CDC and states will share data to study violence

Each year, about 51,000 people in the United States die from homicide, suicide or other violent means, according to the Centers for Disease Control and Prevention. The nation's yearly motor vehicle fatalities total another 40,000.

State and federal health officials are looking to a national vehicular accident reporting system as a model to shed light on the causes of violent death.

CDC and health departments in six states'Maryland, Massachusetts, New Jersey, Oregon, South Carolina and Virginia'are about to pool their information on violent deaths at one location.

If all goes as planned, the 50 states and the District of Columbia will participate in the National Violent Death Reporting System (NVDRS), said Dr. Len Paulozzi, an epidemiologist with the CDC's National Center for Injury Prevention and Control.

'We could then have a complete census of all violent deaths in the nation,' Paulozzi said.

He defined a violent death as one 'where there is an intent to threaten, frighten or hurt someone, including oneself.' That includes homicide, suicide or death caused by a law enforcement officer'even a small category of unintentional firearm deaths.

Although the causes are investigated, the information usually ends up in desk drawers or standalone computers, NVDRS officials said.

They compared their new approach with that of the Transportation Department's Fatality Analysis Reporting System. Since the 1970s, FARS has compiled data from each fatal crash reported. Of more than 100 coded data elements that characterize a vehicle crash, 88 can be queried at www.fars.nhtsa.dot.gov.

Policy-makers over the years have used FARS data to enact measures calling for seat belts, air bags, safer car designs and speed limits. As a result, the rate of traffic deaths per million miles traveled in the United States has dropped by about half since FARS' inception.

Collected data

CDC's initiative follows on the heels of a similar pilot directed by the Harvard School of Public Health. Begun in 1999, the Harvard program culled data from 13 law enforcement and public health sites in nine states.

Lenora Olson, associate director of the Intermountain Injury Control Research Center at the University of Utah in Salt Lake City, worked on Harvard's National Violent Injury Statistics System.

Olson said she and her team 'de-identified' their data'meaning they stripped it of identifying information such as names and addresses'before sending it about twice a year to a secured File Transfer Protocol site.

'We always included a narrative with the data,' Olson said, 'such as that an alleged suspect had alcohol on his breath.'

Using data from the Harvard pilot, researchers at the Center for Violence and Injury Control at Allegheny General Hospital in Pittsburgh, one of the NVISS sites, found that both homicide and suicide rates in Allegheny County dropped precipitously for three months after Sept. 11, 2001.

'We've always had death certificates and some information from the police,' Paulozzi said, 'but there is a lot of information about violent death in separate sources.' NVDRS will pull together related data from medical examiners, death certificates and crime laboratories.

'We want to do it in a more timely way than something like death certificates would allow,' he said.

NVDRS will collect information about victims and suspected perpetrators, geographic locations, circumstances and detailed weapon descriptions.

State health departments will compile the information from their local sources. Although the exact configuration is still under development, Paulozzi said the states might have a client-server setup with a continuous connection to a hub.

They might also simply collect information on notebook PCs in coroners' offices, for example. Eventually the data would go into a Microsoft SQL Server database behind the firewall of a state's health department.

Before data went on to CDC, personal identifiers such as names and addresses would be stripped out by a contractor, InDyne Inc. of McLean, Va.

States would send their data to InDyne secured by 128-bit Secure Sockets Layer browser encryption. InDyne would then transmit the files to CDC's national database.

InDyne also has worked on the FARS program for the National Highway Traffic Safety Administration, said Tim Pruss, the company's operations director.

Gunshot wounds

Brian Wiersema, a senior research specialist in the Criminology and Criminal Justice Department at the University of Maryland at College Park, worked on the Harvard pilot program as well as NVDRS. Partnering with the Maryland State Health and Mental Hygiene Department, the group abstracted data from police and crime lab reports about firearm injuries in Baltimore and Prince George's County, Md. For the NVISS pilot, Wiersema said he submitted data to Harvard via encrypted e-mail.

CDC is funding the program with $1.5 million approved by Congress in December 2001.