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Homicide mortality

ENLACE HOMICIDE INTERPERSONAL VIOLENCE TECHNICAL NOTES ABOUT

 

Homicide is a leading cause of death and a public health priority in the Region of the Americas. 

The Region has the highest homicide rate in the world (19.19 per 100,000 population in 2019)—more than three times the global average of 6.18 per 100,000.

This page highlights the burden of homicide in the total population and in children under 18 years of age in the Region of the Americas.

Topic content

Homicide in the total population

Homicide in children aged 0-17 years

Policies and plans to prevent violence against children

 

 

Homicide in the total population

This exploratory data visualization presents estimates of homicide, defined as the killing of a person by another with intent to cause death or serious injury, as well as years of life lost due to premature deaths from interpersonal violence, by age, sex, and country in the Region of the Americas from 2000 to 2019. It allows seeing variations and time trends across sub-regions and countries.  

Homicide in the Region of the Americas

In 2019, interpersonal violence accounted for:

  • 193,742 deaths in both sexes combined (169,383 in men, and 24,359 in women).
  • The number of homicides increased 21%, from 2000 to 2019.  

The age-standardized homicide rates were:

  • 19.0 deaths per 100,000 population (33.6 deaths per 100,000 population in men, and 4.7 deaths per 100,000 population in women).
  • Both crude and age-standardized homicide rates stagnated in the period from 2000 to 2019.

The homicide rates vary substantially across countries of the Region, from 86.7 deaths per 100,000 people in El Salvador to 1.6 deaths per 100,000 people in Canada.

The 20% of countries with the highest levels of homicide (over 36.5 deaths per 100,000 population) are:

  1. El Salvador
  2. Honduras
  3. Venezuela
  4. Jamaica
  5. Belize
  6. Trinidad and Tobago, and
  7. Colombia

The 20% of countries with the lower levels of mortality due to interpersonal violence (lower than 6.2 deaths per 100,000 population) are:

  1. Canada
  2. Antigua and Barbuda
  3. Chile
  4. Cuba
  5. Suriname
  6. The United States of America, and
  7. Argentina

Years of life lost (YLL) due to premature mortality

In 2019, interpersonal violence was responsible for:

  • 1,041 years per 100,000 population of life lost due to premature deaths (1,856 years per 100,000 population for men, and 249 years per 100,000 population for women).

The top 20% of countries with the highest YLL rates due to interpersonal violence are:

  1. El Salvador
  2. Honduras
  3. Venezuela
  4. Trinidad and Tobago
  5. Belize
  6. Colombia
  7. Brazil

Estimates of homicide mortality in the population

Estimates of homicide mortality by age, sex, country, and years were obtained from the Global Health Estimates 2000-2019 produced by WHO.

INDICATOR DEFINITION

Indicators: Deaths, and Years of Life Lost (YLLs) rates due to interpersonal violence per 100 000 population.

Measure: Deaths, YLLs

Metric: Rate

Unit of measurement: Deats, or Years per 100,000 population

Definition:

Interpersonal violence is defined as the ‘‘Unlawful death inflicted upon a person with the intent to cause death or serious injury”. This definition contains three elements characterizing the killing of a person as intentional homicide:
1. The killing of a person by another person (objective element);
2. The intent of the perpetrator to kill or seriously injure the victim (subjective element);
3. The unlawfulness of the killing, which means that the law considers the perpetrator liable for the unlawful death (legal element).

This definition states that, for statistical purposes, all deaths corresponding to the three above criteria should be considered as intentional homicides, irrespective of definitions provided by national legislations or practices.

According to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), Interpersonal violence includes the following ICD-10 codes: X85-Y09, Y871.

Method of estimation: The estimates of homicide rates draw on data provided by countries from police, and civil registration and vital statistics systems; data from United Nations Office of Drugs and Crime (UNODC) global studies on homicide; and data from WHO’s Mortality Database. The estimation process used observed death data on homicide, in conjunction with modeling for countries without sufficient data availability or inadequate quality, to compute comparable estimates of homicide rates and numbers across countries.

In several countries, two separate sets of data on intentional homicide are produced, respectively from criminal justice and public health/civil registration systems. When existing, figures from both data sources are reported. Population data are derived from annual estimates produced by the UN Population Division.

Crude death rates were calculated as the total number of victims of intentional homicide (ICD-10 codes: X85-Y09, Y871) recorded in a given year divided by the total population in the same year, multiplied by 100,000. Age-specific death rates were calculated with the same approach by age. Age-standardized death rates were computed by the direct method using the WHO world standard population.

Regional aggregates: Regional and subnational estimates were calculated using national data (number of deaths, or number of YLLs) and population estimates from the UN World Population Prospects, 2019 edition. 

Methodological details:

Data sources and methods for estimating deaths and mortality are described in the following documents

Preferred data sources: Civil Registration and Vital Statistics (CRVS) systems.

  1. Hillis S, Mercy J, Amobi A, Kress H. Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics. 2016;137(3):e20154079. doi: 10.1542/peds.2015-4079.
  2. World Health Organization.  Global status report on preventing violence against children. Geneva: World Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO.  [cited 12 Sept 2021]. Available from: https://www.who.int/publications/i/item/9789240004191
  3. Pan American Health Organization. Regional Status Report 2020: Preventing and Responding to Violence against Children in the Americas. Washington, D.C.: Pan American Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO. [cited 13 Sept 2021] Available online: https://doi.org/10.37774/9789275122938
  4. World Health Organization. INSPIRE: Seven strategies for Ending Violence Against Children. Geneva: World Health Organization; 2016. License: CC BY-NC-SA 3.0 IGO. Available online:  https://www.who.int/publications/i/item/inspire-seven-strategies-for-en…;
 

Homicide in children aged 0-17 years

Homicide rates for children, defined as those aged 0-17 years, in the Region of the Americas are the highest in the world (5.8 per 100,000 in 2017, compared to the global average of 1.7 per 100,000). Homicide rates in the Americas are especially high among boys (9.3 per 100,000 for boys, compared to 2.1 for girls), although the girl homicide rate is almost double the rate for girls globally and higher than the rates for girls in all Regions. This data visualization presents estimates of the homicide rates in children (aged 0-17 years) by sex and countries of the Americas in 2017.

Homicides in children aged 0-17 years

Violence starts early in life, making childhood an important time period for preventing and responding to violence.

As of 2017, homicide in the Region of the Americas accounted for:

  • 15,636 deaths among children under 18 for both sexes; and 12,844 deaths among boys and 2,797 deaths among girls.
  • Homicide is responsible for 5.8 deaths per 100,000 children in the Region of the Americas, more than three times the global average. 
  • Child homicide rates are especially high among boys, amounting to 9.3 deaths per 100,000 for boys, compared to 2.1 deaths per 100,000 for girls in the Region. It is important to note though that the girl homicide rate in the Americas is almost double the rate for girls globally and higher than the rates for girls in all other Regions worldwide. 
  • Homicide in children varies across countries. Rates in the Bahamas, Belize, Brazil, Colombia, El Salvador, Honduras and Saint Lucia fall above the regional average on child homicide.

Estimates of homicide mortality for children aged 0-17 years

Homicide estimates were produced by using country-supplied information on the number and proportions of homicide victims aged 0–17 years to adjust existing WHO homicide estimates. The new homicide estimates for 0–17-year-olds underwent a country consultation process for country-level health estimates, before being finalized.

Data sources
Homicide estimates were informed by four main sources of data:

  1. Data collected from self-administered surveys for which responses were received from 155 Member States;
  2. Data on homicide counts for the latest year available and trends supplied by participating Member States from vital registration systems and from police;
  3. Global, regional and national homicide estimates from the Global Health Estimates generated by WHO;
  4. Published scientific studies, reviews and meta-analyses from the years 2012 to 2020 at country, regional and global levels on the prevalence and consequences and preventability of violence against children.

Detailed information on methods can be found in annex of the World Health Organization Global status report on preventing violence against children, available from: https://apps.who.int/iris/handle/10665/332394.

  1. Hillis S, Mercy J, Amobi A, Kress H. Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics. 2016;137(3):e20154079. doi: 10.1542/peds.2015-4079.
  2. World Health Organization.  Global status report on preventing violence against children. Geneva: World Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO.  [cited 12 Sept 2021]. Available from: https://www.who.int/publications/i/item/9789240004191
  3. Pan American Health Organization. Regional Status Report 2020: Preventing and Responding to Violence against Children in the Americas. Washington, D.C.: Pan American Health Organization; 2020. License: CC BY-NC-SA 3.0 IGO. [cited 13 Sept 2021] Available online: https://doi.org/10.37774/9789275122938
  4. World Health Organization. INSPIRE: Seven strategies for Ending Violence Against Children. Geneva: World Health Organization; 2016. License: CC BY-NC-SA 3.0 IGO. Available online:  https://www.who.int/publications/i/item/inspire-seven-strategies-for-en…;
 

Prevention of violence against children

Violence in all its forms has an enormous impact on the health of populations in the Region of the Americas. The Region of the Americas has the highest child homicide rate in the world. In addition to these deaths, millions of children sustain violence-related injuries that require emergency medical treatment, and countless others develop short- and long-term health problems or adopt high-risk behaviors, such as smoking, alcohol and drug abuse, and unsafe sex as a result of their exposure to violence.

Violence against children can be prevented, and its health, social and economic consequences can be mitigated. INSPIRE: Seven strategies for ending violence against children identifies seven strategies that have shown success in reducing violence against children. They include: Implementation and enforcement of laws; Norms and values; Safe environments; Parent and caregiver support; Income and economic strengthening; Response and support services; and Education and life skills. In 2020, PAHO launched the first ever Regional Status Report on Preventing and Responding to Violence against Children in the Americas, presenting a snapshot of progress made by countries in line with INSPIRE. 

The scorecard below provides an overview of country-reported data from the report about the existence of mechanisms for multi-stakeholder or multisectoral coordination on violence against children, national action plans to guide the prevention of violence against children, and prevention and response approaches in line with INSPIRE.  

*INSPIRE: Seven Strategies to End Violence Against Children, a technical package of seven strategies based on the best available evidence and with the highest potential to end violence against all children.

Suggested citation

Homicide mortality in total population and in children under 18 years of age in the Region of the Americas. Pan American Health Organization. 2021.

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