Injuries and violence affect everyone and are a leading cause of disability for persons of all ages, regardless of sex, race/ethnicity, or socioeconomic status. Injuries are the leading cause of death for Americans ages 1 to 44 and are among the top 15 causes of death for Americans of all ages.  Unintentional injuries result from a variety of events including motor vehicle crashes and falls, but in recent years the numbers have been driven up by drug overdoses. Injuries are generally not random and uncontrollable events, and they can often be predicted and prevented.¹

2018-2023

Unintentional poisoning (overdose) has overtaken motor vehicle crashes as the leading cause of injury death in New Jersey. Violence is another leading cause of injury and death, and a major public health problem in the United States and in New Jersey. 

Projects and grants received by NJDOH

• The New Jersey Violent Death Reporting System (NJVDRS), established in 2002, is maintained through a cooperative agreement with CDC and is housed in the NJDOH Center for Health Statistics.  NJVDRS is a violence surveillance system that links data from death certificates, medical examiners, and police reports to create a rich dataset that is timelier than traditional death certificate data alone. NJVDRS data have been used by NJDOH, other State Departments, local health and community groups, and researchers at academic institutions in New Jersey to support intervention and prevention programs, grant proposals, and state and collaborative initiatives to reduce the number of deaths due to violence. An example of this inter-departmental approach comes from collaboration with the Department of Children and Families and the New Jersey Youth Suicide Prevention Advisory Council to develop a Youth Suicide Prevention Plan, and again used NJVDRS data to assess progress toward their objectives.
• In 2023, the NJDOH, Center for Health Statistics received funds from CDC for the optional firearm safety module for the Behavioral Risk Factor Surveillance System (BRFSS).  
• In 2020, NJDOH was awarded nearly $4 million in Garrett Lee Smith Act (GLS) grant funds (SAMHSA:GLS, 2020-2025) through the Substance Abuse and Mental Health Services Administration (SAMHSA) to work with sister agencies and community-based organizations to strengthen services to youth at risk of suicide.  The project, Readiness to Stand United Against Youth Suicide: A New Jersey Public Health Community Initiative (NJ R2S Challenge) led by the Child and Adolescent Health Unit of the Division of Family Health Services of NJDOH is a collaborative grant with the Department of Human Services, Department of Children and Families (DCF), Office of the Secretary of Higher Education, and multiple community-based organizations.  The State also partnered with the NJ American Academy of Pediatrics, Rutgers University, and Monmouth University.  New Jersey’s R2S Challenge promotes education and resiliency to assist young adults who are transitioning from a health care facility to home after a suicide attempt to prevent further attempts and death by suicide among 10-24-year-old youth.
• Since 2019, the Child and Adolescent Health Unit of the Division of Family Health Services was awarded funds through the CDC’s Rape Prevention and Education program to collaborate with the DCF, Division on Women, Office on the Prevention of Violence Against Women, on programs that promote the implementation and evaluation of evidence-based programs to address sexual assault prevention and education.  This 5-year award has been renewed for another funding cycle (CDC:RPE, 2024-2029). 
• New Jersey Department of Health has also been awarded funds from CDC to aid in responding to the opioid overdose crisis. Under NJDOH Healthcare Quality and Informatics, Prevention for States: Data-Driven Prevention Initiative (PfS:DDPI, 2016-2019) sought to identify programs and policies that will support efforts to prevent and reduce opioid overdose, misuse, and abuse through the effective use of data, including the launch of the Department’s State Overdose Data Dashboard.
• NJDOH’s Center for Health Statistics has been funded to conduct surveillance on fatal and non-fatal opioid overdoses through a series of cooperative agreements with the CDC: Enhanced State Opioid-Involved Overdose Surveillance (ESOOS, 2017-2019), Overdose Data to Action (OD2A, 2019-2023), and Overdose Data to Action in States (OD2A-S, 2023-2028).  These interdisciplinary projects, overseen by the Office of Opioid Response and Policy, leverage the existing NJVDRS, ESSENCE/EpiCenter, and other Department infrastructure and staff to gain further insights for drug-involved overdose deaths, initially focused on opioids but expanded to all drugs including stimulants and emerging drug threats.  OD2A projects go further than surveillance because the goal is to couple surveillance data and prevention action.

Legislation

Suicide Prevention

• P.L.2019, c.167 requires the State Attorney General and the Commissioner of Health to establish a suicide prevention training course and informational materials for firearm retail dealers.
• P.L.2019, c.368 establishes a training program to prevent suicide by law enforcement officers; requires reporting of law enforcement officer suicides to the Attorney General.
• P.L.2021, c.261 requires certain student identification cards to contain the telephone number for the suicide prevention hotline.
• P.L.2023, c.168 requires institutions of higher education to implement suicide prevention programs and raise awareness of mental health services.

Overdose Prevention

• P.L.2018, c.106 requires certain schools to maintain a supply of opioid antidotes and permits emergency administration of opioid antidote by school nurse or trained employee.
• P.L.2021, c.152 Overdose Prevention Act Naloxone “Standing Orders” – Revises and expands authorization for any person or entity to obtain, distribute, and administer opioid antidotes.
• P.L.2021, c.153 permits certain paramedics to administer buprenorphine.
• P.L.2021, c.396 authorizes expanded provision of harm reduction services to distribute sterile syringes and provide certain support services to persons who use drugs intravenously.
• P.L.2021, c.430 establishes local drug overdose fatality review teams.
• P.L.2023, c.25 establishes Opioid Recovery and Remediation Fund; establishes requirements for proceeds from opioid settlements to support substance use disorder prevention and treatment programs.

Assets/resources

• Traumatic Loss Coalitions for Youth at Rutgers University provides support to communities affected by traumatic events such as homicide, illness, and suicide.  
• 2NDFLOOR Youth Helpline is a confidential and anonymous helpline for New Jersey’s youth and young adults. 
• New Jersey Cop-2-Cop is a 24/7 confidential peer support program for New Jersey law enforcement officers and their families.  
• New Jersey Vet-2-Vet provides 24/7 peer support to New Jersey National Guard members, active military personnel, veterans, their families, and caregivers, statewide. 
• American Foundation for Suicide Prevention (AFSP), New Jersey Chapter is dedicated to preventing suicide by providing education and support in New Jersey.
• New Jersey Harm Reduction Coalition works to create a New Jersey that values the safety and dignity of all people who use drugs, and to make evidence-informed harm reduction public health resources widely available to everyone in the state.
• County Prosecutor's Offices send out alerts for emerging substances in communities, to both professionals and the public.
• EMS agencies (County EMS Coordinators) ensure naloxone supplies, substance alerts, and coordinate efforts during spikes.
• Emergency Rooms provide naloxone administrations, report suspected overdoses in EpiCenter, and care for incoming patients.
• Harm Reduction Centers provide testing supplies, syringe supplies, substance alerts, connection to treatment, anti-HIV and Hepatitis initiatives, wound care, and more.
• Federally Qualified Health Centers (FQHCs) provide direct health care and are often the only source of medical treatment to which someone at risk for overdose may have access.  
• Opioid Treatment Programs (OTPs)
• County Alcohol and Drug Abuse Directors & County Mental Health Administrators
• Peer Recovery Organizations
• Medication-Assisted Treatment (MAT) Centers of Excellence

Challenges

• Very often victims of violence and injuries, even unintentional injuries, face stigma and discrimination - either due to what is perceived to be the cause of their injury, or due to disability (particularly related to traumatic brain injuries) and other long-term effects of traumatic experiences on mental health and well-being.  This results in declines in mental and physical health status, and increased risk for re-injury by repeated or new mechanisms.

Disparities/inequities

• While some of the health disparities observed in other sections of this report hold true for injuries and violence, the health challenges facing those who live with the aftereffects or ultimately succumb to their injuries are highly complicated by the presence or absence of individual circumstances, resources, and support systems.  Those most at risk for suicide are white, middle-aged, and male; those most at risk for overdose are white and black male populations, depending upon where in the state they are located.  Those most at risk for homicide are young men of color in urban areas and women in intimate partner violence situations across state and sociodemographic strata.  The role that societal and peer stigma plays in being able to request help, accessing services, and asking for another chance cannot be understated.

Final Assessment

While rates for most Healthy NJ 2020 Injury and Violence objectives improved over the decade, some moved in the wrong direction.

Targets were achieved for:

• Homicide among high-risk groups
• Suicide attempts among teens
• Motor vehicle-related injury deaths

Rates improved but targets were not achieved for:

• Overall homicide rate
• Firearm-related injury deaths

Rates worsened for:

• Unintentional poisoning deaths (More than 95% of which are drug overdoses)
• Suicide
• Seat belt use

For more information, please refer to these resources:

• NJ Crime Reports
• NJ Domestic Violence Services
• NJ Falls Prevention
• NJ Highway Traffic Safety
• NJ Poison Information and Education System (NJPIES)
• NJ Traffic and Public Safety
• NJ Violent Death Reporting System (NJVDRS)
• NJ Youth Suicide Prevention 
   
• National Center for Injury Prevention and Control 
  
  • Division of Violence Prevention
• National Violent Death Reporting System (NVDRS)
• Overdose Data to Action (OD2A)
• Web-based Injury Statistics Query and Reporting System (WISQARS)
• Healthy People 2030 
  • Injury Prevention
  • Violence Prevention

Reference:

1. Injury and Violence Prevention. Healthy People 2020. 10/8/20