Indiana Violent Death Reporting System (INVDRS) Advisory ... 2017 Meeting Presentation.pdf · • Data Presentation –2015-2017 Violent Death Demographics –2015 INVDRS Pilot Counties

Indiana Violent Death Reporting

System (INVDRS)

Advisory Board MeetingSeptember 15, 2017

Rachel Kenny, MPH,

INVDRS PI & Epidemiologist

Division of Trauma and Injury Prevention

1

Email Questions: [email protected]

[email protected]

2


Agenda

• Introductions

• Drug Overdose Grants Update-Jessica

Schultz

• Program Updates

• Data Presentation

– 2015-2017 Violent Death Demographics

– 2015 INVDRS Pilot Counties

3


Introductions

4


New INVDRS Staff

• Records Consultants

– Brittany Armstrong

– Patricia Dotson

– Anita McCormick-Peyton

• Intern-Vincent Gallagher

5


2018 meeting dates

•1 p.m.-3 p.m. EST in Rice

Auditorium

–March 16th

– September 21st

6


Program Updates

7


8


2017 Reverse Site Visit

• May 16th-May 18th

• New Orleans, LA

• Attendees: NVDRS-funded states and

CDC staff

Rachel and Ryan attended.

9


10

11

12

2017 Safe States Annual

Meeting

• September 12-14, 2017

• Aurora, Colorado

• Strong focus in Data presentation and

violence prevention

13


Sessions Attended

• Making your Data Work for You

• Advanced Data Analysis Approaches

• Innovative ways to Communicate Data

• Building Capacity for Systems Thinking

among Injury and Violence Preventions

• Link Data to Save Lives: Using NVDRS

to Prevent Suicide and Firearm Injury

14


Sessions Attended

• Preventing Suicide Across the National

Spectrum

• Expanding the Scope of NVDRS

Analyses

• Addressing Firearm Violence with

Public Health Strategies

15


Suicide in Indiana ReportReminder!

16


11 Leading Causes of Death, Indiana, 2011-2015

17

18


19


20


21


22


23


24

Suicide Attempts

• For every suicide death there is on

average 25 suicide attempts

• For every youth suicide death there is

on average 100-200 youth suicide

attempts

– 14,500-29,000 Hoosier youths attempted

suicide in Indiana between 2011 and

2015 25


26


27


28


Other topics in Report

• Suicide in the U.S.

• Additional maps/geographic

distributions

• Special Populations

• Protective factors

• Risk factors

29


Data Sources

• ISDH Mortality Reports, 2011–2015. Epidemiology

Resource Center,

• CDC WISQARS and WONDER databases

• Indiana Hospital Association, Hospital Discharge

Inpatient Data, 2011-2015.

• Indiana Hospital Association, Hospital Discharge

Outpatient/ED Data, 2011-2015.

• Indiana Youth Risk Behavior System Survey, 2011

and 2015.

30


Report available at:

http://www.in.gov/isdh/25396.htm

31


RECENT GRANT APPLICATIONS

32


Grant activities

• Prescription Drug Overdose: Prevention for States – Applied for year 2 (base and supplement)

– Applied for a Program Expansion: 7/2017

• Enhanced State Surveillance of Opioids– Originally awarded but not funded, funding starts September 1

– Applied for supplement: 7/2017

• First Responder Comprehensive Addiction and Recovery Act– Applied 7/2017

33


Prescription Drug Overdose Prevention

for States 2017 Program Expansion

Activity 1.1: Building Capacity and Infrastructure to Enhance Use of INSPECT Data

Activity 1.2: INSPECT Expansion into Electronic Health Records in High Opioid- Prescribing Facilities

Activity 2.1: Piloting of an Overdose Fatality Review

Activity 2.2: Collecting Adverse Childhood Experiences Data through the 2018 Behavioral Risk Factor Surveillance System

Activity 4.1: Overdose Rapid Response Plan to Address Overdose Clusters in Five Pilot Counties

34


Enhanced State Opioid Overdose

Surveillance (ESOOS)

Originally applied 6/2016, funded 9/2017

1. Increase the timeliness of aggregate nonfatal opioid overdose reporting

2. Increase the timeliness of fatal opioid overdose and associated risk factor reporting

3. Disseminate surveillance findings to key stakeholders working to prevent or respond to opioid overdoses

35


ESOOS 2017 Supplemental

1 year supplemental opportunity

Activity 1: Implement comprehensive toxicology testing

Activity 2: Linking INSPECT data to opioid-related overdose deaths during coroner investigations

36


First Responder - Comprehensive

Addiction and Recovery Act (FR CARA)

Program will: 1) Provide resources through the Indiana Naloxone Kit

Distribution Program for First Responders in rural communities;

2) Train first responders on carrying and administering naloxone; and

3) Expand the Indiana Recovery and Peer Support Initiative for referral to appropriate treatment and recovery communities.

As of 9/14/2017, Funding Decision Pending

37


2018 IPAC Meetings

Meetings: 10 a.m. – 12 p.m. EST

• March 16

• Spring Conference, TBD

• July 20 (webcast)

• September 21

• November 16

38


2017 IPAC Meetings

Meetings: 10 a.m. – 12 p.m. EST

• November 17

39


Upcoming Events

• Indiana Emergency Response Conference, Sept. 20-23

• National Traumatic Brain Injury Awareness Month

• National Suicide Prevention Week, Sept. 10-16

• Child Passenger Safety Week, Sept. 17-23

• Falls Prevention Awareness Day, Sept. 22

• National Seat Check Saturday, Sept. 23

40


http://www.thejohnnyo.org/

http://www.suicidology.org/

https://www.trafficsafetymarketing.gov/get-materials/child-safety/child-passenger-safety-week

https://www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-awareness-day/

https://www.trafficsafetymarketing.gov/get-materials/child-safety/child-passenger-safety-week

Upcoming Events• Public Safety + Public Health Opioid Conference, Sept 27

• Domestic Violence Awareness, October

• National Bullying Prevention Month, October

• 8th Annual Prescription Drug Abuse & Heroin Symposium, October 30-31

• 2017 Labor of Love Summit, Nov. 15

• 2017 Midwest Injury Prevention Alliance Summit, November 30-December 1

41


https://www.eventbrite.com/e/public-safety-public-health-opioid-conference-tickets-36838582191

http://www.ncadv.org/

http://www.pacer.org/bullying/nbpm/

https://www.eventbrite.com/e/8th-annual-prescription-drug-abuse-and-heroin-symposium-tickets-35411307173

http://www.infantmortalitysummit-indiana.org/

https://www.midwestinjurypreventionalliance.org/2017-summit/

Public Safety + Public Health

Opioid Conference

42

• September 27th from 8:30 a.m. to 4:30 p.m. at the Ritz Charles

• No registration fee required and breakfast and lunch are provided

• Learn more:




2017 Midwest Injury Prevention

Alliance Summit

43

44

2018 EMS Medical Director’s

Conference


2017 Labor of Love Summit

45

• November 15, J.W. Marriott in downtown Indy

• More info: http://www.infantmortalitysummit-indiana.org/


http://www.infantmortalitysummit-indiana.org/

Thank you for your attention!

Jessica Schultz, MPH

Injury Prevention Epidemiologist Consultant

Email: [email protected]

Phone: 317-617-4155

46


mailto:[email protected]

Data Provider Progress

47


Coroners

48

• 76 signed data

sharing

agreements

Questions/Comments:

[email protected]

Connections?

• Boone

• Jefferson

• Jennings

• Knox

• Miami

• Noble

• Owen

• Posey

• Sullivan

• Switzerland

• Warren

• Warrick

• Wells

• White

49Please contact: [email protected]


Challenges

Agencies Declining to Participate in INVDRS

• Monticello PD

• Elkhart County SD

• Goshen PD

• Elkhart PD

• Cass County SD (~5)

• Gibson County SD (~14)

• Harrison County SD (~17)

• Mishawaka PD (~42)

• Montgomery SD

• New Albany PD (~45)

• Starke County SD (~14)

• Steuben County SD (~6)

50


Challenges

Agencies Not Yet Participating

– White County coroner and sheriff

– Jasper County SD

– Demotte PD

– St. Joseph County SD

– Osceola PD

– Salem PD

51


Successes

• 45 Coroner DSA’s in January 2017 to

76 today

• Elkhart County Coroner is participating

and we have already received their

reports

• Indiana State Police have been

approved to participate and we are now

waiting for their records52


Data Abstraction &

Records Collection

53


Data Availability and

Deadlines

Data Year Death Certificate Data Complete INVDRS

Data-CDC Deadline

2015 Sept. 2016 (prelim),

January 2017 (final)

June 2017



June 2018



June 2019

Etc.

54


2016 Records Collection

• Coroner Reports Received: 52%

• LE Reports Received: 57%

55


Death Certificate Data

for Violent Deaths

56


57

405

977

183

506

1036

206

0

200

400

600

800

1000

1200

Homicide Suicide Undetermined

Dea

th C

ou

nt

Manner of Death by Year

2015 2016


58

52 101107

53 41 33 18

35 109

167172

187 163 144

1510

41 32 39 3412

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

<18 18-24 25-34 35-44 45-54 55-64 >65

Perc

enta

ge o

f D

eath

s

Age Group

2015 Manner of Death by Age Group



59

55 121 13584

49 32 26

33125

162172

210 162 172

26

19 38 35 45 2914

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

<18 18-24 25-34 35-44 45-54 55-64 >65

Perc

enta

ge o

f D

eath

s

Age Group

2016 Manner of Death by Age Group



60


1554

669226

373

466159

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Suicide Homicide Undetermined

Perc

enta

ge o

f D

eath

s

2015-2016 Percentage of Death Manner by Gender

Male Female

Breakdown: Suicides

61


Counties with Most Resident

Suicides: 2015- 2016

1. Marion — 276

2. Lake — 129

3. Allen — 87

4. St. Joseph — 80

5. Hamilton — 76

6. Vanderburgh — 62

7. Vigo — 52

8. Elkhart — 51

9. Porter — 50

10. Madison — 44

11. Hendricks — 43

12. Monroe — 43

13. Johnson — 37

14. Tippecanoe — 37

15. Clark — 31

62


63

0

20

40

60

80

100

120

Dea

th C

ou

nt

Suicide Counts by Month2015 2016 2017


64

35

109

167 172187

163144

33

125

162172

210

162172

0

50

100

150

200

250

<18 18-24 25-34 35-44 45-54 55-64 >65

Dea

th C

ou

nt

Age Group

Suicide Count by Age Group and Year2015 Suicide 2016 Suicide


65

2.09

8.86

19.1620.17 20.71

18.11

14.49

0.00

5.00

10.00

15.00

20.00

25.00

<18 18-24 25-34 35-44 45-54 55-64 >65

Rat

e

Age Group

2015 Suicide Rate by Age Group


Rates per 100,000.

2.5

21.6

32.6 31.834.4

27.129.4

1.7

7.15.7

8.5 7.210.1

3.8

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

<18 18-24 25-34 35-44 45-54 55-64 >65

Rat

e

Age Group

2015 Suicide Rate by GenderMale Female

66


Rates per 100,000.

67

15.38

24.99

6.01

7.23

12.71

2.12

Crude Rate

Male

Female

2015 Suicide rates by race and sex White African-American

*Unstable Rate

Rates per 100,000.


23%

1%

33%

36%

1%6%

2015-2016 Marital Status Suicide

Divorced

Married, but seperated

Married/CivilUnion/Partnership

Never Married

Unknown

Widowed

68


3.6%

13.8%

48.4%

6.3%

15.7%

8.0%

2.2%

1.6%

0.4%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

<= 8th Grade

9th-12th Grade

HS or GED

Associate

Some College Credit

Bachelor

Master

Doctorate

Unknown

2015-2016 Education Level Suicide

69


Breakdown: Homicides

70


Counties with Most

Homicides (2015-2016)

71


1. Marion — 325

2. Lake — 133

3. Allen — 79

4. St. Joseph — 40

5. Elkhart — 25

6. Delaware — 17

7. Vanderburgh — 16

8. Warrick — 10

9. Howard — 9

10. Vigo — 9

11. LaPorte — 8

12. Madison — 8

13. Johnson — 7

14. Porter — 7

15. Hamilton — 6

0

10

20

30

40

50

60

Dea

th C

ou

nt

Homicide Counts by Month2015 2016 2017

72


50

99 100

5239 33

18

55

121135

84

49

32 26

0

20

40

60

80

100

120

140

160

<18 18-24 25-34 35-44 45-54 55-64 >65

Dea

th C

ou

nt

Age Group

Homicides by Age Group and Year2015 2016

73


65

189 188

105

69

49

3141

3147

3119 16 13

0

20

40

60

80

100

120

140

160

180

200

<18 18-24 25-34 35-44 45-54 55-64 >65

Dea

th C

ou

nt

Age Group

2015-2016 Homicide by Gender/AgeMale Female

74


3.23

8.68

11.40

6.07

4.443.62

1.66

0.00

2.00

4.00

6.00

8.00

10.00

12.00

<18 18-24 25-34 35-44 45-54 55-64 >65

Rat

e

Age Group

2015 Homicide Rate by Age Group

75


Rates per 100,000.

3.59

23.57

18.06

9.477.56 7.91

2.842.854.6 4.71

2.671.36 2.16

0.950

5

10

15

20

25

<18 18-24 25-34 35-44 45-54 55-64 >65

Rat

e

Age Group

2015 Age and Gender Homicide RateMale Female

76


Rates per 100,000.

77

2.7 31.7

3.7 54.8

1.7 10.3

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Rate per 100,000

2015 Homicide rates of White and African American

Hoosiers: A look at the disparity.

Crude Rate

Males

Females


Rates per 100,000.

78


12% 1%

13%

71%

3%

2015 - 2016 Marital Status of Homicide Victims

Divorced

Married, but seperated

Married/CivilUnion/Partnership

Never Married

Widowed

9.8%

28.9%

39.9%

4.1%

11.7%

3.4%

0.7%

0.1%

1.5%

<= 8th Grade

9th-12th Grade

HS or GED

Associate

Some College Credit

Bachelor

Master

Doctorate

Unknown

2015-2016 Education Level of Homicide Victims

79


80

3.6%

13.8%

48.4%

6.3%

15.7%

8.0%

2.2%

1.6%

0.4%

9.8%

28.9%

39.9%

5.2%

11.7%

3.4%

0.7%

0.1%

1.5%

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

<= 8th Grade

9th-12th Grade

HS or GED

Associate

Some College Credit

Bachelor

Master

Doctorate

Unknown

Percentage

2015-2016 Manner of Death by Education Level

Suicide Homicide


Child Section

81


69

47

18

1

75

44

21

6

0

10

20

30

40

50

60

70

80

Homicide Suicide Undetermined Accident

Dea

th C

ou

nt

2015-2016 Child (<18) Deaths by Manner 2015 2016

82


98

63

19

7

26 2820

00

20

40

60

80

100

120

Homicide Suicide Undetermined Accident

Dea

th C

ou

nt

<18 Manner of Death 2015 & 2016Male Female

83


2

34

49

02 2

1318

3 3

82

73

0

10

20

30

40

50

60

70

80

90

Accident Undetermined Homicide Suicide

Dea

th C

ou

nt

Manner of Death by Age Group <10 10-14 15-17

84


1.8

13.5

0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0

10-14

15-17

Rate

Age

Ran

ge2015 Child Suicide Rate

85


Rates per 100,000.

5.7

1.8

4.5

0.0 1.0 2.0 3.0 4.0 5.0 6.0

<10

10-14

15-17

Rate

Age

Ran

ge2015 Child Homicide Rate

86


Rates per 100,000.

2015 INVDRS

Data

Data limited to Allen,

Lake, Madison, Marion,

St. Joseph, and

Vanderburgh Counties

87


Data Quality Checks

• CDC checked our 2015 pilot county

data for potential errors, such as:

– Weapon type missing

– Poisoning as cause of death but no

substance listed as having caused the

death

– If Suspect in Homicide is an intimate

partner, ensuring the IPV circumstance is

checked88


Data Completeness Check

• CDC will soon be sending us a report

on our data that outlines the percentage

of our cases with circumstances and

other categories.

• Our completeness comparison to grant

expectations.

89


Data Sources

• 402 Suicides

– 389 with coroner report abstracted

– 226 with law enforcement abstracted

– 229 with both abstracted

• At least one circumstance was known

for 273 of the suicides.

90


Data Sources

• 313 Homicides

– 313 with coroner report abstracted

– 124 with law enforcement abstracted

– 121 with both abstracted

• At least one circumstance was known

for 173 of the homicides.

91


Limitations

• First Year of Data

• Missing LE/Coroner Reports

• Quality of LE/Coroner Reports

• Can’t speculate on more rural Indiana

counties

92


SUICIDE CIRCUMSTANCES

93


94

54.5

23.4

14.9

3.5

2.5

1.2

0.0 10.0 20.0 30.0 40.0 50.0 60.0

Firearm

Hanging/Strangulation/Suffocation

Poisoning

Sharp Instrument

Other

Motor Vehicle

Percentage

Weapon Type for Suicide Decedents


95

45%

37%

16%12%

66%

55%

23%

18%

0%

10%

20%

30%

40%

50%

60%

70%

Depressed Mood MH Problem Alcohol Problem Other SubstanceAbuse

Perc

enta

geSuicide Circumstances-Mental Health and

Substance Abuse% All Suicides % of Suicides with at least 1 Circumstance


Mental Health Diagnoses-150

• 105 Depression

• 17 Bipolar

• 8 Schizophrenia

• 6 PTSD

96


97

14%

2%

6% 6% 5%

19%

10%

19%

6%

21%

3%

8% 9%8%

27%

15%

28%

9%

0%

5%

10%

15%

20%

25%

30%

Perc

enta

geSuicide Circumstances-Life Stressors

% All Suicides % of Suicides with at least 1 Circumstance


98

12

38

Argument Timing BreakdownDuring Argument With 24 hours of Argument


99

2%

19%

25%27%

31%

3%

29%

37%40%

45%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Recent Suicide History ofSuicide

Attempts

DisclosedIntent

Left a Note History ofSuicidal

Thoughts

Perc

enta

geSuicide Circumstances-Suicide Specific% All Suicides % of Suicides with at least 1 Circumstance

100

37, 48%

29, 37%

12, 15%

Disclosed Intent to Whom BreakdownCurrent or Former Partner Other Family Member Friend


HOMICIDE CIRCUMSTANCES

101


102

80%

6%

6%

4%4%

1%

Weapon Type for Homicide Decedents

Firearm

Blunt Instrument

Sharp Instrument

Personal Weapons

Hanging/Strangulation/Suffocation

Other


103

13% 13%

10%

7%

6% 5%5% 4%

3% 3% 3%2%

24%23%

18%

13%

10%10%

9%8%

5%5% 5%

3%

0%

5%

10%

15%

20%

25%

Perc

enta

ge

Homicide Circumstances% All Homicides % of Homicides with at least 1 Circumstance


Precipitated by Other Crime

Breakdown

• Burglary= 6 homicides

• Drug Trade= 6 homicides

• Robbery= 7 homicides

104


What else would you

like to see? Activity!

105

Email Questions: [email protected] Questions: [email protected]

2018 meeting dates

•1 p.m.-3 p.m. EST in Rice

Auditorium

–March 16th

– September 21st

106


Call to Action

• Send interested parties to ISDH Division of Trauma and Injury Prevention

• [email protected]

• INVDRS PI & Epidemiologist

Rachel Kenny

317-233-8197

[email protected] 107



Documents

Indiana Violent Death Reporting System (INVDRS) Advisory ... 2017 Meeting Presentation.pdf · • Data Presentation –2015-2017 Violent Death Demographics –2015 INVDRS Pilot Counties