Emergency Department Data
The Virginia Department of Health’s (VDH) Office of Epidemiology collects and analyzes health data from participating emergency departments (EDs) in Virginia. All non-federal acute care hospitals and free-standing emergency care centers report ED visit data to VDH.
Data are for clinical care of patients in healthcare settings. Public health surveillance is a secondary use. When interpreting firearm injury ED data, please consider syndromic surveillance data limitations.
Case Definition: Firearm injury visits are identified using key terms in the chief complaint (reason for visit) and discharge diagnosis codes.
- Key terms: gun with wound, GSW, gunshot, buckshot, revolver, rifle, shotgun, firearm, pistol, handgun, been shot, I was shot, I got shot, combination of hit, ricochet, graze with bullet.
- ICD-10 diagnosis codes: W32.0, W32.1, W33.0, W33.1, W34.0, W34.1, X72, X73, X74, X93, X94, X95, Y22, Y23, Y24, Y35.0, Y38.4
- SNOMED diagnosis codes: 41430008, 56768003, 63409001, 69861004, 77301004, 86122002, 111050005, 219257002, 283545005, 218081007, 218086002, 218082000, 218087006, 218088001, 269796009, 242869008, 219199009, 219200007, 219201006, 219204003, 219205002, 219203009, 219198001, 219142001, 219143006, 219144000, 219145004, 219146003, 287184008, 287193009
- Exclusions: follow-up visits, visits involving other types of guns (e.g., staple gun), visits where firearm was used as a weapon but not fired (e.g., pistol whip)
Intent: ED visit data are for all types of firearm injuries. These can include self-harm, assault, unintentional, or injuries where the intent is unknown. It is not possible to separate ED visit data by intent.
Measures: ED visit counts and rates per 10,000 ED visits. Rates allow comparison over time and between different groups, such as age, race, sex, and geographic areas.
Geography: VDH assigns city/county and health district using the patient’s residential zip code. The firearm injury data dashboard includes ED visit data for Virginia and non-Virginia residents. Out of state residents are not represented in the map. ED visit counts are combined for certain cities and counties due to some zip codes spanning more than one locality.
Suppression: VDH suppresses counts of 1 to 4 and rates with numerators of 1 to 4 to maintain confidentiality and accurate rate calculations. Suppressed statistics are indicated with an asterisk (*).
Demographics: VDH reports firearm injury data using the following combined race/ethnicity categories:
- Asian or Pacific Islander – Non-Hispanic persons who identify as “Asian” or “Native Hawaiian or Pacific Islander”
- Black – Non-Hispanic persons who identify as “Black or African American”
- Latino – Individuals of any race who identify as “Hispanic or Latino”
- Native American – Non-Hispanic persons who identify as “American Indian or Alaska Native”
- White – Non-Hispanic persons who identify as “White” alone
- Other Race – Non-Hispanic persons who report “Other Race” alone
Death Data
The VDH Office of Vital Records tracks causes of death among Virginia residents using death certificates. Codes on the death certificate indicate underlying and contributing causes of death.
Case Definition: Deaths are classified as firearm-related using the definition from the Centers for Disease Control and Prevention State Injury Indicators Report.
Intent: Firearm-related deaths include all intent types: suicide, homicide, unintentional, legal intervention or war, and undetermined.
Measures: Death counts and rates per 100,000 population. Population data are from the National Center for Health Statistics Bridged Race Population Estimates. Due to the discontinuation by NCHS of NCHS-Bridged Race population estimates, population estimates from 2020 are used for the denominator in rate calculations for the years 2020-2022. Published rates may change in 2024 when the Virginia Department of Health transitions to another federal population data source.
Geography: Data are of Virginia residents only, whether or not they died in Virginia. Health district is based on the residence of the patient at the time of death, not where the death occurred.
Other: Death certificate data are data source used by the Centers for Disease Control and Prevention (CDC) to report on firearm-related deaths for states, jurisdictions, and the United States. For this reason, use death certificate data when comparing firearm-related deaths across jurisdictions. Firearm-related death counts on this dashboard may differ from reported counts from the VDH Office of the Chief Medical Examiner (OCME). This dashboard reports deaths of Virginia residents only and based on the decedent's residence at time of death, whereas OCME reports on firearm-related deaths that occurred in Virginia.