American journal of preventive medicine
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Firearm-related injuries pose a serious public health problem in the United States and are increasingly the focus of public health concern. Despite the magnitude of this problem, ongoing and systematic collection of data on firearm-related injuries to help guide research and policy development has been lacking. The further development of firearm-related injury surveillance systems can provide an objective source of information for policy. ⋯ Some progress has been made in improving the capacity to undertake firearm injury surveillance at national, state, and local levels for mortality, morbidity (including disability), and risk/protective factors, but much work remains to be done. The development of state and local firearm-related injury surveillance systems provides the clearest potential for linking basic information on firearm-related injuries to action, given the critical role that states have in both public health surveillance and regulation of firearms. Broader application of external cause-of-injury codes, increased standardization and validation of definitions and data-collection instruments, improved methods for identifying firearm characteristics and types, and the identification of efficient techniques for linking health and criminal justice data sources are among the key challenges we face as we try to build a more uniform system for monitoring firearm-related injuries in the United States.
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The Colorado Department of Public Health and Environment uses existing data sources to identify and assess firearm-related deaths and injuries statewide. ⋯ Despite these limitations, the surveillance system is a valuable resources for information about firearm-related deaths and injuries, and represents an important first step in reducing the number and severity of firearm-related injuries in Colorado.
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Surveillance data on nonfatal weapon-related injuries--particularly those treated only in the emergency department (ED)--have been largely unavailable. ⋯ The system has proven timely (1996 ED data were available for release in March 1997), flexible (the reporting form has been revised several times), useful (DPH responds to 150 weapon injury data requests annually), acceptable (reporting is voluntary and no hospital declined participation), and sustainable (state funding is currently supporting the ED reporting system).
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During 1994, the Centers for Disease Control and Prevention (CDC) funded seven states to develop and evaluate surveillance systems for firearm-related injuries. In addition, New York City and California had related experience with firearm-related injury surveillance. At the time these nine jurisdictions began developing their surveillance systems, no standardized definitions or recommendations were available about the best methods or procedures of collecting data or suggested data elements of a firearm-related injury surveillance system. ⋯ We describe the process used to develop the RDEs, the 21 data elements suggested by the funded projects, the data sources that may be able to provide those data elements, and an indication of which sources may be most useful. We encourage all developing surveillance systems to strive to include these data elements, although some of the elements will be more easily attainable for fatal injury events than nonfatal ones, and no single data source will be able to provide all the desired information about both morbidity and mortality from firearm-related injuries. The RDEs capitalize on the preliminary experiences of the small group of jurisdictions, but they need to be pilot tested and revised as we collect more information about how well these elements capture the desired information and whether the information obtained is useful.