LATEBREAKER
Health Disparities
Overall and firearm-related homicide disparities across county, race and ethnicity, age, and sex in the United States, 2000-19 Paula Strassle* Paula Strassle Laura Dwyer-Lindgren Erik J Rodriquez Parkes Kendrick George A. Mensah Eliseo J. Pérez-Stable
Homicide is one of the leading causes of death in the US, especially among adolescents and adults ages <45. While research has consistently found racial/ethnic homicide disparities, the intersection between geography, race/ethnicity, sex, and age have not been comprehensively assessed. We applied validated small-area estimation methods to death registration data from the US National Vital Statistics System and population data from the US National Center for Health Statistics to estimate homicide (overall and firearm-related) rates by county, race/ethnicity, age, and sex from 2000–19. Estimates were corrected for misreporting of race/ethnicity and age-standardized to the 2010 Census. In 2019, the national homicide rate was 6.1 (95% uncertainty interval: 6.0–6.2) deaths per 100,000; 76.1% of homicides (75.5–76.6) were firearm-related. The highest rates were among Black males ages 15–24 (74.6 [72.3–77.0]) and 25–44 (70.0 [68.4–71.4]), followed by AIAN males ages 25–44 (33.5 [28.6–38.8]) and 15–24 (24.5 [19.2–31.0]). Among females, rates were highest among AIAN females ages 25–44 (10.2 [8.1–13.0]) and Black females ages 15–24 (9.6 [8.9–10.3]) and 25–44 (9.1 [8.7–9.6]). Rates among AIAN and Black males (Fig) and females ages <65 increased in most counties from 2000–2019. Oklahoma counties had some of the largest increases among AIAN males. In 2019 homicide rates were >100 in 119 and 90 counties (out of 1488) for Black males ages 15–24 and 25–44, respectively. Among AIAN males ages 25–44, 3 out of 474 counties had rates >100. For AIAN females ages 25–44, homicide rates were >20 in 19 counties (13 in Alaska). Similar trends were seen for firearm-related homicide. Homicide remains a significant public health concern in the US, especially among AIAN and Black males and females. These results provide important nuance in homicide disparities and motivate research to identify drivers and develop and implement effective interventions in places and populations of greatest need.
