OCME Forensic Trends in Virginia Virginia Department of Health Office of the Chief Medical Examiner Rosie Hobron, MPH Statewide Forensic Epidemiologist

Virginia population estimates came from the Virginia Department of Health, Division of Health Statistics (http://www.vdh.virginia.gov/healthstats/stats.htm#pop); stars on years 1999-2002 indicate that a different Virginia population source was used for the rate calculation as determined by previous OCME Annual Reports

Number of Cases by Case Type, Manner, and District, 2013 Central Northern Tidewater Western Total Total Deaths Reported to OCME 3937 2117 1723 2272 10049 OCME Cases by Examination Type   Complete examinations (autopsy) 846 716 677 823 3062 External examination 935 517 581 636 2669 Partial examination 5 70 1 77 TOTAL CASES ACCEPTED BY THE OCME 1786 1303 1259 1460 5808 OCME Cases by Manner of Death Accident 788 606 511 630 2535 Homicide 118 39 126 57 340 Natural 539 332 369 467 1707 Suicide 312 289 185 276 1062 Undetermined 29 37 68 30 164

Top Three Methods of Death in 2013 # 3 Motor Vehicles (n=831) #2 Guns (n=848) #1 Drug Poisonings (n=912)

Motor Vehicle Fatalities

*Data for national motor vehicle fatalities was obtained from the Insurance Institute for Highway Safety’s Yearly Snapshots (http://www.iihs.org/iihs/topics/t/general-statistics/fatalityfacts/overview-of-fatality-facts); national population totals were obtained from the United States Census (http://www.census.gov/)

* * No rate can be calculated

Motor Vehicle Fatalities by Location of Injury, 2013

Motor Vehicle Fatalities and Alcohol

Deceased Drivers and Alcohol, 2013 Of the 548 DRIVERS that died as a result of a motor vehicle accident (65.9% of all motor vehicle fatalities) … …511 (93.2%) were tested for drugs and/or alcohol

…Drunk Drivers Continued… Of the 161 deceased DRIVERS with a BAC >0.08%... The average BAC was 0.20% (Range 0.8-0.49; SD 0.07) At least 76 of these decedents (47.2%) were speeding at the time of death At least 96 decedents (59.6%) were NOT wearing a seatbelt at the time of death. Additionally, 18 decedents (11.2%) had an unknown seatbelt status at the time of death

Gun Deaths

Unique Gun Statistics Total gun deaths from 2007-2013 (n=5908) 50.1% (n=2961) were suicides in white males 18.3% (n=1080) were homicides in black males

Drug/Poison Deaths

The Opioid Epidemic From 2007-2013, opioids accounted for nearly 70% of all drug/poison deaths

*The total number of drugs are tallied by whether the drug caused or contributed to death, so the number of drugs will far exceed the total number of actual drug deaths because often, more than one drug caused or contributed to death; additional drug/poisons not present in this figure may have caused or contributed to death

Opioid Demographic Differences Prescription Opioids, 2007-2013 Heroin, 2007-2013

Fatal Heroin Overdoses by Locality of Injury, 2013

Fatal Prescription Opioid Overdoses by Locality of Injury, 2013

Conclusion Accidents and suicides have been on in the incline, homicides on the decline Similar to national trends, the number of motor vehicle deaths in Virginia have been decreasing The number of suicides by firearm have been increasing For the first time in Virginia history, drug/poison deaths were the #1 method of death (2013) for ME cases Opioids are the cause of ~70% of drug/deaths in Virginia While the increase in the number of fatal heroin deaths has been of big concern statewide, opioid prescription drug deaths kill more than twice the number of people as heroin For the last 7 years, the number of prescription opioid deaths has plateaued

QUESTIONS?