1. Billings Area Indian Health Service WISQARS TM Centers For Disease Control & Prevention National Center for Injury Prevention and Control Intermediate Injury Prevention August 23-26, 2011 Billings, MT

2. WISQARS: WISQ RS Web-based Injury Statistics Query and Reporting System Interactive database system that provides customized reports of injury-related data useful for research and for making informed public health decisions. http://www.cdc.gov/ncipc/wisqars/

3. Data Sources: Mortality Data – Official state death certificates Compiled by all the states and submitted to the National Center for Health Statistics for the entire country. – Population data come from the Bureau of Census. Morbidity Data – Estimates based on weighted data from the U.S. Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS). http://www.cdc.gov/ncipc/wisqars/

4. Limitations: WISQARS does not: – Provide date earlier than 1981 – Provide non-injury data, except what is available on the leading causes of death reports. The data can be selected down to the state level, but you cannot select a specific county or individual tribes. http://www.cdc.gov/ncipc/wisqars/

5. Coding Data: Injury death data are assigned an external cause of death code called “E-codes”. – Data from 1979-1998 are coded according to the 9 th Revision of the International Classification of Diseases (ICD-9) – Starting with1999, deaths are coded with the 10 th revision, or ICD-10. The ICD-10 has a new coding scheme that is different than the old e-codes, so it is not valid to combine 1999 data with earlier years at this time. http://www.cdc.gov/ncipc/wisqars/

6. WISQARS Reports: Fatal Injury Data Non-Fatal Injury Data Violent Death Data (new and limited) http://www.cdc.gov/ncipc/wisqars/

7. WISQARS Reports:

8. WISQARS Fatal Injury Data: Fatal Injury Reports Leading Causes of Death Reports Years of Potential Life Lost (YPLL) Fatal Injury Mapping (New)

9. Fatal Injury Reports: Provides tables of total numbers of injury deaths and rates per 100,000 population. You can request a report to list deaths by – Cause and intent of injury – State of residence – Race – Sex – Age – Year http://www.cdc.gov/ncipc/wisqars/

10. Leading Causes of Death Reports : Compute the leading causes of death. Tables show the impact of a particular cause of death Highlight the role that injuries play in mortality at different age groups. Report of leading cause of death report by state of residence, race, sex, year or combined years, and number of causes such as 10 leading causes of death. Can select only injuries and create a leading cause of injury death chart. http://www.cdc.gov/ncipc/wisqars/

11. Years of Potential Life Lost (YPLL) : Measure of premature mortality (early death). YPLL provides insight into the impact of injury-related causes of death compared to other causes of death. YPLL is most commonly calculated as the number of years lost before age 65 “65 – Age of Death = YPLL” YPLL can be reported by state of residence, race, sex, and year or combined years. http://www.cdc.gov/ncipc/wisqars/

12. Fatal Injury Mapping (New): Interactive mapping module for fatal injury data Can map down to County level http://www.cdc.gov/ncipc/wisqars/

13. Small Numbers: American Indian/Alaska Native population numbers are small – You may need to combine years of data to get a more accurate picture The NCHS considers any rate based upon fewer than 20 deaths to be an unstable rate. – Having larger numbers to base the rate on gives you more confidence that the rate is representative. http://www.cdc.gov/ncipc/wisqars/

14. Small Numbers: EXAMPLE - drowning deaths among Alaska Natives during 1999 – 16 deaths and a rate of 17.3 per 100,000. – Because there were fewer than 20 deaths, this rate is considered unstable. – To make this information more useful, you would need to combine at least two years of data. WISQARS shows unstable rates colored white with an asterisk (*). The Leading Causes of Death report and YPLL will work best for Native Americans by combining years of data, – Three years: 1996, 1997, and 1998. – This will give more numbers to look at. – For Fatal Injury Reports, if states are chosen, then combining 3 years of data may also be needed depending on the injury cause. http://www.cdc.gov/ncipc/wisqars/

15. Example: * Rates based on 20 or fewer deaths may be unstable. Use with caution.

16. WISQARS Non-Fatal Data: Non-Fatal Injury Reports Leading Causes of Death Reports

17. WISQARS Non-Fatal Data: Limitations – No data before 2000 – Can sort by Race but not select by Race – American Indian/Alaskan Native not defined in Non-Fatal data set

18. WISQARS Exercise : Computer Lab Complete worksheet Generate reports, calculate rates, compare injury data using WISQARS Fatal Injury Reports, Leading Cause of Death Reports and Years of Potential Life Lost (YPLL). http://www.cdc.gov/ncipc/wisqars/