Intentional injury deaths in Washington state

Background/Purpose: Firearms command the public's and policy-makers' attention following each assault-style rifle attack in a middle-American community. But while firearm-related initiatives wax and wane with each attack, little attention is paid to assessing the overall and relative magnitude of intentional injuries by intent, mechanism, demographic characteristics, region or small area. Per a request from our state legislators, such an assessment on firearm injuries was completed in April, 2013; this presentation builds upon that analysis by assessing all intentional injuries in Washington State. Methods: Washington's age-adjusted death rates by intent, gender, age, race/ethnicity, and region were computed, as were rates for British Columbia and the USA. Tract-based clusters with higher or lower than expected incidents of intentional injury deaths by intent and mechanism were also identified via the spatial scan statistic. These clusters were then profiled using the state's BRFSS data. Results/Outcomes: Between 2008 and 2010, there were 3,340 intentional injury deaths in Washington; 2,746 were suicides, 1,366 of which involved firearms. Of the remainder, 594 homicides, 356 involved firearms. Males were at higher risk. Some variations existed by race/ethnicity. Rates were generally higher in the more rural eastern half of the state. Geographic clusters' characteristics generally comported with expectations, e.g., high firearm suicide clusters had high unemployment, low life satisfaction, little emotional support, poor quality of life, and high firearm availability. Conclusions: In assessing intent and mechanism, the current focus on firearm homicides alone seems disproportionate. By identifying at-risk communities and their risk-factors, interventions may be more efficaciously targeted.