The rise and fall of King County deaths guides public health policy

Just like a retail operation might look at what sold well and what sat on the shelves at the end of each year, the King County Medical Examiner’s Office puts together an annual report on their area of expertise: death.

While a summary of deaths may seem morbid, Dr. David Fleming, director of public health for the county, said when the report was released in November, “Medical Examiner death reviews support Public Health’s prevention efforts.”

For example, according to the 2011 report, while homicides and traffic deaths dropped from 2010, suicides increased. More people died of accidental overdoses than traffic crashes, and the number of overdoses in which oxycodone (prescription pain killer) was involved jumped 60 percent over the prior year.

Public Health takes action and moves funding around in reaction to rising trends in categories of deaths. A few examples: To combat the number of traffic fatalities in King County, Public Health started the Target Zero Task Force in 2010, a multi-agency approach to addressing those issues – from alcohol or drug impairment while driving to safer roadways and intersections to reducing speed and encouraging seat belts. According to the report, traffic deaths dropped from 150 in 2010 to 135 in 2011.

To reduce the number of deaths in our elderly population caused by falling, they started a fall prevention program.

In hopes of stemming the rising tide of suicides, they work to reach communities with the warning signs and partner with Lok-It-Up, a campaign to promote locking away unloaded firearms in the home. Precautionary measures, unfortunately, do not always yield results. Suicides rose from 232 in 2010 to 265 in 2011.

Raw data from the Medical Examiner’s Office shows 13,355 people died in King County in 2011. Of those, the ME’s office assumed jurisdiction in 2,112 deaths and performed autopsies on 1196 of those. In general, the ME’s office steps in in the case of “sudden, unexpected, violent, suspicious, and unnatural deaths.” The purpose, they say, is to assist grieving families with answers, provide information for speedy settling of estate and insurance claims, and for civil or criminal investigations. Deaths considered to be part of the natural disease process are not referred to the ME office.

Here are some additional highlights from the ME report:
- Of the deaths referred to the ME office, there were 54 homicides, 265 suicides, 135 traffic deaths, 594 accidental deaths, 926 natural deaths and 62 undetermined deaths. The performed autopsies in 59 percent of those cases.

- Of all traffic fatalities where testing was done, 21 percent tested positive for the presence of alcohol in the blood.

- Firearms were the most frequent instrument of death in homicides (65 percent) and suicides (44 percent).

- In 2011, of the 35 firearm homicide victims, 14 percent were 19 years and younger (a decrease from 28 percent in 2010). A disproportionate number of those victims were African American (17 percent) when compared to the percentage of African Americans in King County’s population (6.3 percent).

So far in 2012, homicides are unfortunately up compared to 2011. According to the Seattle Police Department, there have been 24 homicides in King County as of the end of September. There were only 13 by that time in 2011, marking an 85 percent increase. If the trend continues, public health will undoubtedly need to take a closer look at the root causes of homicide and react.

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