Suzanne McLone

Rates of firearm homicide by Chicago region, age, sex, and race/ethnicity, 2005-2010

Background The United States reports the highest levels of firearm homicide incidences compared to other high income countries,1 and the focus and causes of these incidences within the US differ by demographic characteristics and location such as urban versus rural environment. Despite these findings, few studies have published on rates varied by region within a city. Objective This study aims to provide descriptive analysis of the rates of firearm homicide by age, sex, and race/ethnicity in each of the seven City of Chicago regions, and to determine if the rates of firearm homicide differ by demographics among the seven City of Chicago regions. Methods The Illinois Violent Death Reporting System conducts routine surveillance of violent deaths. Decedents were selected according to the following criteria: manner of death was homicide, weapon type was firearm, and location of injury that led to death was the City of Chicago. Location of injury was broken down by regions: North, Northwest, Center, West, South, Southwest, and Far South. Multiyear rates per 100,000 and corresponding 95% confidence intervals were calculated. Results There were 2,254 victims of homicide by firearm in the City of Chicago. The overall rate across Chicago for all demographics was 12.9 (12.1–13.5 per 100,000) with an average age of 27.4. The highest age group (20–24) for firearm homicide rates was 43.2 (39.7–46.7) per 100,000. For the youngest age group (10–14), only the Southwest (3.3–10.4) region reported any firearm incidence. The 20 to 24 age group reported the highest rates of all age groups within the South (107.9–151.7), West (80.3–108.2), and Far South (69.6–105.3) regions, whereas the North and Northwest reported the lowest rates for all regions by age. Black firearm homicide rates were 33.5 (31.9–35.1) per 100,000 versus Hispanic and non-Hispanic white firearm homicide rates of 8.5 (7.7–9.3) and 1.2 (1–1.5) per 100,000, respectively. Lastly, the West reported the highest firearm rates at 29.1 (657). Conclusion In conclusion, Chicago is a large city that has high variation in firearm homicide rates among its constituent regions; therefore, an overall firearm homicide rate for the city of Chicago as a whole is not an accurate representation of the true nature of firearm homicides. Policy implementation may be made more effective by providing more regional analysis and targeted interventions via multipronged initiatives to help reduce future firearm rates, and funding for issues that address systemic poverty and adequate access to care and medical facilities. LEVEL OF EVIDENCE Epidemiologic study, level IV.

Factors associated with suicide among adolescents and young adults not in mental health treatment at time of death

BACKGROUND Suicide is the third-leading cause of death among Illinois residents aged 15 to 24 years. The Illinois Violent Death Reporting System (IVDRS) was developed to help prevent these deaths by providing timely, complete data. Understanding the circumstances surrounding suicide for those aged 15 to 24 years who are not receiving mental health treatment can help others: (1) recognize signs of potential crisis and (2) connect them to mental health treatment. METHODS The IVDRS data were collected from five Illinois counties—Cook, DuPage, Kane, McHenry, and Peoria—from 2005 to 2010. All cases with the manner suicide, aged 15 to 24 years, were extracted for analysis. Data were described using frequencies and percentages, and statistical differences between groups were determined using &khgr;2 analysis. RESULTS There were a total of 386 suicides in those aged 15 to 24 years in IVDRS from 2005 to 2010. Most 15- to 19-year-olds (67%) and 20- to 24-year-olds (78%) were not receiving mental health treatment at the time of death. Among those not receiving mental health treatment, 22% and 13% of those aged 15 to 19 and 20 to 24 years, respectively, had disclosed their intent to commit suicide to another. One third were identified as being depressed or in a depressed mood (not necessarily a clinical diagnosis) in both age groups. One quarter in both age groups experienced a crisis (current, acute precipitating, or forthcoming event) within 2 weeks of their suicides. CONCLUSIONS The majority of adolescents and young adults were not in mental health treatment at the time death. Among those not in mental health treatment at the time of death, the 15- to 19-year-olds were more likely to share their suicidal intentions than the 20- to 24-year-olds. LEVEL OF EVIDENCE Epidemiological study, level IV.

Suicide in Illinois, 2005-2010: a reflection of patterns and risks by age groups and opportunities for targeted prevention

BACKGROUND Suicide accounts for two thirds of all deaths from intentional or violence-related injury and is a leading cause of death in the United States. Patterns of suicide have been well described among high-risk groups, but few studies have compared the circumstances related to suicides across all age groups. We sought to understand the epidemiology of suicide cases in Illinois and to characterize the risks and patterns for suicide among different age groups. METHODS We used suicide data collected from the Illinois Violent Death Reporting System to assess demographics, method of suicide, circumstances, and mental health status among different age groups. RESULTS Between 2005 and 2010, 3,016 suicides were reported; 692 (23%) were female, and the median age (n = 3,013) was 45 years (range, 10–98 years). The most common method/weapon types were hanging/strangulation (33%), firearm (32%) and poisoning (21%). Hanging was more common (74%) among young people aged 10 to 19 years, while firearm use was more common among elderly persons age 65 years and older (55%). The percentage of victims within an age group experiencing a crisis within two weeks before committing suicide was highest among 10- to 14-year-olds, while the risk factor of having a family member or friend die in the past 5 years was highest among older victims. CONCLUSION The final analysis demonstrated age-related trends in suicide in Illinois, suggesting prevention programs should tailor services by age. LEVEL OF EVIDENCE Epidemiologic study, level IV.

Educational Attainment of Male Homicide Victims Aged 18 to 24 Years in Chicago: 2006 to 2015:

Homicide is a preventable public health issue that has detrimental effects on both victims and witnesses and increases health care costs. From 2006 to 2015, homicide has been the second leading cause of death for youth aged 15 to 24 years in the United States. Educational attainment has been widely regarded as a protective factor against justice system involvement and violent injury. We conducted a time-trend analysis examining educational attainment levels for male victims of homicide aged 18 to 24 years in the City of Chicago, 2006 to 2015, to describe the educational attainment of youth homicide victims in Chicago. We used data from the Illinois Violent Death Reporting System and the United States Census Bureau from 2006 to 2015. Cases included male victims of homicide, 18 to 24 years of age, the injury leading to death occurred in the City of Chicago, injury leading to death occurred between 2006 and 2015, and whether or not a high school degree or equivalent had been obtained. Data were described over time using percentages and rates per 100,000 with 95% confidence intervals. Chicago male homicide victims aged 18 to 24 years were less likely to have at least a high school degree than the general population of males aged 18 to 24 years in Chicago. The homicide rate for males aged 18 to 24 years without a high school degree was significantly higher than those with a high school degree or equivalent for every time point, except 2007, and also in four of the seven Chicago Planning Regions when compared with the other three. We found there is a concentrated risk pool for undereducated male youth in Chicago.

PW 2633 Homicides in chicago, 2017: a striking decline

Background Homicides in Chicago increased 57% from 2015 to 2016. The first half of 2017 was on par with the first half of 2016. However, August, 2017, marked a dramatic, sustained decrease in homicide deaths, with a net decrease of 18% compared to 2016. Objective To examine the differences among homicide victims in Chicago between two distinct time periods in 2017 by victim demographics, location of residence compared to location of fatal injury, and weapon type. Methods The Illinois Violent Death Reporting System (IVDRS), a statewide surveillance system, collects data from multiple sources, and is the most accurate and timely source of homicide data in Chicago. Using preliminary data from IVDRS, we discovered a sustained decline in homicides beginning in August 2017 and divided cases into two groups, based on date of death: January to July of 2017 and August to December of 2017. Victim demographics, zip code of victim’s residence compared to zip code where the fatal injury occurred (same versus different) and weapon type (firearm versus non-firearm) were analyzed between the two groups using chi-square analysis. Conclusion There was a significant decrease in the proportion of homicide victims aged 15 to 24 that occurred between August 1-December 31, 2017 compared to January 1-July 31, 2017 (36.4% versus 44.5%, respectively [p<0.05]). More specifically, there was a significant decrease in the proportion of victims aged 15 to 24 years who died by firearm (37.7% versus 47.2%, respectively [p<0.05]). Policy implications This significant drop in homicides – and in particular, firearm homicides – among 15 to 24 year olds is positive news. However, we do not yet understand the factors that may have precipitated this change. A careful examination of factors associated with this change is needed to inform policies and programs going forward.

Child deaths of undetermined intent: An analysis of circumstances using Illinois Violent Death Reporting System data

BACKGROUND There is little information available about the circumstances surrounding the deaths of children aged 0 to 14 years in which the manner of death is of undetermined intent. METHODS We analyzed data collected in the Illinois Violent Death Reporting System to describe victim demographics, location of injury, seasonality, day of week, and circumstances surrounding the victims’ deaths. RESULTS From 2005 to 2010 in Cook County, Illinois, 192 cases were identified of children aged 0 to 14 years, in which the manner of death was of undetermined intent. The majority of cases were younger than 1 year (81%), male (62%), and non-Hispanic black (66%); occurred in the City of Chicago (65%); and also occurred most frequently during the months of May (15%) and July (13%) and on Sunday (19%). Circumstances of note were having information on the location of death available for the victim (90%); scene investigation was not performed/unknown/not documented (81%); and the victim not presenting with red petechiae (84%). By ethnicity, a lower proportion of Hispanic victims had parental drug information available compared with non-Hispanic victims (17% and 40%, respectively; p = 0.017); Hispanic victims were more likely than non-Hispanic victims to have a documented acute illness at the time of injury leading to death (57% and 33%, respectively; p = 0.015). The availability of scene information and the successful contact of one or both parents of the victim following the victim’s death varied by location. CONCLUSIONS No public health surveillance system exists for the collection of this type of death. There is not enough information provided to develop an effective intervention. The systematic, thorough collection of information surrounding these deaths is necessary to pinpoint possible contributing mechanisms of death for these children. LEVEL OF EVIDENCE Epidemiologic, level IV.

Factors associated with intimate partner homicide in Illinois, 2005-2010: Findings from the Illinois Violent Death Reporting System

BACKGROUND Critical elements in intimate partner homicides (IPH) often go undocumented. Previous studies have highlighted precipitating causes, but few have examined the place of injury that led to the victim’s death. We sought to describe IPH cases in Illinois and in particular to examine factors surrounding the location of injury that led to the victim’s death. METHODS We analyzed data collected in the Illinois Violent Death Reporting System to assess victim demographics, perpetrator characteristics, the victim/perpetrator relationship, and circumstances surrounding the location of injury that led to the victim’s death. RESULTS From 2005 to 2010, 275 cases were identified as IPH. Women comprised 60.4% of victims and men 39.6%. Among perpetrators, 78.5% were identified as male and 21.5% as female. Of the 31 corollary victims, 54.8% were less than 18 years and 58.1% were injured in front of a family member. Females were 1.6 times more likely to have the injury that led to their death occur at their residence, as compared to males (OR 1.6, 95% CI 1.1–2.9). Cases in which the perpetrator had documented history of abuse were 2.4 times more likely to have the fatal injury occur at the victim’s residence compared to those that did not have previous history (OR 2.4, 95% CI 1.2–4.8). IPH cases in which the perpetrator was the current partner of the victim were twice as likely to have the injury leading to the victim’s death occur at the victim’s residence compared to those perpetrators who were not a current partner (OR 2.1, 95% CI 1.2–3.5). CONCLUSIONS Considering the increased risk of IPH occurring at the place of residence for women at the hands of current intimate partners and by perpetrators with a previous history of abuse, prevention efforts may wish to prioritize in-home and relocation intervention strategies. LEVEL OF EVIDENCE Epidemiologic, level IV.

113 Homicides in the city of chicago, 2008–2016

Statement of purpose This analysis seeks to describe the temporal and demographic trends of homicides in the City of Chicago. Methods/Approach Data from the Illinois Violent Death Reporting System (IVDRS) were used for this analysis. Cases included: homicide victims in which the fatal injury occurred in Chicago, and the date of death occurred 2008–2016. Linear regression, ANOVA and Pearson’s chi-square were used to determine trends over time for number of homicides, age of homicide victims, and sex and race/ethnicity of homicide victims, respectively. Results From 2015 to 2016, there was a 59.6% increase in the number of homicides in Chicago (515 to 822); increases were seen in all twelve calendar months, ranging from 7.8% (August) to 144.1% (October). From 2008 to 2016, there was not a significant trend over time in the number of homicides, overall or for any single calendar month, or by age of homicide victims. There was a significant, positive trend over time in the proportion of black (p=0.002) and male (p=0.043) victims. There was a significant, negative trend over time in the proportion of Hispanic victims (p=0.039). The proportion of homicide victims who were black and male increased significantly over time (p<0.001), and ranged from 63.2% in 2008 to 72.8% in 2016. Conclusions Overall, from 2008 to 2016 there was no significant trend in homicides. However, the number of homicides in Chicago increased dramatically from 2015 to 2016, and more than doubled in February, October and November. Black males were disproportionately affected, and the disparity has increased significantly over time from 2008 to 2016. Significance and Contributions to Injury and Violence Prevention Science This is a classic descriptive analysis which looks at temporal and demographic trends among victims of homicide in Chicago over time which allows a more nuanced understanding of the homicide epidemic in Chicago.

26 Law enforcement-involved deaths in illinois 2005–2010 --demographics and circumstances regarding initiation of contact

Statement of Purpose To report demographics and selected circumstances surrounding law enforcement-involved deaths in five Illinois counties from 2005–2010. Methods/approach Data come from the Illinois Violent Death Reporting System (IVDRS) which collects information from death certificates, coroner/medical examiner, and law enforcement reports. Cases identified as law enforcement deaths occurring between 2005 and 2010 were pulled from the IVDRS. Cases were analysed using descriptive methods for decedent age, race/ethnicity, toxicology, and weapon type. Narrative statements summarising details of each incident were analysed using qualitative methods, focusing on the circumstances regarding the initiation of contact between law enforcement and the decedent. Thematic categories fitting the data were developed from data using inductive methods. Results/Conclusions 129 cases meeting study criteria were identified. The majority of incidents (68.5%) involved Black decedents, median decedent age was 27 years old. Most (96.8%) of these incidents involved firearms and all of the 52.7% of incidents with recorded firearm type involved handguns. Nearly half (44.4%) of decedents tested positive for alcohol, 44.4% tested positive for cocaine, 4.1% tested positive for opiates. We identified three broad categories regarding contact initiation between law enforcement and decedents: 1) calls for service for a crime in progress excluding self-harm/domestic violence, 2) calls for domestic violence/self-harm and 3) officer initiated contacts (traffic stops, suspected suspicious activity). Significance and Contributions to Injury and Violence Prevention Science While there is some emerging data about the demographics of decedents in law enforcement deaths, there are no studies we are aware of that use surveillance data to identify patterns in circumstances surrounding the initiation of incidents resulting in law enforcement deaths. These study findings contribute to improved understanding of the circumstances associated with the initiation of incidents and can inform efforts to prevent law enforcement deaths.