Citation

Stark E. Int. J. Health Serv. 1990; 20(1): 3-26.

Copyright

(Copyright © 1990, Baywood Publishing)

DOI

unavailable

PMID

2407673

Abstract

Although homicide is the fourth leading cause of premature mortality in the United States and the leading cause of death for young blacks, the health professions have been largely oblivious to violence. Prevailing explanations contribute to this neglect by emphasizing biological or psychiatric factors that make homicide unpredictable and cultural and environmental factors such as the emergence of a new "underclass" that link violence to race. Focusing on instances where no other crime is involved, this article proposes that "primary" homicide be reconceptualized as a by-product of interpersonal violence, a broad category of social entrapment rooted in the politics of gender inequality and including wife abuse, child abuse, and assaults by friends and acquaintances. The data show that blacks are no more violent than whites, though they are arrested and die more often as the consequence of violence. In addition, a majority of homicides are between social partners or involve gender stereotypes, are preceded by a series of assaults that are known to service providers, and grow out of "intense social engagement" about issues of male control and independence. Professional failure to respond appropriately is a major reason why assaults become fatal, particularly among blacks. An international strategy that combines sanctions against interpersonal assault, gun control, and the empowerment of survivors might prevent half of all homicides.This article focuses on the interpersonal context of homicide in the US. Homicide is the 11th cause of death in the US and the fourth leading cause of premature mortality with higher danger risks for young urban Blacks. Despite the growing awareness of its significance for health, little attention was given by health professionals on the issue. This neglect could be contributed by the prevailing medical models of analysis and prevention, which emphasizes biological or psychiatric indicators unpredictable as well as cultural and environmental factors that link violence to race. In instances where no other crime is involved, it was proposed that "primary homicide" be conceptualized as an end result of interpersonal violence, a broad category of social entrapment grounded in the politics of gender inequality in the form of wife abuse, child abuse, and other assaults inflicted by friends and acquaintances. Data suggests that more Blacks became victims of violence than Whites despite the fact that they are no more violent than the latter. Moreover, the majority of homicide cases involve social partners or gender stereotypes, preceded by assaults which grow out of "intense social engagement" about issues of male control and independence. The major reason why violence and homicide continue to rise among the Blacks is the failure to recognize the historical and social context of interpersonal violence suggesting the need for appropriate intervention before the fatality escalates. An international strategy, which integrates sanctions against interpersonal abuse, gun control, and empowerment of survivors, might prevent half of homicide cases.