Centers for Disease Control and Prevention (CDC) Releases Latest Data on Deaths

“Surveillance for Violent Deaths — National Violent Death Reporting System, 16 States, 2008,” appears in the August 26, 2011 online edition of Morbidity and Mortality Weekly Report Surveillance Summaries (MMWR). 

 

Report Highlights:

The new report compiled data on 16,138 deaths in 2008 from 16 NVDRS states. A majority of these deaths were:

• Suicides (58.7%)
• Homicide/legal intervention deaths (26.4%)
• Deaths of undetermined intent (14.5%)

NVDRS provides a comprehensive picture by combining once fragmented pieces of information from:

• Death certificates
• Coroner/medical examiner reports
• Toxicology results
• Law enforcement reports
• And other reports related to each death

Data are used to inform prevention efforts by providing a more complete understanding of the circumstances preceding deaths in these 16 states.

To Learn More:

• View an electronic copy of this document.
• Data from the NVDRS states is available online through WISQARS™ (Web-based Injury Statistics Query and Reporting System)
• About CDC’s violence prevention efforts: www.cdc.gov/violenceprevention
• Follow the CDC on Facebook: www.facebook.com/vetoviolence

ABSTRACT

HOMICIDE PATTERNS

"Escalated interpersonal conflicts with an intimate partner, a friend, or another acquaintance remained the primary preceding circumstances for homicide. These circumstances were vastly more common than random acts of violence, hate crimes, or drive by shootings. For incidents with male victims, arguments with an acquaintance other than an intimate partner most often preceded homicide. Homicides with female victims were most often a result of intimate partner violence. Similar findings were provided in previous reports and studies (7--9,21). These findings provide more evidence that homicides are most commonly perpetrated by someone known to the victim, and strategies designed to reduce interpersonal and relationship conflicts might be valuable for prevention efforts.

Homicide-followed-by-suicide (i.e., homicide-suicide) incidents continued to be rare in 2008. However, they did account for the greatest proportion of violent incidents that involved multiple deaths. Similar to other reports and previous data years, perpetrators of homicide-suicide incidents were mostly white males of mid-late adulthood (i.e., aged 35--54 years) and victims were mostly females who were either current of former intimate partners of the perpetrator (21,23,24). As expected, intimate partner problems were among the most common circumstances preceding these incidents (7--9,21); however, job/financial problems and mental health problems were two to three times more common among perpetrators in 2008 versus those in 2007.  

PREVENTION OPPORTUNITIES

NVDRS continues to show that interpersonal conflicts and relationship problems, particularly with an intimate partner, are common circumstances preceding a violent event.

 In addition to demonstrating the need to address the situational stressors highlighted in this report, prevention strategies also need to focus on community level factors. For example, changing cultural and social norms (e.g., attitudes condoning the use of violence as a means of resolving conflict) and addressing the social and economic conditions within communities that often give rise to violence (e.g., inequities with regard to the distribution of and access to resources and opportunities, social isolation and lack of connectedness among persons, families, and communities) might further help prevent violence.

CONCLUSION

Accurate, timely, and comprehensive surveillance data can be used to monitor the occurrence of violence-related fatal injuries and assist public health and other authorities in the development, implementation, and evaluation of programs and policies that reduce and prevent violent deaths and injuries at the national, state, and local levels (36,37). Continued development and expansion of NVDRS is critical to the public health and criminal justice communities at the federal, state, and local levels that work to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states participating in NVDRS, with the ultimate goal of full national representation, including all 50 states, the District of Columbia, and U.S. territories. 

CIRCUMSTANCES - Circumstances preceding fatal injury, by manner of death --- National Violent Death Reporting System, 16 states, 2008 (ABSTRACTED)

SUICIDE/UNDETERMINED

• Intimate partner problem: problems with a current or former intimate partner that appear to have contributed to the suicide.
• Other legal problem: decedent was facing civil legal problems (e.g., a child custody or civil lawsuit).
• Perpetrator of interpersonal violence in previous month: decedent perpetrated interpersonal violence (e.g., being sought by police for assault or having been issued a restraining order resulting from recent violence) during the previous month.
• Victim of interpersonal violence in previous month: decedent was the target of interpersonal violence in the past month.

 HOMICIDE

• Other argument, abuse, conflict: conflict between decedent and suspect was over something other than money, property, or drugs.
• Jealousy ("lovers' triangle"): jealousy or distress over an intimate partner's relationship or suspected relationship with another person led to the homicide.
• Intimate-partner violence--related: homicide is related to conflict between current or former intimate partners; includes the death of actual intimate partners and nonintimate partner decedents killed to cause pain to an intimate partner (e.g., child or parent).

Key STATS - Suicides

30.9% - Intimate Partner Problem - 32.2% of Males and 25.9% Females who commit suicide.

27.9% - Crisis in past or impending 2 weeks - 29% Males and 24% Females

74.6% - Depression - 74.2% Males and 75.4 Females

9.3% - Anxiety - 8.4% Males and 11.4% Female

1.6% - PTSD

KEY STATS - Homicides

22.9% Married

10.2% Spouse/Intimate partner (current or former)

.8% Other intimate partner involvement

18.1% Females Age 35-44

18.7% Males Age 20-24

53.5% Black, Non-hispanic Males

50.7% White Females

52.2% Mudered at home

18.4% Intimate partner-violence-related - 7.6% Males and 51.6% Females

24.3% Assault/Homicide

KEY STATS - Undetermined Death

11.1% Intimate partner problem 

14.7% Crisis in past or impending 2 weeks

To see entire report, please visit the CDC's website.

MEDICAL NEWS: Domestic Abuse May Affect Reproductive Freedom

MedPage Today
By Kristina Fiore, Staff Writer, MedPage Today
Published: January 25, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

In some abusive relationships, men may use strategies to force women to become pregnant, including sabotaging their birth control, researchers reported.

In a cross-sectional study of women treated at five family clinics across northern California, about 20% of women said that their partner tried to coerce them into having a child, Elizabeth Miller, MD, of the University of California Davis, and colleagues reported online in the journal Contraception.

Beyond outright coercion, abusive partners also engaged in birth control sabotage, for example, poking holes in condoms and flushing birth control pills down the toilet.

"It was stunning to have this many women seeking reproductive health services saying, 'this has happened to me,'" Miller said.

To investigate a possible link between domestic violence and forced pregnancy, the researchers conducted a survey of 1,278 women ages 16 to 29 who sought care at the five family planning clinics in northern California.

More than half of the women surveyed -- 53% -- reported physical or sexual partner violence.

Approximately a third of the women who reported partner violence also reported pregnancy coercion or birth control sabotage.

Altogether, the effect of both partner violence and reproductive control nearly doubled a woman's odds of unintended pregnancy (OR 1.99, 95% CI 1.11 to 3.58).

Both pregnancy coercion and birth control sabotage were separately associated with unintended pregnancy as well (OR 1.83, 95% CI 1.36 to 2.46 and OR 1.58, 95% CI 1.14 to 2.20, respectively).

"The findings suggest that pregnancy coercion and birth control sabotage may be an aspect of partner violence that, given its relevance to reproductive health, should be identified by providers in clinical settings," the authors wrote.

Among the reasons men would want their partners to bear children: "It ranges from things like wanting to leave a legacy, to a straightforward desire for attachment, to having absolute control over her body," Miller said. "There are all of these elements to it."

Aisha Mays, MD, director of the Teen and Young Adult Clinic at San Francisco General Hospital who was not involved in the study, said pregnancy coercion is a growing problem that has been around for "quite some time" but is just now being recognized as a major health issue.
"It's about power and control," Mays said. "It's another way of saying, 'this girl's taken, this girl's mine.'"

Mays said she has seen cases in which a young mother who has a child with another partner will be forced by her new boyfriend to have another baby with him.

It's also a way for males to make their partners more dependent on them, according to Amy Bonomi, PhD, MPH, of Ohio State University.
"Women in abusive relationships are sometimes forced to bear children as a means to keep them dependent on their partner and sometimes as a means to justify additional -- and sometimes more severe -- abuse," Bonomi said.

Miller said the findings emphasize the need for family planning clinics to provide intervention programs to combat both reproductive control and partner violence.

Key strategies include advising women about "invisible" forms of birth control such as injectable and intrauterine contraceptives, as well as easy access to emergency contraception.

"If we can identify that reproductive control is going on," Miller said, "we can offer the woman methods for birth control that the partner can't mess with."
Mays added that physicians and counselors should talk about women's empowerment with regard to reproduction during reproductive health visits.
"It tends to be left out," Mays said. "We talk about getting the prescription [for birth control] and its side effects. But we really need to have a discussion around whether the girl is feeling ready for sex."

The study was limited by its cross-sectional design, which "precludes conclusions concerning temporality regarding associations observed among pregnancy coercion, birth control sabotage, and intimate partner violence with unintended pregnancy." Miller et al said additional studies are needed to clarify the chronology of reproductive control and partner violence, and how those factors might combine to affect risk for unintended pregnancy.

The study was supported by grants from the National Institute of Child Health and Human Development, a UC Davis Health System Research Award, and a Building Interdisciplinary Research Centers in Women's Health award.
The researchers reported no conflicts of interest.

This article was developed in collaboration with ABC News.

Primary source: Contraception
Source reference:  Miller E, et al "Pregnancy coercion, intimate partner violence and unintended pregnancy" Contraception 2010; DOI: 10.1016/j.contraception.2009.12.004.