{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:05:47Z","timestamp":1790697947670,"version":"4.1.0"},"reference-count":51,"publisher":"Centers for Disease Control MMWR Office","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MMWR Surveill. Summ."],"DOI":"10.15585\/mmwr.ss7507a1","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:30:06Z","timestamp":1790695806000},"page":"1-31","source":"Crossref","is-referenced-by-count":0,"title":["Surveillance for Violent Deaths \u2014 National Violent Death Reporting System, 50 States, the District of Columbia, and Puerto Rico, 2023"],"prefix":"10.15585","volume":"75","author":[{"given":"Katherine A.","family":"Fowler","sequence":"first","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Vos","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Tsukerman","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kameron J.","family":"Sheats","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter J.","family":"Betz","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Division of Violence Prevention, National Center for Injury Prevention and Control, CDC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6224","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R1","unstructured":"CDC. WISQARS\u2014Web-based Injury Statistics Query and Reporting System. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2026. https:\/\/wisqars.cdc.gov"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R2","unstructured":"CDC. Public health surveillance preparing for the future: Newer. Faster. Smarter. Better. Atlanta, GA: US Department of Health and Human Services, CDC, Office of Public Health Scientific Services; 2018. https:\/\/stacks.cdc.gov\/view\/cdc\/58736"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R3","unstructured":"World Health Organization. International classification of diseases, tenth revision. Geneva, Switzerland: World Health Organization; 2019. https:\/\/icd.who.int\/browse10\/2019\/en"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R4","unstructured":"CDC. National Violent Death Reporting System (NVDRS): NVDRS frequently asked questions. Atlanta, GA: US Department of Health and Human Services, CDC; 2025. https:\/\/www.cdc.gov\/nvdrs\/faq\/"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R5","unstructured":"CDC. National Violent Death Reporting System (NVDRS) coding manual, version 6.1. Atlanta, GA: US Department of Health and Human Services, CDC; 2025. https:\/\/www.cdc.gov\/nvdrs\/media\/pdfs\/2025\/03\/NVDRS-Coding-Manual-Version-6.1_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R6","unstructured":"Census Bureau. County population totals and components of change: 2020\u20132025. Suitland, MD: US Department of Commerce, Census Bureau; 2025. https:\/\/www.census.gov\/data\/tables\/time-series\/demo\/popest\/2020s-counties-total.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R7","unstructured":"National Center for Health Statistics. CDC WONDER: single-race population estimates 2020\u20132023 by state and single-year age request. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2023. https:\/\/wonder.cdc.gov\/single-race-single-year-v2023.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R8","unstructured":"Census Bureau. Methodology for the United States population estimates: vintage 2023. Suitland, MD: US Department of Commerce, Census Bureau; 2023. https:\/\/www2.census.gov\/programs-surveys\/popest\/technical-documentation\/methodology\/2020-2023\/methods-statement-v2023.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R9","unstructured":"Census Bureau. Puerto Rico Commonwealth population by characteristics: 2020\u20132023. Suitland, MD: US Department of Commerce, Census Bureau; 2023. https:\/\/www.census.gov\/data\/datasets\/time-series\/demo\/popest\/2020s-detail-puerto-rico.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R10","unstructured":"US Department of Health and Human Services. Healthy people 2030: objectives and data. Washington, DC: US Department of Health and Human Services, Office of the Secretary, Office of Disease Prevention and Health Promotion; 2020. https:\/\/odphp.health.gov\/healthypeople\/objectives-and-data"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R11","unstructured":"CDC. Adverse childhood experiences prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2019. https:\/\/www.cdc.gov\/violence-prevention\/media\/pdf\/resources-for-action\/ACEs-Prevention-Resource_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R12","unstructured":"CDC. Violence prevention: prevention resources for action. Atlanta, GA: US Department of Health and Human Services, CDC; 2025. https:\/\/www.cdc.gov\/violence-prevention\/php\/resources-for-action\/index.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R13","unstructured":"CDC. Suicide prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC; 2022. https:\/\/www.cdc.gov\/suicide\/pdf\/preventionresource.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R14","unstructured":"Basile KC, DeGue S, Jones K,  Sexual violence prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2016. https:\/\/www.cdc.gov\/violence-prevention\/media\/pdf\/resources-for-action\/SV-Prevention-Resource_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R15","unstructured":"CDC. Community violence prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2024. https:\/\/www.cdc.gov\/violence-prevention\/media\/pdf\/resources-for-action\/CV-Prevention-Resource-for-Action_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R16","unstructured":"Fortson BL, Klevens J, Merrick MT, Gilbert LK, Alexander SP. Child abuse and neglect prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2016. https:\/\/www.cdc.gov\/violence-prevention\/media\/pdf\/resources-for-action\/CAN-Prevention-Resource_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R17","unstructured":"Niolon PH, Kearns M, Dills J,  Intimate partner violence prevention resource for action: a compilation of the best available evidence. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2017. https:\/\/www.cdc.gov\/violence-prevention\/media\/pdf\/resources-for-action\/IPV-Prevention-Resource_508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R18","doi-asserted-by":"publisher","first-page":"e868","DOI":"10.1016\/S2468-2667(23)00207-4","article-title":"Individual-level risk factors for suicide mortality in the general population: an umbrella review.","volume":"8","author":"Favril","year":"2023","journal-title":"Lancet Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R19","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1007\/s40429-021-00361-z","article-title":"Suicide risk and addiction: the impact of alcohol and opioid use disorders.","volume":"8","author":"Rizk","year":"2021","journal-title":"Curr Addict Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R20","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1080\/00952990.2020.1822856","article-title":"Variability in antemortem and postmortem blood alcohol concentration levels among fatally injured adults.","volume":"47","author":"Greene","year":"2021","journal-title":"Am J Drug Alcohol Abuse"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R21","doi-asserted-by":"publisher","first-page":"111348","DOI":"10.1016\/j.drugalcdep.2024.111348","article-title":"A dose-response meta-analysis on the relationship between average amount of alcohol consumed and death by suicide.","volume":"260","author":"Lange","year":"2024","journal-title":"Drug Alcohol Depend"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R22","unstructured":"World Health Organization. Global status report on alcohol and health 2018. Geneva, Switzerland: World Health Organization; 2018. https:\/\/www.who.int\/publications\/i\/item\/9789241565639"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R23","doi-asserted-by":"publisher","first-page":"448","DOI":"10.7326\/M18-0830","article-title":"Chronic pain among suicide decedents, 2003 to 2014: findings from the National Violent Death Reporting System.","volume":"169","author":"Petrosky","year":"2018","journal-title":"Ann Intern Med"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R24","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.pnpbp.2017.08.020","article-title":"Chronic pain and suicide risk: a comprehensive review.","volume":"87","author":"Racine","year":"2018","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R25","unstructured":"CDC. Opioid Rapid Response Program: background and description. Atlanta, GA: US Department of Health and Human Services, CDC, National Center for Injury Prevention and Control; 2021. https:\/\/www.cdc.gov\/overdose-prevention\/media\/pdfs\/ORRP-Background-Description-508.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R26","doi-asserted-by":"publisher","first-page":"107563","DOI":"10.1016\/j.drugalcdep.2019.107563","article-title":"Evidence for state, community and systems-level prevention strategies to address the opioid crisis.","volume":"204","author":"Haegerich","year":"2019","journal-title":"Drug Alcohol Depend"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R27","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1016\/j.annemergmed.2018.01.052","article-title":"Opportunities for prevention and intervention of opioid overdose in the emergency department.","volume":"71","author":"Houry","year":"2018","journal-title":"Ann Emerg Med"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.rr7103a1","article-title":"CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022.","volume":"71","author":"Dowell","year":"2022","journal-title":"MMWR Recomm Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R29","doi-asserted-by":"publisher","first-page":"S264","DOI":"10.1016\/j.amepre.2014.05.028","article-title":"Reducing a suicidal person\u2019s access to lethal means of suicide: a research agenda.","volume":"47","author":"Barber","year":"2014","journal-title":"Am J Prev Med"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R30","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.jad.2021.12.054","article-title":"The lethality of suicide methods: a systematic review and meta-analysis.","volume":"300","author":"Cai","year":"2022","journal-title":"J Affect Disord"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R31","unstructured":"Garnett MF, Curtin SC. Suicide mortality in the United States, 2002\u20132022. NCHS data brief, no. 509. Hyattsville, MD: National Center for Health Statistics; 2024. https:\/\/www.cdc.gov\/nchs\/data\/databriefs\/db509.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R32","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1377\/hlthaff.2023.00399","article-title":"Age trends and state disparities in firearm-related suicide in the US, 1999\u20132020.","volume":"42","author":"Glasser","year":"2023","journal-title":"Health Aff (Millwood)"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R33","doi-asserted-by":"publisher","first-page":"2689","DOI":"10.3390\/ijerph19052669","article-title":"Inequalities of suicide mortality across urban and rural areas: a literature review.","volume":"19","author":"Casant","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R34","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1037\/bul0000482","article-title":"Suicidality in men following relationship breakdown: a systematic review and meta-analysis of global data.","volume":"151","author":"Wilson","year":"2025","journal-title":"Psychol Bull"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R35","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.15585\/mmwr.mm7137a1","article-title":"Suicides among American Indian or Alaska Native Persons\u2014National Violent Death Reporting System, United States, 2015\u20132020.","volume":"71","author":"Stone","year":"2022","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R36","unstructured":"US Department of Health and Human Services. National strategy for suicide prevention: federal action plan 2024. Washington, DC: US Department of Health and Human Services; 2024. https:\/\/www.hhs.gov\/programs\/prevention-and-wellness\/mental-health-substance-use-disorder\/national-strategy-suicide-prevention\/index.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R37","unstructured":"CDC. Suicide prevention: comprehensive suicide prevention program. Atlanta, GA: US Department of Health and Human Services, CDC; 2026. https:\/\/www.cdc.gov\/suicide\/program\/comprehensive-suicide-prevention.html"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R38","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.15585\/mmwr.mm6939a1","article-title":"Infant homicides within the context of Safe Haven laws\u2014United States, 2008\u20132017.","volume":"69","author":"Wilson","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R39","first-page":"187","article-title":"Variation in homicide risk during infancy\u2014United States, 1989\u20131998.","volume":"51","author":"CDC","year":"2002","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R40","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.2105\/AJPH.2021.306234","article-title":"Social and structural determinants of health and youth violence: shifting the paradigm of youth violence prevention.","volume":"111","author":"Nation","year":"2021","journal-title":"Am J Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R41","doi-asserted-by":"publisher","first-page":"578","DOI":"10.2105\/AJPH.2018.304904","article-title":"Validating the National Violent Death Reporting System as a source of data on fatal shootings of civilians by law enforcement officers.","volume":"109","author":"Conner","year":"2019","journal-title":"Am J Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7405a1","article-title":"Surveillance for violent deaths\u2014National Violent Death Reporting System, 50 states, the District of Columbia, and Puerto Rico, 2022.","volume":"74","author":"Forsberg","year":"2025","journal-title":"MMWR Surveill Summ"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R43","doi-asserted-by":"publisher","first-page":"S173","DOI":"10.1016\/j.amepre.2016.08.027","article-title":"Deaths due to use of lethal force by law enforcement: findings from the National Violent Death Reporting System, 17 U.S. states, 2009\u20132012.","volume":"51","author":"DeGue","year":"2016","journal-title":"Am J Prev Med"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R44","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.15585\/mmwr.mm7250a1","article-title":"Unintentional firearm injury deaths among children and adolescents aged 0\u201317 years\u2014National Violent Death Reporting System, United States, 2003\u20132021.","volume":"72","author":"Wilson","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R45","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1001\/jama.293.6.707","article-title":"Gun storage practices and risk of youth suicide and unintentional firearm injuries.","volume":"293","author":"Grossman","year":"2005","journal-title":"JAMA"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R46","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.2105\/AJPH.2017.303863","article-title":"Deciphering suicide and other manners of death associated with drug intoxication: a Centers for Disease Control and Prevention consultation meeting summary.","volume":"107","author":"Stone","year":"2017","journal-title":"Am J Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R47","doi-asserted-by":"publisher","first-page":"1894","DOI":"10.1080\/17441692.2020.1801789","article-title":"Undercounting of suicides: where suicide data lie hidden.","volume":"15","author":"Snowdon","year":"2020","journal-title":"Glob Public Health"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R48","unstructured":"Lavetsky G. Death by suicide in males under 30: patterns, trends, and circumstances. Baltimore, MD: Maryland Department of Health; 2025. https:\/\/health.maryland.gov\/phpa\/OEHFP\/Injury\/Documents\/Suicide_in_Males_Under_Age_30.pdf"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R49","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1177\/00333549221085240","article-title":"A practical review of suicide among veterans: preventive and proactive measures for health care institutions and providers.","volume":"138","author":"Ruiz","year":"2023","journal-title":"Public Health Rep"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R50","unstructured":"US Department of Veterans Affairs. Staff Sergeant Parker Gordon Fox suicide prevention grants. Washington, DC: US Department of Veterans Affairs; 2026. https:\/\/www.mentalhealth.va.gov\/ssgfox-grants\/"},{"key":"key-10.15585\/mmwr.ss7507a1-202609291125-R51","doi-asserted-by":"crossref","DOI":"10.1136\/ip-2026-046194","article-title":"Timely provisional surveillance of suicides using data from CDC\u2019s National Violent Death Reporting System: a cross-sectional analysis of data from 50 US states, the District of Columbia and Puerto Rico, January\u2013June 2024.","author":"Fowler","year":"2026","journal-title":"Inj Prev"}],"container-title":["MMWR. Surveillance Summaries"],"original-title":[],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:30:10Z","timestamp":1790695810000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.cdc.gov\/mmwr\/volumes\/75\/ss\/ss7507a1.htm?s_cid=ss7507a1_w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.15585\/mmwr.ss7507a1","relation":{},"ISSN":["1546-0738","1545-8636"],"issn-type":[{"value":"1546-0738","type":"print"},{"value":"1545-8636","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10,1]]},"published":{"date-parts":[[2026,10,1]]}}}