Allison Ertl · MMWR Surveillance Summaries 2019 · Cross-sectional surveillance report · n=41,466

Surveillance for Violent Deaths — National Violent Death Reporting System, 32 States, 2016

Cited 220 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional public health surveillance registry analysis (graded by design analogy)

OpenAlex W2978418449 · doi:10.15585/mmwr.ss.6809a1 · record verified 2026-08-26

What was done

The CDC analyzed 2016 data from the National Violent Death Reporting System (NVDRS) across 32 US states. The system linked fatal incident records by combining death certificates, coroner and medical examiner reports, law enforcement reports, and secondary investigative sources. Fatalities were categorized by manner of death (suicide, homicide, legal intervention, unintentional firearm, and undetermined intent) and analyzed across demographic characteristics, injury mechanisms, and precipitating circumstances.

What was found

Across 32 states in 2016, NVDRS captured 40,374 fatal incidents involving 41,466 deaths. Deaths comprised suicides (62.3%), homicides (24.9%), undetermined intent (10.8%), legal intervention (1.2%), and unintentional firearm deaths (<1.0%). Suicide rates were highest among males, non-Hispanic American Indian/Alaska Natives, non-Hispanic whites, and men aged ≥75 years, with firearms being the leading method in males and poisoning in females. Homicide rates were highest among males and persons aged 15–44 years, with non-Hispanic Black males experiencing the highest rate. Legal intervention death rates were highest in men aged 20–44 years, with rates among non-Hispanic Black males three times higher than among non-Hispanic white males. Among 3,655 youth suicides (ages 10–24), hanging/strangulation/suffocation was the primary mechanism in ages 10–17 (49.3%), whereas firearms were most common in ages 18–24 (46.2%).

Why it matters

This multi-source surveillance system links circumstantial details with demographic data to pinpoint specific precipitating risk factors, helping public health agencies target interventions for suicide, homicide, and firearm safety.

Limits

Data represent only 32 states in 2016 and cannot be generalized to the entire United States. Documentation of precipitating circumstances depends entirely on the availability, quality, and thoroughness of investigative narratives from law enforcement and coroner/medical examiner reports.

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