In 1991, nearly half (13,122 {49%}) of the 26,513 homicide victims in the United States were males aged 15-34 years. In addition, among males in this age group, homicide accounted for 18% of all deaths and was the second leading cause of death Table_1. During 1963-1991, the pattern of homicide rates changed substantially; the change was greatest for males aged 15-19 years, for whom rates increased substantially Figure_1. This report summarizes these trends and presents strategies for violence prevention and intervention.

Mortality data were obtained from CDC's National Center for Health Statistics; population estimates were projected from census data. Arrest rates were calculated using data from the U.S. Department of Justice.

From 1985 to 1991, the annual crude homicide rate for the United States increased 25% (from 8.4 to 10.5 per 100,000 persons). The homicide rate for persons aged 15-34 years increased 50% during this period (from 13.4 to 20.1 per 100,000), accounting for most of the overall increase. Rates increased for both sexes and all 5-year age groups within the 15-34-year age group. For persons in other age groups, rates were relatively stable from 1985 to 1991: for persons aged less than or equal to 14 years, 1.9 and 2.4, respectively; for persons aged 35-64 years, 8.8 and 9.1, respectively; and for persons aged greater than or equal to 65 years, 4.3 and 4.1, respectively.

From 1963 through 1985, annual homicide rates for 15- 19-year-old males were one third to one half the rates for the next three higher 5-year age groups Figure_1. However, during 1985- 1991, annual rates for males aged 15-19 years increased 154% (from 13.0 to 33.0), surpassing the rates for 25-29- and 30-34-year-old males, even though those rates increased 32% (from 24.4 to 32.3) and 16% (from 22.1 to 25.7), respectively. The homicide rate for 20-24-year-old males increased 76% (from 23.4 to 41.2) from 1985 through 1991.

During 1985-1991, age-specific arrest rates for murder and nonnegligent manslaughter increased 127% for males aged 15-19 years, 43% for males aged 20-24 years, and declined 1% and 13% for males aged 25-29 and 30-34 years, respectively (1,2). In 1991, 15- 19-year-old males were more likely to be arrested for murder than males in any other age group. Reported by: Div of Violence Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The increase in the annual homicide rate for 15- 19-year-old males during 1985-1991 was a dramatic change from the pattern during 1963-1984. Although the immediate and specific causes of this problem are unclear, the increase in the occurrence of homicide may be the result of the recruitment of juveniles into drug markets, the use of guns in these markets, and the consequent diffusion of guns to other young persons in the community, resulting, in turn, in more frequent use of the guns for settling disputes (3). Among 15-19-year-old males, firearm-related homicides accounted for 88% of all homicides in 1991 and 97% of the increase in the rate from 1985 through 1991. Factors underlying the immediate precursors may include poverty, inadequate educational and economic opportunities, social and family instability, and frequent personal exposure to violence as an acceptable or preferred method of resolving disagreements (4,5).

Although the most effective strategies to prevent youth violence have not been determined, efforts to prevent this problem should employ established principles of health promotion and should emphasize the use of multiple complementary interventions (6,7). These interventions include

• Strengthening the science base for prevention efforts. Strategies and methods to prevent violence in youth should be rigorously assessed (6).

• Establishing primary-prevention programs. Primary prevention aims to prevent the occurrence of violence rather than focusing on known perpetrators and victims after the occurrence of violence. This strategy addresses all forms of violence (e.g., spouse abuse, child abuse, and violence among youth) and could affect both potential perpetrators and victims.

• Targeting youths of all ages. Violence-reduction efforts should address the needs of infants, children, and older youths. Measures that have been successful in reducing violent behavior and its precursors in these age groups (8-10) should be considered when developing new programs.

• Involving adults (e.g., parents and other role models). They influence violence-related attitudes and behaviors of youth and should be provided the appropriate knowledge and skills to function as role models.

• Presenting messages in multiple settings. Lessons in one setting (e.g., a school) should be reinforced in other settings in which children and youth congregate, including homes, churches, recreational settings, and clinics.

• Addressing societal and personal factors. Societal factors (e.g., poverty, unemployment, undereducation, and social acceptance of violence {4,5}) should be addressed simultaneously with efforts to affect personal behavior change through activities such as home visitation, school-based training, or mentoring.

References

1. Federal Bureau of Investigation. Crime in the U.S., 1985. Washington, DC: US Department of Justice, Federal Bureau of Investigation, 1986.

2. Federal Bureau of Investigation. Crime in the U.S., 1991. Washington, DC: US Department of Justice, Federal Bureau of Investigation, 1992.

3. Blumstein A. Youth violence, firearms, and illicit drug markets {Working paper}. Pittsburgh: Carnegie Mellon University, The Heinz School, June 1994.

4. Reiss AJ Jr, Roth JA, eds. Understanding and preventing violence. Washington, DC: National Academy Press, 1993.

5. National Committee for Injury Prevention and Control. Injury prevention: meeting the challenge. Am J Prev Med 1989;5(suppl):1992-2203.

6. Mercy JA, Rosenberg ML, Powell KE, Broome CV, Roper WL. Public health policy for preventing violence. Health Aff 1993 (Winter):7-

8. Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. 2nd ed. Mountain View, California: Mayfield Publishing Company, 1991.

9. Olds DL, Henderson CR Jr, Chamberlin R, Tatelbaum R. Preventing child abuse and neglect: a randomized trial of nurse home visitation. Pediatrics 1986;78:65-78.

10. Zigler E, Taussig C, Black K. Early childhood intervention: a promising preventative for juvenile delinquency. American Psychologist 1992;47:997-1006.

11. Hammond RW, Yung BR. Preventing violence in at-risk African-American youth. J Health Care Poor Underserved 1991;2:359-

TABLE 1. Leading causes of death for males aged 15-34 years -- United States,
1991
=============================================================================
Cause                        No.      (%)
-----------------------    ------    -----
Unintentional injury       23,108    ( 32)
Homicide                   13,122    ( 18)
Suicide                     9,434    ( 13)
Human immunodeficiency
  virus infection           8,661    ( 12)
Cancer                      3,699    (  5)
Other                      13,234    ( 19)

Total                      71,258    (100)
-----------------------------------------------------------------------------
=============================================================================

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