Violence As A Public Health Issue: An Analysis of United States Virgin Islands Homicides

1. Violence As A Public Health Issue: An Analysis of United States Virgin Islands Homicides 2006 – 2010 Greta Hart-Hyndman MSN, RN, CNS, ANP-BC Research Scholar Caribbean Exploratory NCMHD Research Center University of the Virgin Islands (Grant #P20MD00286)

2. Water Island

3. Outline of Presentation • Interest in Homicide as a Public Health Issue • Review of Literature • Statement of Research Purpose • Research Questions • Methods /Data Analysis • Results • Limitations • Conclusion • Final Thoughts • Recommendations

4. Interest in Homicide • Increasing number of homicide in USVI • As on US mainland, young Black males as victims and perpetrators killed with guns • Negative impact also affects others -friends, families and larger communities

5. Interest in Homicide • When looking for comprehensive data that could help professionals such as DNPs, it was found that the USVI data was not included in the national repositories of the CDC’s, FBI’s or DOJ’s • Led to my resolve to influence stakeholders to increase awareness of benefits to be derived from USVI participation in national surveillance programs such as the National Violent Death Reporting System (NVDRS) • Led to designing an exploratory study

6. Review of Literature The Violence Policy Center (2011) • Blacks in the US and USVI are disproportionately affected by homicides • In 2008 US black homicide rate for all Blacks 18.07 per 100,000 • Rate for all Whites was 2.99 per 100,000 • Rate for Black males in US was 32.49 per 100,000 • Rate for all males in the US was 7.93 per 100,000

7. Review of Literature The Violence Policy Center (2011) • Average age of the Black male homicide victim was 30 years, and the majority (82%) was killed with guns • 75% of Black victims were murdered by someone they knew • USVI homicide rate – 41 per 100,000 in 2008 (St. Thomas Source, 2010)

8. Review of Literature The U.S. Department of Justice (2011) Homicide trends in the U.S., from 1980-2008 --reported on data from the FBI’s Supplementary Homicide Reports (SHR) • Majority of victims/offenders (53.1% and 65.5%, respectively) were 18 to 34 years of age. • Males are most likely to be involved in homicides as victims (76.8%) and offenders (89.5%). • 23.2% of the victims and 10.5% of the offenders were females. • Victims of homicide included: 50.3% White, 47.4% Black, and 2.3% Other • Offenders were 45.3% White, 52.5% Black, and 2.2% Other

9. Review of Literature The U.S. Department of Justice (2011) • Females were more likely than males to be the victim of intimate killings (63.7%) and sex-related homicides (81.7%) • Males were more likely to be involved in drug (90.5%), gang-related (94.6%) and workplace (79.1%) homicides • Weapon of choice used by males - gun (82.6 %) for females arson (45.3%) and poison (43.9%)

10. Review of Literature Karch et al.(2010) Data from CDC’s National Violent Death Reporting System for 16 states for 2007 • Homicides occurred at a higher rate among males and persons 20-24 • Non-Hispanic Blacks accounted for the majority (52%) of homicide deaths • Majority of homicides committed with firearms & occurred in residential area or on a street/highway • Homicides were precipitated by arguments and interpersonal conflicts or with the commission of another crime

11. Review of Literature Lemard & Hemenway (2006) Police narratives to describe the circumstances, motives and weapons used in homicides in Jamaica • Majority of homicide victims (89%) were 15 – 44 year-old males, representing 121 homicides per 100,000 people • Females in the same age group had a rate of 12 per 100,000. • Majority of homicides caused by arguments (29%) and reprisals (30%)

12. Review of Literature • Guns (66%) were used primarily in reprisals, robbery, and drug/gang-related homicides • A knife was the weapon of choice in half of all dispute-related homicides • The Jamaican homicide rate rose from 8.1 per 100,000 in 1970 to 40 per 100,000 in 2002.

13. Statement of Research Purpose • To identify the characteristics of homicides in the USVI • To answer the “who, what, when, where, how and why” related to USVI homicides • Create an evidence-based platform for promoting future territorial participation in national comprehensive injury and death surveillance systems (NVDRS)

14. Research Questions • Who are the victims and perpetrators of homicide in the USVI? • What, if any, are the relationships between the victims and perpetrators of USVI homicide? • When (month/season /time of day) are most homicides committed in the USVI? • Where are the homicides committed (close to schools, bars, residential areas etc) in the USVI?

15. Research Questions • How are victims of homicide slain in the USVI (firearm, knife, blunt object etc.)? • Why (revenge, drug related, robbery etc) are homicides committed in the USVI?

16. Methods /Data Analysis • Data from the Virgin Island Source - Online Newspaper and Virgin Island Police Department • Data analyzed using the Statistical Package for the Social Sciences (SPSS) • Descriptive statistics, such as frequencies, percentages and distributions, were performed on all variables. • Review by the Institutional Review Boards of the University of Wisconsin, University of the Virgin Islands and National Institute of Health

17. Sample Article from the VI Source • STTDate of death: July 16 A shooting in Hospital Ground resulted in the death of Xxx Xxx, 30. Police say Xxx was driving and trying to flee pursuers in another vehicle when he had an accident. He was shot after fleeing on foot following the wreck. Information gathered at the scene led officers to apprehend three suspects within minutes of the shooting. Arrested near the Western Cemetery were XXX, XXX and XXX, all Puerto Rico natives in their early-to-mid 20s. All three were charged with first-degree murder.

18. Study Data

19. USVI Population 2000 by Gender Race/Ethnicity

20. Homicides Grouped in the USVI 2006-2010 by Year of Incident

21. USVI Homicides 2006 -2010 by Island

22. USVI Homicide Victims 2006-2010 by Gender and Race/Ethnicity

23. USVI Homicide Victims 2006-2010 by Gender and Age

24. USVI Homicide Victims 2006-2010 by Race/Ethnicity and Age

25. Who are the Perpetrators 2006-2010 of Homicide by Gender

26. Who are the Perpetrators 2006-2010 of Homicide by Race/Ethnicity

27. Who are the Perpetrators 2006-2010 of Homicide by Age

28. What is the Relationship Between Victim and Perpetrators 2006-2010

29. When homicides were committed in the USVI 2006-2010 by time of day

30. When homicides were committed in the USVI 2006-2010 by month

31. When homicides were committed in the USVI 2006-2010 by season

32. When homicides were committed in the USVI 2006-2010 by day of the week

33. Where homicides are committed in the USVI 2006-2010

34. How are victims of homicide slain in the USVI 2006-2010

35. Why homicides were committed in the USVI 2006-2010

36. Limitations • Significant amount of data missing • Data collection process does not involve self report but dependence on secondary sources • Possibility race and ethnicity incorrectly coded • The study design is limited to descriptive statistics.

37. Conclusion • Majority of homicides committed in the USVI on St. Thomas. • Summer months highest rates. • Most occurred on Saturday, Sunday and Monday • Majority of victims and perpetrators were Black which is reflective of the population. • Majority of the victims and Perpetrators were males

38. Conclusion • Eleven offenders under the age of 17 • More than three-fourths of the victims slain with a firearm • Majority of victims and perpetrators in the 18–34 age group • Motives, location, and relationship to victims and perpetrators not identified in most of the cases

39. Final Thoughts • Findings disseminated to community stakeholders • Data shared in various formats with other lay and professional groups. • Provide the basis for: - Future studies using comprehensive data base such as the NVDRS

40. Final Thoughts • Prior to (February 2012), the USVI did not have a reliable way of tracking data on violent crimes; no government agencies complied or published incident-based reports on violent deaths. • While the Bureau of Vital Statistics of the USVI Department of Health maintains statistics on deaths, it does not provide a comprehensive report of factors associated with each death. • (February, 2012) The VIPD reported the initiation of the USVI’s participation in the National Uniform Crime Reporting Program with the submission of crime statistics for 2011. • The initiation of reporting data to the FBI Uniform Crime Reporting Program puts the USVI on a pathway to standardization of collecting and reporting data on violent crimes in the future.

41. Final Thoughts • Homicide must be addressed from a clinical standpoint instead of from the more familiar criminal justice perspective • The resolution of this issue requires active involvement of nurse leaders in political advocacy as well as policy development and implementation of community-specific programs to deter and decrease violent crimes

42. Recommendation for Future Research • It is recommended that further exploration of this topic be undertaken to facilitate greater understanding of motives for homicides and the nature of the victim/perpetrator relationships

43. QuestionsHomicide is a public health problem and all must become involved in order to stop the scourge in the community