Results – In 1990, an estimated 1,851,000 people worldwide died of violence (35.3 per 100,000). An estimated 786,000 suicides were committed. Total suicide rates ranged from 3.4 per 100,000 in sub-Saharan Africa to 30.4 per 100,000 in China. An estimated 563,000 homicides were committed. Overall homicide rates ranged from 1.0 per 100,000 in established market economies to 44.8 per 100,000 in sub-Saharan Africa, with peaks among men aged 15 to 24 and women aged 0 to 4. An estimated 502,000 war-related deaths, with peaks in rates for both sexes among people aged 0-4, 15-29 and 60-69. Every year, seven people a day die a violent death in the United States. According to the National Vital Statistics System of the National Center for Health Statistics, more than 19,100 people were homicide victims and more than 47,500 people committed suicide in 2019 alone (the latest year for which data are available). nvDRS data delve deeper into the circumstances (events that preceded a victim`s death or were classified as related) and other contexts of these violent deaths. This study describes for the first time epidemiological trends in violence-related mortality (including murder, suicide and war) for the world and its major regions.

Archival data from The Global Burden of Disease3 series are used to provide global estimates of war-related homicide, suicide and death rates, by age and sex and age. State laws require that death certificates be filed for all deaths and that violent deaths, including homicides, suicides, and deaths with indefinite intent, be reviewed by a coroner or medical examiner. States that receive funding for NVDRS agree to report anonymized data to the CDC. All violent deaths in Connecticut and violent deaths of Connecticut residents that occur outside the state are included in the CTVDRS. Rate of violence-related deaths by region, 1990 (EME (−US) = established market economies excluding the United States; ESF = former socialist economies; LAC = Latin America and the Caribbean; MEC = Middle East Crescent; OAI = other Asia and islands; SSA = Sub-Saharan Africa). NVDRS seeks to address the causes of violent deaths (the «why») by understanding the «who, when, where and how» of these deaths. Circumstances are documented by law enforcement agencies and coroners/medical examiners, and NVDRS integrates this information so that it can be shared by states and communities to better understand the context of violent deaths. In 1990, an estimated 502,000 war-related deaths worldwide (9.3 per 100,000) were recorded (Table 1). The overall rate of war-related deaths ranged from 52.9 per 100,000 in sub-Saharan Africa to no deaths in the United States, emerging markets (-United States) and China. The rate of war-related deaths was highest in sub-Saharan AFRICA, mec and ESF. The ratio of men to women and war-related mortality rates worldwide is 1.3.

The male-to-female ratios for war-related deaths do not differ significantly for war regions: ESF (1.3), OAI (1.5), SSA (1.4), LAC (1.5) and MEC (1.3). At the beginning of the CTVDRS project, an advisory board was established to facilitate the development and monitor the ongoing progress of the project. The Board of Directors meets quarterly and focuses on technical advice and, where necessary, strategic support for data acquisition. In addition, the Council will help develop and articulate effective strategies for the prevention of violent deaths, including problem identification, policy development and evaluation. Our results showed that the number of war-related injuries that resulted in death was similar among women and men. In addition, we found that in areas where wars have taken place, children and women account for a large proportion of war-related deaths. These findings are consistent with the literature indicating that war has devastating effects on the health of civilians.34-37 War also affects the health of children, women and men by reducing access to adequate food, water, shelter and transportation, and by damaging health infrastructure that protects the population from other negative health consequences.34, 36-38 War-related mortality rates in some regions and nation-states can vary significantly from year to year as the political climate and circumstances change. As a result, the regional trends in war-related deaths presented in these 1990 data may be very different from those we will see in the future. We calculated approximate and age-adjusted mortality rates per 100,000 population for each region for suicide, murder, war and general violence. Age-adjusted rates were calculated using the standard global population.21 For each region, age and sex mortality rates per 100,000 population were calculated.

Male-to-female ratios were also calculated for each region by dividing male mortality rates by rates for females. Because violence-related deaths in the U.S. claim to be different from those in other high-income countries,12 we looked at rates in the U.S. separately from other emerging markets. To calculate U.S. rates, we subtracted the number of deaths and the U.S. population from the EME estimates. Unless otherwise noted, all rates have been age-adjusted. NVDRS data is stored in an event-based database. Descriptive data is accessible free of charge via the Web-based Injury Statistics and Queries System (WISQARS). More detailed NVDRS data is available through the NVDRS Restricted Access Database (RAD).

NVDRS RAD is a de-identified, multi-year, multi-level, case-level dataset consisting of hundreds of unique variables. The dataset is available to researchers who meet certain criteria. The RAD database also contains short accounts describing violent deaths, including descriptions summarized by law enforcement agencies and reports from coroners and medical investigators. Access to NVDRS RAD is free. To learn more about this data, admission requirements and the application process, please visit our data access website. Suicide rates were highest in China and former socialist economies, murder rates were highest in sub-Saharan Africa and Latin America/Caribbean, and war-related death rates were highest in sub-Saharan Africa and the growing Middle East. 3. Q: From the Trevor Project: The number of all cases related to the response to sexual orientation of the 1st (gay), 2nd (lesbian), 3rd (bisexual) or 9th (unknown) for violent deaths in Connecticut? The methods used to estimate mortality data for each region are explained in detail in the first volume of The Global Burden of Disease.3,4 Due to the different availability of mortality vitality data, different methods were used to calculate mortality data.4 Estimates for EME and FSE were obtained from vitality recording data. However, estimates for China and India were calculated using sample registration data. In China, sample registration data is based on a unique cause-of-death tracking system in a representative sample of counties called disease surveillance sites, covering 10 million people in rural and urban areas. Unlike China, the sample registration data used in India comes from two separate systems used in urban and rural areas.

For the other regions, reliable mortality data were limited and were not considered representative of the entire population. To address this limitation, cause of death structures were used to estimate the distribution of causes by age and sex for regions in these regions for which valid death registration data were not available (i.e., other regions). The first step was to estimate the overall mortality rate in residual areas using the Lorenz curve method (an equation that can be used to estimate the cumulative proportion of a population as a function of the cumulative proportion of deaths). The Lorenz curve was used to estimate the population covered by areas with registration systems by entering the percentage of regional deaths in those areas. Deaths and population in each remaining area were then determined by subtracting the estimated deaths and population for the registration areas from the regional totals for deaths and population. The all-cause mortality rate for each age and sex group in the residual areas of each region was then calculated using these death and population estimates. Once overall mortality rates were estimated, probabilistic models of cause of death structure were used to determine mortality for broad categories of residual causes (i.e., communicable, maternal, perinatal and nutritional conditions, noncommunicable diseases, and injuries). .