RESUMEN
INTRODUCTION: Homicide is a leading cause of death for American children. We hypothesized demographics and homicide circumstances would differ by victim age. METHODS: We performed a retrospective analysis of the 2003-2020 National Violent Death Reporting System. The National Violent Death Reporting System collects data from nearly all 50 states, the District of Columbia, and Puerto Rico. Demographics (age, sex, race, and ethnicity), homicide year, and weapon type were abstracted. Inclusion criteria were pediatric victims (age < 18). Two groups: 0-4 y old (young cohort [YC]) and 13-17 y old (teen cohort [TC]) were compared. Chi-squared tests, p-test, and t-tests with significance P < 0.05 were used to determine the association between victim demographics, cohort, and homicide mechanism. RESULTS: 10,569 pediatric (male: 70.2% [n = 7424], median age: 12 y old [interquartile range 1-16], black: 52.7% [n = 5573]) homicides met inclusion. Homicides demonstrated a bimodal age distribution (YC: 40.9% [n = 4320] versus TC: 48.9% [n = 5164]). Gender and race were both associated with homicide victimhood (P < 0.001). TC homicides were more likely to be male (YC: 57.8% [n = 2496] versus TC: 83.7% [n = 4320], P < 0.001) and black (YC: 40.1% [n = 1730] versus TC: 65.0% [n = 3357], P < 0.001). Pediatric homicides increased from 2018 (n = 1049) to 2020 (n = 1597), with only TC demonstrating a significant increase (2018: n = 522 versus 2020: n = 971, P < 0.001). Homicide mechanism was significantly associated with age (Blunt: YC: 57.5% [n = 2484] versus TC: 2.9% [n = 148], P < 0.001; Penetrating: YC: 7.9% [n = 340] versus TC: 92.8% [n = 4794], P < 0.001). CONCLUSIONS: Pediatric homicides demonstrate distinct demographic characteristics and homicide mechanisms between two at risk age cohorts. Age-based education and intervention strategies may increase injury prevention programs' efficacy.
RESUMEN
BACKGROUND: Despite representing 4% of the global population, the US has the fifth highest number of intentional homicides in the world. Peripartum people represent a unique and vulnerable subset of homicide victims. This study aimed to understand the risk factors for peripartum homicide. STUDY DESIGN: We used data from the 2018 to 2020 National Violent Death Reporting System to compare homicide rates of peripartum and nonperipartum people capable of becoming pregnant (12 to 50 years of age). Peripartum was defined as currently pregnant or within 1-year postpartum. We additionally compared state-level peripartum homicide rates between states categorized as restrictive, neutral, or protective of abortion. Pearson's chi-square and Wilcoxon rank-sum tests were used. RESULTS: There were 496 peripartum compared with 8,644 nonperipartum homicide victims. The peripartum group was younger (27.4 ± 71 vs 33.0 ± 9.6, p < 0.001). Intimate partner violence causing the homicide was more common in the peripartum group (39.9% vs 26.4%, p < 0.001). Firearms were used in 63.4% of homicides among the peripartum group compared with 49.5% in the comparison (p < 0.001). A significant difference was observed in peripartum homicide between states based on policies regarding abortion access (protective 0.37, neutral 0.45, restrictive 0.64; p < 0.01); the same trend was not seen with male homicides. CONCLUSIONS: Compared with nonperipartum peers, peripartum people are at increased risk for homicide due to intimate partner violence, specifically due to firearm violence. Increasing rates of peripartum homicide occur in states with policies that are restrictive to abortion access. There is a dire need for universal screening and interventions for peripartum patients. Research and policies to reduce violence against pregnant people must also consider the important role that abortion access plays in protecting safety.