Statement of Purpose To describe the proportion of intimate partner homicides (IPH) that include pediatric deaths in the same incident, whether that differs by whether or not a firearm was used, and describe use of protection orders (PO) among IPH victims. Methods Using the National Violent Death Reporting System we identified all IPH in one of the reporting states from 2003-2017 to define our cohort. We used descriptive statistics to describe incident, perpetrator and victim characteristics in

more »

... IPH cases where a firearm was used versus not, and where children (<18 years) were also killed or not. Finally, we conducted narrative reviews of Coroner/Medical Examiner and Law Enforcement reports to identify instances with a PO and used descriptive statistics to describe PO use. Results We identified a total of 8,375 incidents, with 9,130 victims, that were IPH-related. Over half of all victims (58.8%) were killed in a firearm-related incident. A greater proportion of children were killed when a firearm was used than not (proportion difference = 1.6%; 95% CI: 0.8-2.4). Based on narrative review, 5.9% of incidents had a PO filed. No PO explicitly mentioned firearm removal. The majority were granted (95% of those filed), and 23% had been granted within 2 weeks of the incident. Conclusion The presence of firearms increases the risk of death to children in homes with domestic violence. POs were rarely obtained in our sample of IPH-related deaths, but often granted. Prior literature suggests that POs with firearm removal may be effective strategies for reducing risk of IPH, but we found no mention of firearm removal in POs. Significance Results highlight the additional risk posed to children in homes with firearms and domestic violence. POs were infrequently endorsed in the narratives, highlighting a potential opportunity to promote awareness and support their use, especially with firearm removal. Statement of Purpose Suicide mortality has been increasing across the United States over the last several years. Formerly incarcerated persons (FIPs) often have high prevalence of mental health disorders and are especially vulnerable to self-harm. We estimated the burden of suicide mortality among persons released from North Carolina (NC) state prisons, as compared to the NC general population, and examined key characteristics of these fatal injuries. Methods/Approach We conducted a retrospective cohort study of persons released from NC prisons during 2000-2015. Incarceration records were matched to death records from 2000-2016. Suicide deaths were categorized as firearminvolved or non-firearm-involved. We used indirect standardized mortality ratios (SMR) adjusted for year, gender, race, and age to compare suicide mortality among FIPs with the general NC population. Results There were 228,556 individuals in NC who were released from incarceration 386,895 times during 2000-2015 and contributed 2,050,745 years of post-release person-time and 636 post-release suicide deaths (387 non-firearminvolved, 249 firearm-involved). Over the complete follow-up period, the suicide mortality rate among FIPs was 2.0 (95% CI=1.8, 2.1) times as high as the general NC population. When compared to the general population, the SMRs for non-firearm-involved and firearm-involved suicides among FIPs were 2.9 (95% CI=2.6, 3.0) and 1.3 (95% CI=1.1, 1.5), respectively. Conclusions Formerly incarcerated persons have an increased rate of suicide death compared to the general population in NC, potentially attributable to high prevalence of mental health disorders among FIPs. While NC laws restrict persons with certain criminal histories from owning or purchasing firearms, firearm-involved suicide rates were higher among FIPs than the general NC population. Significance and Contributions to Injury and Violence Prevention Science We highlight the need for suicide prevention efforts among this high-risk population. Prevention programs during incarceration and post-release, including lethal means restriction, should be explored.