Application of Syndromic Surveillance to Describe Gunshot-related Injuries in Houston

Introduction In 2011, injury by firearms accounted for 32,351 deaths (10.4 deaths per 100,000 population) in the United States1. This rate was higher than any infectious or parasitic disease (the highest being 2.5 for both viral hepatitis and HIV disease)1. Furthermore, death by gunshots accounted for over half of all suicides and over two-thirds of all homicides in the US1. Despite the disproportionate media coverage of mass shootings and assault weapon violence, the vast majority of these deaths are attributable to non-mass shootings and to handguns2. Though a contentious issue in the United States, understanding this cause of death is vital to confronting the issue locally and nationally. Traditionally, death certificates, crime data, cross-sectional studies, and retrospective studies have most commonly been utilized in this endeavor; however, the collection of real-time emergency department (ED) visit information presents a unique opportunity to track gunrelated injuries to supplement our current understanding of this issue. The Houston Department of Health and Human Services (HDHHS) has been receiving this information for over a decade from EDs in the greater-Houston area, and the department is currently connected to 32 of the largest EDs in the area. The current study aims to enhance the understanding of gunshot-related injuries in the Houston area and present a model for utilizing RODS information for this purpose.