Violent Deaths in Georgia, 2008-2012 — (Georgia Violent Death Reporting System)

SSRI Ed note: Suicide victims were disproportionately represented by military vets, antidepressants in blood of 42.1 % of those tested. No way to know about withdrawal.

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Oct 20, 2016

Georgia Violent Death Reporting System

Brenda Fitzgerald, M.D., Commissioner and State Health Officer
J. Patrick O’Neal, M.D., Director, Division of Health Protection
Cherie L. Drenzek, D.V.M., M.S., State Epidemiologist
A Rana Bayakly, MPH, Chief Epidemiologist, Chronic Disease, Healthy Behaviors, and Injury Epidemiology Section J. Michael Bryan, MPH, Georgia Violent Death Reporting System Epidemiologist

Table of Contents
ACKNOWLEDGEMENTS                                                                                                                                                                      2
INTRODUCTION                                                                                                                                                                                     4
EXECUTIVE SUMMARY                                                                                                                                                                        5
SECTION 1: OVERVIEW OF VIOLENT DEATHS                                                                                                                            6
SECTION 2: HOMICIDES                                                                                                                                                                    14
SECTION 3: SUICIDES                                                                                                                                                                         19
APPENDIX A: TECHNICAL NOTES                                                                                                                                                  24
GLOSSARY                                                                                                                                                                                               26
APPENDIX C: VIOLENT DEATHS BY PUBLIC HEALTH DISTRICT OF RESIDENCE                                                         39
APPENDIX D: VIOLENT DEATHS BY JUDICIAL DISTRICT OF RESIDENCE                                                                      40
REFERENCES                                                                                                                                                                                          41


Violent deaths, such as homicides and suicides, impact the lives of individuals, families, and communities in the United States (U.S.) and around the world. In 2012, worldwide, there were approximately 475,000 deaths by homicide (age-adjusted rate of 6.7 per 100,000 population) and 804,000 deaths by suicide (age-adjusted rate of 11.4 per 100,000 population) (WHO, 2014a; WHO, 2014b). In the U.S. during this period 16,688 people died by homicide (age-adjusted rate of 5.3 per 100,000 population) and more than 40,000 people died by suicide (age-adjusted rate of 13.0 per 100,000 population) (CDC, 2015a). To prevent violent deaths, we must understand the root causes of why they occur, who are being mostly affected, and how these types of violence impact the lives of communities and families. This can be achieved by collecting and linking accurate information about violent death incidents from multiple state and local data sources. The U.S. Centers for Disease Control and Prevention (CDC) implemented the National Violent Death Reporting System (NVDRS) in 2002 as a state based surveillance system to improve surveillance of violent deaths nationwide (CDC, 2014). NVDRS is the only state-based surveillance system that gathers data for each violent death incident (i.e., manner of death, circumstances, mental health status, relationship between victim and suspect, etc.) from multiple data sources into an anonymous database to provide more detailed information on each violent death (CDC, 2014). Georgia is one of 32 states currently participating in the NVDRS. The state-based program is referred to as the Georgia Violent Death Reporting System (GA-VDRS). GA-VDRS aims to: 1) inform decision makers and program planners about the magnitude and characteristics of violent deaths in Georgia, 2) improve violence prevention efforts and 3) monitor violent death burden and trends in Georgia.

The data sources used by the GA-VDRS include:
• Death certificates
• Medical examiner and/or coroner reports
• Police reports (Supplemental Homicide Reports)
• Crime laboratory records • Emergency Medical Services trip reports • Child Fatality Review

The GA-VDRS uses uniform data elements developed by NVDRS in collaboration with funded states.

Executive Summary

The Georgia Violent Death Reporting System (GA-VDRS) is a statewide surveillance system that collects data on all homicides, suicides, deaths of undetermined intent, deaths resulting from legal intervention, and deaths resulting from unintentional firearm injuries in Georgia. The GA-VDRS’ goals are to generate public health information on violent deaths and to provide evidence based information to assist in the development of programs, policies, and strategies to prevent violent deaths in Georgia.

Summary of GA-VDRS Findings, 2008-2012

• From 2008 to 2012, 9,549 violent deaths were reported in Georgia – an average of over 1,900 violent deaths per year.

• Fifty-six percent (56%) of all violent deaths were due to suicide, while 34% were due to homicide.

• Ninety-six percent (96%) of victims were Georgia residents and 83% died in their county of residence.

• Fifty-eight percent (58%) of violent deaths occurred at the victim’s residence: 70% of suicides and 37% of homicides.

• The age-adjusted violent death rate for males was more than three times higher than for females.

• Black males had the highest age-adjusted violent death rate.

• Firearms were the weapon type most commonly used.

Among suicide victims with a known military status, 21% had served in the U.S. Armed Forces.


Note: Sadly, this study tested homicide victims for ingested substances (drugs, alcohol) but presenteded no information on any tests done on perpetrators.


Figure 3c. Age-Specific Suicide Rates by Age Group and Sex, Georgia, 2008-2012

*Age-specific mortality rate was not calculated where number of deaths was <25.

The overall age-specific suicide rate was highest among those 45-54 years old.

  • Among males, suicide rates increased with age, with the greatest age-specific suicide rate being among those over 85 years old.
  • Among females, the age-specific suicide rate is greatest for the 45 to 54 year old age group and declines with age.
  • Males 45 to 54 years of age had 2.6 times the age-specific suicide rate as females.
  • When comparing males to females, the age-specific suicide rate ratio increased with each age group after the 45 to 54 year old group.

Figure 3c. Age-Adjusted Suicide Rates by Race* and Sex, Georgia, 2008-2012

Figure 3e. Percent of Suicides by Type of Weapon# and Sex, Georgia, 2008-2012

#Weapons are not mutually exclusive. Some incidents may include more than one weapon. ^Includes hanging and strangulation *Includes: falls, fire/burns, motor vehicle, other transportation vehicle, personal weapons (males), explosives (males), biological weapons, blunt instrument, drowning (males), personal weapons (males), and other.

    • Overall, 7.5% of male and 8.9% of female suicide victims were fatally injured by an unknown weapon.
    • Firearms were the most common weapon used to fatally injure male and female suicide victims: 64.5% and 48.5%, respectively.
    • The proportion of female suicide victims that died from poisoning was 3.4 times greater than that of male victims


Circumstances information was available in 87% of suicide cases in Georgia during 2008-2012.

Table 3a. Percent of Suicides by Known Circumstances*, Georgia, 2008-2012 (N=4,669) Circumstance % Depressed mood 34.5 Mental health problem 29.0 Physical health problem 24.3 Disclosed suicidal thoughts or intent to complete suicide 22.1 History of mental health/substance abuse treatment 21.7 Intimate partner problem 25.3 Depression/dysthymia 12.2 Job problem 10.5 Alcohol problem 10.0 Non-alcohol related substance abuse problem 9.4 History of suicide attempts 8.5 Financial problem 8.0
*Circumstances were not mutually exclusive.

The most frequent suicide circumstance was being in a depressed mood, followed by having mental health problems.


Toxicology tests were performed on 44% (2,377) of suicide victims in Georgia during 2008-2012. • Of the tested victims with results available (1,590), 57% (907) did not test positive for any toxic substance.

Table 3b. Percent of Suicide Victims with Positive Toxicology Results by Drug Type*, Georgia, 2008-2012 (N = 2,377)

Drug Type %

  • Antidepressants 42.1
  • Alcohol 33.2 Benzodiazepines 24.5
  • Opiates 13.6
  • Cocaine 5.0
  • Amphetamines 4.2
  • Marijuana 3.5
  • Barbiturates 1.3

*Toxicology tests were not mutually exclusive. Antidepressants were the substances most frequently present among suicide victims who were tested. Among those who tested positive for alcohol, 24% had a blood alcohol level (BAC) above the adult legal limit in Georgia (BAC ≥ 0.08%).