Article Text
Abstract
Background Homicide is an extreme expression of violence that has attracted less attention from public health researchers and policy makers interested in prevention. The purpose of this study was to examine the socioeconomic gradient of homicide and to determine whether risk differs by immigration status.
Methods We conducted a population-based cohort study using linked vital statistics, census and population data sets that included all deaths by homicide from 1992 to 2012 in Ontario, Canada. We calculated age-adjusted death rates for homicide by material deprivation quintiles, stratified by immigration status. Count-based negative binomial regression models were used to calculate unadjusted and adjusted rate ratios with predictors of interest being age, urban residence, material deprivation and immigration status. A subanalysis containing immigrants only examined the effect of time since immigration and immigration class.
Results There were 3345 homicide deaths registered between 1992 and 2012. Relative to low material deprivation areas, age-adjusted rates of homicide deaths in high materially deprived areas were similar among refugees (RR: 48.49; 95% CI 36.99 to 62.45) and long-term residents (RR: 47.67; 95% CI 44.66 to 50.83), but were slightly lower for non-refugee immigrants (RR: 38.53; 95% CI 32.42 to 45.45). Female refugees experienced a 1.31 (95% CI 0.88 to 1.94) higher rate and male refugees experienced a 1.23 (95% CI 0.90 to 1.67) higher rate of homicide victimisation compared with long-term residents. In an immigrant only analysis, the risk of homicide among refugees increased with duration of residence.
Conclusions Given the large area-level, socioeconomic status gradients observed in homicides among refugees, community-level and culturally appropriate prevention approaches are important.
- violence
- socioeconomic
- record linkage
- prevention
- homicide
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Footnotes
Correction notice This article has been corrected since it first published. Changes have been made to the references.
Contributors LCR, PD and MO’N conceived the manuscript. MO’N and EB ran all analyses. JL and KK contributed to the study conceptualisation and analytic plan. MO’N and LCR drafted the manuscript. All authors edited, critically reviewed and approved the final content of the manuscript.
Funding This study was funded by a Canadian Institutes for Health Research Operating Grant (FRN-142498). LCR is supported by a Canada Research Chair in Population Health Analytics.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study obtained ethics approval from the Research Ethics Board at the University of Toronto (Protocol 32405).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data may be obtained from a third party and are not publicly available.
Author note In 2018, the Institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name.