Understanding Gun-Related Deaths in Virginia

Explore the comprehensive investigation process of gun-related deaths in Virginia led by the Office of the Chief Medical Examiner (OCME). Learn about the criteria that define an OCME case, the statistics on OCME cases compared to all deaths in Virginia, and the data sources utilized for forensic epidemiology surveillance and fatality review.

• Virginia
• Gun Crimes
• Forensic Epidemiology
• OCME
• Death Investigation

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1. Gun-Related Deaths in Virginia Rosie Hobron, MPH State Forensic Epidemiologist VDH, Office of the Chief Medical Examiner

2. Medical Examiner Vs. Coroner

3. Provide state of the art, high quality, professional medicolegal death investigation for all citizens of the Commonwealth regardless of their geographic location

4. What Makes a Death an OCME Case? Death must have occurred in VA Pursuant to 32.1-283 of the Code of Virginia, all of the following deaths are investigated by the OCME: any death from trauma, injury, violence, or poisoning attributable to accident, suicide or homicide; sudden deaths to persons in apparent good health or deaths unattended by a physician; deaths of persons in jail, prison, or another correctional institution, or in police custody (this includes deaths from legal intervention); deaths of patients/residents of state mental health facilities; the sudden death of any infant less than eighteen months of age whose death might be attributable to SIDS or SUID any other suspicious, unusual, or unnatural death

5. Number of All OCME Deaths and All Unnatural Deaths Compared to All Deaths in Virginia by Year, 2007-2017 80000 70000 60000 Annually, approximately 10% of all deaths occurring in Virginia are OCME cases 50000 Number of Deaths 40000 Annually, approximately 7% of all deaths occurring in Virginia are unnatural deaths 30000 20000 10000 0 2007 3871 5958 57609 2008 3789 5811 58468 2009 3705 5608 57980 2010 3687 5573 58353 2011 3914 5672 60157 2012 3979 5767 60808 2013 4102 5809 61800 2014 4345 6176 62694 2015 4540 6252 64787 2016 5104 6868 65288 2017 5298 7187 67762 OCME Cases (Unnatural manner) All OCME Cases Total Virginia Deaths

6. OCME Data Sources Forensic Epidemiology Surveillance and Fatality Review (FR) All OCME cases Specific types of OCME cases FR-Multi disciplinary stakeholder committee review of cases Only residents of VA Delayed reporting of data (~2 years behind) Strong data collection on risk factors, contributors, and decedent s history Based on deaths that occur in VA Report on recent data Restricted details collected during death investigation

7. OCME Data Methods and Limitations Deaths that occur in VA, not based on state of residence Unique internal OCME coding schema; no ICD-10 codes Date elements based on date of death Delayed deaths (deaths that occur months or years after event)

8. Top 3 Methods of Unnatural Death (All Manners) in VA Total Number of Motor Vehicle, Gun, and Drug Related Fatalities by Year of Death, 2007-2018 1800 1600 1400 1200 Number of Fatalities 1000 800 600 400 200 0 2007 1124 836 721 2008 928 818 735 2009 841 843 713 2010 823 868 690 2011 878 863 819 2012 877 835 799 2013 832 852 914 2014 808 901 994 2015 879 940 1028 2016 890 1058 1428 2017 956 1028 1536 2018* 960 1036 1486 Motor Vehicle Related Gun Related Fatal Drug Overdose 1 Top 3 methods of death (motor vehicles, guns, and drugs) include all manners of death (accident, homicide, suicide, and undetermined)

9. Rates of Gun-Related Death Nationally vs. VA 14.0 12.0 10.0 Rate per 100,000 8.0 6.0 4.0 2.0 0.0 2007 10.4 10.8 2008 10.4 10.5 2009 10.2 10.7 2010 10.3 10.8 2011 10.4 10.7 2012 10.7 10.3 2013 10.6 10.3 2014 10.5 10.8 2015 11.3 11.2 2016 12.0 12.6 2017 12.2 12.1 National Rate* VA Rate National Rate* VA Rate * National rate source (crude rates, not age-adjusted): https://wonder.cdc.gov

10. VA Gun-Related Deaths by Manner 800 Roughly, 1/3 of gun-related deaths are homicides and 2/3 are suicides 700 600 Suicide Number of Deaths 500 400 Homicide 300 200 100 0 2007 7 325 493 11 2008 12 264 523 19 2009 10 287 539 7 2010 5 280 575 8 2011 7 242 608 6 2012 8 236 585 6 2013 5 244 590 13 2014 7 254 635 5 2015 10 286 628 16 2016 8 374 670 6 2017 5 353 664 6 2018* 6 347 674 9 Accident Homicide Suicide Undetermined

11. Gun-Related Suicides vs All Other Methods of Suicide Number of Gun-Related Suicide Compared to All Other Methods of Suicide by Year of Death, 2007-2018* 1400 Over 56% of all suicides involve guns 1200 1000 800 600 400 200 0 2007 410 493 2008 426 523 2009 434 539 2010 419 575 2011 456 608 2012 467 585 2013 471 590 2014 510 635 2015 468 628 2016 486 670 2017 493 664 2018 536 674 Suicides, All Other Methods Gun-related Suicide

12. Gun-Related Suicide Demographics (Gender-Age) Aggregated Five Year Rate of Gun-Related Suicide by Gender and Age Group, 2013-2017 50.0 Men are 5.7 times more likely to be a victim of gun-related suicide than females 45.0 40.0 35.0 Rate per 100k 30.0 25.0 20.0 15.0 Male Rate 10.0 Female Rate 5.0 0.0 10-14 0.5 1.0 15-19 0.8 8.2 20-24 1.5 15.6 25-34 2.6 12.7 35-44 2.4 13.2 45-54 3.9 15.5 55-64 3.0 19.2 65-74 3.5 21.7 75-84 2.6 28.5 85+ 1.5 46.0 Female Rate Male Rate

13. Gun-Related Suicide Demographics (Gender-Race) Aggregated Five Year Rate of Gun-Related Suicide by Gender and Race/Ethnicity, 2013-2017 20.0 White men are victims of gun-related suicide at a rate: 5.6x of white females 2.9x of black males 18.0 16.0 14.0 12.0 Rate per 100k 10.0 8.0 6.0 Male Rate 4.0 Female Rate 2.0 0.0 Asian 0.4 2.5 Black 0.5 6.2 Hispanic 0.3 1.9 Native American 0.0 14.0 White 3.2 17.8 Female Rate Male Rate

14. Gun-Related Suicide by Gun Type Percentage of Gun-Related Suicides by Gun Type, 2013-2017 Unknown 0.5% Shotgun 11.4% Rifle 8.3% Other 0.0% Handgun 79.8%

15. * Rate ranges are based upon quartiles

16. Gun-Related Homicides vs All Other Methods of Homicide Number of Gun-Related Homicides Compared to All Other Methods of Suicide by Year of Death, 2007-2018* 600 Over 72% of all homicides involve guns 500 400 300 200 100 0 2007 115 325 2008 136 264 2009 125 287 2010 111 280 2011 103 242 2012 108 236 2013 96 244 2014 105 254 2015 103 286 2016 104 374 2017 117 353 2018 82 347 Homicides, All Other Methods Gun-related Homicide

17. Gun-Related Homicide Demographics (Gender-Age) Aggregated Five Year Rate of Gun-Related Homicide by Gender and Age Group, 2013-2017 20.0 Men are 4.6 times more likely to be a victim of gun-related homicide than females 18.0 16.0 14.0 Rate per 100k 12.0 10.0 8.0 Male Rate 6.0 4.0 Female Rate 2.0 0.0 <1 0.0 0.4 1-4 0.6 0.4 5-9 0.5 0.2 10-14 0.2 0.4 15-19 1.5 11.0 20-24 2.1 18.6 25-34 2.4 12.4 35-44 1.7 7.4 45-54 1.2 4.1 55-64 1.1 2.8 65-74 0.8 1.5 75-84 0.8 1.0 85+ 0.2 0.0 Female Rate Male Rate

18. Gun-Related Homicide Demographics (Gender-Race) Aggregated Five Year Rate of Gun-Related Homicide by Gender and Race/Ethnicity, 2013-2017 25.0 Black men are victims of gun-related homicide at a rate: 8.1x of black females 11.3x of white males 20.0 Rate per 100k 15.0 10.0 Male Rate 5.0 Female Rate 0.0 Asian 0.5 0.9 Black 2.8 22.6 Hispanic 0.3 2.0 Native American 0.0 6.2 White 0.9 2.0 Female Rate Male Rate

19. Gun-Related Homicide by Gun Type Percentage of Gun-Related Homicide by Gun Type, 2013-2017 Shotgun 3.7% Unknown 11.8% Rifle 4.0% Other 0.1% Multiple 0.9% Handgun 79.5%

20. * Rate ranges are based upon quartiles

21. Key Points on Gun-Related Death in Virginia Rates of gun-related death in Virginia (all manners) are very similar to national rates of gun-related death Handguns were involved in nearly 80% of gun-related homicides and nearly 80% of gun-related suicides Rates of gun-related suicide among men increase with age White men and Native American men had the highest rates of gun-related suicide Black males and males age 20-24 years of age had the highest rates of gun-related homicide

22. CONTACT INFORMATION Kathrin "Rosie" Hobron, MPH VDH, Office of the Chief Medical Examiner Statewide Forensic Epidemiologist 804-786-6063 kathrin.hobron@vdh.virginia.gov Dr. Ryan Diduk-Smith VDH, Office of the Chief Medical Examiner Director, Division of Death Prevention 804-205-3856 Ryan.diduk@vdh.virginia.gov OCME Quarterly Drug Report: http://www.vdh.virginia.gov/medical-examiner/forensic-epidemiology/ Annual Reports: http://www.vdh.virginia.gov/medical-examiner/annual-reports/ Surveillance and Fatality Review links: http://www.vdh.virginia.gov/medical-examiner/fatality-review- surveillance-programs-reports/