Waller Bernadine Y, Joseph Victoria A, Keyes Katherine M
Department of Psychiatry, Columbia University Irving Medical Center-New York State Psychiatric Institute, New York, NY, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Lancet. 2024 Mar 9;403(10430):935-945. doi: 10.1016/S0140-6736(23)02279-1. Epub 2024 Feb 8.
In the USA, Black women aged 25-44 years are disproportionately murdered compared with their White counterparts. Despite ongoing efforts to reduce racial and structural inequities, the result of these efforts remains unclear, particularly in light of the COVID-19 pandemic.
This study examined a cross-sectional time series of homicide death rates, by race, from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research system. We included data for women aged 25-44 years between 1999 and 2020 among 30 states in the USA. Homicide death was classified using underlying cause and multiple cause of death codes; mortality rates were calculated per 100 000 based on US Census Bureau population sizes. Homicide methods were classified as firearm, cutting or piercing, and other. Firearm homicides were compared with other homicides with logistic regression including covariates of race, time, and their interaction. We report odds ratios and 95% CIs.
In 2020, the homicide rate among Black women was 11·6 per 100 000, compared with 3 per 100 000 among White women. This inequity has persisted over time and is virtually unchanged since 1999. Homicide inequities vary across US states; in 11 states, racial inequities have increased since 1999. The racial inequity was greatest in Wisconsin, where in 2019-20, Black women aged 25-44 years were 20 times more likely to die by homicide than White women. Homicide by firearm is increasing in frequency; women in the USA had 2·44 (95% CI 2·14-2·78) times the odds of homicide involving firearms in 2019-20 compared with 1999-2003. Firearm homicide deaths are disproportionately concentrated among Black women in every region in the USA.
Our findings suggest that there is an urgent need to address homicide inequities among Black and White women in the USA. Enacting federal legislation that reduces gun access is a crucial step. Policy makers must address long-standing structural factors that underpin elevated gun violence by implementing sustainable wealth-building opportunities; developing desegregated, mixed income and affordable housing; and increasing green spaces in communities where Black women largely reside.
National Institute of Mental Health of the National Institutes of Health.
在美国，25至44岁的黑人女性被谋杀的比例高于白人女性。尽管一直在努力减少种族和结构性不平等，但这些努力的结果仍不明确，尤其是在新冠疫情的背景下。
本研究通过疾病控制与预防中心的广泛在线流行病学研究数据系统，对按种族划分的凶杀死亡率进行了横断面时间序列分析。我们纳入了美国30个州1999年至2020年期间25至44岁女性的数据。凶杀死亡根据根本死因和多种死因编码进行分类；死亡率根据美国人口普查局的人口规模按每10万人计算。凶杀方式分为枪支、切割或刺伤以及其他。通过逻辑回归比较枪支凶杀与其他凶杀，回归中纳入了种族、时间及其交互作用等协变量。我们报告比值比和95%置信区间。
2020年，黑人女性的凶杀率为每10万人11.6例，而白人女性为每10万人3例。这种不平等长期存在，自1999年以来几乎没有变化。美国各州的凶杀不平等情况各不相同；自1999年以来，11个州的种族不平等有所加剧。威斯康星州的种族不平等最为严重，在2019 - 20年，25至44岁的黑人女性死于凶杀的可能性是白人女性的20倍。枪支凶杀的频率在增加；与1999 - 2003年相比，2019 - 20年美国女性涉及枪支凶杀的几率是其2.44倍（95%置信区间2.14 - 2.78）。枪支凶杀死亡在美国各地区的黑人女性中分布极不均衡。
我们的研究结果表明，迫切需要解决美国黑人和白人女性之间的凶杀不平等问题。颁布减少枪支获取的联邦立法是关键一步。政策制定者必须通过实施可持续的财富积累机会、开发种族融合、混合收入且负担得起的住房以及增加黑人女性主要居住社区的绿地等措施，解决长期存在的导致枪支暴力高发的结构性因素。
美国国立卫生研究院国家心理健康研究所。
