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Homicide in the Nordic countries.

This article reviews and assesses previous studies of homicide in the Nordic countries and compares the main findings with those from other countries. In spite of the relative sparsity of data, the nature of the available information allows a reasonably reliable comparison to be made between different Nordic countries. Although findings from separate studies vary somewhat, some general trends have been noticed and seem to apply to most of the countries in question: in particular, changes that have occurred over the last 2 decades. Thus, all the Nordic countries have experienced an increase in homicide incidence during this period, and with some notable exceptions, this increase has been quite drastic. Certain other trends have been observed, such as the prominent role of alcoholism and drug abuse in homicide offences, as well as the relative increase in nondomestic offences. Homicide followed by suicide has decreased proportionately among males, whereas this trend has not occurred to the same extent among females, who are more frequently involved in domestic homicide. Methods of homicide have also varied somewhat during the last few decades. The case of homicide in Greenland is discussed separately in view of its special circumstances. Studies dealing with the various psychiatric and mental health problems related to homicide in the Nordic countries are discussed and a hypothesis is offered about possible sociocultural factors, in particular alcohol and drug abuse, that seem to be important.

Alcoholism↗

Mental disorder and clinical care in people convicted of homicide: national clinical survey.

OBJECTIVES: To estimate the rate of mental disorder in those convicted of homicide and to examine the social and clinical characteristics of those with a history of contact with psychiatric services. DESIGN: National clinical survey. SETTING: England and Wales. SUBJECTS: Eighteen month sample of people convicted of homicide. MAIN OUTCOME MEASURES: Offence related and clinical information collected from psychiatric court reports on people convicted of homicide. Detailed clinical data collected on those with a history of contact with psychiatric services. RESULTS: 718 homicides were reported to the inquiry between April 1996 and November 1997. Of the 500 cases for whom psychiatric reports were retrieved, 220 (44%; 95% confidence interval 40% to 48%) had a lifetime history of mental disorder, while 71 (14%; 11% to 17%) had symptoms of mental illness at the time of the homicide. Of the total sample, 102 (14%; 12% to 17%) were confirmed to have been in contact with mental health services at some time, 58 (8%; 6% to 10%) in the year before the homicide. The commonest diagnosis was personality disorder (20 cases, 22%; 13% to 30%). Alcohol and drug misuse were also common. Only 15 subjects (18%; 10% to 26%) were receiving intensive community care, and 60 (63%; 53% to 73%) were out of contact at the time of the homicide. CONCLUSIONS: There are substantial rates of mental disorder in people convicted of homicide. Most do not have severe mental illness or a history of contact with mental health services. Inquiry findings suggest that preventing loss of contact with services and improving the clinical management of patients with both mental illness and substance misuse may reduce risk, but clinical trials are needed to examine the effectiveness of such interventions.

Adult↗

An evaluation of state firearm regulations and homicide and suicide death rates.

OBJECTIVE: To determine if any of five different state gun laws were associated with firearm mortality: (1) "shall issue" laws permitting an individual to carry a concealed weapon unless restricted by another statute; (2) a minimum age of 21 years for handgun purchase; (3) a minimum age of 21 years for private handgun possession; (4) one gun a month laws which restrict handgun purchase frequency; and (5) junk gun laws which ban the sale of certain cheaply constructed handguns. DESIGN: A cross sectional time series study of firearm mortality from 1979 to 1998. SETTING: All 50 states and the District of Columbia. SUBJECTS: All residents of the United States. MAIN OUTCOME MEASURES: Firearm homicides, all homicides, firearm suicides, and all suicides. RESULTS: When a "shall issue" law was present, the rate of firearm homicides was greater, RR 1.11 (95% confidence interval 0.99 to 1.24), than when the law was not present, as was the rate of all homicides, RR 1.08 (95% CI 0.98 to 1.17), although this was not statistically significant. No law was associated with a statistically significant decrease in the rates of firearm homicides or total homicides. No law was associated with a statistically significant change in firearm suicide rates. CONCLUSION: A "shall issue" law that eliminates most restrictions on carrying a concealed weapon may be associated with increased firearm homicide rates. No law was associated with a statistically significant reduction in firearm homicide or suicide rates.

Adolescent↗

Homicidal behaviors among psychiatric outpatients.

OBJECTIVE: Most studies of violent behavior among psychiatric patients focus on inpatients or patients recently discharged from psychiatric units. To explore violent behavior among patients living in the community, the authors examined the prevalence of homicidal behaviors in a general psychiatric outpatient population. METHODS: During an intake evaluation, 517 outpatients completed several self-report instruments that included a detailed survey of past and current homicidal behaviors covering homicidal ideation, plans, and attempts. Demographic and clinical characteristics of patients with and without a history of homicidal behaviors were compared. RESULTS: Twenty-two patients (4 percent) reported a past homicide attempt. Patients who reported homicide attempts could be distinguished from patients with no homicidal behaviors by the presence of other aggressive behavior such as suicidal ideation and suicide attempts by themselves and their family members and by elevated current measures of interpersonal sensitivity, hostility, and paranoid ideation. CONCLUSIONS: The rate of homicide attempts in the general outpatient population studied was considerably lower than the reported rates of assault among inpatients. The relationship between past and current episodes of aggressive behavior reinforces the importance of including a careful assessment of past history of violent behaviors as part of the routine psychiatric evaluation.

Adolescent↗

Homicide patterns in the Toyama Prefecture, Japan.

Homicides occurring in the Toyama prefecture, Japan, during the past 10 years were reviewed. Between 1985 and 1994, 56 offenders committed 63 homicides. The mean death rate for homicide was 0.55 per 100,000. The ratio of male to female victims was 1:1, while 82% of the assailants were male and 18% were female. The victim and the assailant had a close family relationship in 58.7% of the cases. Dyadic death (homicide followed by suicide) accounted for 27% of all victims. Twenty-nine per cent of the victims were murdered by mentally unstable offenders, and in almost half (44%) of the cases the offender was convicted. Homicides during robbery were rare (only two cases), and there was only one homicide during sexual assault. Death was caused by blunt instrument injury in 38.1% of cases, asphyxia in 31.7%, stabbing in 17.5%, burns in 9.5% and shooting in 3.2% (only two cases). The majority (80%) of homicides occurred at the residence of the victim(s). None of the victims had a history of drug abuse. Social conditions in Toyama prefecture, and their possible relevance to local homicide patterns, are discussed briefly.

Adolescent↗

[Data comparison on homicide deaths between two information systems, Brazil].

INTRODUCTION: There is much criticism on the quality of criminal data available in Brazil, but there lacks systematic studies to corroborate it. Thus, it was conducted a comparison between homicides registered in Minas Gerais by two public information systems. METHODS: The number of homicide deaths of the Mortality Information System of the Ministry of Health (SIM/MS) and Minas Gerais Military Police (PMMG), from 1979 to 1998, were assessed. The comparison between the two systems was performed using the ratio between absolute numbers, considering the municipalities categorized in five groups according to the population size in 1998, and homicide rates. Two linear regression models were adjusted for rates in time, one for each system. RESULTS: In cities with less than 100,000 inhabitants PMMG homicide data is more complete than SIM/MS one. In cities with more than 100,000 inhabitants, SIM/MS registry is capable of providing homicide deaths data more efficiently, although it can include homicide deaths perpetrated in other municipalities and violent deaths of unknown nature that have not been due to homicide. The under-registration of PMMG in these municipalities can be due to late deaths in hospitals that are not followed up by PMMG. CONCLUSIONS: PMMG and SIM/MS systems represent the lower and upper limits of actual homicide deaths in larger cities. Both data sources should be analyzed and compared when both are available; when only one of them is available, the analysis should take into account the differences indicated in this study.

Brazil↗

Alcohol use and interpersonal violence: alcohol detected in homicide victims.

To characterize the relationship between alcohol use and homicide victimization, we used data from the Los Angeles City Police Department and the Los Angeles Medical Examiner's Office to study 4,950 victims of criminal homicides in Los Angeles in the period 1970-79. Alcohol was detected in the blood of 1,883 (46 per cent) of the 4,092 victims who were tested. In 30 per cent of those tested, the blood alcohol level was greater than or equal to 100 mg/100 ml, the level of legal intoxication in most states. Blood alcohol was present most commonly in victims who were male, young, and Latino, categories where rates have been increasing at an alarming pace. Alcohol was also detected most commonly in victims killed during weekends, when homicides occurred in bars or restaurants, when homicides resulted from physical fights or verbal arguments, when victims were friends or acquaintances of offenders, and when homicides resulted from stabbings. The evidence for alcohol use by homicide victims focuses attention on the need for controlled epidemiologic studies of the role played by alcohol as a risk factor in homicide and on the importance of considering situational variables in developing approaches to homicide prevention.

Adolescent↗

Surveillance for homicide among intimate partners--United States, 1981-1998.

PROBLEM/CONDITION: A substantial percentage of all homicides in the United States are committed by intimate partners of the victims. Among females, approximately 1 in 3 homicides are intimate partner homicides (IPHs). Intimate partner homicides cannot be tracked by using death certificates because death certificates do not record the victim's relationship to the perpetrator. REPORTING PERIOD COVERED: This report summarizes information regarding IPHs that occurred in the United States during 1981-1998. DESCRIPTION OF THE SYSTEM: This report is based on Supplemental Homicide Reports (SHRs) collected by the Federal Bureau of Investigation (FBI) as part of their Uniform Crime Reporting System. SHRs are filed voluntarily by police departments for homicides occurring within their jurisdiction. SHRs include demographic variables regarding victims and perpetrators, their relationship, and weapon(s) used. Data from the SHR file were weighted by comparison with homicide data from death certificates to compensate for underreporting. IPHs were restricted to victims aged > or = 10 years. RESULTS: The risk for death from IPH among males was 0.62 times the risk among females. However, the rate among black males was 1.16 times the rate among black females. Among racial groups, rates among blacks were highest, and the rates among Asian or Pacific Islanders were lowest. Rates were highest among females aged 20-49 years and among males aged 30-59 years. During the study period, rates among white females decreased 23%, and rates among white males decreased 61.9%. Rates among black females decreased 47.6%, and rates among black males decreased 76.4%. Highest rates occurred in the southern and western states among both white and black females. A graded increase in IPH risk occurred with community population size. Approximately 50% of IPHs were committed by legal spouses and 33% by boyfriends or girlfriends for both male and female victims. IPH rates were less than expected during the months of January, October, and November. INTERPRETATION: Although total homicide rates have fluctuated during 1981-1998, IPH rates have decreased steadily during this period, and among certain subpopulations, the decrease has been substantial. Decreases are temporally associated with the introduction of social programs and legal measures to curb intimate partner violence, but a causal relationship has not been established. Likewise, no confirmed explanation exists for the greater decrease in rates among males compared with rates among females. The differences in IPH rates by race indicate that economic, social, and cultural factors are involved. The analysis by community population size and state demonstrates that regional sociocultural differences might be involved also. Access to firearms might be a key factor in both male and female IPHs. PUBLIC HEALTH ACTIONS: The descriptive epidemiology of IPH is changing rapidly and should continue to be monitored. Understanding the reasons forthe recent decreases in IPHs might help identify methods for primary and secondary prevention and further reduce IPH rates.

Adolescent↗

Drug and alcohol use as determinants of New York City homicide trends from 1990 to 1998.

In this population-level study, we analyzed how well changes in drug and alcohol use among homicide victims explained declining homicide rates in New York City between 1990 and 1998. Victim demographics, cause of death, and toxicology were obtained for all homicide (N = 12573) and accidental death victims (N = 6351) between 1990 and 1998 from the Office of the Chief Medical Examiner of New York (OCME). The proportion of homicide and accident decedents positive for cocaine fell between 1990 and 1998 (13% and 9% respectively); the proportion of homicide and accident decedents positive for opiates and/or alcohol did not change significantly. Changing patterns of drug and alcohol use by homicide victims were comparable to changing patterns of drug and alcohol use in accident victims, suggesting that changes in drug and alcohol use among homicide victims between 1990 and 1998 cannot solely explain the decline in NYC homicide rates.

Adolescent↗

[Homicides in Copenhagen in 1984-1989 compared with the period 1959-1983].

During the years from 1959 to 1983 the Copenhagen homicide rate doubled. This increase was due mainly to an increase in the number of "accidental" homicides committed by alcohol intoxicated males, who were only slightly acquainted with their victims. The rate of homicide committed by schizophrenic persons increased by a factor 5, increasing from 1-2 cases every five years to 1-2 cases every year. During the 1980's, the annual homicide rate has been stable. In the investigation of homicide from 1984 to 1989, however, the tendency towards more homicides of accidental type was confirmed. Furthermore, the rate of female homicide increased. During the years from 1984 to 1989 the average number of homicides committed in Copenhagen by schizophrenic persons remained in the order of 1-2 per year.

Denmark↗

Homicide in the workplace in Ontario: occupations at risk and limitations of existing data sources.

This study has identified workplace homicides in Ontario from 1975 to 1985, described those at risk, and examined what existing data sources are most suitable for locating the occurrence of these events. Homicides were identified from two sources: the Office of the Chief Coroner and the Ontario Mortality Database (OMDB). Of the 84 homicides identified, 87% occurred among males; the average annual work-related homicide rate was 0.17 per 100,000 workers, with a male-to-female ratio of 5.2:1. The rates in males were about one-eighth of those reported in California and Texas. The highest rates occurred among policemen, gas station attendants, security guards, and taxi drivers, and in restaurants and in certain retail operations such as jewelry stores. These homicides represented about 4% of all traumatic workplace fatalities. Firearms were responsible for 56% of these homicides and the motive was robbery in 50%. The OMDB proved to be an awkward source from which to identify such deaths because there is no "injury-at-work" field on death certificates. Other existing sources of data were not able to locate work-related homicides. Guidelines to protect those at high risk of assault and homicide should be developed.

Adolescent↗

International and interstate comparisons of homicide among young males.

The homicide rate for males 15 through 24 years of age in the United States was compared with the rates in 21 other developed countries. The US homicide rate, 21.9 per 100,000, was more than four times higher than the next highest rate in Scotland (5.0). Most countries had rates that were between 1 and 3 per 100,000. The lowest rates were in Japan and Austria, each with rates below 0.6 per 100,000 males 15 through 24 years of age. Three quarters of the homicides in the United States resulted from the use of firearms contrasted with less than a quarter of all homicides in the comparison countries. The US homicide rate for black males 15 through 24 years of age (85.6) was more than seven times the rate for white males (11.2). In 1987 there were only four states that had homicide rates among white males that were as low as the rates among males in the comparison countries. The lowest state rate among young black males was still seven times the highest rate abroad. There are about 4000 homicides per year among young males in the United States. If the US homicide rate could be reduced to that in the country with the next highest rate, more than 3000 lives would be saved.

Adolescent↗

Cocaine and homicide in Memphis and Shelby county: an epidemic of violence.

In Memphis and the surrounding county, there were a record number of homicides (179) in 1986. During the same year, there was a marked increase in medical examiner cases where tests were positive for cocaine or its metabolites. Review of medical examiner and toxicology records from 1980 to 1986 found 87 cocaine related deaths; 46 of these were homicides. In 1986 alone, there were 53 cocaine related deaths, all manners, and 31 cocaine related homicides. In this year, 17.3% of the homicides were positive for cocaine or metabolite. The cocaine related homicides were similar to other homicides in terms of age, race, sex, blood ethanol concentration, and cause of death being due most often to firearms. In homicide cases in which an abuse drug was detected, cocaine accounted for the entire increase in 1986. Police records indicated that cocaine directly contributed to the homicide in 39% of the cases in which the drug was found. In other cases, we speculate that cocaine altered behavior may have contributed to the victim's being murdered either during the drug "high" or during the posteuphoric depression or withdrawal phase.

Adult↗

Homicide as a cause of pediatric mortality in the United States.

Homicide is a major cause of pediatric mortality. National law enforcement data were analyzed to characterize and differentiate neonaticide, infanticide, filicide, and overall child homicide. Results include the following: Neonaticides often involved parents or unidentified perpetrators and occurred proportionately more in rural areas than did other types of child homicide. Infanticide appeared to be one end of the spectrum of child homicide and not a distinct entity. Filicide rates were higher for sons than daughters and the crime was committed by more fathers than mothers. Overall child homicide predominately involved young male offenders who were acquaintances of the victim. At remarkably early ages, homicide characteristics began to resemble those of adult homicide. Further research in this area should attempt to gain detailed information concerning the child, his family, and their social network. Pediatricians should be actively involved in determining risk factors for child homicide and in screening children for risk when these factors are determined.

Adolescent↗

Homicide among black males in Jefferson County, Alabama 1978-1989.

This study examined 1505 of 1573 (96%) homicides occurring in Jefferson County, Alabama, between 1978 and 1989, that were investigated by the Coroner/Medical Examiners' Office. During this 12 year period, Jefferson County's average annual homicide rate was 18.9 per 100,000 compared to an 11.3 per 100,000 State of Alabama's rate and a 9.3 per 100,000 US rate. In Jefferson County, the average annual homicide rate among blacks (41.4) was almost six times the rate among whites (7.1). The highest average annual race-specific homicide rate was in black males (75.9), followed by black females (12.4), white males (10.4) and white females (4.1). Black males in the 25-34 year age group had the highest rate (159.7), followed by black males in the 35-44 year age group (151.7) and then by black males in the 15-24 year age group (96.2). These rates ranged from almost eight to over eleven times the rates of similarly aged, black females or white males and were over 33 times higher than the rates for white females of the same age. Our results emphasize the high rates of black male on black male violence, the acquaintance of the black male victim and perpetrator, and the importance of arguments as an inciting event. Moreover, we determined that while the raw numbers and rates for black homicides were and are staggering, the average annual homicide rate for black males was actually declining at a greater rate than for all other race-sex groups. Further, our results suggest that a number of hypothesized determinants commonly believed to be associated with the increase in the homicide rate among black males between 15 and 24 years of age, such as drug use, increased availability of firearms and increased child abuse were not, in fact, major determinants of the change in homicide rates.

Adolescent↗

The impact of homicide trials on the forensic pathologist's time--the Fulton County experience.

Subpoenas received for criminal trials related to homicides in Fulton County (Atlanta) Georgia were tracked in a computer database for an 18 month period in order to determine the proportion of forensic pathologist worktime required for testimony in homicide cases. The number of subpoenas received annually amounted to 64% of the average number of homicides occurring annually. Testimony was required in about 33% of cases in which a subpoena was received, and, therefore, the number of testimony appearances per year was about 21% of the average annual number of homicides. Assuming a 40 hour work week for 52 weeks per year and an average of 3 hours of time preparing for, traveling to, and testifying in court, the time required of the forensic pathologist to testify in homicide trials amounted to about 2% of a full-time-equivalent. Although the time required for testimony in homicide cases may vary among jurisdictions because of the nature of its homicides, distance and travel time to court, and other factors, the data presented here may be used to estimate the impact of homicide trial court time on forensic pathology practice.

Coroners and Medical Examiners↗

Regional differences in homicide patterns in five areas of Japan.

This article describes regional differences in the homicide patterns which occurred in Sapporo City and the surrounding area, and in Akita, Ibaraki, Chiba and Toyama prefectures in Japan. Information collected from each case of homicide included factors such as age, sex of the victim and assailant, causes of death, disposition of the offender, relationship between assailant and victim, reasons for criminal action, et al. The statistical features of homicidal episodes among the five different regions showed considerable variation, as follows. The mean death rates for homicide (number of victims per 100,000 of population) during the period 1986-1995 were 0.44 (Sapporo), 0.8 (Akita), 0.58 (Toyama), 0.7 (Ibaraki) and 0.75 (Chiba), respectively. Close family relationship between the victim and assailant was observed in the homicidal acts which occurred in Sapporo, Akita and Toyama. Assailant's relationship to victim was commonly extra-familial in Ibaraki and Chiba-neighboring megalopolis Tokyo, where some events of murder by a foreigner occurred. Homicide by female assailant, murder by mentally abnormal killers and homicide-suicide events were closely associated with family members. And these factors contributed to the considerable number of victims in Sapporo, Akita and Toyama. But, this close family relationship of the victim to the assailant did not correspond with the elevation in the number of deaths, and it was rather inversely related to the higher death rates recognized in Ibaraki and Chiba. This comparative study suggested that rapid urbanization considerably affects regional differences in homicide patterns.

Journal Article↗

Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries.

A total of 624 consecutive gunshot autopsies from the Institutes of Legal Medicine in Münster and Hamburg was investigated retrospectively. In a subsample of 284 suicides and 293 homicides (n=577), a large variety of features such as firearm, ammunition, number and site of entrance wounds, shooting distance and direction of the internal bullet path were recorded and binary logistic regression analysis performed in the case of bullet paths. Females constituted 26.3% of the homicide victims and 10.6% of the suicides. Short-barrelled firearms outnumbered long arms in homicides by 6:1 and in suicides by 2:1. More than 1 gunshot injury was found in 5.6% of the suicides (maximum 5 gunshots) and in 53.9% of the homicides (maximum 23 gunshots). The suicidal gunshots were fired from contact or near contact range in 89% while this was the case in only 7.5% of the homicides. The typical entrance wound sites in suicides were the temple (36%), mouth (20%), forehead (11%) and left chest (15%) but uncommon entrance wound sites such as the eye, ear, and back of the neck and head were also encountered. In suicidal gunshots to the right temple (n=107), only 6% of the bullet paths were directed downwards and only 4% were directed from back-to-front. In gunshots to the left chest (n=130), bullet paths running right-to-left or parallel occurred frequently in suicides (75%) and infrequently in homicide victims (19%). From 61 suicides who fired the gun inside their mouth, only 1 pointed the gun downwards. Consequently, some bullet path directions cannot be considered indicative of suicide: downwards and back-to-front in gunshots to the temple, left-to-right in gunshots to the left chest and downwards in mouth shots. The isolated autopsy findings can only be indicative of suicide or homicide but the combined analysis of several findings can be associated with a high probability.

Adult↗