NVDRS Special Interest Group (SIG)Survey of Unfunded States

The views and opinions expressed in this presentation are those of the authors and do not necessarily represent official policy or position of the Safe States Alliance.

BACKGROUND: Why did we do it?

Support for NVDRS Expansion

WIDESPREAD SUPPORT FOR EXPANSIONRecent violent events

have sparked broader interest in expansionPresident Obama supports full funding (+ $20 million)Congress recently appropriated ~ $8 million additional for FY 14

2012 National Strategy for Suicide Prevention

American Association of Suicidology American Bar Association American College of Preventive Medicine American Foundation for Suicide Prevention American Psychological Association American Public Health Association American Academy of Pediatrics International Association of Chiefs of Police National Organization of People of Color

Against Suicide Safe States Alliance Suicide Prevention Action Network The Joyce Foundation Tri-Council for Nursing (ANA; AACN; NLN;

AONE)

Funded StatesCurrently funded states

* CA collected data in four counties from 2005-2009

Survey RationaleNo unified national system for surveillance of violent deathsNVDRS currently represents only 34% of the U.S. population under-represents Hispanics, suicides, some regions

There are likely common barriers to full participation by new statesSurvey issued to assess potential, readiness, capacity, and interest of unfunded states SIG also wished to learn about barriers and challenges

faced by unfunded states

METHODS: How did we do it?

Survey Design and DistributionDeveloped and conducted by the NVDRS-SIG Strategic Planning Subcommittee Identified specific barriers and challenges

that could be faced by states Wrote survey based on those barriers and

challenges Conducted pilot study Identified potential respondents through

multiple sourcesoCould have more than one respondent per state

Survey LimitationsMultiple respondents from some statesNot generalizableNot all non-funded states responded

RESULTS: What did we find out?

25 respondents from 20 states Same-state respondents usually

agreed, but not always Results presented by number of

respondents, not statesVery small to very large states represented

Are states interested in applying for NVDRS funding?

Don't know/not sure

No

Maybe

Yes

0 2 4 6 8 10 12 14

4

2

7

12

Why are states interested in applying?

Data driv

en decision m

aking

VDs are st

ate prio

rity

Administrati

on interest

DC easy ac

cess

CME easy ac

cess

LE easy

acce

ss

CDC funding s

ufficient

Other0

3

6

9

12

15

18

16

8 8

12

98

56

N=19

Why are states not interested in applying?

Inabilit

y to build

capaci

ty

No/limite

d state

injury

program

CDC funding i

nsufficient

CME data

acces

s diffi

cult

No inter

est in

state

admin.

VD surve

illance

not prio

rity

LE data

acces

s diffi

cult

Other0

1

2

3

44

3 3

2

1 1 1 1

N=6

What isn’t a problemNo respondents selected these choices: State gov’t obstacles to using federal

funding Difficulty accessing death certificate

data Size of the state

Would uninterested states be interested in applying if sampling were possible?

Yes; 2

Maybe/not sure; 1

No; 3

N=6

Would uninterested states be interested in applying if they could use alternate data or methods?

Yes; 2

Maybe; 3

Don't know/not

sure; 1

N=6

Where would the VDRS be housed?

State

Epi. p

rogram

State

Injury progra

m

State

ME office

Universi

ty

Other sta

te dep

t/office

Other0123456789

10

2

9

2 2

4

1

N=20

Do states have centralized CME or LE data?

Yes No Don't know/not sure0

2

4

6

8

10

12

14

5

10

3

67

12

CME LECME: N=18LE: N=25

Do states have easy access to death certificate data?

Yes No Don't know/not sure0

2

4

6

8

10

12

14

16

18

20

19

2

4

N=25

Data on firearm-related deaths:An advantage or disadvantage?

Advantage Disadvantage Neither0

2

4

6

8

10

12

14

16

18

6

2

17N=25

What is the level of interestin specific violent deaths?

Homicides Suicides Undetermined Accidental FA0

5

10

15

20

25

HighModerateLowUnknown

N=25

SUMMARY

Motivation: Why do states want NVDRS?

Only 2 respondents said their state would not be interested in applyingInterest in participation strongly based on• NVDRS value for input into policy • Access to violent death data, esp. vital

records• State interest in violent deaths,

particularly suicides

20 of 25 of respondents could say where system would be housedMajority reported easy/electronic access to vital records dataHigh proportion of respondents reported “No” or “Don’t know/not sure” to CME & LE data accessAdditional barriers noted Poor/limited state capacity Insufficient federal funding

Feasibility: Are non-NVDRS states equipped to participate?

Five of six respondents who said their state was not interested in applying expressed some interest in sampling within the state and/or using alternate data sources

Flexible Design Options: Could new options allow more states to participate?

Building on the work of the 2011 NVDRS Roundtable discussion, the 2012 Roundtable Report, the survey of non-funded states, and other discussions over the last couple of years

CONSIDERATIONS FOR THE FUTURE

Considerations for the Future• Make expansion an explicit priority and set

specific goals and timelines for including more states, built against a template of greater national representativeness (e.g., by state size, region, and diversity)

• Develop “market intelligence” and involve states directly in development of changes to help NVDRS meet new goals and timelines

• Further explore these findings and begin developing a detailed profile for every likely participating state (e.g., program “owner”, feasible design, barriers, etc.)

Considerations for the Future• Consider alternative designs for states that can

only participate with a sample of records or political sub-areas (cities or counties) or with innovative use of electronic records

• Explore funding strategies tailored to actual state implementation plans (e.g., sample or electronic plans may cost less than statewide abstraction of decentralized resources)

Next stepsUse feedback from the NVDRS SIG meeting and RSV presentation to revise presentationSend revised presentation to all SIG members for inputPost final version of presentation on Safe States website with all explanatory notes

Questions? Comments?Scott Proescholdbell, NVDRS SIG Chair Scott.proescholdbell@dhhs.nc.gov

NVDRS SIG Strategic Planning Subcommittee Roger Trent, rogertrent99@gmail.com Jeannette Hudson, jhudson@edc.org Pat Smith, smithp40@michigan.gov