Perspectives in Disease Prevention and Health Promotion Premature Mortality Due to Suicide and Homicide -- United States, 1984

In 1984, suicide and homicide were responsible for almost 50,000 deaths and over 1.25 million years of potential life lost (YPLL) before age 65 or 11% of all YPLL in the United States (1,2). Suicide was the fifth leading cause of YPLL, and homicide was the sixth. Data* on YPLL attributable to suicide and homicide were analyzed individually, by sex, race (white, black, and other races), and weapon or method of injury. To compare differences in YPLL among different race, sex, and age groups independent of differences in population size, crude YPLL rates per 100,000 persons were calculated.

Suicide

In 1984, suicide accounted for 645,680 YPLL. Seventy-one percent of the total YPLL attributable to suicide occurred among white males (Table 1). White females accounted for another 19%. White males had the highest crude rate of YPLL due to suicide (474/100,000). They were followed by males of all other races except blacks (350/100,000), by black males (303/100,000), and by white females (118/100,000).

Suicides committed with firearms accounted for 57% of the total YPLL attributable to suicide. Firearms were involved in the largest proportion of YPLL due to suicide for both males (60%) and females (46%), followed by hanging (18%) and poisoning (13%) for males and poisoning (32%) for females (Figure 1).

Homicide

Homicide was responsible for 609,678 YPLL in 1984. Seventy-six percent of the total YPLL due to homicide occurred among males (Table 1). White males accounted for 40% of YPLL attributable to homicide, whereas black males accounted for 34%. In 1984, the crude rate of YPLL due to homicide was highest for black males (1,567/100,000), followed by black females (381/100,000), males of other races (296/100,000), and white males (252/100,000).

Firearms were involved in 61% of the total YPLL attributable to homicide and accounted for a higher proportion of YPLL among males (66%) than among females (45%) (Figure 2). Cutting and piercing instruments were involved in 14% of the YPLL due to homicide. The proportion of homicides involving such instruments was greater for females (20%) than males (12%).

For suicide and homicide, approximately 6 of every 10 years of potential life lost are attributable to deaths from injuries involving firearms. In every race/sex group, firearms accounted for a greater proportion of YPLL due to suicide and homicide than did any other method of injury. Based on 1984 mortality statistics, each firearm suicide causes an average of 22 YPLL, and each firearm homicide causes an average of 34 YPLL. These figures do not include deaths from unintentionally inflicted firearm injuries or from firearm injuries resulting from undetermined causes: in 1984, there were 2,170 such deaths (3). Considered as an external means of injury, firearms rank second after motor vehicles as the most frequent cause of mortality due to injury (4). Reported by: Div of Injury Epidemiology and Control, Center for Environmental Health and Injury Control, CDC.

Editorial Note

Editorial Note: The patterns of premature mortality from suicide and homicide reported here for 1984 are comparable to those reported for other recent years (5). White males again accounted for the largest proportion of YPLL attributable to suicide. They also had the highest rate of YPLL due to suicide. In addition, white males accounted for a slightly greater proportion of YPLL attributable to homicide than did black males. As in previous years, however, black males had the highest rate of YPLL from homicide, followed by black females. These indexes are useful in developing priorities for public health programs and research. In particular, they emphasize the urgent need for efforts to prevent premature mortality from suicide among white males and from homicide among black males and the importance of preventing injuries and deaths involving firearms. Other implications of these patterns have been reviewed previously (5-11).

References

1. CDC. Premature mortality in the United States: public health issues in the use of years of potential life lost. MMWR 1986;35(2S).

2. CDC. Changes in premature mortality--United States, 1984-1985. MMWR 1987;36:55-7.

3. Wood NP. Unintentional firearm surveillance, 1970-1984. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, CDC, (in press).

4. Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, Massachusetts: Lexington Books, 1984.

5. CDC. Premature mortality due to suicide and homicide--United States, 1983. MMWR 1986;35:357-60,365.

6. Rosenberg ML, Smith JC, Davidson LE, Conn JM. The emergence of youth suicide: an epidemiologic analysis and public health perspective. Am Rev Public Health 1987;8:417-40.

7. CDC. Suicide surveillance, 1970-1980. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, 1985.

8. CDC. Youth suicide in the United States, 1970-1980. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, 1986.

9. CDC. Homicide among young black males--United States, 1970-1982. MMWR 1985;34: 629-33.

10. O'Carroll PW, Mercy JA. Patterns and recent trends in black homicide. In: Hawkins DF, ed. Homicide among black Americans. New York: University Press of America, 1986.

11. CDC. Homicide surveillance: high-risk racial and ethnic groups--blacks and Hispanics, 1970 to 1983. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, 1986.

*YPLL was calculated using the National Center for Health Statistics' detailed mortality data from computerized death certificate tapes for 1984, the latest year for which data are available.

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