ABSTRACT: The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14-44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio= 0.27, 95% CI = 0.11-0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31-0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39-1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26-0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.
Maternal and Child Health Journal 07/2011; 15(5):660-9. · 2.24 Impact Factor
ABSTRACT: Research concerning suicide and homicide in North Carolina is needed so that medical providers and others who develop and implement preventive and therapeutic interventions related to violence have an empirical base from which to work.
North Carolina Violent Death Reporting System data composed of death certificates, medical examiner reports, and law enforcement reports were analyzed to examine the prevalence of suicide and homicide in North Carolina during 2004-2007 and to describe the sociodemographic characteristics of suicide and homicide victims.
Suicides and homicides accounted for 2.3% of all North Carolina deaths during 2004-2007. There were 12.0 suicides (95% confidence interval [CI], 11.7-12.4) and 7.2 homicides (95% CI, 6.9-7.4) per 100,000 North Carolina residents. Suicide rates were higher among men and boys, whites, non-Hispanics, and persons aged > or = 35 years. Homicide rates were higher among men and boys, American Indians, blacks, Hispanics, and persons aged < or = 24 years. Firearms were the most common method used to commit suicide and homicide, accounting for 59.5% of suicides and 67.0% of homicides.
Every day in North Carolina, approximately 3 persons kill themselves and approximately 2 persons are killed by others. Suicide and homicide inflict a high level of preventable mortality in North Carolina. Learning more about these violent deaths will help to inform the development of effective violence-prevention interventions.
North Carolina medical journal 71(6):519-25.
ABSTRACT: Violence is a leading cause of death in North Carolina. The North Carolina Violent Death Reporting System (NC-VDRS) is part of the National Violent Death Reporting System (NVDRS), which monitors violent deaths and collects information about injuries and psychosocial contributors. Our objective was to describe and evaluate the quality, timeliness, and usefulness of the system.
We used the Centers for Disease Control and Prevention's guidelines for evaluating public health surveillance systems to assess the system. We performed subjective assessment of system attributes by reviewing system documents and interviewing stakeholders. We estimated NC-VDRS's reporting completeness using a capture-recapture method.
Stakeholders considered data provided by NC-VDRS to be of high quality. Reporting to the national system has taken place before the specified 6-month and 18-month deadlines, but local stakeholder reports have been delayed up to 36 months. Stakeholders reported using NC-VDRS data for program planning and community education. The system is estimated to capture all NVDRS-defined cases, but law enforcement officers report only 61% of suicides.
The law enforcement agencies we interviewed may not be representative of all participating agencies in the state. Data sources used to assess completeness were not independent.
NC-VDRS is useful and well-accepted. However, completeness of suicide reporting is limited, and reporting to local stakeholders has been delayed. Improving these limitations might improve the usefulness of the system for planning and appropriately targeting violence prevention interventions.
North Carolina medical journal 73(4):257-62.