In Oklahoma, all nonnatural deaths must be reported to the Office of the Chief Medical Examiner (ME), whose trained investigators report cause of death using a centralized, statewide, standardized reporting system. The purpose of this study was to determine temporal trends of Oklahoma homicide-suicide events and characterize the epidemiology of these events. By reviewing all ME reports of homicides and suicides from 1994 through 2001, we identified 73 homicide-suicide events resulting in 73 suicides and 89 homicides. Suicidal perpetrators of homicide-suicide events were most often white men aged >or=30 years who killed a current or ex-spouse or intimate partner. Homicide victims tended to be younger women the same race as their killer. Firearms were the predominant method of death in both homicides and suicides, with handguns used most frequently. Divorce/estrangement was the main contributing factor to these events, and the most common relationship type was possessive. The existence of a statewide, centralized, and computerized ME system and the ability to access the detailed information in the ME narratives were critical to identifying homicide-suicide events and obtaining the type of detailed information necessary to fully investigate these events.

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On May 3, 1999, powerful tornadoes, including a category F5 tornado, swept through Oklahoma. The authors examined all tornado-related deaths, hospital admissions, and emergency department visits to identify important risk factors. Data on deaths and injuries directly related to the tornadoes and information obtained from a survey of residents in the damage path of the F5 tornado were used in a case-control analysis. The direct force of the tornadoes caused 40 deaths, 133 hospital admissions, and 265 emergency department outpatient visits. The risk of death from the F5 tornado was greater for persons who were in mobile homes (odds ratio (OR) = 35.3, 95% confidence interval (CI): 7.8, 175.6) or outdoors (OR = 141.2, 95% CI: 15.9, 6,379.8) when the tornado struck than for those in permanently anchored houses. Risk of severe injury was also greater for persons in mobile homes (OR = 11.8, 95% CI: 3.4, 51.7) or outdoors (OR = 34.3, 95% CI: 4.4, 1,526.2). However, the risk of death (OR = 0.0, 95% CI: 0.0, 9.9), severe injury (OR = 0.0, 95% CI: 0.0, 2.0), or minor injury (OR = 0.8, 95% CI: 0.1, 3.1) was not greater among persons in motor vehicles than among those in houses. The risk of death (OR = 0.6, 95% CI: 0.1, 1.7), severe injury (OR = 0.2, 95% CI: 0.1, 0.6), or minor injury (OR = 0.3, 95% CI: 0.2, 0.7) was lower among those fleeing their homes in motor vehicles than among those remaining. Recommendations involving the relative safety of motor vehicles during a tornado should be evaluated using experience from recent tornado events.

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