Alcohol, Violence, and Injury-Induced Mortality: Evidence from a Modern-Day Prohibition

Barron, Kai; Parry, Charles; Bradshaw, Debbie; Dorrington, Rob; Groenewald, Pam; Laubscher, Ria; Matzopoulos, Richard

doi:10.1162/rest_a_01228

Cited by 14 publications

(8 citation statements)

References 115 publications

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“…Males accounted for 95% of the estimated 15,168 alcohol attributable-homicides in South Africa in 2000, 2006 and 2012. (26) Alcohol sales bans implemented alongside lockdowns during South Africa's COVID-19 pandemic were associated with reductions in non-natural deaths and trauma cases, (27,28) but this critical policy window has not, as yet, translated into more sustained approach to reduce alcohol harms. (29) There was considerable interprovincial variation in overall homicide.…”

Section: Resultsmentioning

confidence: 99%

South Africa’s male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations

Matzopoulos

Prinsloo

Mhlongo

et al. 2023

Preprint

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Background South Africa has homicide rates six times the global average, predominantly among men, but little is known about male victims. As part of the country's first ever study of male homicide we compared 2017 male and female victim profiles for selected covariates, against global averages and previous estimates for 2009. Methods We conducted a retrospective descriptive study of routine data collected through postmortem investigations, calculating age-standardised mortality rates for manner of death by age, sex and province and male-to-female incidence rate ratios with 95% confidence intervals. We then used generalised linear models and linear regression models to assess the association between sex and victim characteristics including age and mechanism of injury (guns, stabs and blunt force) within and between years. Findings 87% of 19,477 homicides in 2017 were males, equating to seven male deaths for every female, with sharp force and firearm discharge the most common external causes. Rates were higher among males than females at all ages, and up to eight times higher among males aged 15-44 years. Provincial rates varied overall and by sex, with the highest comparative risk for men vs. women in the Western Cape Province (11.4 males for every 1 female). Male homicides peaked during December and were highest on weekends, underscoring the prominent role of alcohol as a risk factor. Significantly more males tested positive for alcohol than females. Interpretation The massive, disproportionate and enduring homicide risk borne by adult South African men highlights the negligible prevention response. Only through challenging the normative perception of male invulnerability can we begin to address the enormous burden of violence impacting men. There is an urgent need to address the insidious effect of such societal norms alongside implementing structural interventions to overcome the root causes of poverty and inequality and better control alcohol and firearms.

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Section: Resultsmentioning

confidence: 99%

South Africa’s male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations

Matzopoulos

Prinsloo

Mhlongo

et al. 2023

Preprint

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“…The result is widespread harm, particularly in SA’s poorest communities with heavy episodic drinking a key risk factor for acute harms such as injuries 38. The effect of changing the pattern of drinking was recently demonstrated in SA when intermittent alcohol sales bans implemented as part of the COVID-19 response coincided with significant reductions in injury deaths and hospitalisations 39–42…”

Section: Discussionmentioning

confidence: 99%

Who is killing South African men? A retrospective descriptive study of forensic and police investigations into male homicide

Matzopoulos,

Marineau,

Mhlongo

et al. 2024

BMJ Glob Health

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Not much is known about the perpetrators of male homicide in South Africa, which has rates seven times the global average. For the country’s first ever male homicide study we describe the epidemiology of perpetrators, their relationship with victims and victim profiles of men killed by male versus female perpetrators. We conducted a retrospective descriptive study of routine data collected through forensic and police investigations, calculating victim and perpetrator homicide rates by age, sex, race, external cause, employment status and setting, stratified by victim-perpetrator relationships. For perpetrators, we reported suspected drug and alcohol use, prior convictions, gang-involvement and homicide by multiple perpetrators. Perpetrators were acquaintances in 63% of 5594 cases in which a main perpetrator was identified. Sharp objects followed by guns were the main external causes of death. The highest rates were recorded in urban informal areas among unemployed men across all victim-perpetrator relationship types. Recreational settings including bars featured prominently. Homicides clustered around festive periods and weekends, both of which are associated with heavy episodic drinking. Perpetrator alcohol use was reported in 41% of homicides by family members and 50% by acquaintances. Other drug use was less common (9% overall). Of 379 men killed by female perpetrators, 60% were killed by intimate partners. Perpetrator alcohol use was reported in approximately half of female-on-male murders. Female firearm use was exclusively against intimate partners. No men were killed by male intimate partners. Violence prevention, which in South Africa has mainly focused on women and children, needs to be integrated into an inclusive approach. Profiling victims and perpetrators of male homicide is an important and necessary first step to challenge prevailing masculine social constructs that men are neither vulnerable to, nor the victims of, trauma and to identify groups at risk of victimisation that could benefit from specific interventions and policies.

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“…Off-premise outlets were classified as ‘essential services’ in all jurisdictions, but some volume limits were mandated in WA because of hoarding fears. These findings are of interest when compared to those from South Africa, where a much stronger stance was taken on alcohol sales and a sudden and unexpected nation-wide alcohol sales ban reduced injury-induced mortality in the country by at least 14% during the 5 weeks of the ban [ 50 ]. They found more specifically that homicides, assault with intent to inflict grievous bodily harm and rape dropped during the alcohol ban period, followed by a large increase once alcohol was again available [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…These findings are of interest when compared to those from South Africa, where a much stronger stance was taken on alcohol sales and a sudden and unexpected nation-wide alcohol sales ban reduced injury-induced mortality in the country by at least 14% during the 5 weeks of the ban [ 50 ]. They found more specifically that homicides, assault with intent to inflict grievous bodily harm and rape dropped during the alcohol ban period, followed by a large increase once alcohol was again available [ 50 ]. Unfortunately, their data were not able to distinguish between domestic and non-domestic violence.…”

Section: Discussionmentioning

confidence: 99%

The Impact of COVID-19 on Trends of Violence-Related Offences in Australia

Miller,

Button,

Taylor

et al. 2023

J Epidemiol Glob Health

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Objective To investigate the medium-term impacts of the COVID-19 pandemic on violence-related offences in Australia, and whether there was evidence of a ‘dual pandemic’ of family violence in addition to COVID-19. Methods Autoregressive Integrated Moving Average time series were conducted to analyse publicly available violent crime statistics data from January 2017 to November 2021. Population rates of homicide, sexual, domestic and non-domestic assault were assessed across each Australian state and territory, with the effects of COVID-19 being modelled using the average monthly World Health Organization COVID-19 stringency rating for each jurisdiction. Findings All jurisdictions in Australia showed increasing or stable domestic assault trends over the past decade, which were not significantly impacted by COVID-19, nor by the subsequent lockdowns. Non-domestic assaults demonstrated a significant, negative relationship with the stringency index for each jurisdiction, except Western Australia. There was no significant change in the rates of homicide or sexual assault across Australia in relation to COVID-19. Conclusion Overall, there was no evidence of a ‘dual pandemic’ in Australia, and whilst domestic assaults continue to increase across the country, non-domestic assaults showed a notable but brief decline. However, these have returned to levels at least as high as pre-COVID-19 and some states show a continuing upward trend. The findings also suggest that alcohol availability may have played a role in continuing high violence numbers. Given the ongoing increasing and high levels of family violence in Australia, revised conceptual frameworks and interventions are indicated.

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Alcohol, Violence, and Injury-Induced Mortality: Evidence from a Modern-Day Prohibition

Cited by 14 publications

References 115 publications

South Africa’s male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations

South Africa’s male homicide epidemic hiding in plain sight: exploring sex differences and patterns in homicide risk in a retrospective descriptive study of postmortem investigations

Who is killing South African men? A retrospective descriptive study of forensic and police investigations into male homicide

The Impact of COVID-19 on Trends of Violence-Related Offences in Australia

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