Online Program

Intentional injury deaths in Washington state

Monday, November 4, 2013

Joe Campo, MPH, Washington State Office of Financial Management, Healthcare Research Group, Forecasting and Research Division, Olympia, WA
Background/Purpose: Firearms command the public's and policy-makers' attention following each assault-style rifle attack in a middle-American community. But while firearm-related initiatives wax and wane with each attack, little attention is paid to assessing the overall and relative magnitude of intentional injuries by intent, mechanism, demographic characteristics, region or small area. Per a request from our state legislators, such an assessment on firearm injuries was completed in April, 2013; this presentation builds upon that analysis by assessing all intentional injuries in Washington State. Methods: Washington's age-adjusted death rates by intent, gender, age, race/ethnicity, and region were computed, as were rates for British Columbia and the USA. Tract-based clusters with higher or lower than expected incidents of intentional injury deaths by intent and mechanism were also identified via the spatial scan statistic. These clusters were then profiled using the state's BRFSS data. Results/Outcomes: Between 2008 and 2010, there were 3,340 intentional injury deaths in Washington; 2,746 were suicides, 1,366 of which involved firearms. Of the remainder, 594 homicides, 356 involved firearms. Males were at higher risk. Some variations existed by race/ethnicity. Rates were generally higher in the more rural eastern half of the state. Geographic clusters' characteristics generally comported with expectations, e.g., high firearm suicide clusters had high unemployment, low life satisfaction, little emotional support, poor quality of life, and high firearm availability. Conclusions: In assessing intent and mechanism, the current focus on firearm homicides alone seems disproportionate. By identifying at-risk communities and their risk-factors, interventions may be more efficaciously targeted.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Demonstrate the role of data analysis in policy development. Explain the value of small area variation analysis. Describe how diverse data sets can be integrated through spatial analyses. Discuss the spatial scan statistic and how it can be utilized in identifying at-risk communities. Assess intentional injuries by magnitude and intent, gender and age, race and ethnicity, and regional and small areas.

Keyword(s): Injury, Geographic Information Systems

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently one of the three staff in the governor's budget office's Healthcare Research Group. Previously, I had been the manager of the Washington State Department of Health's (DOH) Research Section in the Center for Health Statistics. Prior to that I was the DOH cancer epidemiolgist for 10 years, including an one-year research fellowship in Ireland as part of the NCI/Northern Ireland/Republic of Ireland Cancer Consortium.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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