Pediatric Homicides: Not Just a Teenage Problem.

ABSTRACT

INTRODUCTION: Homicide is a leading cause of death for American children. We hypothesized demographics and homicide circumstances would differ by victim age. METHODS: We performed a retrospective analysis of the 2003-2020 National Violent Death Reporting System. The National Violent Death Reporting System collects data from nearly all 50 states, the District of Columbia, and Puerto Rico. Demographics (age, sex, race, and ethnicity), homicide year, and weapon type were abstracted. Inclusion criteria were pediatric victims (age < 18). Two groups 0-4 y old (young cohort [YC]) and 13-17 y old (teen cohort [TC]) were compared. Chi-squared tests, p-test, and t-tests with significance P < 0.05 were used to determine the association between victim demographics, cohort, and homicide mechanism. RESULTS: 10,569 pediatric (male 70.2% [n = 7424], median age 12 y old [interquartile range 1-16], black 52.7% [n = 5573]) homicides met inclusion. Homicides demonstrated a bimodal age distribution (YC 40.9% [n = 4320] versus TC 48.9% [n = 5164]). Gender and race were both associated with homicide victimhood (P < 0.001). TC homicides were more likely to be male (YC 57.8% [n = 2496] versus TC 83.7% [n = 4320], P < 0.001) and black (YC 40.1% [n = 1730] versus TC 65.0% [n = 3357], P < 0.001). Pediatric homicides increased from 2018 (n = 1049) to 2020 (n = 1597), with only TC demonstrating a significant increase (2018 n = 522 versus 2020 n = 971, P < 0.001). Homicide mechanism was significantly associated with age (Blunt YC 57.5% [n = 2484] versus TC 2.9% [n = 148], P < 0.001; Penetrating YC 7.9% [n = 340] versus TC 92.8% [n = 4794], P < 0.001). CONCLUSIONS: Pediatric homicides demonstrate distinct demographic characteristics and homicide mechanisms between two at risk age cohorts. Age-based education and intervention strategies may increase injury prevention programs' efficacy.