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Perspectives in Disease Prevention and Health Promotion Premature Mortality Due to Homicides -- United States, 1968-1985

In 1985, homicides accounted for 612,556 years of potential life lost before age 65 (YPLL) or 5.2% of total YPLL. Assault by firearms and explosives, the major cause of homicides, resulted in 376,291 YPLL or 61.4% of homicide-attributable YPLL. Seventy- six percent of the homicide-attributable YPLL occurred in males (Table 1). As in past years (1), the YPLL rate per 100,000 persons was highest for black males (1669.3) and lowest for white females (99.4).

Homicide-attributable YPLL were calculated for 1968 through 1985 using final mortality data for ICD E-codes* 960-969 from the National Center for Health Statistics, CDC. During these years, homicide-attributable YPLL increased 44% from 424,718 to 612,556. This increase contrasts with total YPLL, which declined 25% from 15,888,756 to 11,851,397 during the same 18-year period. As a proportion of total YPLL, homicide-attributable YPLL increased 93% from 1968 through 1985 from 2.7% to 5.2% (Figure 1). Homicides by firearms and explosives increased from 1.8% of total YPLL in 1968 to 3.1% in 1985.

Since 1968, the average age at death from all causes before age 65 has been steadily increasing; thus the average YPLL per death (i.e., 65 minus the average age at death) has been decreasing. In contrast, the average age at death attributed to homicides before age 65 decreased steadily through the 1970s but appears to be stabilizing in the 1980s (Figure 2). For the 18-year period, the 44% increase in homicide-attributable YPLL reflects the 36% increase in the number of homicide deaths multiplied by the 6% increase in the average YPLL per homicide (1.44=1.36x1.06). The 25% decrease in total YPLL during this period reflects a 17% decrease in all deaths multiplied by a 10% decrease in the average YPLL per death. Reported by: Biometrics Br and Epidemiology Br, Div of Injury Epidemiology and Control, Center for Environmental Health and Injury Control, CDC.

Editorial Note

Editorial Note: The dramatic increase in homicide-attributable YPLL since 1968 highlights the need for public health efforts directed toward the prevention of interpersonal violence. Recent data from the Federal Bureau of Investigation (FBI) show a 5.9% increase in homicides from 1985 through 1987 (2).

The increased impact of homicides in the United States has helped strengthen the Public Health Service's commitment to focus on violence as a public health problem. One effort, the Surgeon General's Workshop on Violence and Public Health, held in 1985 (3), led to regional conferences that have fostered interdisciplinary efforts directed toward this problem. Cooperation among sectors such as criminal justice, social services, health care, and mental and public health may enable development of effective programs for prevention of homicides and for identification, treatment, and referral of victims of nonfatal interpersonal violence.

Since 1978, the homicide rate for black males 15-24 years of age has decreased 13%, suggesting that the 1990 objective for this target group (60/100,000) can be attained (4). However, YPLL data suggest that future public health objectives also should target other population groups.

Comprehensive surveillance of homicides in the United States uses both vital statistics and FBI data. In contrast, surveillance of nonfatal injuries from intentional interpersonal violence is almost nonexistent, although the incidence of this related problem is estimated to be at least 100 times that of homicides (4). Uniform hospital discharge data systems and trauma registries that include cause-of-injury information can serve as the basis for surveillance of nonfatal injuries from violence. These systems can also aid communities in defining priorities for preventing violence and evaluating the effectiveness of interventions.

References

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

  2. Federal Bureau of Investigation. Uniform crime reports for the United States. Washington, DC: US Department of Justice, Federal Bureau of Investigation, 1987.

  3. Department of Health and Human Services, Department of Justice. Surgeon General's Workshop on Violence and Public Health report. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1986; DHHS publication no. HRS-D-MC 86-1.

  4. CDC. Homicides among black males 15-24 years of age, 1970-1984. In: Public health surveillance of 1990 injury control objectives for the nation. CDC surveillance summaries, Feb. 1988. MMWR 1988;37(no. SS-1):53-60. *International Classification of Diseases, External Causes of Injury and Poisoning.



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