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Murder and Medicine: The Lethality of Criminal Assault 1960-1999

NCJ Number
195590
Journal
Homicide Studies Volume: 6 Issue: 2 Dated: May 2002 Pages: 128-166
Author(s)
Anthony R. Harris; Stephen H. Thomas; Gene A. Fisher; David J. Hirsch
Date Published
May 2002
Length
39 pages
Annotation
Despite the proliferation of increasingly dangerous weapons and the large increase in rates of serious criminal assaults since 1960, the lethality of such assaults in the United States has declined significantly; this study tested the theory that parallel developments in medical technology and related medical support services had reduced deaths due to assaults.
Abstract
The study viewed homicides (defined as murders and nonnegligent manslaughters) as aggravated assaults that resulted in the victim's death. Factors that affect whether an aggravated assault victim lives or dies necessarily have a critical impact on the recorded homicide. These factors include the weapon used, injury characteristics, victim health-related characteristics, and health care delivery. The analysis began with an overall appraisal of changes in the lethality of criminal assault in the United States from 1960 to 1999. The study then assessed the possible link between these changes and changes in weaponry. Finally, using national countywide data on the presence of physicians, hospitals, trauma centers, and membership in regionalized trauma care systems, the study explored the link between lethality and the presence of medical resources. The analyses showed that, on a nationwide scale, there had been a continuous drop in lethality since 1960, and this drop was primarily attributable to developments in trauma care. A number of the alternative explanations of the decline in lethality were examined and found to have, at best, a modest influence. The study found considerable support for the hypothesis that advances in emergency medical care have greatly and increasingly reduced the lethality of violent assaults, with observed annual drops in such lethality ranging from 2.5 percent to 4.5 percent. This finding is consistent with general medical findings on trauma. While rigorously controlling for severity of injury, the medical findings have shown annual declines in trauma mortality that have ranged from 3 percent to more than 16 percent. The authors argue that research into the causes and deterrability of homicide would benefit from a "lethality perspective" that focuses on serious assaults, only a small proportion of which end in death. 3 figures, 2 tables, 21 notes, and 92 references