King County Medical Examiner’s Office report: What we learned from those who died in 2016

Public Health – Seattle & King County posted the following article Tuesday by Lindsay Bosslet based on the King County Medical Examiner’s Office 2016 death report:

Last year, 14,373 people died in King County. The King County Medical Examiner’s Office investigated those that were sudden, unexpected or unnatural – 2,494 deaths.

But, the count of life lost is more than a number. By tracking and analyzing different manners of death as well as trends in homicides, traffic fatalities, and drug overdose deaths, we are able to develop preventative measures and learn about emerging issues.

Here are some key findings from 2016, as illustrated in the medical examiner’s recently published annual report, and steps we are taking to save lives.

• In 2016, King County lost 4 infants to Sudden Infant Death Syndrome (SIDS) and 5 infants to Sudden Unexplained Infant Death Syndrome (SUIDS).

SIDS/SUIDS deaths are related to many risk factors, but making sure caregivers understand the risks of bed-sharing with their babies has been a priority. Through the Child Death Review Process, experts developed recommendations, including the distribution of baby bed boxes, lightweight boxes – similar to Finnish Baby Bed Boxes – that function as cribs and help spark conversations between health care providers and new parents about safe sleep and the risks of bed-sharing. Last year, our Nurse Family Partnership Program and Swedish Recovery Services distributed 116 baby bed boxes, and the work is expanding statewide.

• Of all traffic fatalities in which tests were performed, 24% tested positive for the presence of alcohol in the blood.

Public Health and Kent Police Department co-lead the King County Target Zero Traffic Safety Task Force, a multi-agency group that includes law enforcement, community and human services, liquor control, nonprofits, traffic engineers and others. This coalition works to alleviate the leading causes of traffic fatalities, including alcohol and drug impairment, speed, distracted driving and failure to wear seat belts. This work includes high visibility media and enforcement funding for public education and area law enforcement.

• Firearms were the most frequent instrument of death in homicides (72%) and suicide (40%).

Firearms are a highly lethal means of both suicide and assault. In interpersonal violence, firearms are a common instrument in both fatal and nonfatal shootings; the majority of firearm injuries in King County are nonfatal. In both cases, unsafely stored firearms contribute to the problem: Theft of unsecured firearms from homes and cars fuels the illegal firearm trade, and availability of the most lethal means of suicide makes it unlikely that a person will survive an attempt.

King County’s Lok-It-Up program, in partnership with participating law enforcement agencies, firearm retailers, and community partners, promotes voluntary safe storage of firearms for family and community safety.

• A disproportionate number of firearm homicide victims were African American when compared to the percentage of African Americans in King County.

King County residents experience indisputable health disparities based on race and place. These include exposure to violence, adverse childhood experiences, and community trauma. The cycle of exposure to violence, trauma from violence without accessible support, and involvement in violence concentrates this traumatic exposure in particular communities, including those where many King County residents of color live.

Ready availability of firearms in this cycle of violence amplifies the risk. County initiatives, including Best Starts for Kids, are directly addressing trauma exposure, family supports and health equity in King County. Community-led services and supports for youth of color affected by violence offer paths out of the cycle. And, our violence and injury prevention unit’s work, including the Lok-It-Up program, approaches the problem on the population level by promoting safe storage, which can reduce firearm theft and stem the availability of illegally traded firearms.

• Accidental drug overdose deaths in 2016 were the highest ever, representing an increase of 20% over the last 10 years, with the majority of the increase related to heroin and methamphetamine.

King County has not been immune to the opiate epidemic that has swept the country. To address the complex factors surrounding this issue, representatives from Public Health and other agencies coordinated the Heroin and Prescription Opiate Addiction Task Force. This group has recommended a comprehensive strategy that focuses on prevention, increasing access to treatment on demand, and reducing the number of fatal overdoses.

Key Stats

(from Medical Examiner’s report)

• The Medical Examiner’s Office performed autopsies in 59% of jurisdictional deaths (1,398/2,384). In 2016, those jurisdictional deaths included: 85 homicides, 285 suicides, 166 traffic deaths, 832 accidental deaths, 951 natural deaths and 65 deaths due to undetermined causes.

• Several factors appear repeatedly in unnatural deaths. Of all traffic fatalities in which tests were performed, 24% tested positive for the presence of alcohol in the blood. Firearms were the most frequent instrument of death in homicides (72%) and suicides (40%).

• Males comprised 80% (68/85) and women 20% (17/85) of the homicide victims in 2016. The majority of victims, 67% (57/85), were between the age 20 and 49. The number of homicide victims 19 years old and under increased by one when compared to the previous year. In 2016 they accounted for 18% (15/85) of the homicide victims, compared to 2015 when this younger age group represented 18% (14/76) of all homicide victims. 95% (81/85) of the victims were tested for the presence of alcohol. Of those tested 269% (21/81) showed alcohol present at the time of death.

• In 2016, there were 61 firearm homicide victims, 23% (14/61) were 19 years old and younger – a 6 percentage increase from 2015 when 17% (9/54) of firearm homicide victims were 19 years old and younger. In 2016, there was a disproportionate number (22/61 or 36%) of firearm homicide victims that were African American when compared to the percentage of African Americans in King County’s population (6.7%). Of the 22 African American firearm homicide victims, 86% (19/22) were males 29 years old and younger. In comparison, 43% (26/61) of all the homicide firearm victims were White. Of the 26 White firearm homicide victims, 50% (13/26) were males 29 years old and younger.

• For King County in 2016, drugs caused 360 deaths, approximately 15% (360/2,384) of all deaths investigated. The total number of drug-caused deaths increased compared to 2015 when there were 345 drug deaths. In 2016, deaths due to drugs comprised 31% (360/1,180) of all suicidal, accidental and undetermined deaths combined. Accidental drug overdose deaths in 2016 were the highest ever representing an increase of 20% over the last 10 years with the majority of the increase related to heroin and methamphetamine.