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暴力死亡监测——国家暴力死亡报告系统,16个州,2005年

Surveillance for violent deaths--National Violent Death Reporting System, 16 states, 2005.

作者信息

Karch Debra L, Lubell Keri M, Friday Jennifer, Patel Nimesh, Williams Dionne D

机构信息

Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, GA 30341, USA.

出版信息

MMWR Surveill Summ. 2008 Apr 11;57(3):1-45.

Abstract

PROBLEM/CONDITION: An estimated 50,000 persons die annually in the United States as a result of violence-related injuries. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) regarding violent deaths from 16 U.S. states for 2005. Results are reported by sex, age group, race/ethnicity, marital status, location of injury, method of injury, circumstances of injury, and other selected characteristics.

REPORTING PERIOD COVERED

DESCRIPTION OF SYSTEM

NVDRS collects data regarding violent deaths obtained from death certificates, coroner/medical examiner reports, and law enforcement reports. NVDRS began operation in 2003 with seven states (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia) participating; six states (Colorado, Georgia, North Carolina, Oklahoma, Rhode Island, and Wisconsin) joined in 2004 and four (California, Kentucky, New Mexico, and Utah) in 2005, for a total of 17 states. This report includes data from 16 states; data from California are not included in this report because NVDRS has been implemented only in a limited number of California cities and counties rather than statewide as in other states.

RESULTS

For 2005, a total of 15,495 fatal incidents involving 15,962 violent deaths occurred in the 16 NVDRS states included in this report. The majority (56.1%) of deaths were suicides, followed by homicides and deaths involving legal interventions (29.6%), violent deaths of undetermined intent (13.3%), and unintentional firearm deaths (0.7%). Fatal injury rates varied by sex, race/ethnicity, age group, and method of injury. Rates were substantially higher for males than for females and for American Indians/Alaska Natives (AI/ANs) and blacks than for whites and Hispanics. Rates were highest for persons aged 20-24 years. For method of injury, the three highest rates were reported for firearms, poisonings, and hanging/strangulation/suffocation. Suicides occurred at higher rates among males, AI/ANs, whites, and older persons and most often involved the use of firearms in the home. Suicides were precipitated primarily by mental illness, intimate partner or physical health problems, or a crisis during the previous 2 weeks. Homicides occurred at higher rates among males and young adult blacks and most often involved the use of firearms in the home or on a street/highway. Homicides were precipitated primarily by an argument over something other than money or property or in conjunction with another crime. Similar variation was reported among the other manners of death and special situations or populations highlighted in this report.

INTERPRETATION

This report provides the first detailed summary of data concerning violent deaths collected by NVDRS. The results indicate that deaths resulting from self-inflicted or interpersonal violence occur to a varying extent among males and females of every age group and racial/ethnic population. Key factors affecting rates of violent fatal injuries include sex, age group, method of injury, location of injury, and precipitating circumstances (e.g., mental health and substance abuse). Because additional information might be reported subsequently as participating states update their findings, the data provided in this report are preliminary.

PUBLIC HEALTH ACTION

Accurate, timely, and comprehensive surveillance data are necessary for the occurrence of violent deaths in the United States to be understood better and ultimately prevented. NVDRS data can be used to track the occurrence of violence-related fatal injuries and assist public health authorities in the development, implementation, and evaluation of programs and policies to reduce and prevent violent deaths and injuries at the national, state, and local levels. The continued development and expansion of NVDRS is essential to CDC's efforts to reduce the personal, familial, and societal costs of violence. Further efforts are needed to increase the number of states using NVDRS, with an ultimate goal of full national representation.

摘要

问题/状况:在美国,估计每年有50,000人死于与暴力相关的伤害。本报告总结了疾病预防控制中心国家暴力死亡报告系统(NVDRS)提供的2005年美国16个州暴力死亡的数据。结果按性别、年龄组、种族/族裔、婚姻状况、受伤地点、伤害方式、伤害情形以及其他选定特征进行报告。

报告涵盖期间

2005年。

系统描述

NVDRS收集从死亡证明、验尸官/法医报告及执法报告中获取的暴力死亡数据。NVDRS于2003年开始运作,当时有7个州(阿拉斯加、马里兰、马萨诸塞、新泽西、俄勒冈、南卡罗来纳和弗吉尼亚)参与;2004年又有6个州(科罗拉多、佐治亚、北卡罗来纳、俄克拉何马、罗德岛和威斯康星)加入,2005年有4个州(加利福尼亚、肯塔基、新墨西哥和犹他)加入,共计17个州。本报告包括16个州的数据;加利福尼亚州的数据未包含在本报告中,因为NVDRS仅在加利福尼亚州的部分城市和郡县实施,而非像其他州那样在全州实施。

结果

2005年,本报告所涵盖的16个NVDRS州共发生了15,495起致命事件,涉及15,962起暴力死亡。大多数死亡(56.1%)为自杀,其次是他杀和涉及法律干预的死亡(29.6%)、意图不明的暴力死亡(13.3%)以及意外枪支死亡(0.7%)。致命伤害率因性别、种族/族裔、年龄组和伤害方式而异。男性的死亡率显著高于女性,美洲印第安人/阿拉斯加原住民(AI/ANs)和黑人的死亡率高于白人和西班牙裔。20 - 24岁人群的死亡率最高。就伤害方式而言,报告死亡率最高的三种方式为枪支、中毒以及上吊/勒杀/窒息。男性、AI/ANs、白人及老年人的自杀率较高,且自杀大多发生在家中,主要涉及使用枪支。自杀主要由精神疾病、亲密伴侣或身体健康问题,或前两周内的危机引发。他杀在男性和年轻成年黑人中的发生率较高,且大多发生在家中或街道/公路上,主要涉及使用枪支。他杀主要由金钱或财产以外的争执或与另一犯罪行为相关联引发。本报告中突出显示的其他死亡方式以及特殊情况或人群也有类似的差异。

解读

本报告首次详细总结了NVDRS收集的暴力死亡数据。结果表明,自我伤害或人际暴力导致的死亡在各年龄组和种族/族裔人群的男性和女性中均有不同程度的发生。影响暴力致命伤害率的关键因素包括性别、年龄组、伤害方式、受伤地点以及引发情形(如心理健康和药物滥用)。由于随着参与州更新其调查结果,后续可能会报告更多信息,因此本报告提供的数据为初步数据。

公共卫生行动

准确、及时且全面的监测数据对于更好地了解美国暴力死亡的发生情况并最终预防此类事件至关重要。NVDRS数据可用于追踪与暴力相关的致命伤害的发生情况,并协助公共卫生当局制定、实施和评估旨在减少和预防国家、州和地方各级暴力死亡和伤害的项目及政策。NVDRS的持续发展和扩展对于疾病预防控制中心降低暴力造成的个人、家庭和社会成本的努力至关重要。需要进一步努力增加使用NVDRS的州的数量,最终目标是实现全国范围的全面覆盖。

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