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Homicide and near-homicide by anabolic steroid users.

The authors describe three men, all with benign premorbid psychiatric histories, no evidence of antisocial personality disorder, and no history of violence, who impulsively committed violent crimes--including murder--while taking anabolic steroids. Structured psychiatric interviews of each man suggested that steroids played a necessary, if not primary, role in the etiology of the violent behavior. Although the men conceivably might have exaggerated their reports of the effects of steroids in the hopes of improving their legal positions, information from external sources consistently corroborated their accounts in each case. These observations raise the possibility that steroid-induced violence may pose a little-recognized public health problem.

Adult↗

Suicidal and homicidal deaths: a comparative and circumstantial approach.

The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. A comparison of the results between suicides and homicides was performed. From a total of 5773 medicolegal deaths reported at an Apex medical centre of Nagpur University over a period of three years 1998-2000, only 241 cases (4.2%) were homicidal deaths in comparison to 1127 cases (19.5%) of suicidal deaths with suicide rate of 23.1/100,000 per year and homicide rate of 4.9/100,000 per year. Poisoning, burning, hanging and drowning forms the major methods of suicide in contrast to blunt trauma, sharp trauma, burning, and strangulation in homicide. Combined methods were more common in homicide as compared to suicide. Predominance of male was present in all methods of suicide and homicide, except burning. In general, male predominance was seen in both suicidal and homicidal deaths with peak age 21-30 years in suicides in contrast to 31-40 years in homicides. At younger age 11-20 years, the victims of suicide outnumbered the victims of homicide; but at extremes of ages below 10 years and above 60 years, homicides were relatively more common than suicides. Married victims were predominant in both types of deaths. Quarrel and revenge were the common precipitating cause/motive for homicide in comparison to chronic illness and mental illness for suicide. Majority of the accused were having close family relationship with the victims of suicide in contrast to homicides in which most of the assailant were having no family relationship with the victims. 'Acquaintance' were the accused in majority of the victims of homicides in contrast to 'self' in suicides. Most of the victims of homicide were killed outdoor in contrast to victim's own domicile in suicides. In both suicidal and homicidal deaths, most of the victims were found in summer season, but the peaks were noticed in the months of April and May in suicidal deaths and October in homicidal deaths.

Adolescent↗

A comparison of primary and secondary homicides in the United States.

In 1979, over 20,000 people in the United States were victims of homicide, but public health agencies have not yet defined their role in its prevention. Role definition might begin with differentiating various forms of homicide, so the authors used data on all homicides reported by law enforcement agencies for 1976-1979 to determine whether homicides that did not occur during the perpetration of another crime (primary homicides) differ from those that occurred during the perpetration of another crime (secondary homicides). Primary and secondary homicide rates were highest in the South and West, respectively. The relative risk for Standard Metropolitan Statistical Areas (SMSAs) compared with non-SMSAs was 2.4 for secondary homicide but only 1.3 for primary homicide. It was found that 17% of primary homicides and 3% of secondary homicides had a female offender. Primary homicides were more frequently intersexual and intraracial than were secondary homicides. Victim and offender ages were similar to one another in primary homicides and dissimilar in secondary ones. Over 75% of primary homicides involved family members or acquaintances, compared to only 24% of secondary homicides. The authors conclude that primary and secondary homicides are epidemiologically dissimilar, and they suggest that public health concern should focus on primary homicide. Prevention and intervention measures should concentrate on discussed target populations. Techniques might include stress reduction and conflict avoidance.

Adolescent↗

Safe at home? Domestic violence and other homicides among women in New Mexico.

STUDY OBJECTIVE: To define the contribution of domestic violence (DV) to homicides in women in New Mexico and to examine differences in ethnicity, mechanism, previous documented injuries, incidence of sexual assault, and use of alcohol or illicit drugs between DV- and non-DV-related homicides. METHODS: We carried out a retrospective analysis of reports of the state office of the medical investigator (OMI) reports from all female homicides from 1990 to 1993 in New Mexico. A homicide was defined as being related to DV if the perpetrator was a current or former male intimate partner. The chi-squared and Mann-Whitney tests were used to analyze data. RESULTS: The OMI investigated 134 homicides in women for an overall fatality rate of 4.3 per 100,000. A male intimate partner was the perpetrator in 62 cases (46%). The rate of DV homicide among American Indians (4.9 per 100,000) was significantly higher than that among Hispanics (1.7) and non-Hispanic whites (1.8)(RR=2.8; 95% confidence interval (CI), 1.5 to 5.1). Firearms were almost two times as likely to be used in DV homicides as in non-DV homicides (RR=1.8; 95% CI, 1.2 to 2.6). Evidence of old injuries was found more often in DV homicide cases (35.5%) than in non-DV cases (83%) (RR=4.3; 95% CI, 1.8 to 9.8). The presence of alcohol or other drugs was higher among non-DV homicide victims (69%) than DV homicide victims (54.3%) (P=.03). CONCLUSION: American Indian women are at particularly high risk of homicide, including DV homicide. Firearms were overrepresented in DV homicides, suggesting that removing firearms from the homes of previous DV perpetrators would be a useful public health strategy. Alcohol or illicit drugs were found in approximately two thirds of New Mexico women who were victims of homicide. The high prevalence of history of previous injuries among DV homicide victims indicates that early identification of DV victims in the emergency department and other health care settings is an important point of intervention.

Domestic Violence↗

A 28-year (1963-90) study of homicide in Marion County, Oregon.

We describe 240 consecutive homicidal deaths that occurred in Marion County, Oregon, over a 28-year period (1963-90). An epidemiological assessment of the homicides yielded the following information: More than 91% of these deaths were primary homicides. In primary homicide, 63% of the victims and 88% of the offenders were male. In secondary homicide, 76% of the victims and all of the offenders were male. A high percentage of victims (83%) and offenders (84%) in primary homicide were Caucasian, as were 100% of victims and offenders in secondary homicide. About 12% of victims and 10% of offenders in primary homicide were Hispanic. Fifty-nine percent of primary homicides were intrasexual, as compared to 87% of secondary homicides. An intraracial pattern was found in 90% of primary homicides and in 100% of secondary homicides. The most frequent means of death in both primary and secondary homicides were firearms, physical beating, and stabbing. Strangers committed 80% of secondary homicides. This was in marked contrast to the victim-offender relationship found in primary homicides, where strangers were responsible for approximately 16% of the total, acquaintances for approximately 36%, and family members for approximately 48%. The overall clearance rate (i.e., the identification and charging of a suspect for the death) was 88%.

Black or African American↗

The role of alcohol and drugs in homicides in England and Wales.

BACKGROUND: The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. AIMS: To examine rates of alcohol and drug misuse and dependence in people convicted of homicide; the role of alcohol and drugs in the offence; the social and clinical characteristics of alcohol- and drug-related homicides; and the social and clinical characteristics of patients with dual diagnosis who commit homicide. METHODS: A national clinical survey based on a 3-year (1996-9) consecutive sample of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. RESULTS: Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. CONCLUSIONS: Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.

Adolescent↗

The epidemic of gang-related homicides in Los Angeles County from 1979 through 1994.

OBJECTIVE: To determine trends in gang homicides and the population at greatest risk for homicide by reviewing all gang-related homicides in Los Angeles County, California, from January 1979 to December 1994. DESIGN: Homicide files of the Los Angeles Police Department and the Los Angeles County Sheriff's Department from 1979 to 1994 involving violent street gang activity were reviewed. Gang files were reviewed for demographic data, weapons used, homicides by drive-by shootings, and times and geographic areas of occurrence. SETTING: Los Angeles County from January 1, 1979, to December 31, 1994. MAIN OUTCOME MEASURES: Age, race, and sex of gang-related homicide victims; frequency of weapon use; and the change in gang-related homicide rates during the study period. RESULTS: A total of 7288 gang-related homicides occurred in Los Angeles County from 1979 through 1994; 5541 of these homicides occurred in Los Angeles Police Department and Los Angeles County Sheriff's Department jurisdictions. During the study period, the proportion of all homicides that were gang related increased from 18.1% to 43.0% (P < .001). Of the 5541 gang-related homicide victims, 4580 (85.6%) were aged 15 to 34 years, 93.3% were African American or Hispanic, 5157 (93.2%) were male, 3559 (64.2%) were gang members, and 1408 (25.4%) occurred during drive-by shootings. Firearms were used in an increasing proportion of homicides, from 71.4% in 1979 to 94.5% in 1994. Homicides by semiautomatic handguns dramatically increased during the study period. Gang-related homicide rates for African-American males aged 15 to 19 years increased from 60.50 per 100,000 population per year in 1979 to 1981 to 192.41 per 100,000 population per year in 1989 to 1991. CONCLUSIONS: Gang-related homicides in Los Angeles County have reached epidemic proportions and are a major public health problem. To prevent gang violence, the root causes of violent street gang formation must be alleviated, the cycle of violent street gang involvement must be broken, and access to firearms must be limited.

Adolescent↗

Gangs, drugs, and homicide in Los Angeles.

OBJECTIVE: To assess the theory that youth homicides in Los Angeles, Calif, are largely attributable to gang involvement in the trafficking or use of drugs. DESIGN, SETTING, AND PARTICIPANTS: First, we analyzed all homicides in a police database that occurred in Los Angeles between January 1, 1986, and August 31, 1988, to examine the association between gang activity and narcotic use and trafficking. Second, we used detailed data from police files to examine the same associations for a subset of homicides in south central Los Angeles. Third, we investigated the association between gang homicide victimization and victim cocaine use for all 1987 Los Angeles homicides. Finally, we compared narcotics arrest histories for gang homicide victims with histories for other homicide victims. RESULTS: Gang-motivated homicides were less likely than other homicides to involve narcotics, and narcotics-motivated homicides were less likely to involve a gang member. Victims of gang-motivated homicides in 1987 were less likely than other homicide victims to have detectable levels of blood cocaine. Finally, young victims of gang-involved homicide were no more likely to have a history of narcotics arrests than other victims. CONCLUSIONS: Our investigation does not support the theory that a substantial proportion of homicides are attributable to gang involvement in narcotics trafficking.

Adolescent↗

Firearm and nonfirearm homicide among persons 15 through 19 years of age. Differences by level of urbanization, United States, 1979 through 1989.

OBJECTIVE: To examine trends (1979 through 1989) and current status in firearm and nonfirearm homicide rates by level of urbanization among persons 15 through 19 years of age. DESIGN: The Compressed Mortality File, a county-level mortality and population database maintained by the National Center for Health Statistics, Centers for Disease Control, Hyattsville, Md, and the 1980 Human Resource Profile County Codes are used to analyze age-, sex-, and race-specific firearm and nonfirearm homicide rates by urbanization level. SETTING: United States, 1979 through 1989. SUBJECTS: Black and white males and females 15 through 19 years of age whose underlying cause of death was either firearm homicide (E965.0 through E965.4 or E970) or nonfirearm homicide (E960 through E964, E965.5 through E969, or E971 through E978) in the ICD-9 (International Statistical Classification of Diseases, Injuries, and Causes of Death, Ninth Revision). MAIN OUTCOME MEASURES: Urbanization level-specific firearm and nonfirearm homicide rates. RESULTS: The 1989 firearm homicide rate in metropolitan counties was nearly five times the rate in nonmetropolitan counties (13.7 vs 2.9 deaths per 100,000 population). Firearm homicide rates were highest in core metropolitan counties, 27.7 per 100,000 population; rates were higher for black males than for any other race-sex group in each of five county urbanization strata for 1979 through 1989. Nonfirearm homicide rates are considerably lower, with smaller urban differentials; the rate in metropolitan counties was 1.4 times the rate in nonmetropolitan counties (2.6 vs 1.8 per 100,000 population). From 1979 through 1984, firearm homicide rates declined in each of the county strata. From 1984 through 1987, firearm homicide rates increased, and from 1987 through 1989 they increased rapidly, from 23% to 35% per year in the four metropolitan strata. From 1979 through 1989, nonfirearm homicide rates declined or remained stable. CONCLUSIONS: Large urbanization differentials in firearm homicide and smaller differentials in nonfirearm homicide are identified. Firearm homicide rates are highest and increasing the fastest among black teenage males in the core, fringe, and medium metropolitan strata.

Adolescent↗

Epidemiology of homicide in Allegheny County, Pennsylvania, between 1966-1974 and 1984-1993.

BACKGROUND: We compared homicide death rates and characteristics of homicide victims and perpetrators in 1966-1974, 1984-1990, 1992-1993, and 1996 in Allegheny County, Pennsylvania, in an attempt to detect possible differences in the pattern of homicides. METHODS: Data were obtained from death certificates, coroner's records, police reports and newspapers. RESULTS: In the 1990s the homicide death rate increased for 15- to 24-year-old black men. The rate was 69 per 100,000/year for black men ages 15-24 years from 1966 to 1974 and rose to 275 per 100,000 from 1992 to 1993. Currently, the rates appear to be declining again. Preliminary data from 1996 showed the number of homicide deaths excluding vehicular homicides between 1993 and 1996 to decline from 19 to 8 for white men, from 70 to 42 for black men, from 9 to 3 for white women, and from 13 to 6 for black women with little change in the population (denominator). The dramatic drop from 111 to 61 deaths over a short time is similar to changes across the United State and is characteristic of epidemic rise and fall of homicides in the community. CONCLUSIONS: Between 1966 and 1993 Allegheny County experienced two separate homicide epidemics, one between 1966 and 1976 and the other between 1990 and 1993. Epidemics of homicide occur frequently and have different characteristics. New characteristics of the most recent epidemic of homicide include more homicides out of home, among strangers; less association with alcohol; and multiple perpetrators. Drug-use-associated homicides have also increased. Guns are the primary agents of homicide epidemics.

Adolescent↗

Alcohol and homicide: a cross-cultural comparison of the relationship in 14 European countries.

AIMS: To assess an empirical basis for cross-national and cross-cultural comparisons of four aspects of the association between alcohol consumption and homicide: the relative strength of the association, the fraction of homicide rates attributable to alcohol consumption, possible gender differences in the association between consumption and victim rates and possible variations in beverage-specific effects on homicide rates. DESIGN, SETTING AND PARTICIPANTS: Time series analyses on different series of annual aggregate-level data on alcohol sales and homicide rates for the period 1950-95 were performed for each individual country. Estimates were pooled across countries within three regions of alleged differences in drinking pattern: southern Europe, central Europe and northern Europe. FINDINGS: Total alcohol sales were positively and statistically significantly associated with homicide rates in five countries. Beer sales were positively and statistically significantly associated with homicide rates in four countries, wine sales in another two countries, and spirits sales in two countries. The effect of alcohol sales was stronger for male homicide rates than for female homicide rates, and the estimated fraction of homicides that could be attributed to alcohol consumption appeared to be of the same magnitude in the three regions. When estimates were pooled across countries, the strongest association between total sales and homicides was found in the northern European countries and the weakest, but still statistically significant, in the southern European countries. Pooled estimates showed that beer sales were positively and significantly associated with homicide rates in all three European regions, whereas wine sales were positively and moderately associated with homicide rates only in the traditional wine drinking cultures in southern Europe. CONCLUSION: The findings support the hypothesis that homicide rates are influenced by alcohol sales and more so in the northern European countries where the drinking culture is, to a larger extent, characterized by heavy drinking episodes. Moreover, the findings are suggestive of beverage-specific effects on violent behaviour being contingent upon characteristics of the drinking culture.

Alcohol Drinking↗

Homicide of children aged 0-4 years, 2003-04: results from the National Violent Death Reporting System.

INTRODUCTION: To better understand, and ultimately prevent, infant/child homicide, it is imperative to more thoroughly elucidate the circumstances and conditions related to such instances. Data were obtained from the US National Violent Death Reporting System (NVDRS) to illuminate circumstances related to homicide among children aged 4 years or less, and to identify demographic groups which may be at increased risk. METHODS: The NVDRS is an active surveillance system that provides comprehensive information on all violent deaths that occur within participating states within the US. Standard statistical tests were conducted to determine homicide rates among children ages 0-4 across states that provided data for both 2003 and 2004 (Alaska, Maryland, Massachusetts, New Jersey, Oregon, South Carolina, and Virginia). These data were further used to investigate infant/child homicides by race, gender, and other relevant circumstances (for example, victim-suspect relationship, weapon type, and location of homicide). A Poisson regression model was fitted to the sample data to investigate the multivariate relationship between the infant/child homicide rate and available demographic information. RESULTS: The 2003 homicide rate for children ages 0-4 was 3.0 per 100,000 population. The 2004 homicide rate was 2.5 per 100,000 population. African Americans were 4.2 times as likely as whites to be victims of homicide. Suspects were commonly parents/caregivers. The vast majority of infant/child homicides occurred in houses or apartments, using weapons that include household objects. CONCLUSION: Homicides of infants and young children are most often committed in the home, by parents/caregivers, using "weapons of opportunity". This suggests that the risk of infant/child homicide is greatest within the primary care giving environment. Moreover, the use of "weapons of opportunity" may be indicative of maladaptive stress responses. Prevention and intervention strategies to reduce infant/child homicide should target the home environment and attend to maladaptive stress responses.

Black or African American↗

Homicide rates among US teenagers and young adults: differences by mechanism, level of urbanization, race, and sex, 1987 through 1995.

CONTEXT: Homicide rates for persons 15 through 24 years old began to decline between 1993 and 1994, but recent trends in homicide rates by mechanism of homicide and urbanization group have not been described. OBJECTIVE: To examine homicide trends from 1987 through 1995 for persons 15 through 24 years old by urbanization level. DESIGN: Homicide rates by urbanization level were analyzed using the Compressed Mortality File, a county-level mortality and population database maintained by the National Center for Health Statistics, Centers for Disease Control and Prevention, and the rural-urban continuum codes developed by the Economic Research Service, US Department of Agriculture. SETTING: United States, 1987 through 1995, according to 5 urbanization strata: core, counties with the primary central city of a metropolitan statistical area (MSA) of 1 million or more; fringe, remaining counties within an MSA of 1 million or more; medium, counties within an MSA of 250000 to 999999; small, counties in an MSA of less than 250000; and nonmetropolitan, counties not in an MSA. SUBJECTS: All persons 15 through 24 years old by race whose cause of death was homicide (International Classification of Diseases, Ninth Revision codes E960-E969). MAIN OUTCOME MEASURES: Firearm and nonfirearm homicide rates and average annual percentage changes by 5 urbanization levels, race, and sex. RESULTS: From 1987 through 1991, the average annual firearm homicide rates among persons 15 through 24 years old among all 5 urbanization strata increased between 10.7% in small counties and 19.8% in fringe counties. From 1991 through 1993, the rates increased between 3.3% in core counties and 11.7% in small counties. From 1993 through 1995, the rates declined between 4.4% in fringe counties and 15.3% in medium counties. By 1995, firearm homicide rates among persons 15 through 24 years old ranged from 6.5 and 7.3 per 100000 in the nonmetropolitan and small counties, respectively, to 9.6 and 13.3 per 100000 in the fringe and medium strata, respectively, to 33.5 per 100000 in the core stratum. During 1987 through 1990, nonfirearm homicide rates either were stable or increased, and from 1990 through 1995, nonfirearm homicide rates declined in all 5 strata, on average 3.7% to 8.0% per year, with rates in 1995 ranging from 2.1 to 4.7 per 100000 across the strata. CONCLUSIONS: After increasing since 1987, firearm and nonfirearm homicide rates began declining between 1993 and 1995 among persons 15 through 24 years old. These declines are taking place across all urbanization strata and among white and black males and females.

Adolescent↗

Youth homicide racial disparities: gender, years, and cause.

OBJECTIVE: To study racial disparities and the weapons used to commit youth homicide in New Jersey. METHODS: The homicide data were obtained from New Jersey death certificate files, 1989-1997. RESULTS: There was a statistically significant racial disparity in homicide incidence rates in this study. The homicide incidence rates was 10 times and four times higher among African-American than white, adolescents (age 15-19 years) and young adults (age 20-24 years) (respectively). Youth (15-24 years) homicide incidence rate correlated with New Jersey's 21 counties' high urbanization index and with low level of education. The ratio of male/female homicide incidence rates was 6:4 for adolescents and young adults, respectively. African-American adolescent homicide rates increased consistently from 1989 to 1997. Sixty percent of all youth homicide was committed by firearms. CONCLUSION: Significant youth homicide racial and gender disparities exist in New Jersey's 21 counties. If the existing trend of homicide violent crime victimization continues in New Jersey, African-American teenagers will soon become the leading segment of the population to be murdered in the state. Sixty percent of the youth homicide victimization was committed by firearms; and correlation analyses of New Jersey's 21 counties suggested that low levels of education and high levels of urbanization provided an environment of key risk factors for homicide.

Adolescent↗