Murder of the Elderly: An Analysis of Increased Vulnerability

1983 ◽  
Vol 13 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Sheryl Kunkle ◽  
John A. Humphrey

The vulnerability of older persons to murder is investigated. Data on all homicide victims sixty years of age or older in North Carolina during two time frames, 1972–1973 and 1976–1977, form the basis for the analysis. Available evidence for the U.S. indicates that the elderly are considerably less prone to criminal victimization than are younger persons. This is particularly the case for aggravated assault. Dussich and Eichman have posited that the relative low visibility of the elderly, due to social isolation and lack of mobility, make them less vulnerable to crimes against the person [1]. However this study finds that: 1) in the U.S. murder among the aged is rising faster than any other age group, 2) in North Carolina the sole rise in homicide is among the elderly, and 3) sharpest increases are noted among older black women, white women and white men. An exception to this trend are black men, previously the highest risk group of older adults, who showed a decline in homicide victimization.

2020 ◽  
pp. 108876792093931
Author(s):  
Shytierra Gaston ◽  
CheyOnna Sewell

This study contributes to homicide research by parsing out the Hispanic Effect and applying an intersectional approach to examining U.S. homicide victimization trends by race, ethnicity, and gender, jointly. Drawing on mortality data, we document and describe total, firearm, and non-firearm homicide victimization rates from 1990 to 2016 for six subgroups: Black women, Black men, Hispanic women, Hispanic men, White women, and White men. The analysis of within- and between-group homicide trends reveals important subgroup-specific patterns that prior studies using aggregate or confounded data have masked. The findings have important research, theory, and policy implications and advocate for an intersectional approach to studying homicide.


2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.


2021 ◽  
pp. 1-17
Author(s):  
Abby G. Lieberman ◽  
Michelle L. Stock ◽  
Katarina E. AuBuchon ◽  
Janine B. Beekman ◽  
Sharon F. Lambert

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Gursukhman Sidhu ◽  
Charisse J Ward ◽  
Keith Ferdinand

Introduction: Despite a recent gradually slowing and perhaps recent increase in the burden of atherosclerotic cardiovascular disease (ASCVD) related hospitalization in the United States population with diabetes, it is unclear whether the prior downward trend was uniform or there was an unbalanced division amongst sex and race. Methods: Adults aged ≥40 years old with comorbid diabetes as a secondary diagnosis were identified using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The prevalence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), procedures like major amputations in the secondary diagnosis field and their association with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis were determined. Complex samples multivariate regression was used to determine the odds ratio (O.D.) with 95% confidence limits (C.L.s). Sex and race risk-adjusted ASCVD related in-hospital mortality rates were estimated. Results: The rate of total ASCVD hospitalizations adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women cumulatively compared to a stable downtrend in white men and white women. There was a higher odd of an ASCVD hospitalizations if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% Confidence Interval (CI) 95% 1.28 - 1.31), dyslipidemia (OR 2.03; 95% CI 2.01 - 2.05), renal failure (OR 1.84; 95% CI 1.82 - 1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29 - 1.33). When compared to white men, black men (OR 1.43; 95% CI 1.3 - 1.57) and black women (OR 1.15; 95% CI 1.04 - 1.27) had a higher likelihood of undergoing a major limb amputation during an ASCVD hospitalization. Conclusions: Blacks with diabetes continue to have a higher hospitalizations burden with a concomitant disparity in procedures and outcomes.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christina M Shay ◽  
Prasenjeet N Motghare ◽  
David R Jacobs ◽  
Cora E Lewis ◽  
J. Greg Terry ◽  
...  

Background: Higher visceral adipose tissue (VAT) volume is associated with greater risk for hypertension (HTN). Although VAT volume and prevalence of HTN vary by sex and race, the differences in VAT volumes associated with identification of individuals with prevalent HTN across these groups is unclear. Objective: To determine VAT volume cut points that maximize true positive, true negative and optimal identification of prevalent HTN and to compare the cut points across sex and race groups. Methods: Data were examined from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center longitudinal study of the development of cardiovascular risk in black and white men and women ages 18-30 years at baseline. In 2010-11, the Year 25 exam was performed (43-55 years) and VAT volume (cm3) was quantified by computed tomography based on two 5 mm contiguous slices at the level of the 4th-5th lumbar vertebra (n=3,153). HTN was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg and/or anti-hypertension medication use. Receiver operating characteristic (ROC) curve analysis was used to identify VAT volume cut points associated with true positive, true negative and optimal identification of prevalent HTN. Results: Year 25 prevalence of HTN ranged from 18.2% (white women) to 49.4% (black women); mean VAT volume ranged from 113.5 cm3 (white women) to 172.1 cm3 (white men). White males exhibited the highest VAT volumes (22-36% higher) and black women exhibited the lowest VAT volumes (3-50% lower) associated with true positive, true negative and optimal identification of HTN compared to other race/sex groups (Table 1). VAT volumes associated with HTN among black participants were generally lower than those exhibited for whites. Conclusions: Although the utility of VAT alone to identify HTN cases is modest - likely a result of unaccounted HTN confounders - these findings display the distinct race- and sex-specific differences in VAT volumes associated with prevalent HTN in middle age adults.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Raegan Durant ◽  
Stephen Glasser ◽  
Christopher Gamboa ◽  
...  

Introduction: To identify potential targets for eliminating disparities in cardiovascular disease outcomes, we examined race-sex differences in awareness, treatment and control of hyperlipidemia in the REGARDS cohort. Methods: REGARDS recruited 30,239 blacks and whites aged ≥45 residing in the 48 continental US between 2003-7. Baseline data were collected via telephone interviews followed by in-home visits. We categorized participants into coronary heart disease (CHD) risk groups (CHD or risk equivalent [highest risk]; Framingham Coronary Risk Score [FRS] >20%; FRS 10-20%; FRS <10%) following the 3 rd Adult Treatment Panel. Prevalence, awareness, treatment and control of hyperlipidemia were described across risk categories and race-sex groups. Multivariable models examined associations for hyperlipidemia awareness, treatment and control between race-sex groups compared with white men, adjusting for predisposing, enabling and need factors. Results: There were 11,677 individuals at highest risk, 847 with FRS >20%, 5791 with FRS 10-20%, and 10,900 with FRS<10%; 43% of white men, 29% of white women, 49% of black men and 43% of black women were in the highest risk category. More high risk whites than blacks were aware of their hyperlipidemia but treatment was 10-17% less common and control was 5-49% less common among race-sex groups compared with white men across risk categories. After multivariable adjustment, all race-sex groups relative to white men were significantly less likely to be treated or controlled, with the greatest differences for black women vs. white men (Table). Results were similar when stratified on CHD risk and area-level poverty tertile. Conclusion: Compared to white men at similar CHD risk, fewer white women, black men and especially black women who were aware of their hyperlipidemia were treated and when treated, they were less likely to achieve control, even after adjusting for factors that influence health services utilization.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6572-6572
Author(s):  
Katherine Elizabeth Reeder-Hayes ◽  
Anne-Marie Meyer ◽  
Stacie Dusetzina ◽  
Huan Liu ◽  
Stephanie B. Wheeler

6572 Background: Oral endocrine therapy (ET) is the cornerstone of adjuvant therapy for hormone receptor-positive (HR+) breast cancer, greatly reducing the risk of recurrence and death when taken for at least 5 years. Failure to initiate ET is a known problem that adversely affects recurrence and survival. The survival gap between black and white women with breast cancer is most pronounced in HR+ subtypes, and could be related to differences in ET use. The relationship between race and failure to initiate ET is not well defined. We investigated patterns of ET initiation by race in a diverse cohort of women covered by commercial health insurance. Methods: We identified 2753 women with incident HR+ breast cancer in the North Carolina Central Cancer Registry whose records linked to insurance claims using the statewide Integrated Cancer Information and Surveillance System (ICISS) database maintained by the University of North Carolina. The sample included privately insured women age <65 years who were diagnosed with stage I-III HR+ breast cancer between 2004 and 2009 and received primary therapy including breast surgery within 12 months of diagnosis. We used multivariate Poisson regression with robust variance to examine the effect of race on likelihood of initiating ET (tamoxifen, anastrozole, letrozole or exemestane). Results: 14% of eligible women did not initiate any form of ET within 12 months of diagnosis. Black women initiated ET at a significantly lower rate (IRR 0.83, 95% CI 0.73-0.93) after adjustment for age, disease characteristics, other treatments, and socioeconomic variables. Women receiving breast conserving surgery (BCS) without radiation (RT) were less likely to initiate compared to those receiving BCS + RT or mastectomy, and women whose treatment included chemotherapy were less likely to initiate ET. Conclusions: Black women in our sample were significantly less likely to initiate ET in a timely fashion than their white counterparts. This underutilization may contribute to the pronounced survival gap among black women with HR+ breast cancer, and represents an opportunity for intervention to reduce breast cancer disparities. Further investigation is needed to understand the reasons why black women do not initiate ET.


2017 ◽  
Vol 27 (4) ◽  
pp. 371 ◽  
Author(s):  
Thierry Gagné ◽  
Gerry Veenstra

<p>A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001- 2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (ORHT = .98, 95% CI (.97, .99); ORDM = .93, 95% CI (.92, .94)) and White women (ORHT = .95, 95% CI (.95, .96); ORDM = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (ORHT = .99, 95% CI (.92, 1.06); ORDM = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (ORHT = .86, 95% CI (.80, .92); ORDM = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.</p><p><em>Ethn Dis.</em>2017;27(4):371-378; doi:10.18865/ ed.27.4.371. </p>


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