Originally published by 2 Minute Medicine^® (view original article). Reused on AccessMedicine with permission.

1. The homicide rate for children in the United States has increased by an average of 4.3% per year since 2013.

2. Children under the age of 10 are most often killed by parents or caregivers in the setting of abuse/neglect. Children ages 11 and older are most often killed by friends or acquaintances in the setting of arguments and crime.

Evidence Rating Level: 2 (Good)

Study Rundown:

Homicides, including those carried out using firearms, are a leading cause of death among US children. Using data from the National Vital Statistics System and the National Violent Death Reporting System, this cross-sectional study analyzed the characteristics and trends in child homicides in the United States. From 2007 to 2013, the authors found that the annual child homicide rate decreased by a mean of 5.6% annually; however, since 2013, this rate increased by a mean of 4.3% each year, with a striking 27.7% increase in child homicides between 2019 and 2020. Furthermore, these increases have not occurred at the same rate across all subpopulations. Boys, children ages 6 to 17, Black and Hispanic children, children living in urban areas, and children living in the South have seen the largest increases in homicide rates. This study benefits from a large, national data set, with robust data available on the circumstances of each death studied. However, it is limited by potential misclassification bias, particularly of race/ethnicity data, as well as erroneous determinations of the cause of death of infants and very young children.

Click to read the study in JAMA Pediatrics

Click to read an accompanying editorial in JAMA Pediatrics

Relevant Reading: Current causes of death in children and adolescents in the United States

In-Depth [cross-sectional study]:

Using both publicly available death certificate data from the National Vital Statistics System (NVSS) and information on the circumstances surrounding child homicides from the National Violent Death Reporting System (NVDRS), this study investigated the characteristics and trends in child homicides in the United States from 1999 to 2020. Recent trends were explored by comparing homicide rates in 2019 and 2020 using z-tests. 3,670 youth homicides were analyzed from this two-year period. These analyses showed a significant increase in the child homicide rate, which rose 27.7% in 2020 compared to the year prior. Long-term trends were assessed using joinpoint regression with inverse-variance weighting. 38,362 child homicides were documented over a two-decade period from 1999 to 2020. The annual child homicide rate was found to have decreased by a mean of 5.6% each year between 2007 and 2013; since then, it has increased by 4.3% each year. Historical trends also show significant increases in the homicide rate for boys, children ages 6 to 17, Black and Hispanic children, children living in urban areas, and children living in the South (p<0.05 for all). In the second half of the paper, descriptive analyses derived from the NVDRS were discussed. 9,881 homicides, which occurred from 2003 to 2019 in 45 US states, were included in the sample. Children under 5 years old were most often killed in the context of abuse/neglect, by parents or caregivers using personal weapons (i.e., “hands, fists, feet”). Children ages 5 to 10 were also most often killed in the context of abuse/neglect, by parents or caregivers using firearms. Children ages 11 and older were most often killed by friends and acquaintances using firearms, frequently in the setting of arguments and crime.

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