2018* data are provisional
* Rate per 100,000 NC population; † <5 deaths; rate suppressed
0.0
3.6 3.7
11.3
39.7
0.02.9 0.0
3.76.0
0
10
20
30
40
50
Age Group
Male Female
††
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 10
Firearm-Related Deaths by Manner and Firearm Type, ages 0-17:NC-VDRS, 2014-2018*
Manner by Percent Firearm Type by Percent
Data Source: North Carolina Violent Death Reporting System, 2017 ; Analysis conducted by Injury Epidemiology and Surveillance Unit
Technical Note: 239 violent deaths caused by firearms for ages 0-17: 2014-2018- using Dec 2019 datafile
*2018 data are provisional
47.7
42.7
8.6
Homicide Suicide Unintentional firearm
73.2
10.0
10.9
5.9
Handgun Rifle
Shotgun Other/Unknown
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 11
Circumstances
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 12
Firearm-related Suicide
Circumstances
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 13
Firearm Suicides: Percent of Circumstances:
NC-VDRS ages 0-17, 2014-2018*
Analysis by Injury Epidemiology and Surveillance Unit- using Dec 2019 datafile
*2018 data are provisional
21.8
26.9
20.5
7.7
29.5
15.4
5.1
21.4 21.4 21.4
7.1
35.7
14.3
7.1
0
5
10
15
20
25
30
35
40
Depressed Mood Current MentalHealth Problem
Current MentalHealth Treatment
History of SuicideAttempt(s)
Left a SuicideNote
Disclosed Intent Physical HealthProblem
PE
RC
EN
TMale Female
N= 102: total number suicide firearm deaths 0-17
N= 92: At least 1 known circumstance (90.2%)
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 14
Firearm-related Homicide
Circumstances
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 15
Firearm-related Homicide: Percent of Circumstances for ages 0-17: NC-VDRS, 2016-2017
Analysis by Injury Epidemiology and Surveillance Unit- using Dec 2019 datafile
26.7
24.0
13.314.7
13.3
10.5
21.1
31.6
10.5
31.6
0
5
10
15
20
25
30
35
Argument Crime Drug Gang IPV
PE
RC
EN
T
Male Female
N= 114: total number homicide firearm deaths 0-17
N= 94: At least 1 known circumstance (82.7%)
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 16
Firearm-Related ED Visits
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 17
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 18
Quick Note: ICD-10-CM Transition
• The International Classification of Diseases, 10th revision, Clinical Modification replaced ICD-9-CM in 2015
− Affects Hospital Discharge (HD), Emergency Department (ED), and outpatient diagnosis coding
• ICD-10-CM captures more detail than ICD-9-CM
− Contains almost 5 times as many codes
− Number of relevant injury codes jumped from 2,600 (ICD-9-CM) to 43,000
− ICD-10-CM data is not comparable to ICD-9-CM data
• Case definitions and external cause of injury categories are still being evaluated and are subject to change
• Current nonfatal firearm-related injury case definition includes any mention of the following codes:
W32.0, W33.0, W34.00, W.34.09 Accidental Discharge of Firearm
X72, X73, X74.8, X74.9 Intentional Self-Harm by Firearm
X93, X94, X95.8, X95.9 Assault by Firearm
Y38.4 Terrorism Involving Firearms
Y22, Y23, Y24.8, Y24.9 Firearm Discharge of Undetermined Intent
Y35.0 Legal Intervention Involving Firearm Discharge
*With a 7th character of A or missing (Initial encounter/active treatment)
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 19
Firearm-Related ED Visit (0-17) Rates, 2016-2018
20.5
3.8 4.7 4.5
20.3
8.9
* 1.7 2.4 2.9
9.4
47.7
0
10
20
30
40
50
60
Ra
te p
er
10
0,0
00
*NC Residents, 2016-2018; NH: Non-HispanicSource: NC State Center for Health Statistics, Hospitalization Discharge Data (2016-2018) [Excludes Deaths]Analysis by Injury Epidemiology and Surveillance Unit
N = 855 ED Visits
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 20
*NC Residents, 2016-2018; Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2016-2018) [Excludes Deaths]Analysis by Injury Epidemiology and Surveillance Unit
N = 855 ED Visits
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 21
Firearm-Related Hospitalization (0-17) Charges, 2016-2018
•$96,239 average charge
•$3,477 minimum charge
•$1,479,954 maximum charge
*NC Residents, 2016-2018Source: NC State Center for Health Statistics, Hospitalization Discharge Data (2016-2018) [Excludes Deaths]Analysis by Injury Epidemiology and Surveillance Unit
N = 275 Hospitalizations
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 22
Prevention
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 23
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 24
Data Source: NC Child Health Assessment and Monitoring Program (NC CHAMP), 2011
Analysis by Injury Epidemiology and Surveillance Unit
Percent of NC Parents Firearm Practices (Do you use a gun or chamber lock?)
NC CHAMP (ages 0-17), 201132.8% Have firearm in or around home
25.4% Keep firearms loaded
29.2% Keep firearms unlocked
17.3% Unlocked & loaded
62.5
37.5
0
10
20
30
40
50
60
70
No Yes
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NC Division of Public Health | Injury and Violence Prevention Branch | Public Health Leaders Conference | January 23rd, 2020 25
Scott ProescholdbellInjury Epidemiologist, Injury and Violence Prevention Branch
Dana Dandeneau Injury Epidemiology Fellow, Injury and Violence Prevention Branch
Tammy NorwoodProgram Manager, NC-VDRS, Injury and Violence Prevention Branch