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Abstract
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OBJECTIVE--To look at trends in mortality and homicide rates in a specific metropolitan area, comparing the urban and suburban mortality trends. DESIGN--Descriptive study of mortality rates. Linear regression determined whether changes in mortality rates over time represented significant trends. SETTING--Industrial metropolitan area in the United States, population, 2,337,891. PARTICIPANTS--Pediatric deaths (1 to 18 years of age) in a 9-year period. Population characteristics: 36% black, 64% white, 50% each urban and suburban. MAIN OUTCOME MEASURES--Pediatric mortality rates for 1980 through 1988, grouped by urban vs suburban, age, gender, and race. Rates calculated using national census figures and plotted over time. RESULTS--There was a 50% increase in all-cause mortality in the urban pediatric population as compared with no change or a slight decline in the suburban and national populations. The increase was found in the black urban population. Homicide showed the largest increase (252%). Firearm-related homicides accounted for the majority of homicide deaths. CONCLUSIONS--(1) There were significant differences in mortality between the urban and suburban pediatric populations. (2) The increase in homicides, specifically firearm homicides, in the urban population accounted for the increase in overall mortality rates. (3) The increase in homicide rates was significant only for the 10- to 14-year-old males and the 15- to 18-year-old male and female portions of the black urban population. (4) Firearm homicides have become epidemic in the black urban population we studied.
VioLit summary:
OBJECTIVE:
The goal of this study by Ropp et al. was to compare urban and suburban trends in pediatric mortality, including homicide.
METHODOLOGY:
A quasi-experimental method using secondary sources was used for this study. Wayne County, Michigan was divided into urban (Detroit) and suburban populations and examined. The areas were similar except for a high percentage of black children in Detroit and a very small percentage of black children in the suburban population and higher social and economic stress in Detroit as measured by average income, crime rate, and other indicators. Mortality data in the form of death certificates for youths aged 1-18 for the years 1980-1988 were collected from the Michigan Department of Health Center for Health Statistics. Pediatric deaths were classified by age group (1-4, 5-9, 10-14, and 15-18), gender, race, and location. Year was also included as an independent variable to test for trends. Multiple regression was used to analyze the data.
FINDINGS/DISCUSSION:
During the 9-year period between 1980 and 1988, the all-cause mortality rate for all children increased almost 50% for the urban population; rising from 49.48 per 100,000 in 1980 to 73.20 in 1988. The mortality rate declined in the suburban population from 32.9 to 27.9 during the same period. Black urban males showed a consistent, significant increase in all-cause mortality over the interval (p<.001). The rate increased from 68.5 to 119.2; for black urban females, the rate increased from 29.9 to 44.7 (p<.05). Neither white males or white females in the urban population nor any gender or race-specific suburban group showed any significant change in all-cause mortality during the 9-year interval. Non-homicide death rates for all children showed a nonsignificant increase over the period; homicide death rates increased by 252%, increasing from 8.76 to 30.84 (p<.001). Black males in Detroit had significantly higher homicide rates than females (p=.001), and homicide rates increased significantly with the increasing age group (p<.001). With age and gender taken into account, there was a significant increase in homicide rates from 1980 through 1988 (p=.03). There were significant increases in homicide deaths for males in both the 10-14 age groups and the 15-18 age groups; for females, the only significant increase was for the 15-18 age group. In comparing the homicide rate for 15-18 year old black urban males with the rate for black suburban males and the white urban and suburban males, it was found that there was a significant rise in homicides only in the black urban subgroup. An overwhelming preponderance of gun involvement was found. The rate of firearm-related homicides increased from 54.4 in 1980 to 168.3 in 1988 (p=.001). In 1988, homicides were the leading cause of death for black males aged 5 and older. For females, homicides ranked as the leading cause of death in the 10-14 and 15-18 age groups. In all other age groups, homicide was one of the top two causes of death in 1988. While in 1900 the overwhelming cause of child death was natural, the trend in both the urban and suburban population was for natural causes to be 25% and 46% all child deaths, respectively. The single largest contributor to the rise in child mortality was attributed to homicide.
AUTHORS' RECOMMENDATIONS:
The authors argued that there was some evidence for a concern with guns and children. The American Academy of Pediatrics recommended several steps including the removal of handguns from children's environments by steps which involved a complete approach from restriction to education. Similar recommendations have been made by the American College of Emergency Physicians. In general, the authors advocated a public health approach to the problem of child homicide involving more research and an encompassing approach to include addressing the broader social issues that affect the black urban population who is most affected.
EVALUATION:
This study lends empirical support to the dramatic increase in homicide of black youths, particularly young black males. The authors offered some limitations to the interpretations of their findings. There may have been large variability in mortality rates over time that would make detection of significant trends more difficult. Also, there were possible misclassification problems with the death certificates. Overall, this study points to the need for both research and policy which targets black youths in the urban setting.
(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
N1 - Call Number: F-636, AB-636
KW - 1980s
KW - Michigan
KW - Urban Violence
KW - Urban Youth
KW - Suburban Violence
KW - Suburban Youth
KW - Death Rates
KW - Homicide Incidence and Prevalence
KW - Homicide Rates
KW - Homicide Victim
KW - Juvenile Victim
KW - Child Victim
KW - Victimization Incidence and Prevalence
KW - Early Childhood
KW - Middle Childhood
KW - Late Childhood
KW - Late Adolescence
KW - Early Adolescence
KW - Firearms Violence
KW - Firearms Homicide
KW - African American Victim
KW - African American Juvenile
KW - African American Child
KW - Caucasian Child
KW - Caucasian Juvenile
KW - Caucasian Victim |