Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.
Public Health Ontario, Santé publique Ontario, 480 University Avenue, Suite 300, Toronto, ON, M5G 1V2, Canada.
Int J Equity Health. 2017 Jul 24;16(1):133. doi: 10.1186/s12939-017-0632-9.
Homicide - a lethal expression of violence - has garnered little attention from public health researchers and health policy makers, despite the fact that homicides are a cause of preventable and premature death. Identifying populations at risk and the upstream determinants of homicide are important for addressing inequalities that hinder population health. This population-based study investigates the public health significance of homicides in Ontario, Canada, over the period of 1999-2012. We quantified the relative burden of homicides by comparing the socioeconomic gradient in homicides with the leading causes of death, cardiovascular disease (CVD) and neoplasm, and estimated the potential years of life lost (PYLL) due to homicide.
We linked vital statistics from the Office of the Registrar General Deaths register (ORG-D) with Census and administrative data for all Ontario residents. We extracted all homicide, neoplasm, and cardiovascular deaths from 1999 to 2012, using International Classification of Diseases codes. For socioeconomic status (SES), we used two dimensions of the Ontario Marginalization Index (ON-Marg): material deprivation and residential instability. Trends were summarized across deprivation indices using age-specific rates, rate ratios, and PYLL.
Young males, 15-29 years old, were the main victims of homicide with a rate of 3.85 [IC 95%: 3.56; 4.13] per 100,000 population and experienced an upward trend over the study period. The socioeconomic neighbourhood gradient was substantial and higher than the gradient for both cardiovascular and neoplasms. Finally, the PYLL due to homicide were 63,512 and 24,066 years for males and females, respectively.
Homicides are an important cause of death among young males, and populations living in disadvantaged neighbourhoods. Our findings raise concerns about the burden of homicides in the Canadian population and the importance of addressing social determinants to address these premature deaths.
杀人——一种暴力的极端表现——尽管杀人是可预防和过早死亡的原因，但很少受到公共卫生研究人员和卫生政策制定者的关注。确定处于危险之中的人群和杀人的上游决定因素对于解决阻碍人口健康的不平等问题很重要。本项基于人群的研究调查了 1999 年至 2012 年期间加拿大安大略省杀人事件对公共卫生的影响。我们通过比较杀人事件与主要死因（心血管疾病 (CVD) 和肿瘤）的社会经济梯度，量化了杀人事件的相对负担，并估计了因杀人而导致的潜在寿命损失 (PYLL)。
我们将安大略省登记处死亡登记处（ORG-D）的生命统计数据与人口普查和所有安大略省居民的行政数据相链接。我们使用国际疾病分类 (ICD) 代码从 1999 年至 2012 年提取了所有杀人、肿瘤和心血管死亡事件。对于社会经济地位 (SES)，我们使用了安大略省边缘化指数 (ON-Marg) 的两个维度：物质剥夺和居住不稳定。使用特定年龄的发病率、发病率比和 PYLL 来概括不同剥夺指数的趋势。
15-29 岁的年轻男性是杀人案的主要受害者，其发病率为每 100,000 人 3.85 [95%置信区间：3.56；4.13]，且在研究期间呈上升趋势。社会经济邻里梯度很大，且高于心血管疾病和肿瘤的梯度。最后，男性和女性因杀人而导致的潜在寿命损失分别为 63,512 年和 24,066 年。
杀人是年轻男性和生活在弱势社区人群的重要死亡原因。我们的研究结果引起了人们对加拿大人口中杀人事件负担的关注，以及解决这些过早死亡问题的重要性。
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