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
CDC. Premature mortality due to suicide and homicide--United
States, 1983. MMWR 1986; 35:357-60,365.
Federal Bureau of Investigation. Uniform crime reports for the
United States. Washington, DC: US Department of Justice, Federal
Bureau
of Investigation, 1987.
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.
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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