Connecticut Violent Death Reporting System Data Analysis 2015-2021

The Connecticut Violent Death Reporting System 2015 to 2021 Presented by Michael Makowski, MPH June 6, 2022 Injury and Violence Surveillance Unit Community, Family Health and Prevention Section Connecticut Department of Public Health Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS Data about Violent Death Victims The Connecticut Violent Death Reporting System (CTVDRS) collects data about the victimsof homicide, suicide, unintentional firearm injuries, and undetermined deaths Data sources: LE reports, Supplementary Homicide Reports, Family Violence ( DESPP), OCME investigation, autopsy and toxicology data Data collection began in 2015 * Data from Connecticut Violent Death Reporting System (CTVDRS) 2015 to April 30 th, 2022 Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS Variables Collected Data collected is victim centic Basic and extended demographics-(marital martial status, level of education, occupation) Injury and Death Information- Date of Death, Where Death Occurred- City, In Their Residence; Manner and Death Cause Weapon- Firearm, Sharp instrument, Asphyxia, Poison, etc. Circumstances- Risk or Stressors Suspect- Relationship of victim to suspect Toxicology Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS Variables Collected Circumstances Risks/ Stressors or Triggers Diagnosed Mental Illness (MI); current treatment for MI, Substance Abuse- Alcohol or Drugs Intimate Partner Problems; Injury Result: of an Argument; During Commission of a Crime (for example, robbery, drug trade, etc.) Drive-by shooting; gang related History of suicide attempts/ ideations; Physical Health Problems- chronic pain, chronic or terminal illness Criminal history or past arrests/convictions Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS New Module Public Safety Officer Module Includes Law Enforcement; Fire/EMS; Court & Correction Officers; Dispatchers Employment status- Active or Retired? History of Work-Related Trauma and/ or Stressors Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS Time Frames for Data Collection Per CDC- States have 16 months to complete data collection- example Jan. 2022 to April 2023 for 2022 data CTVDRS cases are initiated from OCME data; monthly reception of the previous month s data Aim to initiate cases within 120 days; includes pending cases that change to suicide or homicide Currently Law Enforcement data being collected for 2021 data Connecticut Department of Public Health - Keeping Connecticut Healthy

NOFO-Next 5 Year Grant Cycle 2022-2027 What will be new for this grant cycle? Development of public-facing data dashboard New partners/stakeholders- Comprehensive Suicide Prevention Grant- Local Health Districts Community Gun Violence Commission- Violence Prevention Groups; HVIPs Data Linkages- ED data ( mental illness, marijuana, alcohol and other substance use) with CTVDRS data; conviction data ( Judicial) Connecticut Department of Public Health - Keeping Connecticut Healthy

Suicide Trends: 2015 2021* Number of Deaths by Suicide in CT from 2015 to 2021* Crude Suicide Rates for CT 2015 to 2021 per 100,000 Pop. 440 12.5 426 420 Crude Suicide Rates per 100,000 CT Pop. 11.9 12 420 11.7 403 11.5 Number of Suicides 400 11.2 389 392 384 11 10.8 10.7 380 10.9 10.5 359 9.9 360 10 340 9.5 320 9 2015 2016 2017 2018 2019 2020 2021 2015 2016 2017 2018 2019 2020* 2021* Year Year Connecticut Department of Public Health - Keeping Connecticut Healthy

Suicide Trends: 2015 2021 Year(s) Number of Suicides Crude Suicide Rate Percent Change in Rate from 2015-19 ---- * preliminary data ** provisional data based on 2020 census data for Connecticut (N=3,603,448) 2015-2019 2,021 11.3 2020* 359 9.9** - 12.4 2021* 392 10.9** -3.5 Connecticut Department of Public Health - Keeping Connecticut Healthy

Demographics of Suicides in Connecticut, by Race and Ethnicity CT Suicides by Race Non Hispanic(n=2,528): 2015-2021* CT Suicides, by Ethnicity (n=2,765): 2015-2021* 7.00% 7.00%2.00% 91.00% 93.00% White Black Asian Not Hispanic Hispanic Connecticut Department of Public Health - Keeping Connecticut Healthy

* data as of 12/31/21 CTVDRS Age-Specific Rates Comparison 2021 to (2015-2019) Age-Groups Number of Suicides 2015-2019 Yearly 5 -year average (2015-2019) Age-Specific Rate 2015-2019 per 100,000 pop Number of Suicides 2021* Age-Specific Rate 2021 per 100,000 pop 0-17 yrs 49 10 2.7 12 1.6 18-24 yrs 162 32 9.3 38 11.1 25-44 yrs 526 105 12.1 100 11.4 45-64 yrs 908 182 17.8 136 13.6 65+ 377 75 12.7 106 16.8 Total 2,022 392 * data as of 12/31/21 Connecticut Department of Public Health - Keeping Connecticut Healthy

* data as of 12/31/21 Suicide Lethal Means Suicide Lethal Means Suicide Lethal Means 6% 3% 4% 36% 22% 29% Hanging, Suffocation Firearm Poisoning Sharp Instrument Fall Other Connecticut Department of Public Health - Keeping Connecticut Healthy

Lethal Means: CT Suicides 2015-2021* Most Common Methods Death by Suicide: Males 1)Hanging/asphyxiation (39%) 2)Firearm (35%) 3)Drug overdose (14%) Females 1)Drug overdose (44%) 2)Hanging/asphyxiation (31%) 3)Firearm (9%) Data Source: CT Violent Death Reporting System Connecticut Department of Public Health - Keeping Connecticut Healthy

Suicide Rates of Connecticut Cities and Towns 2015 to 2019 City/Town Plainville Bristol Vernon Branford Meriden Enfield Wallingford Torrington Norwich Windsor Southington Shelton Milford Groton Manchester Middletown Waterbury New Britain West Haven New Haven Hamden Stamford Stratford Bridgeport Danbury Fairfield Norwalk Suicide Rate per 100,000 Number of Suicides 23.7 18.9 17.1 16.4 16.0 15.7 15.6 15.0 14.7 14.5 14.1 14.0 13.6 12.2 12.1 12.0 12.0 11.3 10.6 8.6 7.8 7.7 7.3 6.7 6.6 6.5 6.1 6.0 21 57 25 23 48 35 35 26 29 21 31 29 37 24 35 28 65 41 29 56 24 50 23 49 28 20 27 37 Based on resident city and at least 20 suicides during 2015 to 2019 Connecticut Department of Public Health - Keeping Connecticut Healthy Hartford

Suicide Rates of Connecticut Cities and Towns 2020-2021 Based on resident city and at least 10 suicides from 2020 to 2021 * For counts less than 20 rates are considered unstable, unreliable City/Town Windham Branford Vernon Hamden Enfield West Hartford Manchester New Britain Fairfield Meriden New Haven Norwalk Stamford Greenwich Danbury Waterbury Hartford Bridgeport Suicide Rate per 100,000 Number of Suicides *20.5 *17.1 *16.5 *13.1 *13.1 *10.9 *10.9 *10.8 *10.6 *9.9 9.3 *9.3 8.9 *8.7 *7.5 *7.4 *6.6 *6.4 10 10 10 16 11 14 13 16 13 12 25 17 24 11 17 17 16 19 Connecticut Department of Public Health - Keeping Connecticut Healthy

Risk Factors for Suicide in 2015-2021 94% ( N=2,585) of risk factors or circumstances are known Most Common Risks 1. Mental Health Problem (42.1%; N=1,088) W/Diagnosis : Depression 27.2 % ( N=704); Bipolar Disorder 3.8% (N=99); Anxiety 1.8% (N= 49); Schizophrenia 1.7% (N=45); Post-Traumatic Stress Disorder < 1% (N=21) 2) Depressed Mood (40.7%; N=1,053) 3) Substance Misuse- Reported Alcohol & Substance Misuse (27.9%, N=722) 4) Physical Health Problem ( Acute, Chronic, Terminal Illness or Pain) (21.7%, N=561) 5) Intimate Partner Problem ( divorce; break-up) (18.2%, N=472) 6) Previous Suicide Attempt(s) (15.5%, N=401) Data Source: CT Violent Death Reporting System Connecticut Department of Public Health - Keeping Connecticut Healthy

Risk Factors for Suicide in 2015-2021 7) History Suicidal Ideations (15.0 % ; N=388) 8) Criminal Legal Problems ( pending court appearance; arrests warrants; under investigation) (7.4%; N=190) 9) Financial Problems (5.5%; N=144) 10)Job Problem (4.8 %; N=126) Data Source: CT Violent Death Reporting System Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Misuse Suicide in 2015-2021 From Circumstances Other Text Box : specific mention of drugs 1)Opiates ( pain meds); heroin ; (31.5 % N= 35) 2)Marijuana (16.2 %; N=18) 3)Cocaine/ Crack (12.6 %; N=14) Data Source: CT Violent Death Reporting System Connecticut Department of Public Health - Keeping Connecticut Healthy

Homicide Rates In Connecticut 2015 to Present 2020 and 2021 data is preliminary* Rates are provisional, currently using 2020 population data for CT As of December 31, 2021 there were 166 homicides Crude Homicide Rates and Numbers for CT 2015 to 2021 180 5.00 Rate of Homicide in CT per 100,000 pop. 4.50 160 Number of Homicides per Year 4.00 140 3.50 120 3.00 100 2.50 80 2.00 60 1.50 40 1.00 20 0.50 0 0.00 2015 2016 2017 2018 2019 2020 2021 Number of Homicides 129 87 124 97 122 157 166 Crude Homicide Rates 3.59 2.43 3.46 2.72 3.42 4.40 4.60 Number of Homicides Crude Homicide Rates Connecticut Department of Public Health - Keeping Connecticut Healthy

Homicide 2015 to 2021* by Sex Homicide 2020 & 2021 by Sex Homicides 2015 to 2019 by Sex 500 300 437 450 253 400 250 350 200 300 250 150 200 150 100 65 100 73 49 (40%) 50 25 50 19 5 0 0 Homicide Female IPV Male IPV Homicide Female IPV Male IPV M F M F Connecticut Department of Public Health - Keeping Connecticut Healthy

Comparison of Homicide Rates Pre-Pandemic (2015 to 2019) to Pandemic (2020-2021) by Race/Ethnicity Comparison of Homicide Rates Pre-Pandemic (2015 to 2019) to Pandemic (2020-2021) by Race/Ethnicity Rate of Homicides by Race and Ethnicity per 100,000 Population, CT 2015-2019 Race/Ethnicity Average Number Homicides (2015 to 2019) Crude Rate *2015-2019 Crude Rate*2020- 2021 Number of Homicides 2020-2021 Rate Difference 2015 to 2019 Compared to 2021 Hispanic 4.60(3.8-5.4) Non-Hispanic, Other* 0.05 Non-Hispanic Black 51 14.0(12.3- 15.7) 21.8 (18.0- 25.1) 165 + 58% Non-Hispanic White 1.37(1.2-1.6) Non-Hispanic White 33 1.37(1.2-1.6) 1.3(1.0-1.6) 56 No change Non-Hispanic Black 14.0 (12.3-15.7) Hispanic 27 4.60(3.8-5.4) 7.5(6.0-9.0) 93 + 63 % 0 5 10 15 *per 100,000 CT population Connecticut Department of Public Health - Keeping Connecticut Healthy

Homicide by Age Average age of homicide victim 34 yrs old vs 51 yrs for suicide Connecticut Department of Public Health - Keeping Connecticut Healthy

CTVDRS Data Lethal Means 2015 to 2021 Years Weapon Type Number of Homicides by Weapon Type 343 Total Number of Homicides for 2015 to 2019 559 Rate Weapon Death per 100 Homicides Pre-Pandemic (2015to 2019) Firearm 61.3 Sharp Force Injury (Stabbing) 69 559 12.3 Pandemic 2020 Firearm Sharp Force Injury (Stabbing) Firearm Sharp Force Injury (Stabbing) 108 31 157 157 68.7 19.7 2021 120 18 161 161 74.5 11.2 Connecticut Department of Public Health - Keeping Connecticut Healthy

Circumstances of Circumstances of Homicide/ Possible Areas Homicide/ Possible Areas for Intervention for Intervention Circumstances Number of Occurrences 167 Rate per 100 Homicides 36.9 Disputes/Arguments Commission of a Crime: Assault Robbery Drug Trade Drug Involvement For 2015 to 2019 homicide circumstances were known for 80% (N=452)of the cases ( LE and OCME reports) Gang* or groups involvement: rate 9 per 100 homicides 132 63 48 86 29.2 13.9 10.6 19.0 * Defined by law enforcement as organized gangs as Bloods, Crips and Latin Kings Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides 2015 to 2021 Rate of Positive Drug Results from Blood at the Time of Autopsy 2015 to 2019 (N= Number of Homicides (559)) Rate of Positive Drug Results from Blood at the Time of Autopsy 2020 to 2021 (N= Number of Homicides (318)) Drug Number of Positives Rate per 100 Homicides Drug Number of Positives Rate per 100 Homicides Marijuana 168 52.8 (44.8-60.8) Marijuana 171 30.5 (26.0-35.0) Alcohol 91 28.7(22.8-34.6) Alcohol 135 24.1(20.0-28.2) Cocaine 48 15.1(10.8-19.4) Opiates 66 11.8(8.9-14.7) Opiates 42 13.2(9.3-17.1) Cocaine 56 10.1(7.3-12.8) Benzodiazepi nes 41 7.3(5.1-9.5) Benzodiazepines 12 3.7(1.6-5.8)

Substance Use in Homicides by Race/Ethnicity Number of Positive Marijuana Results by Race by Year Rate of Positive Marijuana Results at the Time of Autopsy by Race per 100 Homicides Comparison Of Positive Marijuana Rate for Homicide Victims by Race 2018 2019 2020 2021 Black NH 19 27 44 61 37.4 40 Hispanic 7 6 25 17 Rate of Positive Marijuana Test per 100 Homicides 35 28 White NH 3 7 10 9 30 22.1 25 19.5 15.9 20 Other NH ( Asian, Native American, Pacific Islander) Number of Homicides 0 1 0 1 15 7.2 3.1 6.8 6.3 10 4.9 1.7 5 in CT 5.7 0 2018 2019 2020 2021 Black NH 19.5 22.1 28 37.4 97 122 157 161 Hispanic 7.2 4.9 15.9 6.8 White NH 3.1 5.7 6.3 1.7 * Note: Rates calculated from counts less than 20 should be interpreted with caution Year due to the variability of small numbers resulting in low reliability of rates Black NH Hispanic White NH Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides by Race/Ethnicity Number of Alcohol Results (BAC .08 )by Race by Year Rate of Alcohol Results (BAC .08 ) by Race per 100 Homicides 2018 2019 2020 Rate of BAC .08 Results in Blood of Homicide Victims at the Time Autopsy per 100 Homicides by Race 2021 Black NH 7 12 19 11 16 Hispanic 6 6 12 6 14 12 10 White NH 13 15 14 2 02468 Other NH ( Asian, Native American, Pacific Islander) Number of Homicides 0 0 0 0 2018 2019 2020 2021 Hispanic 6.1 4.9 7.6 3.8 Black NH 7.2 9.8 12.1 7.6 White NH 13.4 12.2 8.9 4.5 Other NH(Asian,Native American) 0 0 0 0 97 122 157 161 Rate of BAC Greater Than Equal To .08 in Blood of Homicide Victims per 100 Homicides *note: Rates calculated from counts less than 20 should be interpreted with caution Hispanic Black NH White NH Other NH(Asian,Native American) due to the variability of small numbers resulting in low reliability of rates Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides by Race/Ethnicity Number of Positive Opiate Results Rate of Opiate Positive Results in Blood of Homicide Victims at the Time of Autopsy per 100 Homicides by Race 2018 4 3 8 0 2019 5 4 13 0 2020 8 7 8 0 2021 9 2 8 0 Black NH Hispanic White NH Other NH ( Asian, Native American, Pacific Islander) Number of Homicides 12 10 8 6 4 2 0 2018 2019 2020 2021 Hispanic 3 3.2 4.4 1.5 Black NH 4.1 4.1 5.1 6.8 White NH 8.2 10.6 5.1 6.1 97 122 157 116 Other NH(Asian,Native American) 0 0 0 0 * Note: Rates calculated from counts less than 20 should be interpreted with caution Rate of Positive Opiate Results per 100 Homicides due to the variability of small numbers resulting in low reliability of rates Hispanic Black NH White NH Other NH(Asian,Native American) Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides by Race/Ethnicity Number of Positive Cocaine Results * Rates of Cocaine Positive Results in Blood of Homicide Victims at Time of Autopsy per 100 Homicides by Race 2018 6 6 7 0 2019 3 6 13 0 2020 7 10 12 0 2021 6 4 9 0 Black NH Hispanic White NH Other NH ( Asian, Native American, Pacific Islander) Number of Homicides 12 10 8 6 4 2 0 2018 2019 2020 2021 Hispanic 6 4.9 6.3 3 Black NH 6 2.4 4.4 4.5 White NH 7 10.6 7.6 6.8 Other NH(Asian,Native American) 97 122 157 116 0 0 0 0 Rate of Positive Cocaine Results per 100 Homicides * Note: Rates calculated from counts less than 20 should be interpreted with caution Hispanic Black NH White NH Other NH(Asian,Native American) due to the variability of small numbers resulting in low reliability of rates Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides by Race/Ethnicity Number of Positive Benzodiazepine Results * Rates of Benzodiazepine Results in Blood of Homicide Victims at Time of Autopsy per 100 Homicide by Race 2018 2 3 9 0 2019 4 3 8 0 2020 0 3 5 0 2021 2 0 2 0 10 Black NH Hispanic White NH Other NH ( Asian, Native American, Pacific Islander) Number of Homicides 0123456789 2018 2019 2020 2021 Hispanic 3 2.4 1.9 0 Black NH 2 3.2 0 1.5 White NH 9 6.5 3.1 1.5 97 122 157 116 Other NH(Asian,Native American) 0 0 0 0 * Note: Rates calculated from counts less than 20 should be interpreted with caution Rate of Positive Benzodiazepines Results per 100 Homicides due to the variability of small numbers resulting in low reliability of rates Hispanic Black NH White NH Other NH(Asian,Native American) Connecticut Department of Public Health - Keeping Connecticut Healthy

Substance Use in Homicides Region 2, 2015 to 2021 Rate of Positive Drug Results from Blood at the Time of Autopsy 2020 to 2021 (N= Number of Homicides (86)) Rate of Positive Drug Results from Blood at the Time of Autopsy 2015 to 2019 (N= Number of Homicides (126)) Drug Number of Positives Rate per 100 Homicides Drug Number of Positives Rate per 100 Homicides Marijuana 50 58.1 Marijuana 32 25.4 Alcohol 22 25.6 Alcohol 26 20.6 Cocaine 15 17.4 Opiates 14 11.1 Opiates 9 10.5 Cocaine 21 16.6 Benzodiazepines 4 4.7 Benzodiazepines 12 7.3

Presence of Marijuana and Alcohol in Accidental Overdoses Statewide Number of Unintentional Drug Overdose Deaths with Presence of Marijuana and Alcohol, Connecticut, 2019-2021* Unintentional Drug Overdose Deaths with Presence of Marijuana and Alcohol, Connecticut, 2019-2021* 38.6 1496 34.6 1600 40 1369 33.8 28.6 1400 35 1196 30.1 1200 30 25.4 1000 25 Number Percentage 800 20 578 474 600 428 412 404 15 304 400 10 200 5 0 0 Total Deaths Marijuana Alcohol % Marijuana % Alcohol 2019 2020 2021** 2019 2020 2021**

The Connecticut Violent Death Data Questions? Mike Makowski, MPH; Epidemiologist Michael.Makowski@ct.gov Main office phone: 860-509-8251 Connecticut Department of Public Health - Keeping Connecticut Healthy