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Apr 29, 2024 · Causes of Law Enforcement Deaths. Updated April 29, 2024.
- Overview
- Abstract
- Introduction
- Methods
- Results
- Discussion
- Limitations
- Conclusion
- References
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•Introduction
Problem/Condition: In 2018, approximately 68,000 persons died of violence-related injuries in the United States. This report summarizes data from CDC’s National Violent Death Reporting System (NVDRS) on violent deaths that occurred in 39 states the District of Columbia, and Puerto Rico in 2018. Results are reported by sex, age group, race and ethnicity, method of injury, type of location where the injury occurred, circumstances of injury, and other selected characteristics.
Period Covered: 2018.
Description of System: NVDRS collects data regarding violent deaths obtained from death certificates, coroner and medical examiner reports, and law enforcement reports. This report includes data collected for violent deaths that occurred in 2018. Data were collected from 36 states with statewide data (Alabama, Alaska, Arizona, Colorado, Connecticut, Delaware, Georgia, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin), three states with data from counties representing a subset of their population (21 California counties, 28 Illinois counties, and 39 Pennsylvania counties), the District of Columbia, and Puerto Rico. NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.
Results: For 2018, NVDRS collected information on 52,773 fatal incidents involving 54,170 deaths that occurred in 39 states and the District of Columbia. In addition, information was collected on 880 fatal incidents involving 975 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately. Of the 54,170 deaths, the majority (64.1%) were suicides, followed by homicides (24.8%), deaths of undetermined intent (9.0%), legal intervention deaths (1.4%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm deaths (<1.0%). (The term “legal intervention” is a classification incorporated into the International Classification of Diseases, Tenth Revision, and does not denote the lawfulness or legality of the circumstances surrounding a death caused by law enforcement.) Demographic patterns and circumstances varied by manner of death. The suicide rate was higher among males than among females and was highest among adults aged 35–64 years and non-Hispanic American Indian or Alaska Native (AI/AN) and non-Hispanic White persons. The most common method of injury for suicide was a firearm among males and hanging, strangulation, or suffocation among females. Suicide was most often preceded by a mental health, intimate partner, or physical health problem, or a recent or impending crisis during the previous or upcoming 2 weeks. The homicide rate was highest among persons aged 20–24 years and was higher among males than females. Non-Hispanic Black males experienced the highest homicide rate of any racial or ethnic group. The most common method of injury for homicide was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Homicides most often were precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, were related to intimate partner violence. Homicide suspects were primarily male and the highest proportion were aged 25–44 years. When race and ethnicity information was known, non-Hispanic Black persons comprised the largest group of suspects overall and among those aged ≤44 years, and non-Hispanic White persons comprised the largest group of suspects among those aged ≥45 years. Almost all legal intervention deaths were experienced by males, and the legal intervention death rate was highest among males aged 30–34 years. Non-Hispanic AI/AN males had the highest legal intervention death rate, followed by non-Hispanic Black males. A firearm was used in the majority of legal intervention deaths. When a specific type of crime was known to have precipitated a legal intervention death, the type of crime was most frequently assault or homicide. The most frequent circumstances reported for legal intervention deaths were use of a weapon by the victim in the incident and a mental health or perceived substance use problem (other than alcohol use). Law enforcement officers who inflicted fatal injuries in the context of legal intervention deaths were primarily males aged 25–44 years. Unintentional firearm deaths were most frequently experienced by males, non-Hispanic White persons, and persons aged 15–24 years. These deaths most often occurred while the shooter was playing with a firearm and most frequently were precipitated by a person unintentionally pulling the trigger or mistakenly thinking that the firearm was unloaded. The rate of deaths of undetermined intent was highest among males, particularly among non-Hispanic Black and non-Hispanic AI/AN males, and among persons aged 45–54 years. Poisoning was the most common method of injury in deaths of undetermined intent, and opioids were detected in approximately 80% of decedents tested for those substances.
Interpretation: This report provides a detailed summary of data from NVDRS on violent deaths that occurred in 2018. The suicide rate was highest among non-Hispanic AI/AN and non-Hispanic White males, and the homicide rate was highest among non-Hispanic Black males. Mental health problems, intimate partner problems, interpersonal conflicts, and acute life stressors were primary circumstances for multiple types of violent death. Circumstances for suspects of homicide varied by age group and included having prior contact with law enforcement and involvement in incidents that were precipitated by another crime, intimate partner violence, and drug dealing or substance use.
Public Health Action: NVDRS data are used to monitor the occurrence of violence-related fatal injuries and assist public health authorities in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent violent deaths. For example, Arizona and Wisconsin used their state-level VDRS data to support suicide prevention efforts within their respective states. Wisconsin VDRS used multiple years of data (2013–2017) to identify important risk and protective factors and subsequently develop a comprehensive suicide prevention plan. Arizona VDRS partners with the Arizona Be Connected Initiative to provide customized community-level data on veteran suicide deaths in Arizona. Similarly, states participating in NVDRS have used their VDRS data to examine intimate partner violence–related deaths to support prevention efforts. For example, data from the South Carolina VDRS were used to examine intimate partner homicides that occurred in South Carolina during 2017. South Carolina VDRS found that 12% of all homicides that occurred in 2017 were intimate partner violence–related, with females accounting for 52% of intimate partner homicide–related victims. These data were shared with domestic violence prevention collaborators in South Carolina to bolster their efforts in reducing intimate partner violence–related deaths. In 2018, NVDRS data included four additional states compared with 2017, providing more comprehensive and actionable violent death information for public health efforts to reduce violent deaths.
In 2018, violence-related injuries led to approximately 68,000 deaths in the United States (1). Suicide was the 10th leading cause of death overall in the United States and disproportionately affected young and middle-aged populations. By age group, suicide was the second leading cause of death for persons aged 10–34 years and the fourth leading cause of death for persons aged 35–54 years. During 2018, non-Hispanic American Indian or Alaska Native (AI/AN) and non-Hispanic White males were disproportionately affected by suicide.
In 2018, homicide was the 16th leading cause of death overall in the United States but disproportionately affected young persons (1). Homicide was among the five leading causes of death for children aged 1–14 years, was the third leading cause of death for persons aged 15–34 years and was the fifth leading cause of death for persons aged 35–44 years. Young non-Hispanic Black males also were disproportionately affected by homicide. Homicide was the leading cause of death for non-Hispanic Black males aged 15–34 years, the second leading cause of death for those aged 1–9 years, and the third leading cause of death for those aged 10–14 years.
Public health authorities require accurate, timely, and complete surveillance data to better understand and ultimately prevent the occurrence of violent deaths in the United States (2,3). In 2000, in response to an Institute of Medicine* report noting the need for a national fatal intentional injury surveillance system (4), CDC began planning to implement NVDRS (2). The goals of NVDRS are to
•collect and analyze timely, high-quality data for monitoring the magnitude and characteristics of violent deaths at national, state, and local levels;
•ensure data are disseminated routinely and expeditiously to public health officials, law enforcement officials, policymakers, and the public;
•ensure data are used to develop, implement, and evaluate programs and strategies that are intended to reduce and prevent violent deaths and injuries at national, state, and local levels; and
NVDRS compiles information from three required data sources: death certificates, coroner and medical examiner reports, and law enforcement reports (2). Some participating Violent Death Reporting System (VDRS) programs might also collect information from secondary sources (e.g., child fatality review team data, Federal Bureau of Investigation Supplementary Homicide Reports, and crime laboratory data). NVDRS combines information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident. The ability to analyze linked data can provide a more comprehensive understanding of violent deaths. Participating VDRS programs use vital statistics death certificate files or coroner or medical examiner reports to identify violent deaths meeting the NVDRS case definition (see Manner of Death). Each VDRS program reports violent deaths of residents that occurred within the state, district, or territory (i.e., resident deaths) and those of nonresidents for whom a fatal injury occurred within the state, district, or territory (i.e., occurrent deaths). When a violent death is identified, NVDRS data abstractors link source documents, link deaths within each incident, code data elements, and write brief narratives of the incident.
In NVDRS, a violent death is defined as a death resulting from the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community (2). NVDRS collects information on five manners of death: 1) suicide, 2) homicide, 3) legal intervention death, 4) unintentional firearm death, and 5) death of undetermined intent that might have been due to violence (see Manner of Death). NVDRS cases are coded based on ICD-10 (5) or the manner of death assigned by a coroner, medical examiner, or law enforcement officer. Cases are included if they are assigned ICD-10 codes (Box 1) or a manner of death specified in at least one of the three primary data sources consistent with NVDRS case definitions.
NVDRS is an incident-based system, and all decedents associated with a given incident are grouped in one record. Decisions about whether two or more deaths are related and belong to the same incident are made based on the timing of the injuries rather than on the timing of the deaths. Deaths resulting from injuries that are clearly linked by source documents and occur within 24 hours of each other (see Manner of Death) are considered part of the same incident. Examples of an incident include 1) a single isolated violent death, 2) two or more related homicides (including legal intervention deaths) when the fatal injuries were inflicted <24 hours apart, 3) two or more related suicides or deaths of undetermined intent when the fatal injuries were inflicted <24 hours apart, and 4) a homicide followed by a suicide when both fatal injuries were inflicted <24 hours apart (6).
Information collected from each data source is entered into the NVDRS web-based system (2). This system streamlines data abstraction by allowing abstractors to enter data from multiple sources into the same incident record. Internal validation checks, hover-over features that define selected fields, and other quality control measures are included. Primacy rules and hierarchal algorithms related to the source documents occur at the local VDRS program level. CDC provides access to the web-based system to each VDRS program. VDRS program personnel are provided ongoing coding training to learn and adhere to CDC guidance regarding the coding of all variables and technical assistance to help increase data quality. Data are transmitted continuously via the web to a CDC-based server. Information abstracted into the system is deidentified at the local VDRS program level.
Violent Deaths in 39 States and the District of Columbia
For 2018, a total of 39 states and the District of Columbia collected data on 52,773 incidents involving 54,170 deaths (Supplementary Table S1, https://stacks.cdc.gov/view/cdc/112767). Suicide (n = 34,726; 64.1%) accounted for the highest rate of violent deaths (16.8 per 100,000 population aged ≥10 years), followed by homicide (n = 13,441; 24.8%) (5.7 per 100,000 population). Deaths of undetermined intent (n = 4,902; 9.0%), legal intervention deaths (n = 764; 1.4%), and unintentional firearm deaths (n = 337; <1.0%) occurred at lower rates (2.1, 0.3, and 0.1 per 100,000 population, respectively). Deaths by manner that include statewide counts and the rates for California are available (Supplementary Table S2, https://stacks.cdc.gov/view/cdc/112767).
Violent Deaths in Puerto Rico
For 2018, Puerto Rico collected data on 880 incidents involving 975 deaths. Homicide (672; 68.9%) accounted for the highest rate of violent death (21.0 per 100,000 population), followed by suicide (266; 27.3%; 9.2 per 100,000 population aged ≥10 years) (Supplementary Table S15, https://stacks.cdc.gov/view/cdc/112767).
Violent deaths affect males and females and persons of all ages, races, and ethnicities. NVDRS data on specific manners of violent death can be used to describe characteristics of and inequities experienced by populations particularly affected by fatal violence. NVDRS data can also be used to identify cross-cutting risk factors for multiple forms of violence. These details increase the knowledge base about the circumstances associated with violence and can assist public health authorities and their partners in developing and guiding effective, data-driven approaches to violence prevention.
The occurrence of violent death varies greatly across states, the District of Columbia, and Puerto Rico (1). This report summarizes data on violent deaths that occurred in 2018 in 39 states and the District of Columbia, representing 72.0% of the U.S. population and accounting for 72.9% of violent deaths in the United States in 2018 (1), and Puerto Rico. In 2019, NVDRS expanded data collection to include all 50 states, the District of Columbia, and Puerto Rico, providing more comprehensive, accessible, and actionable violent death information that can be used to guide the development of evidence-based violence prevention efforts at local, regional, state, and national levels. Expanding NVDRS to a nationwide system also contributes to the national prevention initiative Healthy People 2020 objectives to increase the number of states that link data on violent deaths from death certificates, coroner or medical examiner reports, and law enforcement reports at state and local levels and the Healthy People 2030 objectives to reduce the number of suicides, homicides, and firearm-related deaths (12,13).
The findings in this report are subject to at least seven limitations. First, NVDRS data are available from a limited number of states, the District of Columbia, and Puerto Rico and therefore are not nationally representative. In addition, California, Illinois, and Pennsylvania data were from a subset of counties and are not representative of all violent deaths occurring in these states. However, Illinois and Pennsylvania contributed data that represent a very high percentage of the state populations (86.0% and 82.2%, respectively), and all of these states include a mix of data from large urban population centers and smaller, more rural counties.
Second, the availability, completeness, and timeliness of data depend on partnerships among VDRS programs and local health departments, vital statistics registrars’ offices, coroners and medical examiners, and law enforcement personnel. Data sharing and communication among partners are particularly challenging when states and U.S. territories have independent county coroner systems rather than a centralized coroner or medical examiner system, numerous law enforcement jurisdictions, or both. NVDRS incident data might be limited or incomplete for areas in which these data-sharing relations are not fully developed. Partnerships with local vital statistics registrars’ offices usually are more established because they are part of the public health infrastructure. As part of an active surveillance system, VDRS programs work closely with local vital registrars’ offices to identify deaths meeting the NVDRS case definition and to avoid cases being missed or inappropriately included. CDC also monitors case ascertainment and variable completeness through regular technical assistance calls, which include an internal data quality dashboard in the web-based system that is updated in real-time. Overall, core variables that represent demographic characteristics (e.g., age, sex, and race and ethnicity) and manner of death were known for >99.5% of cases.
Third, toxicology data are not collected consistently across all states, the District of Columbia, and Puerto Rico or for all alcohol and drug categories. In addition, toxicology testing is not conducted for all decedents; thus, the percentages of decedents with positive results for specific substances might be affected by testing practices in coroner or medical examiner offices (75).
Fourth, abstractors are limited to the data included in the investigative reports they receive. For example, beyond basic demographics, suspect data are often incomplete or unavailable, which might result in an underestimate of suspect circumstances. In addition, reports might not fully reflect all information known about an incident, particularly for homicides and legal intervention deaths, when data are less readily available until a full investigation and adjudication are completed. In the current report, demographic information regarding the race and ethnicity, sex, and age of homicide suspects and officers involved in legal intervention deaths was incomplete for some incidents. How this unknown information is distributed and whether missing data are related to reporting biases is unclear.
Fifth, case definitions present challenges when a single death is classified differently in different documents (e.g., unintentional firearm death in a law enforcement report, homicide in a coroner or medical examiner report, and undetermined on the death certificate). NVDRS abstractors reconcile these discrepancies using standard NVDRS case definitions and select a single manner of death based on all source documents (6).
Sixth, variations in coding occur depending on the abstractor’s level of experience. For this reason, CDC provides extensive abstractor guidance and training, a coding manual to promote standardized data collection (6), and data validation checks. As part of their internal data quality efforts, VDRS programs are required to reabstract at least 5% of cases to examine consistency in coding and identify training needs of data abstractors.
Public health surveillance is the foundation for public health practice (76). Monitoring the prevalence of violence-related fatal injuries, defining priorities, and guiding violence prevention activities are essential parts of public health surveillance (66). In 2018, NVDRS received funding for nationwide expansion. As of 2019, all 50 states, the D...
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4.Bonnie RJ, Fulco CE, Livermore CT, eds. Reducing the burden of injury: advancing prevention and treatment. Washington DC: National Academy Press; 1999. https://www.nap.edu/read/6321/chapter/1external icon
5.World Health Organization. International classification of diseases, tenth revision. Geneva, Switzerland: World Health Organization; 2007. http://icd.who.int/browse10/2019/enexternal icon
6.CDC. National Violent Death Reporting System (NVDRS) coding manual version 5.3 [Internet]. Atlanta, GA: US Department of Health and Human Services, CDC; 2019. https://www.cdc.gov/violenceprevention/pdf/nvdrs/nvdrsCodingManual.pdfpdf icon
Deaths due to the use of lethal force by law enforcement are also referred to as legal intervention deaths, consistent with the ICD-10 category for deaths resulting from law enforcement action without regard to intent or legality.
- Sarah DeGue, Katherine A. Fowler, Cynthia Calkins
- 2016
May 23, 2023 · Deaths collected by NVDRS include suicides, homicides, legal intervention deaths (i.e., deaths caused by law enforcement acting in the line of duty and other persons with legal authority to use deadly force, excluding legal executions), unintentional firearm deaths, and deaths of undetermined intent that might have been because of violence ...
CDC. Injury Center. Violence Prevention. Data Sources. National Violent Death Reporting System (NVDRS) Print. In the United States, more than seven people per hour die a violent death. In 2019, more than 19,100 people were victims of homicide and over 47,500 people died by suicide.
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police conflict and executions was the estimated cause of death for 1150 deaths (998–1310) in the USA. 1. The burden of police violence fatalities in the USA is known to fall disproportionately on Black, Indigenous, and Hispanic populations.
Mar 13, 2019 · We reviewed incident narratives from deaths identified through the algorithm to confirm whether the death met our criteria as a legal intervention homicide: (1) the manner of death (on case review) was homicide (i.e., not suicide, unintentional, or undetermined), (2) the suspect was a law enforcement officer (including police, sheriff, federal ...
