Homicide rates among US teenagers and young adults - Differences by mechanism, level of urbanization, race, and sex, 1987 through 1995

Context. - Homicide rates for persons 15 through 24 years old began to decline between 1993 and 1994, but recent trends in homicide rates by mechanism of homicide and urbanization group have not been described. Objective. - To examine homicide trends from 1987 through 1995 for persons 15 through 24 years old by urbanization level. Design. - Homicide rates by urbanization level were analyzed using the Compressed Mortality File, a county-level mortality and population database maintained by the National Center for Health Statistics, Centers for Disease Control and Prevention, and the rural-urban continuum codes developed by the Economic Research Service, US Department of Agriculture. Setting. - United States, 1987 through 1995, according to 5 urbanization strata, core, counties with the primary central city of a metropolitan statistical area (MSA) of 1 million or more; fringe, remaining counties within an MSA of 1 million or more; medium, counties within an MSA of 250000 to 999999; small, counties in an MSA of less than 250 000; and nonmetropolitan, counties not in an MSA. Subjects. - All persons 15 through 24 years old by race whose cause of death was homicide (International Classification of Diseases, Ninth Revision codes E960-E969). Main Outcome Measures. - Firearm and nonfirearm homicide rates and average annual percentage changes by 5 urbanization levels, race, and sex. Results. - From 1987 through 1991, the average annual firearm homicide rates among persons 15 through 24 years old among all 5 urbanization strata increased between 10.7% in small counties and 19.8% in fringe counties. From 1991 through 1993, the rates increased between 3.3% in core counties and 11.7% in small counties. From 1993 through 1995, the rates declined between 4.4% in fringe counties and 15.3% in medium counties. By 1995, firearm homicide rates among persons 15 through 24 years old ranged from 6.5 and 7.3 per 100000 in the nonmetropolitan and small counties, respectively, to 9.6 and 13.3 per 100000 in the fringe and medium strata, respectively, to 33.5 per 100000 in the core stratum. During 1987 through 1990, nonfirearm homicide rates either were stable or increased, acid from 1990 through 1995, nonfirearm homicide rates declined in all 5 strata, on average 3.7% to 8.0% per year, with rates in 1995 ranging from 2.1 to 4.7 per 100000 across the strata. Conclusions. - After increasing since 1987, firearm and nonfirearm homicide rates began declining between 1993 and 1995 among persons 15 through 24 years old. These declines are taking place across all urbanization strata and among white and black males and females.