Area Disadvantage and Intimate Partner Homicide: An Ecological Analysis of North Carolina Counties, 2004-2006
Madkour, Aubrey Spriggs, Martin, Sandra L., Halpern, Carolyn Tucker, Schoenbach, Victor J., Violence and Victims
Using data from the North Carolina Violent Death Reporting System and other sources, we examined ecologic relationships between county (n = 100) disadvantage and intimate partner homicide (IPH), variability by victim gender and county urbanicity, and potential mediators. County disadvantage was related to female-victim homicide only in metropolitan counties (incidence rate ratio [IRR] 1.25); however, disadvantage was associated with male-victim IPH regardless of county urbanicity (IRR 1.17). None of the potential intervening variables examined (shelter availability, intimate partner violence services' funding) was supported as a mediator. Results suggest disparities across North Carolina counties in IPH according to county disadvantage. Future research should explore other potential mediators (i.e., service accessibility and law enforcement responses), as well as test the robustness of findings using additional years of data.
Keywords: gender; domestic violence; socioeconomic status; prevention
Intimate partner violence (IPV) is defined as violence or threat of violence in a close relationship, including current or former spouses and dating partners (National Center for Injury Prevention and Control, 2006) . Data from the 1995 National Violence Against Women Survey estimated women age 18 and older experience 4.8 million intimate partner assaults annually, while adult men experience 2.9 million such assaults (Tjaden & Thoennes, 2000). The CDC estimated that the costs of IPV against women in 1995 exceeded $5.8 billion, including nearly $4.1 billion in the direct costs of medical and mental health care and nearly $1.8 billion in the indirect costs of lost productivity (National Center for Injury Prevention and Control, 2003). Although no similar total cost estimates are available for male victims, another study found the average per-person cost of physical victimization for women was more than twice the cost of physical victimization for men (Arias & Corso, 2005). Given the prevalence and associated costs, intimate partner violence has been recognized as a major public health problem.
The most severe consequence of intimate partner violence is intimate partner homicide. From 1976 to 2005, about 11% of homicide victims were killed by an intimate partner (Fox & Zawitz, 2004) . In 2005, 329 males and 1,181 females in the United States were killed by an intimate partner (Fox & Zawitz, 2007) . There was a decrease in the number of intimate partner homicides between 1976 and 2005, but this decrease was greater for males than for females (Catalano, 2006; Puzone, Saltzman, Kresnow, Thompson, & Mercy, 2000) . Rates of intimate partner homicide also declined in the last two decades for most partner types. Using data from the FBI's Supplemental Homicide Report data file, Puzone et al. (2000) found that between 1976 and 1995, the rate of homicide per 100,000 population declined significantly for wives (1.79-1.05), husbands (1.61-.40), and boyfriends (1.55-.50) but not for girlfriends (1.34-1.06) (Puzone et al., 2000).
There are many recognized risk factors for intimate partner homicide, including prior domestic violence, access to guns, estrangement or relationship breakup, having stepchildren, alcohol abuse, prior forced sex, threats to kill, and nonfatal strangulation (Campbell, Glass, Sharps, Laughon, & Bloom, 2007) . Intimate partner homicide also has been related to contextual disadvantage (i.e., spatial concentration of poverty, unemployment, female-headed households, low education, public assistance receipt), but inconsistently across studies. Examining data from female-victim intimate partner homicides in Chicago between 1965 and 1995, Browning ( 2002 ) found neighborhood concentrated disadvantage was positively associated with such homicide rates (Browning, 2002) . In another study using data from a large city, Frye and Wilt ( 2001 ) analyzed medical examiner data on female homicides in New York City between 1990 and 1997, finding that neighborhood socioeconomic status (SES) was negatively associated with intimate partner femicide rates (Frye & Wilt, 2001) . …