American journal of preventive medicine
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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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Firearm-related injuries rank second only to motor vehicle-related injuries as a cause of injury death in Wisconsin. ⋯ With minimal resources and time, the Wisconsin Firearm-Related Injury Surveillance System uses existing state government databases to describe and report the burden of firearm-related injuries. Additional information on circumstances, perpetrators, and weapons involved are available but additional resources are needed to integrate this information with existing data.
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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.
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Over half of all breast cancer deaths occur among women 65 years of age or older. However, mammography screening decreases with increasing age, despite better survival rates for tumors detected early. ⋯ Despite dual coverage, Medicare beneficiaries enrolled in Medicaid had few mammograms. African-American Medicare beneficiaries, with and without Medicaid, had low mammography rates. Intervention efforts should be targeted toward these women.