2011 surveillance report : violent deaths in Georgia, 2006-2009

Georgia Violent Death Reporting System
2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009
Chronic Disease, Healthy Behaviors and Injury Epidemiology Section Georgia Violent Death Reporting System

Dr. Brenda Fitzgerald, M.D., Commissioner and State Health Officer Dr. 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

Acknowledgements
A. Rana Bayakly, MPH, Chief Epidemiologist, Chronic Disease, Healthy Behaviors and Injury Epidemiology Section Willie L. Crew, Program Manager, Georgia Violent Death Reporting System Viani Ramrez-Irizarry, MPH, Epidemiologist, Georgia Violent Death Reporting System Cijji Johnson, BS, Current Data Abstractor, Georgia Violent Death Reporting System Courtney Allen, BS, Current Operations Analyst, Georgia Bureau of Investigations Zenobia Wright, MSPH, Current Data Abstractor, Georgia Violent Death Reporting System Antoine Perrymon, MPH, Current Data Abstractor, Georgia Violent Death Reporting System Askari Dobbs, Past Data Abstractor, Georgia Violent Death Reporting System Merriah Croston, Past Data Abstractor, Georgia Violent Death Reporting System Erin O'Conner, Past Data Abstractor, Georgia Violent Death Reporting System Steven Veselsky, Past Data Abstractor, Georgia Violent Death Reporting System Jacqueline English, Past Data Abstractor, Georgia Violent Death Reporting System J. Michael Bryan Jr., MPH, Chronic Disease Epidemiologist Suparna Bagchi, MSPH, DrPH, Behavioral Surveillance Team Lead
Special thanks to the 159 Georgia Sheriff's Offices, 566 county and municipal Police Departments, 155 County Coroners', the Cobb County, DeKalb County, Fulton County, and Gwinnett County Medical Examiners' Offices.

For more information or to obtain this report in an alternative format, please contact:
Georgia Department of Public Health Chronic Disease, Healthy Behaviors and Injury Epidemiology Section 2 Peachtree Street, SW, Suite 14-297 Atlanta, Georgia 30303 404-657-2635 http://health.state.ga.us/
This publication and its contents are solely the responsibility of the authors and do not represent the official views of the Centers for Disease Control and Prevention (CDC) which supported this publication by Grant #U17CCU423100

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

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Georgia Violent Death Reporting System

Table of Contents
Introduction......................................................................................................................... iv Executive Summary..............................................................................................................v Section 1: Overview of Violent Deaths................................................................................1 Section 2: Homicides..........................................................................................................11 Section 3: Suicides..............................................................................................................17 Section 4: Suicide Attempts Among High School Students: YRBS Results......................24 Appendix A: Technical Notes.............................................................................................27 Glossary.............................................................................................................................31 Appendix B: Crude and Age-Adjusted Mortality Rates by County...................................34 Appendix C: Maps....................................................................................44 References...........................................................................................................................47

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

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Introduction
Violent deaths impact individuals, families, and communities throughout the United States (U.S.). The U.S. Centers for Disease Control and Prevention (CDC) implemented the National Violent Death Reporting System (NVDRS) as a state based surveillance system to improve surveillance of violent deaths nationwide. Georgia is one of nineteen states currently participating in the NVDRS, and the state program is referred to as the Georgia Violent Death Reporting System (GVDRS).
Goals
Inform decision makers and program planners about the magnitude and characteristics of violent deaths in Georgia
Monitor violent death burden and trends in Georgia
Objectives
According to the CDC, more than 32,000 people die by suicide and another 18,000 people die by homicides in the United States annually. To prevent these violent deaths, we must understand and link information from multiple data sources. NVDRS seeks to make better use of data collected by health and law enforcement agencies, and coroners/ medical examiners.
The following data sources are included in the Georgia Violent Death Reporting System: Death certificates Medical examiner and/or coroner reports Police reports (Supplemental Homicide Reports at a minimum) Crime laboratory records
The Georgia Violent Death Reporting System (GVDRS) uses the uniform data elements developed by NVDRS in collaboration with funded states.

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Georgia Violent Death Reporting System

Executive Summary
The Georgia Violent Death Reporting System (GVDRS) 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 GVDRS' 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 GVDRS Findings, 2006-2009
8,080 violent deaths were reported in Georgia from 2006 to 2009, an average of 2,020 violent deaths per year.
Fifty-one percent of violent deaths were due to suicide, while homicides contributed to 36% of all violent deaths in Georgia.
Ninety-five percent of victims were Georgia residents and died in their county of residence.
Forty-seven percent of violent deaths occurred at the victim's residence o 71% of suicides were completed at the victim's residence o 34% of homicides occurred at the victim's residence
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.
Twenty-one percent of suicide victims had served in the U.S. Armed Forces.

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Georgia Violent Death Reporting System

Section 1: Overview of Violent Deaths
Violent Death Definition
Violent death is defined as a death that results from the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community. The person using the force or power need only have intended to use force or power; they need not have intended to produce the consequence that actually occurred. In addition, the GVDRS captures unintentional firearm deaths and legal intervention deaths, which are defined in Appendix A.
Manner of Death

Table 1a. Number of Violent Deaths by Manner of Death, Georgia, 2006-2009

Manner of Death

Number

%

Age-Adjusted Rate per 100,000

Suicide

4,123

51.0

10.0

Homicide

2,927

36.2

7.1

Undetermined

928

11.5

2.2

Unintentional Firearm

80

1.0

*

Legal Intervention

22

0.3

*

Total

8,080

100.0

20.0

*Age-adjusted mortality rate was < 1 per 100,000 population.

Similar to national numbers, suicides accounted for more than half of violent deaths in Georgia during 2006-2009.
More than one-third of violent deaths in Georgia were homicides, while nationally a quarter of violent deaths were homicides.
Georgia's total age-adjusted violent death rate was the same as the national rate (CDC, 2011).

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Figure 1a. Age-Adjusted Violent Death Rates by Year and Sex, Georgia, 2006-2009

Rate per 100,000 population

35 31
30

25

20

19

15 9
10

5

0

2006

MALE
32

FEMALE

TOTAL
32

20

20

9

9

2007

YEAR

2008

32 20 10
2009

The total age-adjusted violent death rate increased by 5% from 2006 to 2009. From 2006 to 2009 the age-adjusted violent death rate increased by 3% and 11%
for males and females, respectively.

Figure 1b. Age-Specific Violent Death Rates by Age Group and Sex, Georgia, 2006-2009

TOTAL MALE FEMALE

Rate per 100,000 population

70

63

60

48

50 40

38

40

35

39

33

34

30

23

25

23

26

20

20

24

23

20 10

8

9 7

8

10

10

13

9

9

8

8

0

<15 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age Group

Overall, people 45 - 54 years old had the highest age-specific violent death rates during 2006 to 2009.
Males over 85 years old had the highest age-specific violent death rate. Among females, those 45 to 54 years old had the highest age-specific violent
death rate.

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Georgia Violent Death Reporting System

Figure 1c. Age-Adjusted Violent Death Rates by Race* and Sex, Georgia, 2006-2009

Rate per 100,000 population

MALE FEMALE

40

35

30

28

25

20

15 9
10

5

0

WHITE

36
8
BLACK

RACE

* Other races/ethnicities excluded due to insufficient data.
Overall, black males had the highest age-adjusted violent death rate, which was 28% higher than for white males.
White females had a slightly higher violent death rate than black females.

Companion Cases
Companion cases are defined as incidents that include more than one violent death such as:
1. Two or more homicides, including legal interventions, when the deaths involve at least one person who is a suspect or victim in the first death and a suspect or victim in the second death, and the fatal injuries are inflicted less than 24 hours apart.
2. Two or more suicides or undetermined manner of death when there is some evidence that the second or subsequent death was planned to coincide with or follow the preceding death, and the fatal injuries are inflicted less than 24 hours apart.
3. One or more homicides or unintentional firearm deaths combined with one or more suicides when the suspect in the first death is the person who commits suicide, and the fatal injuries are inflicted less than 24 hours apart.
4. Two or more unintentional firearm deaths when: The same firearm inflicts two or more fatal injuries, and the fatal injuries are inflicted by one shot or burst of shots.

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One percent of all GVDRS cases collected were classified as companion cases. Of these, 54% were homicides while 50% of victims were involved in cases where homicide was followed by suicide.

Table 1b. Companion Cases by Manner of Death and Number of Victims, Georgia, 2006-2009

Manner of Death

Number of Cases Number of Victims

Homicide

54

119

Homicide followed by Suicide

42

125

Suicide

3

6

Undetermined

1

2

Total

100

252

Place of Injury

The place of injury was known for 82% of violent deaths in Georgia during 2006-2009. Of those with a known place of injury, 60% occurred in a house or apartment, including the porch or yard.

Table 1c. Number of Violent Deaths by Place of Injury, Georgia, 2006-2009

Place of Injury

Frequency

%

House, apartment, including driveway, porch, yard Unknown Other* Motor vehicle Street/road, sidewalk, alley Hotel/motel Natural area Parking lot/public parking garage Total

4,858

60.0

1,425

17.5

528

6.5

463

6.0

312

4.0

184

2.0

162

2.0

148

2.0

8,080

100

*Includes: abandoned location, medical facility, railroad tracks, supervised residential facility, synagogue/church/temple, industrial/construction areas, office building, education institution, athletic area, childcare center, bank, liquor store, public transportation or station, and farm.

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Georgia Violent Death Reporting System

Top Ten Cities of Injury

Table 1d. Number of Violent Deaths by Cities of Injury, Georgia, 2006-2009

City

Number

%

Atlanta Savannah Macon Marietta Decatur Lawrenceville Columbus Augusta Stone Mountain College Park

900

11.4

246

3.1

201

2.5

190

2.4

189

2.4

143

2.0

125

1.6

119

1.5

113

1.4

103

1.3

The city of Atlanta had the highest number of violent deaths followed by Savannah.

Resident and Occurrent Cases^
GVDRS collects violent death information on all residents of Georgia as well as violent deaths that occurred in Georgia regardless of the person's residency^ (occurrent cases). Almost all (95%) violent deaths occurred among residents of Georgia (see Table 1e).

Table 1e. Number of Violent Deaths by Type of Case, Georgia, 2006-2009

Type of Case Frequency

%

Rate per 100,000

Resident

7,689

95

20

Occurrent

391

5



Total

8,080

100

20

Age-adjusted violent death rate cannot be calculated for occurrent cases. ^See Appendix B for resident and occurrent cases by County.

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Figure 1d. Age-Adjusted Violent Death Rates by Rural-Urban Status*, Georgia, 2006-2009

Source: Georgia Violent Death Reporting System (2006-2009) *Rural-Urban Status established using Rural-Urban Continuum Codes (cf. http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/)
Metro areas with more than 1,000,000 population had the lowest age-adjusted violent death rate.
Metro areas with 250,000 to 999,999 population had the highest age-adjusted violent death rate.

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Georgia Violent Death Reporting System

Figure 1e. Age-Adjusted Homicide and Suicide Rates by Rural-Urban Status*, Georgia, 2006-2009

Rate per 100,000 population

HOMICIDE SUICIDE

12.0

10.0

9.0

8.0

7.2

6.0

10.7 7.7

10.2 6.2

10.2 5.6

11.0 6.5

4.0

2.0

0.0

Me tro : 1,000,000+

Metro: 250,000 - Metro: <250,000 Metro Adja cent 999,999

Rura l

Rural-Urban Continuum Code

*Rural-Urban Status established using Rural-Urban Continuum Codes (cf. http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/)

Metro adjacent areas had the lowest age-adjusted homicide rate. Metro areas with 250,000 to 999,999 population had the highest
age-adjusted homicide rate. Metro areas with more than 1,000,000 population had the lowest
age-adjusted suicide rate. Rural areas had the highest age-adjusted suicide rate.

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Public Health District of Injury^

Table 1g. Number of Violent Deaths by Public Health District of Injury and Manner of Death, Georgia, 2006-2009

Public Health District of Injury

Suicide

Homicide Undetermined

Accidental Firearm

Legal Intervention

Fulton

351

644

125

5

6

DeKalb

197

395

41

**

**

East Metro

346

196

58

6

**

East

266

219

49

7

**

La Grange

308

118

73

5

**

Northwest

340

84

68

**

**

Cobb-Douglas

276

117

82

**

**

North Central

239

155

48

7

**

East Central

204

148

48

5

**

North

279

72

50

**

**

Northeast

203

77

43

**

**

West Central

133

137

47

**

**

Southwest

144

126

33

**

**

Southeast

166

98

31

8

**

North Georgia

203

28

33

6

**

Clayton

77

137

20

**

**

South

106

67

27

**

**

South Central

66

44

12

**

**

Total

3,904

2,862

888

68

22

Number Missing = 336

**Cells with number of deaths of 5 or fewer were suppressed to retain confidentiality. ^ See Appendix C for map.

Total
1,131 635 607 542 505 496 476 451 408 406 325 323 305 303 270 236 202 123 7,744

Suicides were most frequent in Fulton and East Metro. Homicides were most frequent in Fulton and DeKalb.

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Georgia Violent Death Reporting System

Judicial District of Injury^

Table 1h. Number of Violent Deaths by Judicial District of Injury and Manner of Death, Georgia, 2006-2009

Judicial District

Suicide

Homicide

Undetermined

Accidental Firearm

Legal Intervention

Total

District 1

416

246

76

10

**

748

District 2

589

647

138

8

**

1,386

District 3

222

201

47

8

**

478

District 4

14

7

**

**

**

22

District 5

21

**

**

**

**

25

District 6

447

266

106

8

**

831

District 7

565

276

146

7

**

998

District 8

552

312

97

8

**

971

District 9

285

80

60

6

**

432

District 10

793

827

213

13

7

1,853

Total

3,904

2,862

888

68

22

7,744

Number Missing = 336

**Cells with number of deaths of 5 or fewer were suppressed to retain confidentiality. ^ See Appendix C for map.

District 10 had the highest number of violent deaths followed by District 2.

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Type of Weapon
Figure 1e. Percent of Violent Deaths by Type of Weapon, Georgia, 2006-2009
Other* Blunt Instrument 8%
4% Sharp Instrument
5% Poisoning
9%

Hanging/ Strangulation/
Suffocation 12%

Firearm 62%

*Includes: personal weapons, falls, fire or burns, drowning, motor vehicle, intentional neglect, shaking, and non-powder gun.
Firearms (62%) were the most commonly used weapon, followed by hanging, strangulation or suffocation (12%).

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Georgia Violent Death Reporting System

Section 2: Homicides
Homicide Definition
Homicide is a death resulting from the intentional use of force or power, threatened or actual, against another person, group, or community. Sufficient evidence must indicate that the use of force was intentional.
Figure 2a. Age-Adjusted Homicide Rates by Year and Sex, Georgia, 2006-2009

Rate per 100,000 population

14

12

11

10

8

7

6

4

3

2

0 2006

MALE 12
8

FEMALE

TOTAL 11 7

3

3

2007

YEAR

2008

9 6 3
2009

The total age-adjusted homicide rate decreased by 14% from 2006 to 2009 The age-adjusted homicide rate decreased by 18% for males. However, it
remained constant for females from 2006 to 2009. The overall age-adjusted homicide rate for males (11 per 100,000 population) was
almost four times the overall age-adjusted homicide rate for females (3 per 100,000 population).

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

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Figure 2b. Age-Specific Homicide Rates by Age Group and Sex, Georgia, 2006-2009
TOTAL MALE FEMALE

Rate per 100,000 population

25

23

21

20

15

14

13

10
5 232 0
<15

4 15-24

5 25-34

12 8
4

10 7
3

35-44 45-54 Age Group

7 4
2

5 42

55-64 65-74

34 75-84

Among males, the age-specific homicide rate was highest among the 15 to 24 years age group.
Among females, the 25-34 years age group had the highest age-specific homicide rate.

Figure 2c. Age-Adjusted Homicide Rates by Race* and Sex, Georgia, 2006-2009

MALE FEMALE

Rate per 100,000 population

30 24
25

20

15

10

4

5

5

2

0 WHITE

BLACK

RACE

* Other races/ethnicities excluded due to insufficient data.

Black males had the highest age-adjusted homicide rate. The age-adjusted homicide rate for black males was six times that for white males. Black females had more than twice the age-adjusted homicide rate as white
females.

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Georgia Violent Death Reporting System

Figure 2d. Age-Adjusted Homicide Rates* by Marital Status and Sex, Persons >15 years old, Georgia, 2006-2009

Rate per 100,000 population

MARRIED NEVER MARRIED DIVORCED WIDOWED

80

72

70

60

50

46

40

30

23

20

10

33 28
14 13 8

0

MALE

FEMALE SEX

*Population is based on 2000 US Standard Population data

Overall, never married males and widowed females had the highest age-adjusted homicide rates for their respective sexes.
The age-adjusted homicide rate for never married males was five times higher than for never married females.
The age-adjusted homicide rate for divorced males was almost four times higher than for divorced females.
The age-adjusted homicide rate for married males was three times higher than for married females.

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Figure 2e. Age-Adjusted Homicide Rates by Rural-Urban Status, Georgia, 2006-2009

Source: Georgia Violent Death Reporting System (2006-2009) *Rural-Urban Status established using Rural-Urban Continuum Codes (cf. http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/)
Metro adjacent areas had the lowest age-adjusted homicide rate. The metro areas with 250,000 to 999,999 population had the highest age-adjusted
homicide rate.

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Georgia Violent Death Reporting System

Type of Weapon

Figure 2f. Percent of Homicides by Type of Weapon and Sex, Georgia, 2006-2009

Males

Females

Hanging/Strangulation/ Suffocation 2% Other* 3%
Personal Weapons 3% Blunt Instrument 7%
Sharp Instrument 9%

Other* Personal Weapons 7%
4%
Hanging/Strangulation/ Suffocation 10%
Blunt Instrument 15%

Firearm 44%

Firearm 76%

Sharp Instrument 20%

*Includes: poisoning, falls, fire or burns, drowning, motor vehicle, intentional neglect, shaking, and non-powder gun.

Weapons were known for 87% of homicides among females and 95% of homicides among males.
For both sexes, firearms were the weapons used most frequently to commit homicide.

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Homicide Circumstances

Circumstances were available in 52% of homicide cases in Georgia during 2006-2009.

Table 2a. Percent of Homicides by Circumstance*, Georgia, 2006-2009 (N=1,523)

Circumstance

%

Other argument, abuse or conflict

35

Precipitated by another crime

30

Intimate partner violence related

17

Drug involvement

12

Intimate partner problem

8

Justifiable self defense/law enforcement

7

Drive-by shooting

3

Argument over money/property/drugs

3

Jealousy (lover's triangle)

3

Other relationship problem

2

Crisis in past 2 weeks

2

Gang related

2

*Circumstances were not mutually exclusive.

The most frequent circumstances for homicides included being involved in an argument, abuse or conflict.

Toxicology Test Results

Toxicology test were performed on 56% of homicide victims in Georgia during 2006-2009. Of the tested victims, 54% did not test positive for any toxic substances.

Table 2b. Percent of Homicide Victims with Positive Toxicology Results by Drug Type,
Georgia, 2006-2009 (N=774)

Drug Type

%

Alcohol

26

Cocaine

15

Marijuana

14

Other Drugs

12

Antidepressants

6

Amphetamines

4

Opioids

4

*Toxicology tests were not mutually exclusive

Alcohol and cocaine were the drugs most frequently detected among tested victims.

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Georgia Violent Death Reporting System

Section 3: Suicides
Suicide Definition
Suicide is defined as a death resulting from intentional use of force against oneself. It is only included in the GVDRS database when sufficient evidence indicates that the use of force was intentional.

Figure 3a. Age-Adjusted Suicide Rates by Year and Sex, Georgia, 2006-2009

Rate per 100,000 population

20

17

15
10 10

5

4

0
2006

MALE 17 10 4

FEMALE

TOTAL

17

10 4

2007

YEAR

2008

19 11 4 2009

The overall age-adjusted suicide rate increased by 10% in Georgia from 2006 to 2009.
The overall age-adjusted suicide rate for males (18 per 100,000 population) was more than four times higher than for females (4 per 100,000 population).
Between 2006 and 2009, the age-adjusted suicide rate increased by 12% for males while remaining constant for females.

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Figure 3b. Age-Specific Suicide Rates by Age Group and Sex, Georgia, 2006-2009

Rate per 100,000 population

TOTAL MALE FEMALE

60

53

50 39
40

30 20
10 1 1 0

21

26

24

26

18

13

8

11

3

13 4

17 5

14 8

18 15

6

5

18 5

<15 15-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

Age Group

Overall, suicide rates increased with age. Males over 85 years old had the highest age-specific suicide rate. Among females, those 45 to 54 years old had the highest age-specific
suicide rates.
Figure 3c. Age-Adjusted Suicide Rates by Race* and Sex, Georgia, 2006-2009

Rate per 100,000 population

MALE FEMALE

25

21

20

15
10 5
5
0 WHITE

8 1
BLACK

RACE

* Other races/ethnicities excluded due to insufficient data.

White males had the highest age-adjusted suicide rate and more than twice the suicide rate as black males.
White females were five times more likely to commit suicide than black females.

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Georgia Violent Death Reporting System

Figure 3d. Age-Adjusted Suicide Rates* by Marital Status and Sex, Persons >15 years old, Georgia, 2006-2009

Rate per 100,000 population

MARRIED NEVER MARRIED DIVORCED WIDOWED

200

188

175

150

125

105

102

100

75

64

50

25

0

MALE

41

22 13

16

FEMALE

SEX

*Population is based on 2000 US Standard Population data

Overall, divorced males and females had the highest age-adjusted suicide rates among their respective sexes.
Divorced and never married males were nearly five times more likely to commit suicide than divorced and never married females.
The age-adjusted suicide rate for never married males was almost five times higher than for never married females.
The age-adjusted suicide rate for widowed males was six times higher than for widowed females.

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Figure 3e. Age-Adjusted Suicide Rates by Rural-Urban Status, Georgia, 2006-2009

Source: Georgia Violent Death Reporting System (2006-2009) *Rural-Urban Status established using Rural-Urban Continuum Codes (cf. http://www.ers.usda.gov/Briefing/Rurality/RuralUrbCon/)
Metro areas with more than 1,000,000 population had the lowest age-adjusted suicide rate.
Rural areas had the highest age-adjusted suicide rate.

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Georgia Violent Death Reporting System

Type of Weapon

Figure 3f. Percent of Suicides by Type of Weapon and Sex, Georgia, 2006-2009

Males

Females

Sharp Fall

Instrument 1% *Other

2%

2%

Poisoning

9%

Hanging/Strangulation/ Suffocation 20%

Fall Sharp 2% Instrument

*Other 4%

2%

Hanging/Strangulation/ Suffocation 15%

Firearm 48%

Firearm 66%

Poisoning 29%

*Includes: personal weapons, blunt instrument, falls, fire or burns, drowning, motor vehicle, and other.

Among suicides in Georgia during 2006-2009, weapons were known for 92% of females and 96% of males.
Firearms were the most frequent suicide weapon of choice for both sexes.

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Suicide Circumstances

Circumstances information was available in 68% of suicide cases in Georgia during 2006-2009.

Table 3a. Percent of Suicides by Circumstance*, Georgia, 2006-2009 (N=2,802)

Circumstance

%

Current mental health problem

34

Intimate partner problem

27

Disclosed intent to commit suicide

25

Crisis in the past 2 weeks

25

Depression/dysthymia

22

Ever treated for mental illness

22

Physical health problem

18

History of suicide attempts

16

Other substance problem

12

Job problem

9

Alcohol problem

8

Financial problem

8

Current depressed mood

5

Other relationship problem

5

Other death of friend or family in past 5 years

4

Perpetrator of interpersonal violence in the past month

3

Other argument, abuse or conflict

4

Family stressors

3

*Circumstances were not mutually exclusive.

The most frequent suicide circumstance was having a current mental health problem.

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Georgia Violent Death Reporting System

Toxicology Test Results
Toxicology tests were performed on 37% of suicide victims in Georgia during 2006-2009. Of the tested victims, 42% did not test positive for any toxic substance.

Table 3b. Percent of Suicide Victims with Positive Toxicology Results by Drug Type*,
Georgia, 2006-2009 (N = 898)

Drug Type

%

Antidepressants

52

Other Drugs

45

Alcohol

30

Opioids

14

Cocaine

8

Marijuana

5

Amphetamines

3

*Toxicology tests were not mutually exclusive

Antidepressants were the drugs most frequently present among those suicide victims who were tested.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

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Section 4: Suicide Attempts Among High School Students: YRBS Results
Youth Risk Behavior Survey (YRBS)
The Georgia YRBS is an anonymous survey administered biennially to high school and middle school students to monitor students' engagement in risky health behaviors including those that contribute to unintentional injuries and violence, tobacco use, alcohol and other drug use, unhealthy dietary behaviors, and physical inactivity.
For this report, associations between suicide attempts among high school students and violence-related behaviors were analyzed using combined data from the 2005, 2007, 2009, and 2011 Georgia YRBS surveys.
Demographics and Violence-Related Behaviors

Table 2.1 High School Student Population by Demographics and Violence-Related Behaviors, YRBS, Georgia, 2005-2011 (N=8,071)

% Prevalence 95% CI

Sex

Male

50.3

48.4 52.1

Female

49.7

48.0 51.6

Race

White

48.3

43.3 53.4

Black

39.1

34.2 44.0

Other Race

12.6

11.1 14.0

Grade

9th

31.1

27.0 35.3

10th

26.1

21.8 30.5

11th

22.1

18.1 26.1

12th

20.4

17.2 23.6

Violence-Related Behaviors

Violent behavior+

40.5

38.9 42.1

Victimized+

25.7

23.8 27.5

Made suicide plan

13.1

11.9 14.4

Felt sad or hopeless in the past 2 weeks

29.6

28.2 30.9

Attempted Suicide

8.7

7.9 9.3

Ever used drugs+

11.8

10.2 13.5

Tried marijuana before 13 years of age

8.5

7.7 9.4

Had first drink before 13 years of age

23.4

22.1 24.7

Used marijuana more than once in the past 30 days

19.3

18.2 20.4

Had 1+ drinks in the past 30 days

34.5

32.7 36.3

+See Appendix A for definitions

24

Georgia Violent Death Reporting System

Twenty-six percent of all students were victimized+
Forty percent of all students were involved in violent behaviors during this period and of these, 38.2% had been victimized.
Nearly 30% of students had felt depressed two weeks prior to participating in the survey.
Thirteen percent of students had made a suicide plan, while almost 9% attempted suicide.
Twenty-three percent of students had tried alcohol and nearly 9% had tried marijuana before the age of 13.
More than 34% of students currently drink alcohol while 19% currently use marijuana.
Students that Attempted Suicide

Table 4b. Demographic Distribution of High School Students that Attempted Suicide, YRBS,
Georgia, 2005-2011 (n=614)

% Prevalence

95% CI

Sex

Male

42.1

36.9

47.4

Female

57.9

52.6

63.1

Race

White

42.9

38.4

47.3

Black

39.5

35.0

43.9

Other

17.7

14.5

20.8

Grade

9th

33.9

29.7

38.0

10th

28.4

24.4

32.5

11th

17.9

14.7

21.1

12th

17.8

14.4

21.3

Suicide attempts were more prevalent among females, whites, and ninth graders.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

25

Violence-Related Behaviors Among Students that Attempted Suicide

Table 4c. Prevalence of Violence-Related Behaviors Among High School Students that Attempted Suicide, YRBS, Georgia, 2005-2011 (n=614)

Violence-Related Behaviors

% Prevalence (95% C.I.)

Total

Male

Female

Violent Behavior+

63.1 (57.8-68.5) 67.5 (59.4-75.7) 58.8 (53.1-64.4)

Carried Weapon in the Past 30 Days

39.1 (34.3-44.0) 51.0 (43.2-58.8) 29.6 (23.5-35.7)

Involved in Fight in Past 12 Months

54.2 (48.8-59.6) 57.0 (49.8-64.2) 51.2 (44.7-57.8)

Victimized+

53.1 (48.1-58.1) 53.2 (46.8-59.6) 51.5 (44.3-58.8)

Felt Sad or Hopeless in Past 2 Weeks

67.7 (62.4-73.0) 57.4 (48.7-66.2) 74.0 (68.3-79.6)

Made Suicide Plan

60.7 (56.2-64.7) 54.3 (46.5-62.2) 65.6 (58.9-72.2)

Had First Drink Before 13 Years of Age

45.8 (40.2-51.4) 48.7 (39.7-57.7) 43.0 (36.6-49.3)

Tried Marijuana Before 13 Years of Age

22.8 (18.7-26.9) 30.5 (24.2-36.8) 16.2 (10.9-21.4)

Used Marijuana More than Once in Past 30 Days 34.2 (29.6-38.8) 34.6 (27.6-41.7) 32.4 (26.8-38.0)

Had 1+ Drinks in Past 30 Days

49.8 (45.5-54.0) 43.5 (37.4-49.5) 52.7 (46.2-59.1)

Ever Used Drugs+

35.0 (30.9-39.1) 44.6 (38.2-50.9) 26.2 (20.9-31.5)

+See Appendix A for definitions

Students that attempted suicide were significantly more likely to engage in violent behaviors, have been victimized, make suicide plans, feel depressed in the past 2 weeks, use drugs in their lifetime, try marijuana or alcohol before the age of 13, and use marijuana or alcohol in the past 30 days than those who did not attempt suicide.

Males who attempted suicide were more likely to carry a weapon to school, be involved in violent behaviors, have been victimized, have their first drink and try marijuana before the age of 13, use marijuana more than once in the past 30 days, and ever use drugs than females who attempted suicide.

Females who attempted suicide were more likely to feel depressed in the past 2 weeks, make suicide plans, and have more than 1 drink in the past 30 days than males who attempted suicide.

26

Georgia Violent Death Reporting System

Appendix A: Technical Notes

GVDRS Methods

Descriptive Statistics

This report presents summarized information on violent deaths in Georgia by counts, percentages, and rates. Counts are the basic measure of frequency of violent deaths. Percentages represent the distribution in the underlying population broken down by race, gender, or age. Crude rates are used to develop community-level prevention strategies. Age-adjusted rates are included to compare and contrast communities or states which may have a widely disparate age distribution in the population.
Case Identification
Case identification is based upon the manner of death listed on the death certificate. An incident is recorded for each death categorized as suicide, homicide, undetermined manner of death, legal intervention, and unintentional firearm. Additional information from law enforcement and coroners/medical examiners reports are collected, matched, and merged with records in the violent death reporting system database. The county of injury is the primary focus of the data collection effort. This data element assists in determining occurrent cases compared to resident cases.
To identify violent death cases to be included in the database, the NVDRS (including the GVDRS) uses the International Classification of Diseases, Tenth Revision (ICD-10) codes for the underlying cause of death.

Table 1A. ICD-10 codes used in the National Violent Death Reporting System

Manner of Death

Death 1 Year After Injury Death >1 Year After Injury

Intentional self-harm (suicide)

X60--X84

Y87.0

Assault (homicide)

X85--X99, Y00--Y09

Y87.1

Event of undetermined intent

Y10--Y34

Y87.2, Y89.9

Unintentional exposure to inanimate mechanical forces (firearms)

W32--W34 Y35.0--Y35.4, Y35.6--Y35.7

Y86 determined to be attributable to firearms

Legal intervention excluding executions, (Y35.5)

U01, U03

Y89.0

Terrorism

--

U02

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

27

Primacy Among Data Sources
Data sources may not always agree about every fact of a given incident. A way to identify what is likely the best available information among different sources is needed. Therefore, the data sources have been ranked in terms of their likely accuracy for each data element.
The term used for the ranking is "primacy." The source with 1st primacy is considered most reliable for a given variable and will be the source of choice. Lower primacy sources are the most reliable after 1st primacy and can be used when a higher-primacy source is not available. For example, sex of the victim is taken first from the death certificate (DC), second from the coroner/medical examiner report (CME), and finally from police reports (PR). When different sources have complete but discordant data, the simplest approach is to use primacy. Table 2A shows the variables used for this report and the primacy given to each.
Youth Risk Behavior Survey (YRBS) Methods
Data from 2005, 2007, 2009, and 2011 YRBS were combined and analyzed using a total sample size of 8,071 high school students. Associations between suicide attempt and violent behaviors, victimization, depression, and alcohol and drug use were determined using Chi-square analysis and 95% confidence intervals.
Violent behavior was defined as either carrying a weapon in the past 30 days or being involved in a physical fight in the past 12 months.
Victimization was defined as either being bullied, physically hurt by girlfriend or boyfriend, being threatened or injured with a weapon in the past 12 months, or missing school because feeling unsafe in the past 30 days.
Suicide attempt was defined as either attempting suicide more than once in the past 12 months or attempting suicide with injury in the past 12 months.
Drugs were defined as ever using either cocaine, heroin, methamphetamine, ecstasy, or injecting drugs.

28

Georgia Violent Death Reporting System

Table 2A. Variables* by CDC Document Type+ Primacy Rules

Variable Person Type Age Age Type Sex Race Ethnicity Resident Address Resident State Resident County Veteran Status Marital Status Date of Death Death Place Death State Cause of Death Manner of Death Date of Injury Place of Injury Injury Address Injury State Injury County Injury City At Home Toxicology Alcohol Tests Weapon Type Circumstances

Primacy 1 CME DC DC DC DC DC CME DC DC DC DC DC DC DC DC CME DC PR DC DC DC DC CME CME CME SYS CME

Primacy 2 DC CME CME CME CME CME DC CME CME
CME CME CME CME
DC CME CME CME CME CME CME PR
PR

Primacy 3 PR PR PR PR PR PR PR PR PR
PR
PR
PR PR
PR PR PR PR
CFR

*This table does not list all the variables found in NVDRS. +DC = Death Certificate; CME = Coroner/Medical Examiner Report;
PR = Police Report

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

29

30

Georgia Violent Death Reporting System

Glossary
Age-Adjusted Mortality Rate per Year: number of resident violent deaths recorded during the calendar year divided by the resident population of the jurisdiction, as defined in official U.S. Census figures, and multiplied by the age-specific weights. The weighted rates are then summed across the age groups to give the age-adjusted rate, and multiplied by 100,000 for a rate per 100,000 population. It is a mortality rate statistically modified to eliminate the effect of different age distributions in the different populations.
Asphyxiation: a condition due to lack of oxygen to breathe and resulting in death.
Blunt instrument: a weapon that does not have a sharp or penetrating point, such as a club or a bat.
Brawl: three or more persons involved in a mutual, physical fight. The brawl may or may not escalate to involve weapons. This excludes one-sided physical fight or a fight between only two people.
Crude Mortality Rate per Year: number of resident violent deaths recorded during the calendar year divided by the resident population of the jurisdiction, as defined in official U.S. Census figures, and multiplied by 100,000 for a rate per 100,000 population.
Current depressed mood: identifies victims who were documented as having a current depressed mood by a family member or someone close to the victim. The depressed mood may be part of a clinical depression or a short-term sadness.
Current Mental Health Problem: victims who were identified as having a mental health problem. Diagnoses include: depression/dysthymia, bipolar disorder, schizophrenia, anxiety disorder, post-traumatic stress disorder, attention deficit disorder (ADD) or hyperactivity disorder, eating disorder, obsessive-compulsive disorder, other (specified in diagnosis text), including mental retardation, autism, personality disorders, Alzheimer's, etc.
Current Treatment for Mental Health Problem: victims who were in current treatment for a mental health problem in the last two months. Treatment includes seeing a psychiatrist, psychologist, medical doctor, therapist, or other counselor for a mental health or substance abuse problem; receiving a prescription for an antidepressant or other psychiatric medication; or residing in an inpatient or halfway house facility for mental health problems. Treatment also includes past treatment, unless noted that the problem has been resolved. Mental health problems include those disorders and syndromes listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision) and alcohol and other substance dependence.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

31

Drowning: death resulting from oxygen deprivation while being submerged/ immersed under water or other liquid.
Drugs: ever using either cocaine, heroin, methamphetamine, ecstasy, or injecting drugs.
Fall: death resulting from a fall, push, or jump from a high place.
Legal intervention death: death when the decedent was killed by a police officer or other peace officer (persons with specified legal authority to use deadly force), including military police, acting in the line of duty. Specific scenarios that should be classified as legal interventions include: "justifiable" and "criminal" homicides meeting the above definition.
Personal weapons: includes the body, such as fists, feet, or hands used as a weapon.
Poisoning: weapon including drugs (prescription, street, or alcohol), toxins, chemical substances, or gas (such as carbon monoxide).
Sharp instrument: weapons that have a cutting edge or penetrating point, such as a knife, razor, chisel, or broken glass.
Suffocation: condition of being deprived of oxygen and synonymous with asphyxiation.
Sudden Unexpected Infant Death (SUID): deaths in infants less than 1 year of age that occur suddenly and unexpectedly, and whose cause of death is not immediately obvious prior to investigation.
Suicide attempt: was defined as either attempting suicide more than once in the past 12 months or attempting suicide with injury in the past 12 months.
Victimization: either being bullied, physically hurt by girlfriend or boyfriend, being threatened or injured with a weapon in the past 12 months, or missing school because feeling unsafe in the past 30 days.
Violent behavior: either carrying a weapon in the past 30 days or being involved in a physical fight in the past 12 months.

32

Georgia Violent Death Reporting System

Undetermined manner of death: death resulting from the use of force or power against oneself or another person, for which the evidence indicating one manner of death is no more compelling than the evidence indicating another manner of death. Specific scenarios that should be classified as undetermined manner of death are:
Coroner or medical examiner ruling that states: "accident or suicide," "accident or homicide," "undetermined," "open verdict," or "jumped or fell"
Self-inflicted injuries when the records give no evidence or opinions in favor of either unintentional or intentional injury.
Unintentional firearm injury death: death resulting from a penetrating injury or gunshot wound from a weapon that uses a powder charge to fire a projectile when there was a preponderance of evidence that the shooting was not intentionally directed at the victim. Specific scenarios that should be classified as unintentional firearm deaths:
Celebratory firing that was not intended to frighten, control, or harm anyone A person shoots himself when using a gun to frighten, control, or harm
another person A child less than the age of 6 shoots himself or another person A soldier who is shot during field exercises in peacetime A person mistakenly thinks a gun is unloaded and shoots himself or another
person while fooling around with it A child who dies after birth from an unintentional firearm injury that is
sustained prior to birth, i.e., in utero
Veteran Status: victims identified in the death certificate as ever served in the U.S. Armed Forces.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

33

Appendix B: Crude and Age-Adjusted Mortality Rates by County, Georgia, 2006-2009

County
Appling Atkinson Bacon Baker Baldwin Banks Barrow Bartow Ben Hill Berrien Bibb Bleckley Brantley Brooks Bryan Bulloch Burke Butts Calhoun Camden Candler Carroll Catoosa Charlton Chatham Chattahoochee Chattooga Cherokee Clarke Clay Clayton Clinch Cobb Coffee Colquitt Columbia Cook Coweta

Table 1B. Crude and Age-Adjusted Violent Death Rates by County, Georgia, 2006-2009

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

County

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

20

27.9

30.2

Jefferson

13

*

*

**

*

*

Jenkins

5

*

*

11

*

*

Johnson

9

*

*

**

*

*

Jones

18

16.4

16.2

34

18.3

18.9

Lamar

16

23.4

24.2

13

*

*

Lanier

6

*

*

55

20.2

20.0

Laurens

30

15.7

15.6

83

22.2

22.4

Lee

22

16.5

17.3

11

*

*

Liberty

49

20.3

20.1

13

*

*

Lincoln

**

*

*

164

26.4

26.2

Long

12

*

*

15

29.5

28.3

Lowndes

69

16.7

17.1

18

29.1

30.5

Lumpkin

13

*

*

13

*

*

Macon

23

26.5

25.6

17

13.8

15.1

Madison

14

*

*

33

12.3

14.5

Marion

11

*

*

25

27.4

28.3

McDuffie

16

14.4

15.3

20

20.9

19.6

McIntosh

**

*

*

6

*

*

Meriwether

22

24.0

26.7

33

17.4

16.5

Miller

**

*

*

7

*

*

Mitchell

11

*

*

82

18.3

18.6

Monroe

15

15.0

14.7

33

13.2

13.7

Montgomery

5

*

*

7

*

*

Morgan

8

*

*

262

26.2

24.9

Murray

23

14.1

14.7

8

*

*

Muscogee

174

23.0

22.2

16

15.0

15.4

Newton

67

17.4

17.9

101

12.3

12.7

Oconee

16

12.5

12.5

82

18.0

21.0

Oglethorpe

12

*

*

**

*

*

Paulding

82

15.8

17.8

234

21.4

21.7

Peach

31

29.3

28.5

**

*

*

Pickens

26

21.3

21.1

409

14.7

14.6

Pierce

12

*

*

38

23.5

24.0

Pike

16

23.2

23.2

36

20.0

20.8

Polk

25

15.0

15.8

57

13.0

13.2

Pulaski

11

*

*

16

24.3

23.2

Putnam

22

27.1

23.1

63

13.0

13.6

Quitman

**

*

*

34

Georgia Violent Death Reporting System

County
Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis

Table 1B. Crude and Age-Adjusted Violent Death Rates by County, Georgia, 2006-2009

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

County

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

6

*

*

Rabun

22

33.2

34.0

23

26.0

26.2

Randolph

**

*

*

8

*

*

Richmond

213

26.8

25.8

15

17.2

17.3

Rockdale

54

16.4

17.1

21

18.3

18.5

Schley

**

*

*

630

21.4

20.4

Screven

7

*

*

16

20.3

19.9

Seminole

8

*

*

5

*

*

Spalding

41

16.1

15.7

70

18.4

18.3

Stephens

19

18.7

17.3

96

19.2

19.9

Stewart

**

*

*

8

*

*

Sumter

17

13.1

12.3

**

*

*

Talbot

10

*

*

30

14.6

15.2

Taliaferro

**

*

*

21

25.5

25.5

Tattnall

22

23.5

22.1

19

20.9

19.8

Taylor

10

*

*

9

*

*

Telfair

13

*

*

28

31.0

28.8

Terrell

12

*

*

48

11.3

12.7

Thomas

29

15.9

15.5

97

25.4

25.3

Tift

35

20.7

20.0

79

12.2

12.9

Toombs

24

21.6

22.1

25

28.7

28.0

Towns

5

*

*

854

21.3

20.7

Treutlen

**

*

*

25

21.8

19.2

Troup

57

22.4

22.0

**

*

*

Turner

6

*

*

80

26.6

27.2

Twiggs

7

*

*

31

14.8

14.7

Union

22

26.3

25.2

15

15.0

13.9

Upson

14

*

*

9

*

*

Walker

45

17.4

17.6

502

16.1

16.6

Walton

45

13.4

13.7

15

8.8

8.6

Ware

22

15.3

16.3

74

10.2

10.6

Warren

**

*

*

5

*

*

Washington

11

*

*

30

26.2

25.5

Wayne

32

27.5

25.8

12

*

*

Webster

**

*

*

24

24.9

25.1

Wheeler

**

*

*

11

*

*

White

23

23.1

23.9

118

15.8

16.2

Whitfield

45

12.1

12.6

76

14.4

14.5

Wilcox

8

*

*

7

*

*

Wilkes

**

*

*

41

17.0

17.2

Wilkinson

6

*

*

15

27.3

30.1

Worth

19

22.3

24.8

11

*

*

* Rates were not reported for counties with less than 15 deaths. **The number of deaths was 5 or fewer and has been suppressed to retain confidentiality.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

35

Table 2B. Crude and Age-Adjusted Suicide Rates by County, Georgia, 2006-2009

County

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

County

Number

Crude Rate per 100,000

Appling

8

*

*

Jefferson

6

*

Atkinson

**

*

*

Jenkins

**

*

Bacon

7

*

*

Johnson

6

*

Baker

**

*

*

Jones

14

*

Baldwin

18

9.7

9.8

Lamar

10

*

Banks

8

*

*

Lanier

**

*

Barrow

39

14.3

14.6

Laurens

13

*

Bartow

55

14.7

14.9

Lee

15

11.2

Ben Hill

**

*

*

Liberty

27

11.2

Berrien

8

*

*

Lincoln

**

*

Bibb

56

9.0

9.1

Long

7

*

Bleckley

12

*

*

Lowndes

41

9.9

Brantley

7

*

*

Lumpkin

8

*

Brooks

5

*

*

Macon

13

*

Bryan

12

*

*

Madison

8

*

Bulloch

29

10.8

13.1

Marion

**

*

Burke

11

*

*

McDuffie

12

*

Butts

13

*

*

McIntosh

**

*

Calhoun

**

*

*

Meriwether

13

*

Camden

18

9.5

9.2

Miller

**

*

Candler

**

*

*

Mitchell

7

*

Carroll

44

9.8

10.2

Monroe

9

*

Catoosa

27

10.8

11.1

Montgomery

**

*

Charlton

**

*

*

Morgan

7

*

Chatham

112

11.2

10.7

Murray

19

11.7

Chattahoochee

5

*

*

Muscogee

65

8.6

Chattooga

12

*

*

Newton

31

8.1

Cherokee

74

9.0

9.5

Oconee

13

*

Clarke

43

9.4

11.0

Oglethorpe

6

*

Clay

**

*

*

Paulding

56

10.8

Clayton

66

6.0

7.1

Peach

18

17.0

Clinch

**

*

*

Pickens

16

13.1

Cobb

242

8.7

8.8

Pierce

7

*

Coffee

20

12.4

13.1

Pike

10

*

Colquitt

19

10.6

10.8

Polk

13

*

Columbia

44

10.0

10.1

Pulaski

5

*

Cook

6

*

*

Putnam

15

18.5

Coweta

38

7.9

8.5

Quitman

**

*

Crawford

**

*

*

Rabun

17

25.7

Crisp

5

*

*

Randolph

**

*

Dade

7

*

*

Richmond

93

11.7

Age-Adjusted Rate per 100,000 * * * * * * * 10.8 12.0 * * 10.2 * * * * * * * * * * * * 12.3 8.6 8.9 * * 12.7 17.5 12.1 * * * * 16.3 * 25.9 * 11.8

36

Georgia Violent Death Reporting System

County
Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis

Table 2B. Crude and Age-Adjusted Suicide Rates by County, Georgia, 2006-2009

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

County

Number

Crude Rate per 100,000

11

*

*

Rockdale

29

8.8

12

*

*

Schley

**

*

198

6.7

6.8

Screven

**

*

6

*

*

Seminole

6

*

**

*

*

Spalding

23

9.1

26

6.8

7.2

Stephens

9

*

55

11.0

11.8

Stewart

**

*

**

*

*

Sumter

5

*

**

*

*

Talbot

**

*

17

8.3

8.6

Taliaferro

**

*

15

18.2

17.9

Tattnall

12

*

8

*

*

Taylor

6

*

5

*

*

Telfair

**

*

22

24.3

21.9

Terrell

5

*

32

7.5

7.9

Thomas

13

*

65

17.0

17.1

Tift

15

8.9

59

9.1

10.0

Toombs

15

13.5

17

19.5

18.4

Towns

**

*

288

7.2

7.2

Treutlen

**

*

21

18.3

16.1

Troup

28

11.0

**

*

*

Turner

5

*

35

11.6

11.3

Twiggs

**

*

14

*

*

Union

16

19.1

7

*

*

Upson

7

*

5

*

*

Walker

33

12.8

285

9.1

9.7

Walton

27

8.0

10

*

*

Ware

12

*

45

6.2

6.5

Warren

**

*

**

*

*

Washington

6

*

20

17.4

16.6

Wayne

14

*

7

*

*

Webster

**

*

15

15.5

14.9

Wheeler

**

*

8

*

*

White

14

*

71

9.5

9.8

Whitfield

30

8.1

48

9.1

9.2

Wilcox

**

*

**

*

*

Wilkes

**

*

23

9.5

9.6

Wilkinson

**

*

11

*

*

Worth

9

*

5

*

*

Age-Adjusted Rate per 100,000 9.1 * * * 8.8 * * * * * * * * * * 8.8 13.8 * * 10.7 * * 17.7 * 12.6 8.5 * * * * * * * 8.7 * * * *

*Rates were not reported for counties with less than 15 deaths. **The number of deaths was 5 or fewer and has been suppressed to retain confidentiality.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

37

Table 3B. Crude and Age-Adjusted Homicide Rates by County, Georgia, 2006-2009

County

Crude Age-Adjusted

Number Rate per

Rate per

100,000

100,000

County

Crude Number Rate per
100,000

Age-Adjusted Rate per 100,000

Appling

9

*

*

Jefferson

6

*

*

Atkinson

**

*

*

Jenkins

**

*

*

Bacon

**

*

*

Johnson

**

*

*

Baker

**

*

*

Jones

**

*

*

Baldwin

15

8.1

8.4

Lamar

5

*

*

Banks

**

*

*

Lanier

**

*

*

Barrow

12

*

*

Laurens

12

*

*

Bartow

13

*

*

Lee

6

*

*

Ben Hill

**

*

*

Liberty

16

6.6

6.2

Berrien

**

*

*

Lincoln

**

*

*

Bibb

89

14.3

14.4

Long

**

*

*

Bleckley

**

*

*

Lowndes

17

4.1

4.3

Brantley

8

*

*

Lumpkin

**

*

*

Brooks

6

*

*

Macon

6

*

*

Bryan

**

*

*

Madison

6

*

*

Bulloch

**

*

*

Marion

7

*

*

Burke

9

*

*

McDuffie

**

*

*

Butts

**

*

*

McIntosh

**

*

*

Calhoun

**

*

*

Meriwether

7

*

*

Camden

10

*

*

Miller

**

*

*

Candler

**

*

*

Mitchell

**

*

*

Carroll

21

4.7

4.7

Monroe

6

*

*

Catoosa

**

*

*

Montgomery **

*

*

Charlton

**

*

*

Morgan

**

*

*

Chatham

120

12.0

11.4

Murray

**

*

*

Chattahoochee

**

*

*

Muscogee

72

9.5

9.3

Chattooga

**

*

*

Newton

26

6.8

6.6

Cherokee

9

*

*

Oconee

**

*

*

Clarke

25

5.5

6.7

Oglethorpe

**

*

*

Clay

**

*

*

Paulding

12

*

*

Clayton

142

13.0

12.4

Peach

10

*

*

Clinch

**

*

*

Pickens

5

*

*

Cobb

110

3.9

3.9

Pierce

**

*

*

Coffee

11

*

*

Pike

**

*

*

Colquitt

13

*

*

Polk

10

*

*

Columbia

7

*

*

Pulaski

**

*

*

Cook

7

*

*

Putnam

**

*

*

Coweta

19

3.9

3.9

Quitman

**

*

*

Crawford

**

*

*

Rabun

**

*

*

Crisp

14

*

*

Randolph

**

*

*

38

Georgia Violent Death Reporting System

County
Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis

Table 3B. Crude and Age-Adjusted Homicide Rates by County, Georgia, 2006-2009

Number

Crude Rate per 100,000

Age-Adjusted Rate per 100,000

County

Crude Number Rate per
100,000

Age-Adjusted Rate per 100,000

**

*

*

Richmond

89

11.2

10.4

**

*

*

Rockdale

21

6.4

6.6

6

*

*

Schley

**

*

*

390

13.2

12.3

Screven

5

*

*

8

*

*

Seminole

**

*

*

**

*

*

Spalding

13

*

*

39

10.2

10.1

Stephens

5

*

*

25

5.0

5.0

Stewart

**

*

*

5

*

*

Sumter

9

*

*

**

*

*

Talbot

5

*

*

7

*

*

Taliaferro

**

*

*

**

*

*

Tattnall

9

*

*

9

*

*

Taylor

**

*

*

**

*

*

Telfair

8

*

*

**

*

*

Terrell

**

*

*

11

*

*

Thomas

10

*

*

14

*

*

Tift

17

10.0

9.7

13

*

*

Toombs

5

*

*

**

*

*

Towns

**

*

*

454

11.3

10.7

Treutlen

**

*

*

**

*

*

Troup

16

6.3

6.3

**

*

*

Turner

**

*

*

40

13.3

14.3

Twiggs

**

*

*

9

*

*

Union

**

*

*

**

*

*

Upson

**

*

*

**

*

*

Walker

5

*

*

166

5.3

5.3

Walton

10

*

*

**

*

*

Ware

7

*

*

13

*

*

Warren

**

*

*

**

*

*

Washington

**

*

*

6

*

*

Wayne

12

*

*

**

*

*

Webster

**

*

*

6

*

*

Wheeler

**

*

*

**

*

*

White

5

*

*

28

3.7

3.9

Whitfield

8

*

*

15

2.8

2.9

Wilcox

**

*

*

**

*

*

Wilkes

**

*

*

12

*

*

Wilkinson

**

*

*

**

*

*

Worth

6

*

*

5

*

*

*Rates were not reported for counties with less than 15 deaths. **The number of deaths was 5 or fewer and has been suppressed to retain confidentiality.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

39

Table 4B. Number of Violent Deaths by Type of Case and County,Georgia, 2006-2009

Resident

Occurrent

County

Number

Crude Rate

Age-Adjusted Rate per 100,000

Number

Percent of Total (%)

Appling

20

27.9

30.2

**

0.2

Atkinson

**

*

*

**

0.0

Bacon

11

*

*

**

0.1

Baker

**

*

*

**

0.1

Baldwin

34

18.3

18.9

10

0.6

Banks

13

*

*

5

0.3

Barrow

55

20.2

20.0

10

0.6

Bartow

83

22.2

22.4

21

1.2

Ben Hill

11

*

*

**

0.2

Berrien

13

*

*

**

0.2

Bibb

164

26.4

26.2

28

1.6

Bleckley

15

29.5

28.3

**

0.2

Brantley

18

29.1

30.5

**

0.0

Brooks

13

*

*

**

0.1

Bryan

17

13.8

15.1

**

0.1

Bulloch

33

12.3

14.5

8

0.4

Burke

25

27.4

28.3

**

0.2

Butts

20

20.9

19.6

9

0.5

Calhoun

6

*

*

**

0.1

Camden

33

17.4

16.5

12

0.7

Candler

7

*

*

5

0.3

Carroll

82

18.3

18.6

15

0.8

Catoosa

33

13.2

13.7

9

0.5

Charlton

7

*

*

**

0.2

Chatham

262

26.2

24.9

40

2.2

Chattahoochee

8

*

*

**

0.1

Chattooga

16

15.0

15.4

**

0.2

Cherokee

101

12.3

12.7

19

1.1

Clarke

82

18.0

21.0

13

0.7

Clay

**

*

*

**

0.0

Clayton

234

21.4

21.7

65

3.6

Clinch

**

*

*

**

0.1

Cobb

409

14.7

14.6

62

3.4

Coffee

38

23.5

24.0

7

0.4

Colquitt

36

20.0

20.8

5

0.3

Columbia

57

13.0

13.2

13

0.7

Cook

16

24.3

23.2

**

0.2

Coweta

63

13.0

13.6

10

0.6

Crawford

6

*

*

**

0.1

Crisp

23

26.0

26.2

**

0.2

Dade

8

*

*

**

0.1

40

Georgia Violent Death Reporting System

Table 4B. Number of Violent Deaths by Type of Case and County,Georgia, 2006-2009

Resident

Occurrent

County

Number

Crude Rate

Age-Adjusted Rate per 100,000

Number

Percent of Total (%)

Dawson

15

17.2

17.3

7

0.4

Decatur

21

18.3

18.5

6

0.3

DeKalb

630

21.4

20.4

166

9.2

Dodge

16

20.3

19.9

5

0.3

Dooly

5

*

*

**

0.1

Dougherty

70

18.4

18.3

16

0.9

Douglas

96

19.2

19.9

20

1.1

Early

8

*

*

19

1.1

Echols

**

*

*

**

0.1

Effingham

30

14.6

15.2

9

0.5

Elbert

21

25.5

25.5

**

0.1

Emanuel

19

20.9

19.8

**

0.2

Evans

9

*

*

**

0.2

Fannin

28

31.0

28.8

5

0.3

Fayette

48

11.3

12.7

**

0.2

Floyd

97

25.4

25.3

17

0.9

Forsyth

79

12.2

12.9

12

0.7

Franklin

25

28.7

28.0

8

0.4

Fulton

854

21.3

20.7

358

19.9

Gilmer

25

21.8

19.2

**

0.1

Glascock

**

*

*

**

0.0

Glynn

80

26.6

27.2

18

1.0

Gordon

31

14.8

14.7

10

0.6

Grady

15

15.0

13.9

**

0.2

Greene

9

*

*

**

0.2

Gwinnett

502

16.1

16.6

89

4.9

Habersham

15

8.8

8.6

**

0.2

Hall

74

10.2

10.6

36

2.0

Hancock

5

*

*

**

0.1

Haralson

30

26.2

25.5

10

0.6

Harris

12

*

*

7

0.4

Hart

24

24.9

25.1

**

0.1

Heard

11

*

*

**

0.2

Henry

118

15.8

16.2

28

1.6

Houston

76

14.4

14.5

20

1.1

Irwin

7

*

*

**

0.2

Jackson

41

17.0

17.2

11

0.6

Jasper

15

27.3

30.1

**

0.2

Jeff Davis

11

*

*

**

0.1

Jefferson

13

*

*

**

0.1

Jenkins

5

*

*

**

0.1

Johnson

9

*

*

**

0.2

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

41

Table 4B. Number of Violent Deaths by Type of Case and County,Georgia, 2006-2009

Resident

Occurrent

County

Number

Crude Rate

Age-Adjusted Rate per 100,000

Number

Percent of Total (%)

Jones

18

16.4

16.2

35

1.9

Lamar

16

23.4

24.2

**

0.2

Lanier

6

*

*

**

0.1

Laurens

30

15.7

15.6

**

0.1

Lee

22

16.5

17.3

**

0.2

Liberty

49

20.3

20.1

7

0.4

Lincoln

**

*

*

**

0.1

Long

12

*

*

**

0.2

Lowndes

69

16.7

17.1

19

1.1

Lumpkin

13

*

*

5

0.3

Macon

23

26.5

25.6

**

0.2

Madison

14

*

*

8

0.4

Marion

11

*

*

**

0.1

McDuffie

16

14.4

15.3

**

0.2

McIntosh

**

*

*

5

0.3

Meriwether

22

24.0

26.7

5

0.3

Miller

**

*

*

**

0.1

Mitchell

11

*

*

5

0.3

Monroe

15

15.0

14.7

6

0.3

Montgomery

5

*

*

**

0.2

Morgan

8

*

*

6

0.3

Murray

23

14.1

14.7

5

0.3

Muscogee

174

23.0

22.2

34

1.9

Newton

67

17.4

17.9

24

1.3

Oconee

16

12.5

12.5

**

0.2

Oglethorpe

12

*

*

5

0.3

Paulding

82

15.8

17.8

13

0.7

Peach

31

29.3

28.5

7

0.4

Pickens

26

21.3

21.1

7

0.4

Pierce

12

*

*

**

0.2

Pike

16

23.2

23.2

**

0.1

Polk

25

15.0

15.8

8

0.4

Pulaski

11

*

*

**

0.0

Putnam

22

27.1

23.1

6

0.3

Quitman

**

*

*

**

0.1

Rabun

22

33.2

34.0

5

0.3

Randolph

**

*

*

**

0.1

Richmond

213

26.8

25.8

47

2.6

42

Georgia Violent Death Reporting System

Table 4B. Number of Violent Deaths by Type of Case and County,Georgia, 2006-2009

Resident

Occurrent

County

Number

Crude Rate

Age-Adjusted Rate per 100,000

Number

Percent of Total (%)

Rockdale

54

16.4

17.1

10

0.6

Schley

**

*

*

**

0.1

Screven

7

*

*

**

0.2

Seminole

8

*

*

**

0.2

Spalding

41

16.1

15.7

9

0.5

Stephens

19

18.7

17.3

7

0.4

Stewart

**

*

*

**

0.0

Sumter

17

13.1

12.3

6

0.3

Talbot

10

*

*

**

0.1

Taliaferro

**

*

*

**

0.0

Tattnall

22

23.5

22.1

11

0.6

Taylor

10

*

*

**

0.1

Telfair

13

*

*

**

0.2

Terrell

12

*

*

**

0.2

Thomas

29

15.9

15.5

**

0.1

Tift

35

20.7

20.0

6

0.3

Toombs

24

21.6

22.1

6

0.3

Towns

5

*

*

5

0.3

Treutlen

**

*

*

**

0.0

Troup

57

22.4

22.0

6

0.3

Turner

6

*

*

**

0.1

Twiggs

7

*

*

**

0.1

Union

22

26.3

25.2

6

0.3

Upson

14

*

*

5

0.3

Walker

45

17.4

17.6

9

0.5

Walton

45

13.4

13.7

17

0.9

Ware

22

15.3

16.3

8

0.4

Warren

**

*

*

**

0.0

Washington

11

*

*

**

0.1

Wayne

32

27.5

25.8

5

0.3

Webster

**

*

*

**

0.0

Wheeler

**

*

*

6

0.3

White

23

23.1

23.9

**

0.2

Whitfield

45

12.1

12.6

9

0.5

Wilcox

8

*

*

**

0.0

Wilkes

**

*

*

**

0.1

Wilkinson

6

*

*

**

0.0

Worth

19

22.3

24.8

**

0.1

*Rates are not reported for counties with less than 15 deaths. **The number of deaths was 5 or fewer and has been suppressed to retain confidentiality.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

43

Appendix C: Maps
Figure 1C. Georgia Public Health Districts

44

Georgia Violent Death Reporting System

Figure 2C. Georgia Judicial Districts and Circuits

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

45

46

Georgia Violent Death Reporting System

References
Centers for Disease Control and Prevention. [2005-2011]. Georgia Youth Risk Behavior Survey. Retrieved on November 30, 2011 from www.cdc.gov/yrbs
Centers for Disease Control and Prevention. (2010). National Violent Death Reporting System (NVDRS) Coding Manual, Version 4. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Retrieved February 16, 2011 from www.cdc.gov/injury
Centers for Disease Control and Prevention. (2011). National Violent Death Reporting System (NVDRS). In Injury Prevention and Control: Data & Statistics WISQARSTM. Retrieved May 18, 2011 from http://www.cdc.gov/injury/wisqars/ nvdrs.html
National Center for Health Statistics. (2010). Postcensal estimates of the resident population of the United States for July 1, 2000-July 1, 2009, by year, county, age, bridged race, Hispanic origin, and sex (Vintage 2009). Retrieved April 5, 2011 from: www.cdc.gov/nchs/nvss/bridged_race.htm
US Census Bureau, populations Estimate Program. (2010). Georgia County, Population Estimates. Retrieved May 18, 2011 from Ghttp://factfinder.census.gov/ servlet/GCTTable?_bm=y&-geo_id=04000US13&-_box_head_nbr=GCT-T1&ds_name=PEP_2009_EST&-_lang=en&-format=ST-2&-_sse=on.

2011 Surveillance Report: Violent Deaths in Georgia, 2006-2009

47