Na#onalCenterforInjuryPreven#onandControl

UsingFederalDatatoOp#mizeandInformPreven#onProgramsandResearch

MickBallesteros,PhDBranchChiefSta#s#cs,Programming,andEconomicsBranchDivisionofAnalysis,Research,andPrac#ceIntegra#onNa#onalCenterforInjuryPreven#onandControlCentersforDiseaseControlandPreven#on

3rdAnnualInjuryPreven0onCoordinatorsSymposiumMay15,2017

InventoryofNa#onalInjuryDataSystemshAps://www.cdc.gov/injury/wisqars/InventoryInjuryDataSys.html

BehavioralRiskFactorSurveillanceSystem(BRFSS)

BehavioralRiskFactorSurveillanceSystem(BRFSS)§  CDC’sChronicDiseaseCenter(NCCDPHP)§  Scope:Startedin1984;na0onwidein1993;now50states,DC,andseveralUSterritories§  Methods

–  Telephone(landandcell)interviews(>500,000/year)–  U.S.adults18yearsandolder–  FixedCore,rota0ngcore,op0onalmodulesforself-reportedhealthbehaviors

§  Access–  Publicusedatafiles(1984-2015)(

hAps://www.cdc.gov/brfss/annual_data/annual_data.htm)–  Onlinequerying(hAps://www.cdc.gov/brfss/data_tools.htm)

•  PrevalenceandTrends•  Crosstabula0onsandsomeregressioncapabili0es

BRFSSInjuryQues#ons§  CoreQues0ons

–  DrinkandDrive(2010,2012,2014)–  SeatBeltUse(2011-2015)

§  RecentOp0onalModules–  AdverseChildhoodExperiences(2004,2009-2012)–  CarbonMonoxideDetectors(2009)–  In0matePartnerViolence(2005-2007)–  SexualViolence(2005-2007)–  Residen0alFires(2003)

§  Datafrom2012BRFSS

§  Prevalenceoffallinginpast12monthssignificantlyhigheramongadultswitharthri0s.

§  Among>45yearswitharthri0s,46statesandDCfallprevalence>30%and16states>40%

Ref:MMWR.2014;63(17):379-383.

YouthRiskBehaviorSurveillanceSystem(YRBSS)

YouthRiskBehaviorSurveillanceSystem(YRBSS)§  CDC’sChronicDiseaseCenter(NCCDPHP)§  Scope

–  Developedin1990;Na0onaldatacollec0on;Somerepresenta0veState-leveldataavailable;Someci0esalsoavailable

§  Methods–  Schoolbasedsurvey–  9ththrough12thgradestudents(publicandprivateschools)–  Na0onalsample>15,000students

§  Access–  Publicusedatafiles(1993-2015)(

hAps://www.cdc.gov/healthyyouth/data/yrbs/data.htm)–  Onlinequerying(hAps://nccd.cdc.gov/youthonline/App/Default.aspx)

YRBSSInjuryQues#ons§  Uninten0onalInjuries

–  Usedbicyclehelmets–  Usesseatbelts–  Rodewithdriverwhohadbeen

drinking–  Drinkanddrive–  Textedwhiledrivingcar

§  Violence–  Carriedweapon,gun–  Threatenedorinjuredwith

weapononschoolproperty–  Wasinphysicalfight,injured

–  Feltunsafetogotoschool–  Waselectronicallybullied–  Experiencedphysicalorsexualda0ng

violence§  Suicide-Related

–  Feltsadorhopeless–  SeriouslyconsideredaAemp0ngsuicide–  Madeaplanforsuicide–  AAemptedsuicide–  AAemptedsuicidethatresultedin

injury,poisoning,oroverdose

Any TWD in past 30 days (>1d) % (95% CI)

TWD every day (30d) % (95% CI)

Overall (n=8,505)

45.5 (40.8-48.2) 11.5 (10.1-13.1)

Age (years) 16 17

>18

32.6 (28.8-36.6) 50.0 (44.9-55.1) 57.7 (53.6-61.7)

7.4 (5.9-9.3)

12.3 (10.5-14.5) 18.1 (15.4-21.2)

Sex Female

Male

42.3 (38.0-46.8) 46.4 (42.8-50.0)

10.3 (8.5-12.3) 12.6 (11.2-14.2)

Race/ethnicity White*

Black*

Hispanic

50.7 (45.8-55.6) 30.1 (25.1-35.6) 38.8 (35.8-41.9)

13.0 (11.2-15.0) 8.6 (6.9-10.6) 9.9 (8.3-11.8) *Non-Hispanic

2011Na0onalYRBSData

Ref:Pediatrics.2013:131:e1708-e1715

FatalAccidentRepor#ngSystem(FARS)

FatalAccidentRepor#ngSystem(FARS)§  RunbytheNa0onalHighwayTrafficSafetyAdministra0on(NHTSA-DOT)§  Scope

–  Establishedin1975–  CensusofallMVcrashesonpublicroadsthatresultedinatleast1deathwithin50

states,DCandPuertoRico§  Methods

–  StatescompileandreportdatatoNHTSA–  Datasources:PoliceReports,VehicleReg.files,DriverLicensefiles,StateHighway

Depart.data,vitalrecords/deathcer0ficates,coroner/MEreports,EMSreports§  Access

–  PublicusedatafilesfromFTPsite(kp://kp.nhtsa.dot.gov/fars/)–  Onlinequerying(hAps://www-fars.nhtsa.dot.gov//QueryTool/QuerySec0on/SelectYear.aspx)

FARSCrashInforma#onCollected§  Crash

–  Date,0me,loca0on–  Weathercondi0ons

§  Vehicles–  Make,model,year,body

type–  Impactpoints–  Numberofoccupants–  Sequenceofevents

§  PeopleInvolved–  Driver

•  Registra0onstate•  Licensetypeandstatus•  Previousviola0ons

–  Occupants•  Age,sex•  Sea0ngposi0on•  Restraintuse•  Alcohol/druginvolvement•  Injuryseverity

–  Bicyclists/pedestrians

Ref:MMWR.2014;63(5):113-118.

Na#onalViolentDeathRepor#ngSystem(NVDRS)

Na#onalViolentDeathRepor#ngSystem(NVDRS)§  NCIPC(InjuryCenter)atCDC§  Scope

–  2000:pilot–  2003:Datacollec0onbeginswith6states–  2014:32statestotal–  2016:8addi0onalstates,DC,andPuertoRicoadded

IA

ME

WA

CA

NV

AZ

NE

KS

LA

MN

MI IL

MO

AL

IN

WV

NY

CurrentNVDRSStates

OR

AK

CO

GA

MD

MA

NJ

NCOK

RI

SC

VA

WI

UTKY

NM2002

2003

2004

2009

2014

2016

OH

HI

NH

CT

VT

PA

PR

DC DE

Na#onalViolentDeathRepor#ngSystem(NVDRS)§  Methods

–  Ac0ve,ongoingstate-basedsurveillancesystem–  Informa0onabstractedusingaweb-basedapplica0on–  Providescomprehensiveinforma0ononviolentdeathswithinpar0cipa0ngstatestofully

characterizeincidents§  Primaryrequireddatasources:

–  Deathcer0ficates–  Coronerormedicalexaminer(CME)reports(includingtoxicology)(havenarra0ves)–  Lawenforcement(LE)reports(havenarra0ves)

§  Secondaryop0onaldatasources:–  ChildFatalityReview(CFR)teamdata–  In0matePartnerViolence(IPV)Reviewteamdata–  Crimelabdata–  SupplementaryHomicideReports–  Hospitaldata

Na#onalViolentDeathRepor#ngSystem(NVDRS)§  Access

–  OnlinequeryingthroughWISQARS(hAps://www.cdc.gov/injury/wisqars/)–  RestrictedAccessDatabaseavailableuponrequest(

hAps://www.cdc.gov/violencepreven0on/nvdrs/rad.html)

SurveillanceforViolentDeaths–NVDRS,17States,2013BHLyons,KAFowler,SPDJack,CJBetz,JMBlairBHLyons,KAFowler,SPDJack,CJBetz,JMBlair

Male Female Total

Method Firearm

Hanging/Suffocation Poisoning

n=9,876 57% 25% 10%

n=2,869 32% 24% 35%

N=12,747 51% 25% 16%

Diagnosed Mental Health Problem Depression

Anxiety disorder Bipolar disorder

n=3,572 72% 14% 12%

n=1,632 76% 18% 17%

N=5,204 73% 15% 14%

Type of Recent Crisis Intimate Partner

Criminal Legal Physical Health

Family Relationship

n=2,929 44% 15% 13% 8%

n=715 39% 7%

12% 14%

N=3,644 43% 14% 13% 9%

LeadingKeyCircumstancesSuicideDeathsbyDecedent’sSex

Ref:MMWRSurveillanceSummaries.2016;65(10):113-118.

InjuryDeaths:Na#onalVitalSta#s#csSystem(DeathCer#ficateData)

Na#onalVitalSta#s#csSystem(DeathCer#ficateData)§  CDC’sNa0onalCenterforHealthSta0s0cs§  Scope

–  Censusofalldeathcer0ficatesforU.S.residents§  Methods

–  StatessendtoNCHS,crea0onofna0onaldatabase–  Singleunderlyingcauseofdeath

•  Upto20addi0onalmul0plecauses•  1999-present:ICD-10coded

–  Age,race,ethnicity–  Placeofresidence(state,county)–  Placeofdeath,monthandweekdayofdeath–  Whetheranautopsywasperformed

Na#onalVitalSta#s#csSystem(DeathCer#ficateData)§  Access

–  Publicusedatafiles(1968-2015)hAps://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm#Mortality_Mul0ple

–  Onlinequerying•  WISQARS•  WONDERhAps://wonder.cdc.gov/

Ref:MMWR.2017;66(10):270-273.

Non-fatalInjuriesNa#onalElectronicInjurySurveillanceSystem–AllInjuryProgram(NEISS-AIP)Useforsec0onheaders

Na#onalElectronicInjurySurveillanceSystem–AllInjuryProgram(NEISS-AIP)

§  U.S.ConsumerProductSafetyCommission(CPSC)andCDC’sInjuryCenter(NCIPC)§  Scope

–  Na0onalEs0matesofInjury-relatedEmergencyDepartmentVisitsandHospitaliza0ons§  Methods

–  NEISS-AIPStartedin2000–  First0me,injury-relatedvisitsonalltypesandcausesofinjuries

•  Injurieswherenoproductismen0oned(e.g.,fellonground)•  Injuriesrelatedtoproductsnotcurrentlycollected

(e.g.,motorvehicles)•  Inten0onalinjuries;assaultsorsuicideaAempts

–  Na0onallyrepresenta0vesampleof66of100NEISSU.S.hospitalswith>6bedsandanED

NEISS All Injury Program Hospitals

Lanham, MD

Patchogue, NY

Santurce, PR

Very Large Hospitals

Large Hospitals

Medium Hospitals

Small Hospitals

Children’s Hospitals

Data Source: U.S. CPSC

Pittsfield, MA

Bridgeton, NJ

Claremont, NH

Brooklyn, NY

New York, NY

Rockville, MD

Yale, CT

Bronx, NY

Na#onalElectronicInjurySurveillanceSystem–AllInjuryProgram(NEISS-AIP)

§  Methods–  Approximately500,000casesperyear($3.40USDpercase)–  Dedicatedcodersabstractmedicalrecords–  Extensivetrainingandqualityassurancemeasureswithbothautomatedandvisual

edits–  Dataonmechanismandintentofinjury

§  Access–  Publicusedatasets(hAps://www.icpsr.umich.edu/icpsrweb/ICPSR/series/198)–  Onlinequerying

•  WISQARS

TrendsinSports-andRecrea#on-RelatedTrauma#cBrainInjuriesTreatedinU.S.EmergencyDepartments:NEISS-AIP2001-2012VCoronado,THaileyesus,TCheng,JBell,JHaarbauer-Krupa,MLionbarger,JFlores-Herrara,LMcGuire,JGilchrist

Ref:JHeadTraumaRehabil.2015.30(3):185-197

Web-basedInjurySta#s#csQueryandRepor#ngSystem

hbps://www.cdc.gov/injury/wisqars

Data:NVSS

Data:NVSSData:NEISS-AIP

Data:NVDRS

Data:NVSS,NEISS-AIP

Medical $79,025,584,000

Work Loss $126,145,699,000

Total Cost $205,171,282,000

Uninten#onalFalls,AllAges,UnitedStates,2015

WISQARSUpdatesandEnhancements

Formoreinforma0on,contactCDC1-800-CDC-INFO(232-4636)TTY:1-888-232-6348www.cdc.govThefindingsandconclusionsinthisreportarethoseoftheauthorsanddonotnecessarilyrepresenttheofficialposi0onoftheCentersforDiseaseControlandPreven0on.

Thankyou!ContactInfo:MickBallesterosmballesteros@cdc.gov770-488-1481