In 2000, infant homicide rates nearly equaled homicide rates among teens ages 15-19, having more than doubled since 1970 (from 4.3 to 9.1 per 100,000 children under age one). (See Figure 1)

Importance
Homicide is the leading cause of injury deaths among infants (under one year of age) in the United States (15th leading cause of infant mortality from all causes).1 Half the infant homicides occur by the fourth month of life, and the risk of infant homicide is highest on the day of birth. Homicide risk is greater in the first year of life than in any other year of childhood before age 17.2

Furthermore, research studies of infant death data drawn from multiple agency records (such as police or social service records) indicate that the actual rate of infant deaths attributable to substantial abuse or neglect of infants and children up to 4 years old is more than twice as high as the official rates reported in death certificate data.3 Better reporting of the circumstances surrounding infant fatalities should improve the quality of death certificate records. Studies have also indicated that a large but uncertain number of unreported infant homicide deaths may occur among very young infants, particularly those infants for whom no birth or death certificates are found, such as those who are born with no trained attendants and in no clinical settings.4

Key risk factors associated with infant homicides focus on the circumstances surrounding the birth of the child. Among the homicides on the first day of life, 95 percent of the victims were not born in a hospital.5 Other important maternal risk factors include a second or subsequent infant born to an unmarried teenage mother (19 years of age or younger); an initial prenatal visit after the sixth month of pregnancy or no prenatal care; a history of maternal mental illness; 12 or less years of education of the mother; and premature birth (gestation of less than 28 weeks).6 There is a notable absence of data on risk factors associated with males, either biological fathers or others, reflecting the lack of father data on birth certificates.

Trends
Between 1970 and 1990, the official infant homicide rate rose dramatically - from 4.3 to 8.4 infant deaths per 100,000 residents (See Figure 1). This higher rate continued during the 1990s; in 2000, the infant homicide rate was 9.1. Almost one infant homicide per day was reported in the year 2000 (349 total).

The increase in infant homicide rates is especially troubling since this trend occurred during a period of overall decrease in infant mortality from all sources. Infant mortality rates dropped from 12.8 per 1,000 live births in 1980 to 6.9 per 1,000 live births in 2000.7

Differences by Gender
Males are generally more likely than females to be killed during the first year of life. In 2000, the infant homicide rate was 10.3 per 100,000 children under age one for boys, compared with 7.8 for girls. (See Table 1)

Differences by Race and Hispanic Origin
Non-Hispanic blacks are substantially more at risk than other races to die of an intentional injury during their first year of life. In 2000, non-Hispanic blacks had an infant homicide rate of 25.6, while non-Hispanic whites had a rate of 6.0. Hispanics had an infant homicide rate of 7.3. (See Figure 2)

Injury mortality data by age for 1981-2000 by census region and state can be found using WISQARS at http://www.cdc.gov/ncipc/wisqars/. State and county mortality data by age for 1979-1999 can be found using CDC WONDER at http://wonder.cdc.gov/mortSQL.shtml. Both WISQARS and WONDER are maintained by the Centers for Disease Control and Prevention (CDC).

International Estimates
None Available

National Goals
The Healthy People 2010 initiative has set a goal to reduce maltreatment fatalities in children under age 18 (from 1.6 per 100,000 in 1998 to 1.4 per 100,000 by 2010).

For additional information visit: http://www.health.gov/healthypeople/document/html/objectives/15-33.htm (Goal 15-33)

Research References

1Overpeck, MD, RA Brenner, AC Trumble, LB Trifilette, and HW Berendes. 1998. Risk factors for infant homicide in the United States. New England Journal of Medicine. 339(17):1211-1216.

2Paulozzi, L., & Sells, M. (2002). Variation in homicide risk during infancy - United States, 1989-1998. Morbidity and Mortality Weekly Report, 51 (09): 187-189. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5109a3.htm

3Crume, TL, C DiGuiseppi, T Byers, AP Sirotnak, and CG Garrett. 2002. Underascertainment of child maltreatment fatalities by death certificates, 1990-1998. Pediatrics. 110(2).http://www.pediatrics.org/cgi/reprint/110/2/e18.pdf

4Overpeck, MD, RA Brenner, C Cosgrove, AC Trumble, K Kochanek, and M MacDorman. 2002. National underascertainment of sudden unexpected infant deaths associated with deaths of unknown cause. Pediatrics 109(2):274-283.

5Paulozzi, L., & Sells, M. (2002).

6Ibid and Overpeck, MD, RA Brenner, AC Trumble, LB Trifilette, and HW Berendes. 1998.

7Iyasu, S, K Tomashek, and W Barfield. 2002. Infant mortality and low birth weight among black and white infants. Morbidity and Mortality Weekly Report, 51(27):589-592. Centers for Disease Control and Prevention. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5127a1.htm

8Knight, B. Forensic problems in practice. Practitioner 1976: 217:444-448.

Definition
Infant homicides are classified as deaths purposefully inflicted by other persons on children less than 1 year old. Data on infant homicide are developed by the National Center for Health Statistics, drawn from death certificates recorded by local medical examiners or coroners and reported to the National Vital Statistics System. These records code infant deaths by use of the injury classification framework developed by the International Classification of Diseases (ICD) codes, 9th and 10th editions. For more information about ICD codes please see: http://www.cdc.gov/nchs/data/dvs/icd10fct.pdf

A small number of stillbirths may be overclassified as infant homicides. However, medical examiners usually will attribute a death to infanticide only when they can rule out other causes (ie., autopsy evidence indicates that respiration had occurred, no evidence indicates death from natural causes, and circumstantial evidence is consistent with homicide). Data Source
Data for 1970-1999 total rates and by gender: National Center for Health Statistics. (2002) Health United States, 2002 With Chartbook on Trends in the Health of Americans. National Center for Health Statistics. Table 46. See http://www.cdc.gov/nchs/hus.htm

Data for 1990-2000 race-ethnicity and 2000 gender: derived by Child Trends from WISQARS (Web-based Injury Statistics Query and Reporting System) - an "interactive database system that provides customized reports of injury-related data." See http://www.cdc.gov/ncipc/wisqars/

Data for 2000 infant homicide rate totals: Minino AM, Arias E, Kochanek KD, Murphy SL, Smith BL. (2002). Deaths: Final Data for 2000. National vital statistics reports; vol 50 (15). Hyattsville, Maryland: National Center for Health Statistics. Table 9. http://www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_15.pdf

Raw Data Source
National Vital Statistics System http://www.cdc.gov/nchs/nvss.htm

Approximate Date of Next Update
Fall 2003