Traumatic child death and documented maltreatment history, Los Angeles.

OBJECTIVES. Child abuse is a presumed but largely untested risk factor for child homicide. This research investigated the social and child protective service history of child homicide victims. METHODS. A pairwise matched case-control design was used to assess documented child maltreatment as a risk factor for homicide vs unintentional injury death. Homicide victims aged 0 to 14 years were identified through Los Angeles Police Department case summaries. Control subjects (children who died of an unintentional injury) were matched to case subjects (children who died from homicide) by age, sex, race/ethnicity, and date of death. Case and control subjects were linked with county service records to determine any known history of maltreatment. RESULTS. A total of 220 children were homicide victims during 1978 through 1987 in the city of Los Angeles. Only one in six children who died (of homicide or unintentional injury) or his/her family was known to county social or child protective services prior to the death. Recorded history of child protective services was associated with homicide victimization (adjusted odds ratio = 3.40, 95% confidence interval = 1.25, 9.27). CONCLUSIONS. Current service systems need assistance in identifying and protecting children at high risk of homicide.     

Firearm availability and suicide, homicide, and unintentional firearm deaths among women

Context In the United States, more than 45,000 women died from gun violence over the last decade. Objective To determine whether measures of firearm availability are related to rates of suicide, homicide, and unintentional firearm deaths among women in the United States. Design Pooled cross-sectional time series data on suicide, homicide, and unintentional firearm deaths (1988–1997) were used to estimate the association between the rate of violent death among women and four proxies of firearm availability. Two proxies came from survey reports of household firearm ownership rates; two were derived from mortality statistics. Setting United States, 1988–1997. Results The increased rate of suicide and homicide in states with high gun levels was accounted for primarily by significantly elevated firearm suicide and firearm homicide rates. Unintentional firearm death rates were also increased in states with more guns. At the regional level, qualitatively similar results were obtained. Conclusion Between 1988 and 1997, the suicide, homicide, and unintentional firearm death rates among women were disproportionately higher in states where guns were more prevalent. The elevated rates of violent death in states with more guns was not entirely explained by a state’s poverty or urbanization and was driven primarily by lethal firearm violence, not by lethal nonfirearm violence.     

Region of birth,migration and homicide rates of African Americans

A study was made of all homicide deaths among black Americans during the period 1979–1991 in order to test two competing hypotheses about region of birth and region of death. One hypothesis was that Southern‐born blacks had the highest homicide rates in every region of the US. The competing hypothesis was that blacks who did not migrate out of their region of birth had the highest homicide rates. We found that Southern‐born blacks had the highest homicide rates among the population 35 + years old in the Northeast, Midwest, South and West. Yet non‐migrants (region‐born population) had higher rates than their Southern‐born counterparts among the population 15–34 years old. Long distance migrants who were born in the Northeast, West or were foreign‐born had the lowest homicide rates, by far. The distressing implications of these findings for public health efforts to prevent violent death are discussed.     

Characteristics of childhood homicide in Ohio, 1974-84.

Childhood homicide deaths in Ohio from 1974 to 1984 were examined using Ohio Vital Statistics records and US Census Data. Homicide rates varied from 25/100,000 for Black infant males to 0.8/100,000 for White females ages 5-9. Child battering was the leading cause of death for children less than 5 years. Firearms accounted for 56 per cent of homicide deaths for children 10-14 years of age. The childhood homicide rates in the four largest Ohio cities were substantially higher in areas with low socioeconomic indicators.     

Variation in homicide risk during infancy--United States, 1989-1998

Homicide is the 15th leading cause of death during the first year of life (i.e., infancy) in the United States. In addition, the risk for homicide is greater in infancy than in any other year of childhood before age 17 years and is greatest during the first 4 months of life. To determine how the risk for homicide varied by week during infancy and by day during the first week of life, CDC analyzed death certificate data for 1989-1998. This report summarizes the results of this analysis, which indicated that risk for infant homicide is greatest on the day of birth. Efforts to prevent infant homicides should focus on early infancy.     

Age- and sex-specific analysis of homicide mortality as a function of economic development: a cross-national comparison

AIMS: This study examined the association between homicide rates and GNP per capita (as a measure of economic development) among all age- and sex-specific groups in 53 countries. METHODS: Cross-sectional data on homicide rates by age- and sex- specific groups were obtained for 53 countries from World Health Statistics Annual 1996. The association between homicide rates and economic development was studied by using two methods: (1) with regression analysis and (2) by categorizing the data into four income-based country groups and then comparing the differences in their mean values. RESULTS: Results indicate that there was a negative correlation between homicide rates and economic development. The association between homicide rates and country GNP per capita became stronger with increasing age. Pearson's product moment correlation coefficient was strongest among older age groups (65+year) in both sexes (male, r = -0.77 and female, r = -0.71). The correlation was weakest and positive among 1- to 4-year-old children (males, r = 0.17 and females, r = 0.07). The homicide rate among females was highest for <1-year-old children in low income countries (LICs) (12.8 per 100,000). CONCLUSIONS: Lower middle-income countries are in the stage of high priority where both homicide rates and homicide as percentage of total death are high, and its impact was greatest for young males. However, infanticide as a public health problem seems highly concentrated in the poorest countries, while homicide among small children, 1-4 years old, appears to be a universal phenomenon across all nations.     

Years off Your Life? The Effects of Homicide on Life Expectancy by Neighborhood and Race/Ethnicity in Los Angeles County

Homicide is one of the leading causes of death in Los Angeles County and is known to be elevated in low-income urban neighborhoods and in black males. However, because homicide occurs primarily among young adults, mortality rate statistics may underrepresent its importance. We estimated the impact of homicide on life expectancy by demographic group and geographic area in Los Angeles County, 2001–2006. Life expectancy estimates were calculated using mortality records and population estimates for Los Angeles County. Cause elimination techniques were used to estimate the impact of homicide on life expectancy. Homicide was estimated to reduce life expectancy by 0.4 years for Los Angeles County residents and by 2.1 years for black males. The impact of homicide on life expectancy was higher in low-income neighborhoods. In some low-income urban neighborhoods, homicide was estimated to decrease life expectancy in black males by nearly 5 years. Homicide causes substantial reductions in life expectancy in Los Angeles County. Its impact is magnified among black males and in low-income urban areas, underscoring the need for homicide reduction in urban centers.     

The changing nature of murder in Russia

The death rate from homicide in Russia increased rapidly during the 1990 s. It is now about 20 times higher than in western Europe and is among the highest recorded anywhere in the world. However, this issue has received little attention so far from public health researchers or policymakers.This paper describes the changing nature of homicide during the 1990 s in Russia as a whole and, in more detail, in the Udmurt Republic. The study uses data from three sources: routine mortality data for Russia from 1970 to 1999; statistics on criminal investigations and convictions in Russia between 1990 and 1997; and an in-depth study of homicide trial records in the Udmurt Republic in 1989-1991 and 1998.Deaths from homicide increased between 1970 and 1985, falling slightly during the 1985 anti-alcohol campaign and then resuming their increase until 1994. Another fall in the late 1990 s was arrested in 1998, with an increase in 1999. By 1999 the age standardised homicide death rate in Russia was 81% higher than in 1990, an increase almost twice that of all causes of death combined. Throughout the 1990 s about 10% of those convicted of homicide were female. Of those homicides leading to convictions in the Udmurt Republic, 71% of those killed by males were male, as were 76% of those killed by females. Killings of women by men often involved sexual assaults. In Russia as a whole, about 80% of those convicted of homicide were reported to be under the influence of alcohol at the time. In the Udmurt Republic, where data on both offender and victim were available, victims were also commonly intoxicated.The nature of homicide in Russia has changed considerably in less than a decade, with many more now involving aggravating circumstances, such as murder to conceal another crime, in association with robbery or rape, or by a group of people. Although still a small proportion of the total convicted, the number of murders by hired killers is also on the rise.The characteristics of those convicted of homicide have also changed during the 1990 s. They are now younger, less likely to have previous convictions, and to have a more diverse range of educational levels. The previous urban-rural gap, with higher levels in rural areas, has also narrowed.     

Effects of the Repeal of Missouri’s Handgun Purchaser Licensing Law on Homicides

In the USA, homicide is a leading cause of death for young males and a major cause of racial disparities in life expectancy for men. There are intense debate and little rigorous research on the effects of firearm sales regulation on homicides. This study estimates the impact of Missouri’s 2007 repeal of its permit-to-purchase (PTP) handgun law on states’ homicide rates and controls for changes in poverty, unemployment, crime, incarceration, policing levels, and other policies that could potentially affect homicides. Using death certificate data available through 2010, the repeal of Missouri’s PTP law was associated with an increase in annual firearm homicides rates of 1.09 per 100,000 (+23 %) but was unrelated to changes in non-firearm homicide rates. Using Uniform Crime Reporting data from police through 2012, the law’s repeal was associated with increased annual murders rates of 0.93 per 100,000 (+16 %). These estimated effects translate to increases of between 55 and 63 homicides per year in Missouri.     

Violent deaths in the United States, 1900–1975: Relationships between suicide,homicide and accidental deaths

Time trends are presented for suicide, homicide and accident mortality rates in the United States, 1900–1975. These data suggest that national mortality rates for suicide, homicide and motor- vehicle accidents tend to be parallel over time. Non-motor-vehicle accidents, while showing some fluctuations similar to those of other forms of violent deaths, manifest a more general decrease throughout the century. In addition, suicide rates tend to be significantly correlated over time with homicide, motor- vehicle and non-motor-vehicle accident death rates for most race and sex combinations. These results need to be viewed with caution due to the methodologic problems inherent in using national mortality data. However, the findings raise serious questions about the traditional understanding of the relationships between the various forms of violent death in populations; in particular, the popular view that suicide and homicide are inversely related in populations is questioned. The explanatory usefulness of conceptualizing violent deaths as reflecting self-destructive tendencies is discussed.     

Risks of drug-related death, suicide, and homicide during the immediate post-release period among people released from New York City jails, 2001-2005

The authors assessed the risks of drug-related death, suicide, and homicide after release from New York City jails in 155,272 people who were incarcerated anytime from 2001 through 2005 and examined whether the mortality rate was associated with homelessness. Using jail records matched with death and single-adult homeless registries in New York City, they calculated standardized mortality ratios (SMRs) and relative risks. After adjustment for age, sex, race, and neighborhood, the risks of drug-related death and homicide in formerly incarcerated persons were 2 times higher than those of New York City residents who had not been incarcerated in New York City jails during the study period. These relative risks were greatly elevated during the first 2 weeks after release (for drug-related causes, SMR = 8.0, 95% confidence interval (CI): 5.2, 11.8; for homicide, SMR = 5.1, 95% CI: 3.2, 7.8). Formerly incarcerated people with histories of homelessness had higher rates of drug-related death (RR = 3.4, 95% CI: 2.1, 5.5) and suicide (RR = 2.1, 95% CI: 1.2, 3.4) than did persons without such histories. For individuals who died of drug-related causes, longer jail stays were associated with a shorter time until death after release. These results suggest that jail- and community-based interventions are needed to reduce the excess mortality risk among formerly incarcerated people.     

Homicide risk among immigrants in California, 1970 through 1992.

According to the death certificates of the 65,510. California residents who died of homicide from 1970 through 1992, foreign-born persons are overrepresented in the homicides of California residents. Analysis of homicide data for 15- to 34-year-olds (n = 38,774), who account for a majority of all homicide victims indicated that immigrant-to-nonimmigrant risk patterns differed by ethnicity and across time. During the 23-year study period, foreign-born Whites, Hispanics, and Asians and others were at significantly higher risk and foreign-born Blacks were at a statistically similar risk of homicide compared with their US-born counterparts (risk ratio = 2.12, 1.24, 1.72, and 0.60, respectively).     

Homicide surveillance--United States, 1979-1988.

From 1979 through 1988, 217,578 homicides occurred in the United States, an average of greater than 21,000 per year. Homicide rates during this 10-year period were about 1.5 times higher than the rates during the 1950s. The national homicide rate of 10.7/100,000 in 1980 was the highest ever recorded. Homicide occurs disproportionately among young adults. Among the 15- to 34-year age group, homicide is the fourth most common cause of death among white females, the third most common cause among white males, and the most common cause among both black females and black males. In 1988, nearly two-thirds (61%) of homicide victims were killed with a firearm, 75% of these with a handgun. More than half (52%) of homicide victims were killed by a family member or acquaintance, and about one-third (35%) of homicides stemmed from a conflict not associated with another felony. The homicide mortality rate among young black males 15-24 years of age has risen 54% since 1985. Ninety-nine percent of the increase was accounted for by homicides in which the victim was killed with a firearm. The surveillance data summarized in this report should assist public health practitioners, researchers, and policymakers in addressing this important public health problem.     

Homicide victims in New Orleans: recent trends

Data are presented on 694 criminal homicide victims killed in the city of New Orleans during four years; 1979, 1982, 1985, and 1986. The homicide rate for black males was 6.5 times higher than that for white males for the years studied. Over 70% of victims were killed by handguns. When victims were assigned to one of five socioeconomic strata, homicide rates for blacks exceeded those for whites by a factor of at least 2.5 times for each socioeconomic stratum. White victims were more likely than were black victims to be legally intoxicated at the time of death, but black victims were nearly four times more likely to have illicit drugs other than alcohol detected. During the time period investigated, there was a marked decrease in the number of victims with pentazocine and tripelennamine ("Ts and blues") detected and an abrupt increase in the number of victims with detectable phencyclidine and cocaine levels. Further studies are needed to investigate risk factors for homicide victimization so that effective intervention strategies can be employed.     

Urban-rural shifts in intentional firearm death: different causes, same results

OBJECTIVES: We analyzed urban-rural differences in intentional firearm death. METHODS: We analyzed 584629 deaths from 1989 to 1999 assigned to 3141 US counties, using negative binomial regressions and an 11-category urban-rural variable. RESULTS: The most urban counties had 1.03 (95% confidence interval [CI]=0.87, 1.20) times the adjusted firearm death rate of the most rural counties. The most rural counties experienced 1.54 (95% CI=1.29, 1.83) times the adjusted firearm suicide rate of the most urban. The most urban counties experienced 1.90 (95% CI=1.50, 2.40) times the adjusted firearm homicide rate of the most rural. Similar opposing trends were not found for nonfirearm suicide or homicide. CONCLUSIONS: Firearm suicide in rural counties is as important a public health problem as firearm homicide in urban counties. Policymakers should become aware that intentional firearm deaths affect all types of communities in the United States.     

The epidemiology of severe injuries to children in northern Manhattan: methods and incidence rates

The epidemiology of injury incidence in inner-city children has not previously been described. This study presents the methods used and the incidence rates found for severe injury (causing hospitalisation or death) in a population of 89,000 children under age 17 years in northern Manhattan, a largely poor area of New York City. The average annual incidence rate (measured from 1983 to 1987) for severe injuries to children under 17 was 846/100,000 a year. The vast majority (79%) were classified as unintentional. Nine per cent were due to assault, 3% were self-inflicted and in an additional 9% the intention was unclear. Classified by cause, the highest incidence (per 100,000/year) was found for falls (218), vehicle-related (141, primarily pedestrian), ingestion (119) and burns (110). Guns caused 3% of the injuries (27). The death rate from injury was 18.7/100,000, 36% of which was due to homicide. In an additional 28%, intentional injury was suspected. The suicide rate was 0.4/100,000. The leading causes of injury death included guns and burns (both 2.7/100,000). Compared with childhood injury rates in predominantly rural and suburban populations, the rates reported here for northern Manhattan are higher for overall injury incidence (fatal and non-fatal) and for homicide, but lower for injury mortality not due to homicide.     

Violence and social inequalities: mortality rates due to homicides and life conditions in Salvador, Brazil]

INTRODUCTION: Some studies have been questioning the association between poverty and violence. This study's purpose is to assess the distribution of homicide indicators associated with living conditions in Salvador, Brazil. METHODS: A cluster study for the years 1991 to 1994 was carried out including the 75 data centers of the city of Salvador, BA, Brazil. Using death certificates for the study period, yearly mortality rates and mortality ratios were estimated. The 1991 census data of monthly wages and years of education for all family providers were used to define a four-category variable related to living conditions. Mortality rates due to homicide and the relative risk regarding the lowest living condition area were calculated for each social stratum. The 95% confidence intervals were calculated using the Confidence Interval Analysis software. RESULTS: The highest mortality rates due to homicide were seen in the poorest areas. The relative risk due to homicide for the lowest and the highest living condition areas was statistically significant at 5% level and ranged from 2.9 to 5.1. CONCLUSIONS: The data show a strong association between social inequalities and homicide in this urban area, emphasizing the importance of crime reduction programs.     

Are Pregnant and Postpartum Women: At Increased Risk for Violent Death? Suicide and Homicide Findings from North Carolina

The purpose of this study is to estimate rates of suicide and homicide death among pregnant, postpartum and non-pregnant/non-postpartum women ages 14–44, and to determine comparative rates of violent death for pregnant and/or postpartum women compared to non-pregnant/non-postpartum women. North Carolina surveillance and vital statistics data from 2004 to 2006 were used to examine whether pregnant or postpartum women have higher (or lower) rates of suicide and homicide compared to other reproductive-aged women. The suicide rate for pregnant women was 27% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.27, 95% CI = 0.11–0.66), and the suicide rate for postpartum women was 54% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.54, 95% CI = 0.31–0.95). Homicide rates also were lower for pregnant and postpartum women, with the homicide rate for pregnant women being 73% of the rate for non-pregnant/non-postpartum women (rate ratio = 0.73, 95% CI = 0.39–1.37), and the homicide rate for postpartum women being half the rate for non-pregnant/non-postpartum women (rate ratio = 0.50, 95% CI = 0.26–0.98). Although pregnant and postpartum women are at risk for homicide and suicide death, the highest risk group is non-pregnant/non-postpartum women. Violence prevention efforts should target all women of reproductive age, and pay particular attention to non-pregnant/non-postpartum women, who may have less access to health care services than pregnant and postpartum women.