Injuries/Violence
COVID-19 Onset, Stay-At-Home Orders, and Racialized Inequities in Homicide Mortality Across the US Maryam Tanveer* Maryam Tanveer N. Jeanie Santaularia, PhD MPH Kate Vinita Fitch, BA Naoko Fulcher, MS Shabbar I. Ranapurwala, PhD
Background
We examined the impact of COVID-19 pandemic onset (March 2020) on homicide mortality in the United States and examined effect measure modification by stay-at-home orders (SAHO) and demographics.
Methods
We conducted a single series interrupted time series study using data from the National Vital Statistics System from Jan 1, 2017-Dec 31, 2022, with COVID-19 onset as an interruption. Homicide deaths were identified using ICD 10 codes: X85-Y09, Y87.1. Monthly homicide deaths rates were calculated per 100,000 person-years (PY) to create a monthly time series (72 time points). We used autoregressive integrated moving average (ARIMA) regression, adjusted for seasonality, to model the immediate and sustained trend changes in the homicide mortality due to the pandemic. We stratified models by SAHO (no SAHO, <1 month, >=1 month), race and ethnicity (Hispanic, non-Hispanic (NH) American native, NH black, NH white, NH Asian), sex (male, female), and age (<18, 18-25, 26-35,…, 66-75, >75).
Results
In Jan 2017, the US homicide death rate was 5.9/100,000 PY, and while there were annual seasonal changes, the overall time trend from Jan 2017 to Feb 2020 was stable. However, with COVID-19 onset, there was an increase of 2.0 homicide deaths/100,000 PY (95%CI: 1.5, 2.4) across the US, which persisted until the end of 2022 without additional trend changes, but with seasonal variations. Black, American Native, and Hispanic people experienced the highest rates of being murdered and experienced the largest increases in death rates during the pandemic. Males and age groups 18-55, experienced larger increase in homicide mortality than females and other age groups. COVID-19-related immediate homicide mortality increases occurred in all states regardless of SAHO.
Conclusion
The COVID-19 pandemic had long-lasting impacts on homicide mortality that magnified inequities, especially for black, American native, and Hispanic people, males, and those aged 18-55, but were not impacted by SAHO.