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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kenneth J Tardiff, MD, MPH1, Sandro Galea, MD, MPH2, Jennifer Ahern, MPH2, Andrew C Leon, PhD3, and David Vlahov, PhD2. (1) Department of Psychiatry, New York Presbyterian Hosptial, 525 East 68th Street Box 140, New York, NY 10021, 212.746.3871, kjtardif@med.cornell.edu, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 5th Avenue, New York, NY 10029, (3) New York Presbyterian Hospital, 525 East 68th Street, Box 140, New York, NY 10021
BACKGROUND Rates of homicide have fallen dramatically in New York City (NYC) and most other major cities in the United States in the 1990's. It has been suggested that this decline in homicides was caused, in part, by a decline in substance use. METHODS All homicides and fatal accidents, excluding accidental drug overdoses, in the Office of Chief Medical Examiner records for 1990-1998 were identified. Accidents were used as a control to reflect substance use in the general population. We calculated annual rates of homicide and accidents with positive toxicology, age and race standardized to the 1990 census for NYC. RESULTS Cocaine positive homicide rates declined 86.0% compared to a decline of 67.9% for cocaine positive accident rates from 1990-1998. Ethanol positive homicide rates declined 78.3% compared to a decline of 42.2% for ethanol positive accident rates. Opiate positive homicide rates declined 77.5% compared to a decline of only 1.1% for opiate positive accident rates. CONCLUSIONS There was a marked decline in the use of opiates among homicide victims but not among accident victims; there was a decline in the use of cocaine and ethanol in both homicide victims and accident victims. If similar patterns existed in the general population this would suggest that changes in some aspect of opiate use or dealing may be related to the decline of homicide in the 1990s. Further exploration of this decline should include patterns of substance use during the 1990s as well as changes in law enforcement policy and substance abuse treatment.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.