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 ) 1

2 Water Island

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 3

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 4

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 5

Review of Literature 6 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 per 100,000 Rate for all Whites was 2.99 per 100,000 Rate for Black males in US was per 100,000 Rate for all males in the US was 7.93 per 100,000

Review of Literature 7 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)

Review of Literature The U.S. Department of Justice (2011) Homicide trends in the U.S., from 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 8

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%) 9

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 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 10

Review of Literatur e 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%) 11

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

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) 13

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? 14

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? 15

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 16

Sample Article from the VI Source STT Date 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. 17

Study Data Study Data by IncidentsN Reported in the VI Source for Reviewed for Validity254 Classified as Homicide248 Classified as Suicide2 Classified as Accident3 Classified as Other1 18

USVI Population 2000 by Gender Race/Ethnicity RaceGender Black or African American 82,750 (76.18%) Male51,864 White14,218Female56,748 Other Races7,825 Hispanics**15,196 Total Population108,612 ** may also be Black or other races 19

Homicides Grouped in the USVI by Year of Incident 20

USVI Homicides by Island IslandsPopulationHomicidesPercent St. Thomas51, St. Croix50, St. John4, Water Island

USVI Homicide Victims by Gender and Race/Ethnicity Race/Ethnicity MaleFemaleTotal White Non-Hispanic 12 (5.4%) 1 (4.5%) 13 (5.3%) Black Non-Hispanic 176 (78.6%) 16 (72.7%) 192 (78.0%) Hispanic 33 (14.7%) 3 (13.6%) 36 (14.6%) Other 3 (1.3%) 2 (9.1%) 5 (2.0%) Not Recorded --2 Total 224 (100.0%) 22 (100.0%) 248 (100.0%) 22

USVI Homicide Victims by Gender and Age AgeMaleFemaleTotal < 141 (.4%) 2 (.8%) 14 thru 179 (3.8%)1 (.4%)10 (4.2%) 18 thru 2471 (30.1%) 5 (2.1%) 76 (32.2%) 25 thru 3467 (28.4%) 7 (3.0%) 74 (31.4%) 35 thru 4945 (19.1%)4 (1.7%)49 (20.8%) 50 thru 6421 (8.9%)1 (.4%)22 (9.3%) 65 >2 (.8%)1 (.4%)3 (1.3%) Not Recorded--12 Total216 (91.5%) 20 (8.5%) 248 (100.0%) 23

USVI Homicide Victims by Race/Ethnicity and Age AgeWhite Non- Hispanic Black Non- Hispanic HispanicOtherTotal < thru thru (27.7%) thru (23.1%) thru (17.2%) thru >21003 Not Recorded Total

Who are the Perpetrators of Homicide by Gender 25

Who are the Perpetrators of Homicide by Race/Ethnicity 26

Who are the Perpetrators of Homicide by Age 27

What is the Relationship Between Victim and Perpetrators

When homicides were committed in the USVI by time of day Time of DayNPercent 12:01 AM – 6:00 AM :01 AM - 12:00 N :01 PM - 06:00 PM :01 PM – 12:00 MN Time not listed Total

When homicides were committed in the USVI by month 30

When homicides were committed in the USVI by season 31

When homicides were committed in the USVI by day of the week 32

Where homicides are committed in the USVI

How are victims of homicide slain in the USVI

Why homicides were committed in the USVI

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. 36

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 37

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 38

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 39

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 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. 40

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 41

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 42

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