Purpose Improve the focus and strength of risk-based prevention efforts of violent deaths by linking trended data on homicides and suicides of youth with public health regions of a Midwestern state.

Methods Using Wisconsin Interactive Statistics on Health, violent death data for a state and its five public health regions were trended for years 2000–2012, and percent changes of average rates per 100,000 between 2000–2002 (T1) and 2010–2012 (T2) were calculated. Data were parsed by intent (suicide and homicides) and Method (firearm- and nonfirearm-related) for ages under 25.

Results During 2000–2012, there were 1,733 youth deaths from suicide and homicide in the state. Between time points T1 and T2, Suicides increased by 9% (n = 24) and homicides decreased by 26% (n = 73). Suicide rates increased among all regions, except for one. The region with the highest increase in suicide rate saw a 75% increase (n = 9) in nonfirearm-related suicides. One region saw a 33% decrease (n = 68) in homicides but still had the highest rate at both time points. Firearms were used in 75% of homicides in one region, but 76% of homicides were non-firearm related in another.

Conclusion The data show that the trends of youth suicides and homicides in a state vary considerably by region and over time. This reinforces the need to balance local, regional, and statewide prevention efforts to reduce youth homicide and suicide. Our investigation demonstrates the need for more frequent and geographically-specific investigations of violent deaths to improve the identification of high risk populations and environments and strengthening local, regional, and statewide prevention and policy initiative.

Significance Updated analyses are essential in guiding evidence-informed decision-making, developing risk-targeted regional prevention strategies, and expeditiously assessing the effects of current and future efforts. The Methods and recommendations spanned from this study could have similar implications for other states and health outcomes.