Youth suicide in Wisconsin: mortality, hospitalizations, and risk factors.

OBJECTIVE: To review Wisconsin data on youth suicide mortality, hospitalizations from nonfatal self-inflicted injuries, and self-reported risk behaviors. METHODS: Suicide mortality data for youth (defined here as persons 10-24 years of age) were obtained from the Centers for Disease Control and Prevention (CDC) for 1995-2001 and from the Wisconsin Division of Public Health for 2002. Hospitalization data for Wisconsin from 1995-2002 were obtained from the Wisconsin Division of Public Health. Survey data on self-reported risk behaviors were obtained from the CDC for 2001. RESULTS: While the rate of youth suicide declined by 24% in the United States during the 9-year period studied, Wisconsin's rate declined only slightly (8%). Firearms accounted for 60% of completed youth suicides in Wisconsin. Medication overdoses and cutting accounted for 88% of self-inflicted injury hospitalizations for Wisconsin youth from 1995 to 2002. Wisconsin high school students reported similar rates of risk factor behaviors as youth in New Jersey (the state with the lowest suicide rates in the nation), but were more likely to use firearms (60% versus 32%). CONCLUSION: Rates of suicide mortality, attempts, and self-reported risk behaviors among youth in Wisconsin continue to be unacceptably high. Physicians can play an important role in reducing youth suicide rates by acting within their clinical practices, as leaders in community suicide-prevention activities, and as advocates for policy change.

Wisconsin's violent death reporting system: monitoring and responding to Wisconsin's violent deaths.

In 2003, the Centers for Disease Control and Prevention (CDC) awarded the Wisconsin Department of Health and Family Services, Injury Prevention Program, a grant to participate in a multistate project called the National Violent Death Reporting System (NVDRS). The purpose of the Wisconsin Violent Death Reporting System (WVDRS) is to link violent death records (death certificates, police reports, medical examiner and coroner reports, crime laboratories, and perhaps child fatality review teams) from the same event, promote more timely information retrieval, describe in detail circumstances that may have contributed to the violent death, and identify and characterize perpetrators and their relationships to victims. This article describes the development of WVDRS and its importance in understanding and preventing violent injury and death in Wisconsin.

Trends, risk factors, and prevention of falls in older adults in Wisconsin.

Wisconsin's death rate due to falls among adults 65 years and older is more than twice the national average. The hospitalization rate due to falls-related injuries in Wisconsin increased slightly from 1995 to 2002, with an injury rate of 2159 per 100,000 in 1995, and 2263 per 100,000 in 2002. Emergency department (ED) utilization and hospitalization rates for falls-related injury are higher for women than for men in Wisconsin. In 2002, the total statewide charges for hospitalizations and ED visits for falls-related injuries were more than $96 million. Two thirds of those admitted to the hospital for a falls-related injury were discharged to a nursing home or rehabilitation facility. Multifactorial intervention strategies have been shown to decrease the rate of falls in randomized, controlled trials. The purpose of this paper is to describe trends in falls-related injury fatalities, hospitalizations, and ED visits in Wisconsin. Also included are cost data related to falls, identification of risk factors, and descriptions of the possible role of physicians and other health care professionals in interdisciplinary, multifocal programs to prevent falls-related injuries in high-risk older adults.