Citation

Kaplan MS, Caetano R, Giesbrecht N, Huguet N, Kerr WC, McFarland BH, Nolte KB. Am. J. Prev. Med. 2017; 53(1): 130-133.

Affiliation

Office of the Medical Investigator, University of New Mexico, Albuquerque, New Mexico.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.amepre.2017.01.043

PMID

28347589

Abstract

The Centers for Disease Control and Prevention (CDC) created the National Violent Death Reporting System (NVDRS) in 2002 to conduct surveillance for homicides, suicides, and unintentional deaths involving firearms. As of 2016, a total of 42 states are funded to contribute cases to the NVDRS using data from coroner and medical examiner (C/ME) reports, death certificates, law enforcement reports, and toxicology reports.1 Since 2011, the authors’ research team has worked with the NVDRS Restricted Access Database (RAD) on two projects funded by the National Institute on Alcohol Abuse and Alcoholism, focusing on acute alcohol use immediately prior to suicide. Not only is suicide a major public health problem, but also according to CDC, 8,179 deaths and 273,206 years of potential life lost resulted from alcohol-attributable suicides in 2006–2010 (the latest years available).2 This paper provides a unique perspective on NVDRS RAD strengths and limitations for researchers analyzing associations between alcohol variables and suicide and for investigators interested in other aspects of suicide. In contrast to standard suicide mortality data obtained exclusively from death certificates, NVDRS RAD has much broader data elements and provides accurate, timely, and comprehensive surveillance data. Also, NVDRS RAD is the only data set that identifies BACs among suicide decedents and homicide-followed-by-suicide cases and includes nearly complete toxicology data for suspected poisoning deaths. In addition, NVDRS RAD provides geographic indicators (e.g., county and ZIP code) that can be used to link decedents to contextual neighborhood factors. Finally, NVDRS data have been useful for creation of prevention programs for several vulnerable populations.11,12 As with most existing databases, NVDRS RAD has limitations. First, NVDRS is not national but recently increased funding allowed participation of 42 states. Second, collection of the circumstances preceding death is not standardized but varies across jurisdictions and among law enforcement personnel and C/MEs. As discussed in detail below, especially noteworthy limitations include lack of standardization for and possible selection bias in collecting mental health and substance use information. Should additional funding be earmarked for expanding NVDRS to nonparticipating states or for improving the quality of the data (e.g., toxicology data) currently collected in participating states? Ideally, all NVDRS decedents should receive a full panel of toxicology testing. Given funding constraints, researchers and state public health authorities can advise on sampling strategies so that representative decedents could ....

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