Long-Term Global Trends and Sex Disparities in Homicide Mortality: A Comparative Analysis of 39 Countries Over 40 Years

Abstract

Introduction:  The homicide rate is widely regarded as a key indicator of societal violence. Although homicides account for less than 1% of all deaths globally and have generally declined over time, they remain a critical public health and social concern. Homicide continues to attract sustained attention from both the media and the public, contributing to a perception that violence is increasing, despite empirical evidence.

Objectives: This study aims to analyse long-term trends in homicide mortality across multiple countries, with particular attention to variations by sex and geographic region. Specifically, it aims to evaluate whether the perceived increase in insecurity and violence, especially violence against women, is supported by empirical evidence derived from homicide data.

Methods: We extracted data on homicide deaths from the WHO Mortality Database (1979 to the latest available year) and mid-year population estimates from the United Nations Population Division. Countries with at least medium-quality data and a minimum of five years of observations were included. Age-standardized mortality rates (ASRs) were calculated by sex, and male-to-female ratios were used to assess sex differences. Annual percent changes (APCs) were estimated using joinpoint regression models.

Results: A total of 39 countries were included in the analysis. Among males, ASRs ranged from 0.22 per 100,000 person-years in Japan to 46.6 in Colombia; among females, rates ranged from 0.17 in Japan to 4.86 in Guatemala. Most countries showed declining trends over time, although recent increases were observed in France among males (APC 2017–2022: +12.8%, 95% CI: 5.9–20.1), Sweden among males (APC 2011–2023: +5.6%, 95% CI: 3.1–8.2), and in the United States among both males (APC 2014–2022: +5.2%, 95% CI: 3.1–7.3) and females (APC 2014–2022: +4.4%, 95% CI: 2.8–5.9).

In Europe, the median male-to-female ASR ratio was 1.9, whereas higher ratios were observed in the United States (4.0), South Africa (7.2), and Latin America (ranging from 3.2 to 12.0).

Italy was among the countries with the lowest homicide mortality rates in both males (0.46 per 100,000 person-years in 2021) and females (0.26 per 100,000 person-years in 2021), with a male-to-female ASR ratio of 1.8.

Conclusions: Homicide mortality has declined in both sexes across most countries over the past four decades. Nevertheless, substantial geographical disparities persist, with particularly high burdens observed in Latin America, South Africa, and the United States. Recent increases reported in several high-income countries underscore the fragility of these gains and highlight the need for sustained surveillance and context-specific prevention strategies. The persistence of marked sex differences, where males consistently account for the majority of victims, suggests that the underlying drivers of male vulnerability to lethal violence remain largely unchanged. Although female homicide rates have remained relatively stable overall, they exhibit a distinct epidemiological profile, often associated with intimate partner violence. This pattern calls for continued, targeted policy responses addressing gender-specific risk factors.