1. NVDRS Special Interest Group (SIG) Survey of Unfunded States The views and opinions expressed in this presentation are those of the authors and do not necessarily represent official policy or position of the Safe States Alliance.

2. BACKGROUND: Why did we do it?

3. Support for NVDRS Expansion W IDESPREAD SUPPORT FOR EXPANSION Recent violent events have sparked broader interest in expansion President Obama supports full funding (+ $20 million) Congress recently appropriated ~ $8 million additional for FY 14  2012 National Strategy for Suicide Prevention  American Association of Suicidology  American Bar Association  American College of Preventive Medicine  American Foundation for Suicide Prevention  American Psychological Association  American Public Health Association  American Academy of Pediatrics  International Association of Chiefs of Police  National Organization of People of Color Against Suicide  Safe States Alliance  Suicide Prevention Action Network  The Joyce Foundation  Tri-Council for Nursing (ANA; AACN; NLN; AONE)

4. Funded States Currently funded states * CA collected data in four counties from 2005-2009

5. Survey Rationale No unified national system for surveillance of violent deaths NVDRS currently represents only 34% of the U.S. population  under-represents Hispanics, suicides, some regions There are likely common barriers to full participation by new states Survey issued to assess potential, readiness, capacity, and interest of unfunded states  SIG also wished to learn about barriers and challenges faced by unfunded states

6. METHODS: How did we do it?

7. Survey Design and Distribution Developed and conducted by the NVDRS-SIG Strategic Planning Subcommittee  Identified specific barriers and challenges that could be faced by states  Wrote survey based on those barriers and challenges  Conducted pilot study  Identified potential respondents through multiple sources o Could have more than one respondent per state

8. Survey Limitations Multiple respondents from some states Not generalizable Not all non-funded states responded

9. RESULTS: What did we find out? 25 respondents from 20 states  Same-state respondents usually agreed, but not always  Results presented by number of respondents, not states Very small to very large states represented

10. Are states interested in applying for NVDRS funding?

11. Why are states interested in applying?

12. Why are states not interested in applying ?

13. What isn’t a problem No respondents selected these choices:  State gov’t obstacles to using federal funding  Difficulty accessing death certificate data  Size of the state

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

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

16. Where would the VDRS be housed? N=20

17. Do states have centralized CME or LE data?

18. Do states have easy access to death certificate data?

19. Data on firearm-related deaths: An advantage or disadvantage? N=25

20. What is the level of interest in specific violent deaths?

21. SUMMARY

22. Motivation: Why do states want NVDRS? Only 2 respondents said their state would not be interested in applying Interest in participation strongly based on NVDRS value for input into policy Access to violent death data, esp. vital records State interest in violent deaths, particularly suicides

23. 20 of 25 of respondents could say where system would be housed Majority reported easy/electronic access to vital records data High proportion of respondents reported “No” or “Don’t know/not sure” to CME & LE data access Additional barriers noted  Poor/limited state capacity  Insufficient federal funding Feasibility: Are non-NVDRS states equipped to participate?

24. Five of six respondents who said their state was not interested in applying expressed some interest in sampling within the state and/or using alternate data sources Flexible Design Options: Could new options allow more states to participate?

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

26. Considerations for the Future Make expansion an explicit priority and set specific goals and timelines for including more states, built against a template of greater national representativeness (e.g., by state size, region, and diversity) Develop “market intelligence” and involve states directly in development of changes to help NVDRS meet new goals and timelines Further explore these findings and begin developing a detailed profile for every likely participating state (e.g., program “owner”, feasible design, barriers, etc.)

27. Considerations for the Future Consider alternative designs for states that can only participate with a sample of records or political sub-areas (cities or counties) or with innovative use of electronic records Explore funding strategies tailored to actual state implementation plans (e.g., sample or electronic plans may cost less than statewide abstraction of decentralized resources)

28. Next steps Use feedback from the NVDRS SIG meeting and RSV presentation to revise presentation Send revised presentation to all SIG members for input Post final version of presentation on Safe States website with all explanatory notes

29. Questions? Comments? Scott Proescholdbell, NVDRS SIG Chair  Scott.proescholdbell@dhhs.nc.gov Scott.proescholdbell@dhhs.nc.gov NVDRS SIG Strategic Planning Subcommittee  Roger Trent, rogertrent99@gmail.comrogertrent99@gmail.com  Jeannette Hudson, jhudson@edc.orgjhudson@edc.org  Pat Smith, smithp40@michigan.govsmithp40@michigan.gov