A study that identified suicide, not homicide, as the leading manner of violent death in Virginia in 2003 will be given to the state's law enforcement agencies, school systems and mental health providers, although officials said it could be months before its importance is apparent.
"We don't know exactly what kind of ripples this will make, but I think that a year from now, as a consequence of our distributing the report, people will recognize how it impacts their programs and use it to save lives," said Virginia Powell, project manager for the study at the state's Office of the Chief Medical Examiner.
The 43-page study, published last week by the medical examiner's office, found that suicide accounted for 60 percent of 1,332 violent deaths reported in Virginia in 2003.
Those most at risk for suicide, according to the analysis, were men older than 65. Violent death was defined in the study as death resulting from "the intentional use of force or power against oneself or another person, group or community."
Central to the report, Powell said, is the idea that suicide should be treated as a health problem that can be prevented if risk factors are detected early enough.
"The study puts information out there that people don't know about," Powell said, and distills it to make it easy to understand. Violent deaths, whether from homicide or suicide, are "so final and so abrupt and so tragic."
The report said that 39 percent of the 799 people found to have committed suicide in Virginia in 2003 were receiving some kind of mental health treatment at the time of their deaths. About 25 percent had disclosed their intentions to someone else.
The state's Department of Health plans to use the data to tailor suicide prevention campaigns to at-risk groups identified in the report.
Most vulnerable, according to the report, are older white men and veterans of the armed forces. Veterans alone accounted for one in four suicides.
Whites were found to commit suicide at twice the rate of blacks, with the highest rate occurring in western Virginia. Firearms were used in nearly 56 percent of the suicides.
The rate was lowest among married people and those with some education beyond high school, and highest among those separated or divorced and those with some high school education.
"The fact that this is all population-based and not just a sample from a community is the value of the report," said Karen Head, who wrote the report and also works at the medical examiner's office in Richmond. "Here we have a picture of what happened in 2003. Granted, it's not yet a basis for trends, but we're working on that."
The study also divided the suicides into categories, including victims' mental states and possible triggers, including job, financial and other stresses.
"It's a report full of numbers, but the general public needs to become educated about suicide and its characteristics. One in four disclose their intentions, and so people need to be paying attention," Powell said. "There needs to be a general raising of the level of information and literacy on the significance of suicide as a public health threat."
The report was the first published in Virginia as part of the National Violent Death Reporting System, a five-year, $1.2 million pilot program. It is funded by the Centers for Disease Control and Prevention and now includes 16 other states.
On its Web site, the CDC says the reporting system was established to "address a crucial gap in understanding national and regional trends in violent deaths" by combining relevant state records in one place.
Virginia pooled detailed information from the state health department, medical examiners and coroners and law enforcement into a database, painting a picture of the circumstances in which suicides and homicides occur, officials said.
Ileana Arias, director for the National Center for Injury Prevention and Control at the CDC, said the information gleaned from the reporting system is important nationally because it can help policy makers and those in position to allocate resources see where spending would be most effective.
"We're very excited about this," Arias said.
Alex Crosby, an epidemiologist in the division of violence prevention at the CDC's injury center, agreed. He said the study allows for better targeting of groups with greater risks.
"We've been limited in our knowledge, and now we'll be more readily able to identify some factors," he said. With the elderly, for example, the study will draw attention to the need for health care providers and family members to "pay particular attention to what's going on."
Virginia officials said a study of data collected in 2004 would be ready for release early next year. In that report, officials said, the figures and statistics will be published alongside the 2003 data so comparisons can be made.
States expected to publish reports in coming months include Maryland, Colorado, Georgia, Oklahoma and North Carolina, according to the CDC. Others, such as California and Connecticut, didn't begin collecting data until this year and won't release anything until 2006.
The report is available at www.vdh.virginia.gov/news/index.asp.