States and associated hazard information.

IntroductionNegative mental health outcomes associated with disaster exposure can increase risks of interpersonal and self-directed violence. However, the link between disaster exposure and increased incidence in violent deaths is not clearly established.Study objectiveThe objective of this work is to assess the incidence of violent deaths in non-disaster and disaster periods across five distinct disaster events.MethodsThis study uses an ecological, quasi-experimental design to assess violent deaths in pre-disaster and disaster periods across five U.S. states (e.g., North Carolina, Oregon, Oklahoma, Wisconsin, and Colorado) with federally declared disasters resulting from natural hazards (e.g., flood, wildfire, tropical cyclone, storms). Deaths recorded in the National Violent Death Reporting System were used to describe violent deaths with injuries occurring three-months prior to and after disaster onset. Poisson regression with population offsets and fixed effects was used to calculate incidence rate ratios for disaster affected and unaffected counties within the same state, comparing violent death rates in disaster periods with non-disaster periods.ResultsMost of all deaths were White (80.75%), male (76.87%), and unmarried (65.03%); the median age of decedents was 41.5 years (IQR: 28–55). Overall, the incidence of violent deaths was consistent between disaster and non-disaster periods for both affected (IRR: 0.985; 95% CI: 0.760–1.276) and unaffected counties (IRR: 1.062; 95% CI: 0.975–1.158). Rate ratios were heterogenous but not significant across individual disasters, with only non-suicide and all-cause violent deaths increasing significantly following severe storms and flooding in Wisconsin for counties ineligible for public assistanceConclusionThe results of this study are consistent with the heterogenous findings on violent deaths and disasters throughout literature. As disasters become more frequent and severe, it is important to further consider the relationship between disaster impacts and negative mental health outcomes, including violent deaths.研究背景：灾害暴露相关的不良心理健康结局，可提升人际暴力与自伤暴力的发生风险。然而，灾害暴露与暴力死亡发生率升高之间的关联尚未明确。 研究目标：本研究旨在评估5起独立灾害事件中，非灾害期与灾害期的暴力死亡发生率。 研究方法：本研究采用生态准实验设计，针对美国5个州（北卡罗来纳州、俄勒冈州、俄克拉荷马州、威斯康星州与科罗拉多州）的联邦认定自然灾害事件（如洪水、野火、热带气旋、风暴），评估灾害发生前后的暴力死亡情况。研究采用全国暴力死亡报告系统（National Violent Death Reporting System）收录的死亡数据，统计灾害发生前后3个月内的暴力死亡案例。通过纳入人群偏移量与固定效应的泊松回归（Poisson regression），计算同一州内受灾害影响与未受影响县域的发生率比（incidence rate ratios, IRR），对比灾害期与非灾害期的暴力死亡率。 研究结果：所有死者中绝大多数为白人（80.75%）、男性（76.87%）且未婚（65.03%）；死者年龄中位数为41.5岁（四分位距IQR：28~55岁）。总体而言，受灾害影响县域（IRR：0.985；95%置信区间CI：0.760~1.276）与未受影响县域（IRR：1.062；95% CI：0.975~1.158）的暴力死亡发生率在灾害期与非灾害期均保持一致。各单起灾害的发生率比存在异质性，但均无统计学显著性；仅威斯康星州不符合公共援助资格的县域，在遭遇强风暴与洪水后，非自杀性及全因暴力死亡发生率出现显著升高。 研究结论：本研究结果与现有文献中关于灾害与暴力死亡的异质性研究结论一致。随着灾害发生频率与严重程度不断提升，亟需进一步探讨灾害影响与包括暴力死亡在内的不良心理健康结局之间的关联。