LaMar Hasbrouck, MD, MPH, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K-60, Atlanta, GA 30341, 770-488-1561, lmh0@cdc.gov, Angela K. McGowan, JD, MPH, Community Guide Branch/DPRAM/EPO, Centers for Disease Control and Prevention, 4770 Buford Highway, K-73, Atlanta, GA 30341, and Alex Crosby, MD; MPH, Centers for Disease Control, 1600 Clifton Rd, Atlanta, GA 30333.

Background: During 2002, local media in Detroit, Michigan reported increases in violent deaths among children and adolescents. An investigation was conducted to examine these deaths. Methods: A violent death was defined as a homicide, suicide or any firearm-related death of a Detroit resident aged < 16 during 2002. Cases and controls were identified by medical examiners’ (ME) records; additional data were obtained from police reports, school records and the state’s public assistance and child/family welfare (PACFW) agency. Cases were matched to controls. Groups were compared using bivariate analysis. Results: Twenty-nine cases were identified. The median age was 10 years, and more than half were male (n=15 [52%]). The majority of deaths resulted from homicide (n=25 [86%]). Cases were more likely to have a history of family violence (Odds Ratio [OR] 7.3, 95% confidence interval [CI], 1.8 - 30.0); > 2 adults in the household (OR 4.0, 95% CI, 1.5 – 10.8); and a family of > 4 persons (OR 3.0, 95% CI, 1.3 - 8.1). Cases were less likely to have had prior contact with the state’s PACFW agency (OR 0.2, 95% CI 0.1 - 0.5). There were no differences between cases and controls on family history of alcohol/drug use; prior contact specifically with child protective services; and school disciplinary history. Conclusions: Some epidemiologic features of these deaths were similar to known risk factors (e.g., family violence); however, others (e.g., females, 2-parent households) differed. Nontraditional factors may help focus programs on specific at-risk groups.

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