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Violence Essay, Research Paper
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Source: Archives of Pediatrics & Adolescent Medicine, Sept 1995 v149 n9
Title: Violent crime in the United States: an epidemiologic profile.
Author: Laura Rachuba, Bonita Stanton and Donna Howard
Abstract: Violent crime rates appear to have increased among youth while
declining or remaining stable among other age groups. Researchers used data
from several nationwide databases to track trends in crime from the early
1970s through 1992. Overall violent crime increased by 81% with a twofold
increase in aggravated assault, while murder rates varied little. According to
another database, violent crime rates remained stable. All databases showed
marked increases in violent crime rates in youths and young adults. Blacks
were disproportionately affected. For example, the homicide rate among
males aged 15 to 24 was more than nine times the rate among white males.
Particularly concerning was the increase in murders among children aged 10
14, which went up 93%. Guns were involved in over 60% of the murders, and
greatest rate of increase in murders involving guns was in children aged 10 to
Author’s Abstract: COPYRIGHT American Medical Association 1995
Objectives: To determine if (1) there was an increase in the rates of acts of
violence in the United States from 1973 to 1992 and (2) there were
disproportionate changes in rates of violent crime among specific
groups. Methods: Crime data from the Uniform Crime Reporting Program
National Crime Victimization Survey beginning in January 1973 and ending
December 1992 were examined. Homicide data from 1970 to 1991 were
with the National Center for Health Statistics mortality data from the Centers
for Disease Control and Prevention. Analyses were performed for overall
rates as well as for specific demographic groups. Results: Rates of
victimization from all types of violent crime have increased among
and young adults (from ages 10 through 25 years), regardless of gender or
race. Absolute rates were highest among African Americans and males. Both
highest rates and the greatest increases in homicide from 1971 to 1990 were
among adolescents and young adults, while rates for those aged 25 years and
older decreased. A substantial increase in firearm-related homicides among
adolescents and young adults occurred as well, with rates decreasing for
aged 25 years and older. Overall rates of homicide have remained relatively
constant during the past two decades. Data addressing overall trends in the
rates of nonfatal violence during the past 20 years are inconclusive.
Conclusions: Adolescents are now experiencing the highest and most rapidly
increasing rates of lethal and non-lethal violence. The increase in violence
among youths 10 to 14 years of age is especially important and alarming. The
concentration of violence among children and adolescents has important
intervention implications. Because adolescence is a time of great
developmental changes, approaches to understanding and preventing violence
among our nation’s youths should incorporate a developmental perspective
also focuses on the relationship and interactions between individuals and
their environments, at the family, community, and societal levels. (Arch
Pediatr Adolesc Med. 1995;149:953-960)
Subjects: Violent crimes – Demographic aspects
Violent deaths – Demographic aspects
Electronic Collection: A17477467
Full Text COPYRIGHT American Medical Association 1995
Editor’s Note: This article documents what so many of us knew from reading
newspapers, watching television, and directly working with teenagers.
it be wonderful if some of the Department of Defense initiatives and funds
were aimed at defending our youth?
Catherine D. DeAngelis, MD
IN THE PAST DECADE, the public media and law enforcement, public
medical professionals have expressed a growing concern regarding violence
the United States. The establishment of the Center for Injury Prevention and
Control within the Centers for Disease Control and Prevention, the inclusion
of questions regarding violent behavior in several national surveys conducted
by the Centers for Disease Control and Prevention, and a substantial increase
in citations of “violence” in the medical literature provide evidence that
violence is now recognized as a public health issue. For example, the Index
Medicus (National Institutes of Health) listed 70 citations under “violence”
in 1970, 127 in 1980, 196 in 1990, and 290 in 1993. Despite
society’s increased focus on violence, epidemiologic characterization of the
problem remains imprecise, resulting in critical knowledge gaps as to the
definition of violence, changes in the rates and character of violence over
time, and factors associated with these changes. In fact, even the widely
promulgated premise that violence is increasing has been challenged recently.
Critics argue that sensationalistic reporting of crime statistics is
responsible for this misperception.
Multiple factors regarding the study of violence contribute to this imprecise
epidemiologic characterization. The study of violence as a public health issue
is a relatively new perspective compared with its study as a criminal issue.
As such, the violent act itself (as opposed to the mental and physical health
outcomes of violence) has historically been the focus of interest in studies
of violence. Indeed, except for homicide, the majority of national databases
that provide violence surveillance (eg, the Uniform Crime Report and the
National Crime Victimization Survey) do not characterize the health outcome
the violent act. Given the judicial perspective of the agencies sponsoring
such databases, an emphasis on the criminal nature of the violent action is,
of course, logical.
As a corollary, given the traditional disinterest among health professionals
in violence research, most existing medical databases do not differentiate
between unintentional and intentional injuries. For example, the International
Classification of Diseases, Ninth Revision, the most widely used medical
nomenclature for diagnostic categories, identifies the medical injury (eg,
“penetrating wound to the abdomen”) but does not enable identification of the
mechanism of injury (eg, “gunshot wound”). Even the more precise
classification afforded by the External Cause of Injury codes is used by a
few medical institutions. Furthermore, in medical institutions in which
External Cause of Injury codes are used, sufficient cause-of-injury
information is not obtained from emergency providers, making the use of
codes difficult. Similarly, the numerous immediate and long-term adverse
physical and mental health outcomes that result from the act of violence
remain poorly defined and poorly articulated. Given the interactive nature of
many acts of violence, such articulation and clarification will doubtless be a
It is not possible to address all of the issues mentioned above in a single
article. Furthermore, many of these issues cannot be adequately examined
databases are expanded to include information on the acts and the outcomes.
However, existing data can be used to delineate some trends and to generate
hypotheses about relationships. In the present article, we propose to examine
whether evidence exists in the United States for (1) increased rates of acts
of violence over time and (2) a disproportionate change in the rates of acts
of violence among specific demographic groups.
OVERALL TEMPORAL TRENDS
Figure 1 depicts rates of violent crimes from 1973 to 1992 according to the
UCR Program data. The rate of overall violent crime increased 81%. The
increase in rate (twofold) occurred for aggravated assault. The homicide rate
remained relatively consistent during a 20-year period, a finding that was
consistent with the N CHS mortality data.
The Victimization Survey data from 1973 to 1992 indicate that the rate of
violent crime fluctuated during the 20-year study interval but remained stable
overall (Figure 2). Although the Victimization Survey rates were higher than
the UCR Program rates for each type of violent crime during these years, both
data sets showed that the rate and number of violent crimes peaked in 1980,
subsequently declined, and began increasing again after 1989. For specific
types of crime, rates decreased for rape, robbery, and aggravated assault
while simple assault rates increased.
SUBANALYSES BY DEMOGRAPHIC VARIABLES
The NCHS homicide data demonstrated that from 1970 to 199 1, youths aged
34 years experienced the highest rates of homicide (Figure 3). The largest
increase (220%) in homicide rates occurred for those aged 15 to 19 years,
followed by a 56% increase for those aged 20 to 24 years. A substantial
proportionate increase (47%) also occurred for youths aged 10 to 14 years,
although the absolute rates and increases were smaller than for the older
teens and young adults. Rates remained constant for those aged 30 to 34
and decreased for those aged 35 to 39 and 40 to 44 years.
The Victimization Survey data showed that fates of overall violent crime
increased from 1973 to 1992 for those aged 12 to 34 years, but remained the
same or decreased for those aged 35 years and older. Furthermore, rates were
highest among those aged 16 to 19 years. Robbery rates increased among
aged 16 to 19 years (64%) and 25 to 34 years (40%), but decreased for those
aged 12 to 15 years and 35 years and older. Aggravated assault rates
for those aged 12 to 15 years (32%) and 16 to 19 years (12%) but decreased
remained the same for those aged 20 years and older. Simple assault rates
increased for all age groups between 12 and 49 years, with the largest
increase among youths aged 12 to 15 years (58%). Rates decreased for those
aged 50 years and older.
Age by Gender
According to NCHS data from 1970 to 1991, an increase in the homicide rate
experienced by males aged 10 to 29 years and females aged 10 to 34 years
(Table 1 For males, the largest proportionate increase (93%) occurred for
youths aged 10 to 14 years, while the largest absolute increases were seen
among youths aged 15 to 19 years of age and those aged 20 to 24 years. For
females, the largest increase occurred among youths aged 15 to 19 years
Increases in rates also occurred among those aged 10 to 14 years (44%), 20
24 years (32%), and 30 to 34 years (28%).
[TABULAR DATA 1 OMITTED]
According to the Victimization Survey data from 1973 to 1992, robbery rates
increased for males aged 16 to 19 years and 25 to 34 years and females aged
to 34 years. However, the largest proportionate increase (250%) occurred
females aged 16 to 19 years. Aggravated assault rates increased for males
12 to 15 years (15%) and 60 years and older (50%). Female aggravated
rates increased among those aged 12 to 19, 25 to 34, and 50 to 64 years, with
the largest increases experienced by persons aged 50 to 64 years (twofold)
12 to 15 years (80%). Rates remained the same or decreased for all other
groups. Among males, simple assault rates increased for those aged 12 to 24
years and decreased among those aged 25 years and older. Simple assault
among females increased for all those younger than 50 years, with the largest
increase (90%) occurring among those aged 25 to 34 years. The highest rates
violent crime occurred among youths aged 12 to 24 years.
Age by Gender by Race
The age by gender by race comparison demonstrates the most striking
demographic differences in homicide rates (Table 1). According to the NCHS
data from 1970 to 1991, regardless of race, male homicide rates increased for
those aged 10 to 24 years. Homicide rates for white males increased for those
aged 10 to 34 years but remained constant among those aged 35 to 44 years.
largest proportionate increases occurred for those aged 10 to 14 years
15 to 19 years (296%), and 20 to 24 years (78%), although the absolute
increase in rate among youths aged 10 to 14 years was not as great as in the
older age groups. The largest increase in homicide rates for African-American
males occurred for those aged 15 to 19 years (220%), 20 to 24 years (84%),
10 to 14 years (34%). Rates decreased for African-American men aged 25
and older. Among white females from 1970 to 1991, rates increased for those
aged 10 to 39 years, with the largest increases occurring among those aged 15
to 19 years (85%),,10 to 14 years (50%), and 20 to 24 years (43%).
African-American females aged 10 to 14 and 15 to 19 years experienced an
increase in homicide rates (65% and 47%, respectively). Rates remained
constant or decreased for African-American women aged 29 to 44 years. The
greatest racial discrepancies in homicide rates existed among those aged 15 to
24 years. In this age group, the homicide rate for African-American males
more than ninefold greater than that for white males. Among women aged 25
29 years, the homicide rate for African Americans was six times greater than
that for whites.
The Victimization Survey data for 1990 and 1992 showed that, regardless of
race and gender, those aged 12 to 24 years had the highest rates of violent
crime victimization. Among african-American males and females, youths
to 19 years had the highest rate, followed by those aged 12 to 15 years. For
white males and females, youths aged 12 to 15 years had the highest rate,
followed by those aged 16 to 19 years. The rate of greatest magnitude
among African-American males aged 16 to 19 years. Data were not available
robbery, rape, or assault rates.
The UCR data were used to examine weapon involvement in homicide and
aggravated assault. From 1973 to 1992, firearms accounted for more than
homicides (Figure 4). During this period, the percentage of firearms involved
in homicide and aggravated assault remained stable. The percentage of
instrument involvement decreased slightly for homicide, while it increased for
aggravated assault. Involvement of blunt instruments remained unchanged in
homicide but increased 9% in aggravated assault. A 3% decrease occurred in
use of personal weapons (hands, feet, or fists) for homicide and aggravated
Firearm involvement in homicide from 1979 to 1991 increased for persons
10 to 24 years (Table 2 and Table 3). The greatest rate of increase in
firearm-related homicide occurred among children aged 10 to 14 years and
decreased or remained the same for all groups aged 25 years and older
2 and3). African-American males aged 15 to 19 years experienced the largest
absolute increase 352%); however, African-American men aged 20 to 24
experienced the most victimization.
Table 2. Temporal Trends in Firearm-Related Homicide
According to Age by Gender by Race(*)
Age, y White American White American
10-14 0.7 2.4 1.4 8.2
15-19 7.2 34.8 11.7 122.6
20-24 12.6 88.3 14.6 162.9
25-34 12.1 104.5 10.8 96.8
35-44 9.9 78.1 7.2 53.4
10-14 0.2 1.0 0.5 2.7
15-19 1.7 6.9 2.1 11.2
20-24 2.6 13.6 2.7 16.8
25-29 2.4 13.5 2.4 13.7
30-34 2.4 11.1 2.0 7.5
(*) Unpublished data are from the National
Center for Health Statistics.
Table 3. Percentae Change in Firearm-Related
Homicide Rates from 1979 Through 1991 Accordin
to Age by Gender by Race(*)
10-14 15-19 20-24 25-34 35-44
Male +339 +352 +84 -7 -32
Female +257 +61 +23 … -32
Male +91 +62 +16 -14 -27
Female +268 +26 … … -16
(*) Unpublished data are from the National Center for Health Statistics.
Ellipses indicate no change.
Violence has increased substantially among African-American and white
adolescents of both genders. Both the highest rates and the greatest increases
in homicide were seen among adolescents and young adults (eg, aged *25
By contrast, the overall homicide rate increased slightly from 1970 to 1991
and has remained static from 1979 to 1991. Thus, contrary to media reports
public perception, during the past decade the overall rate of homicide has not
been escalating but has remained relatively unchanged. Moreover, among
older than 30 years, rates remained stable or declined. A similar picture was
evident for most other acts of violence, such that rates generally increased
among adolescents and young adults and generally decreased among older
The concentration of escalating violence during the adolescent and
years was consistent across race and gender. Disparities along racial lines
were also found to be greatest in these age groups. African-American males
their adolescent and early adult years experienced a homicide rate ninefold
that of similar-aged white males. This difference remained, despite the fact
that the greatest increase in homicide during the past 20 years was
consistently seen among white males. African-American females in this age
range experienced rates several times higher than that of their age-matched
white counterparts. Finally, an alarming increase existed in firearm-related
homicides among adolescents and young adults under the age of 25 years. By
contrast, the proportion of homicides related to firearms decreased among all
adults older than 25 years.
IMPLICATIONS OF THE FINDINGS
Adolescents are now experiencing the highest and fastest increasing rates of
lethal and nonlethal victimization from violence. Despite their lower rates of
violent crime, as compared with older adolescents and young adults, the
increase in violence among youths aged 10 to 14 years is an especially
important–and alarming–finding. Violent juvenile crime arrest rates have
increased steadily in the past decade, reaching their highest rates in the
past 20 years. Accompanying the increase in arrest rates has been a large
increase of weapon involvement in crimes committed by youths. The
concentration of increasing violence during the adolescent years argues
strongly for the incorporation of a developmental approach to violence
prevention. The increasing involvement of weapons in victimization and
perpetration, largely limited to the adolescent population, centers on
firearms as the weapon of choice. Thus, before intervention or prevention
programs can address the problem of adolescent violence, research needs to
explore the appeal of firearms for adolescents, their motivation to carry
firearms, and their intention actually to use firearms.
As noted above, violence has traditionally been regarded by society as a
criminal act rather than a public health concern. Although, in the past
decade, a shift has begun in this orientation,[19,21] little attempt has been
made to examine the host of psychosodial and developmental factors
related to the act and experience of violence. Whereas much has been written
about the concentration of violence among the poor, males,[23,24]
minorities,[25-27] and older adolescents and young adults,[23,28,29] a need
exists for a unifying research framework that underscores the fact that the
greatest concentration of violence is now centered among all adolescents,
adolescents as young as 10 to 14 years of age becoming increasingly
The concentration of violence among our youths has important intervention
implications. Multiple developmental influences salient during adolescence
must be considered and incorporated into violence prevention and violence
treatment programs. Adolescence is a time of intense curiosity and risk
taking, a time when individuals learn to think in probabilistic terms.
During adolescence, a transition occurs from concrete operational reasoning
more formal abstract thinking, including the ability to think beyond the
present and consider future goals. Confounding this maturation in thought,
however, is the adolescent’s feeling of invulnerability (eg, of being an
exception to the rule), resulting at times in experimentation without full
appreciation of the consequences of their actions. Further examination is
required of the relationship between cognitive development and risk-taking
behavior, particularly engagement in violent activities.
Previous research suggests a potential link between increased exposure of
children to violence in their family setting or community and subsequent
increased acts of violence. This finding suggests that violence may
involve a modeling process and reflect a socially learned behavioral response
to problematic situations and events, an interpretation that is consistent
with social learning theory. Social learning theory also suggests that
wide-scale changes in mass media to avoid modeling and reinforcement of
violent behavior through its glamorization will be essential to future efforts
to prevent violence in adolescents.[32,33] Furthermore, for self-directed
behavior change to occur, providing reasons to alter high-risk behavior is not
enough. Resources and social supports must be provided to facilitate change
It must be recognized that violence-related activities–and, indeed, the
violent act itself–entail certain perceived benefits and appeals. For
example, there is empiric evidence of a strong association between drug
trafficking and violence (including firearms violence). 35 36 Early
adolescents involved in drug trafficking report high levels of economic
motivation[37,38] and high levels of thrill seeking.[39,40] Since the
immediate rewards from engagement in risk behaviors may be highly positive,
adolescents are likely to perceive the benefits of violence-related
activities, with little regard for the potential risks.[41-43] Furthermore,
biologic changes and transitions in relationships between the family, peers,
and intimate relationships–all hallmarks of adolescence–will
significantly influence violence-related activities and interventions.
RACIAL AND SOCIOECONOMIC CONSIDERATIONS
Adolescence marks a transition in an individual’s development. It is a time
that requires the creation of a stable self-concept, both as an individual and
as a member of society. For African-American adolescents, there is the added
component of negotiating the minority experience as a member of a minority
race and an identity as an African American.[38,44,45] The integration of the
individual’s personal identity with his or her racial identity is particularly
challenging when poverty and racism interfere with the perceived pathways to
success and when local cultural systems run counter to national
norms.[38,46-48] Therefore, racial identity development must be incorporated
into a developmental model of violence prevention and intervention.
Furthermore, research efforts are needed to address the complex and
interactive sociocultural influences unique to different racial and
POTENTIAL LIMITATIONS OF THE STUDY
Although all three data sets (the Victimization Survey, the UCR Program, and
the NCHS mortality data) provide strong evidence of increased violence
adolescents, overall rates and trends are not consistent among the three data
sets. A possible explanation for differences in rates (the Victimization
Survey rates are consistently higher than the UCR Program data rates) and
trends (the UCR Program data show a steady increase in violent crime rates
while the Victimization Survey data show rates to be steady or decreasing)
lies in the different methods of data collection. The Victimization Survey is
based on active surveillance (eg, individuals are contacted and questioned
semiannually about their experience with crime), while the UCR Program
are acquired through passive surveillance (eg, victims are required to notify
the police of the violent act). Only 40% to 50% of crimes are reported to
police, possibly explaining the lower overall rates in the UCR Program
data. There is evidence of higher rates of reporting in recent years,
explaining in part the overall increase in violent crime seen in the UCR
Program data. The NCHS data, possibly the most reliable source of homicide
surveillance, are based on medical examiners’ judgments, which are subject to
error or bias as well.
FUTURE RESEARCH NEEDS
Health professionals concerned with adolescent violence have many questions
and few answers. Why are adolescents, independent of gender and race,
increasingly engaging in acts of violence? What are the consequences of early
involvement in acts of violence, as either the victim or the perpetrator? Why
are rates of violence higher among some adolescent demographic subgroups
others? Why are firearm-related homicides increasing among youths aged 10
24 years but decreasing for those aged 25 years and older?
In the late 1980s, the public health field recognized that the epidemic of the
acquired immunodeficiency syndrome had engulfed the adolescent
Therefore, new developmentally appropriate intervention approaches that
on those targeting adults were necessary.[41,49] Evidence exists that public
health research has responded to this challenge (B.S.; Nina Kim, Ma; Jennifer
Galbraith, MA; Maureen Parrott, MD; unpublished data, September 1994).
Likewise, it is time to recognize that the highest rates of violence and the
highest increases in violence are occurring not among adults but among
children. Researchers should draw on the substantial intervention and
developmental literature regarding adolescent risk behavior to incorporate
these data into national planning activities for primary, secondary, and
RELATIVE ARTICLE: MATERIALS AND METHODS
Crime data from the National Crime Victimization Survey (Victimization
Survey)[10-12] and the Uniform Crime Reporting (UCR) Program,
Janary 1973 and ending in December 1992, were examined. Homicides from
1991 were analyzed with the National Center for Health Statistics (NCHS)
mortality data[14,15] from the Centers for Disease Control and Prevention.
Firearth-related homicides from 1979 to 1991 were also analyzed with the
mortality data from the Centers for Disease Control and Prevention.
The Victimization Survey[10-12] data were obtained from a stratified,
multistage cluster sample of housing units. Housing units included family
households and group quarters, such as dormitories, rooming houses, and
religious group dwellings. A basic screening questionnaire and a crime
incident report were used to obtain victimization data. (For further
information on the survey method, see Sourcebook of Criminal Justice
Statistics–1993, Appendix 8.) Thus, the Victimization Survey addresses
crime from the perspective of the victim; homicide is not included in the
Victimization Survey, since this survey is based on self-report data.
Nationwide data on crimes are collected from individual law enforcement
agencies and tabulated by city, county, metropolitan statistical area,
demographic group, and geographic division. Statistics are published
annually, with a lag between incidence and reporting of about 6 months. The
UCR system collects basic information about the most serious crime
in a single event. Supplemental information about the circumstances of
homicides and characteristics of arrestees is also contained in this data set.
NCHS Mortality Data
These data are generated by the 50 states and the District of columbia.[14,15]
The statistics include age, gender, race, geographic data, and cause of death
coded according to the International Classification of diseases, Ninth
Revision. Data were obtained from the Centers for Disease Control and
Prevention. Data on firearm-related homicides were obtained through CDC
WONDER/PC Version 2, the on-line computer software package from the
for Disease Control and Prevention.
Although no standard definition of violence exists, violence is defined in
this article as “behaviors by individuals that intentionally threaten,
attempt, or inflict physical harm on others.” This broad definition,
therefore, includes all acts of violent crime and is compatible with the
definitions used by the UCR Program and the Victimization Survey. Personal
crimes of violence include homicide, rape, robbery, and assault (both
aggravated and simple). Rates of personal crimes of violence include both
attempted and completed crimes (unless otherwise specified) and always
contact between the victim and the offender.
The following definitions are those used by the UCR Program and the
Victimization Survey. Assault is an unlawful physical attack or threat of
attack. Aggravated assault consists of an attack with a resultant serious
injury or an attack with a weapon regardless of whether an injury occurred.
Simple assault consists of an attack without a weapon. If there is a resultant
injury, it is minor or, if undetermined, requires less than 2 days of
hospitalization. The UCR Program data do not categorize simple assault as
violent crime. Homicide includes both murder and nonnegligent manslaughter
(the willful killing of one human being by another). Rape is defined as carnal
knowledge through the use of force or the threat of force, including attempts
(statutory rape is excluded). The UCR Program data include only
of females. Robbery is defined as completed or attempted theft, directly from
a person, of property or cash by force or threat of force, with or without a
Analyses focused on two specific questions: (1) Is there evidence for
increased rates of acts of violence? (2) Is there evidence that a specific
demographic group is experiencing this increase disproportionate to the
general population? Given the exploratory nature of these analyses, specific
hypotheses were not articulated. Rather, each of the data sources described
above was explored for data relevant to these questions. Violent crime data
were examined overall and by specific sociodemographic variables. Trend
were available for all analyses of violent crime except age by gender by race.
For this three-way analysis, 1992 data were used. It was anticipated that
these analyses would lead to the formulation of hypotheses that could be
empirically tested in subsequent research as well as enable targeting of
subsequent intervention efforts.
[Figure 1 to 4 ILLUSTRATION OMITTED]
Accepted for publication January 30, 1995.
Reprint requests to Center for Minority Health Research, University of
Maryland, 712 W Lombard St, Baltimore, MD 21201 (Ms Rachuba).
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Baltimore (Dr Stanton).
— End –
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