New System Tracks Homicides, Suicides

In its December issue, Injury Prevention Online publishes a special section on the National Violent Death Reporting System (NVDRS). It includes 14 articles that examine various aspects of the NVDRS, which was established in 2002 as an initiative of the Centers for Disease Control & Prevention to collect data on violent deaths in order to provide a more comprehensive picture of the causes and inform prevention strategies. 17 states now participate, and the intention is for the NVDRS to become a national system with participation from all 50 states, the District of Columbia and the U.S. territories.

The special section looks closely at how states are categorizing deaths, identifying consistencies and inconsistencies in how they track data on suicides and homicides.

Homicide/Suicides

When homicides are followed by suicides that occur within 24 hours of the homicide, three in four victims are female and the overwhelming majority of perpetrators (92 percent) are male. More than half the victims in these cases (58 percent) are current or former intimate partners of the perpetrators, and less than five percent of homicide/suicide incidents involve strangers.

Homicide/suicide is relatively rare, with seven states reporting 84 homicides followed by 65 suicides in 2003, and 13 states reporting 164 homicides followed by 144 suicides in 2004.

The authors recommend greater efforts to assist families in crisis and enhance the safety of people experiencing intimate partner violence, and the establishment of a national system to permit better monitoring and foster greater understanding of homicide/suicide.

Violent Deaths in North Carolina

1,674 North Carolinians suffered violent deaths in the state in 2004. Many more men than women were killed as a result of both suicide and homicide in the state that year. But more than half of female homicides (57 percent) involved intimate partner violence, compared to just 13 percent of male homicides.

Rape or sexual assault was reported for six percent of the female homicides and none of the male homicides. Three in four female homicides involving intimate partner violence (78 percent) occurred in the home. Argument, abuse and/or conflict were the most common precipitating factors in both female and male homicides.

"Fatal violence in females is distinct from fatal violence in males," the authors conclude, recommending that gender differences in the incidence, circumstances and methods of fatal violence be considered when violence prevention strategies are developed. "The primary prevention of intimate partner violence, including dating violence, and more effective mental health services… are two pressing areas that these data suggest should be addressed," they write.

Homicides of Young Children

In 2003 and 2004, seven states reported a total of 129 homicide deaths of children under age 4. The 2003 homicide rate for children this age was 3.0 homicides for every 100,000 population, but in 2004 it dropped to 2.5 homicides for every 100,000 population.

Homicides of infants and young children are most often committed in the home, by parents or caregivers, using "weapons of opportunity" that may indicate that a parent or caregiver is under stress.

The Injury Prevention Online special section also looks at the issue from an international perspective, concluding that, "The NVDRS is an important work in progress for the U.S. Each country should examine its own needs, traditions, resources, and existing infrastructure when deciding what kind of violence surveillance system to develop. However, collaboration in developing common definitions and classifications provides an important foundation for international comparisons."

The articles in the special section are available online, free of charge, at http://ip.bmj.com/content/vol12/suppl_2/.

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