Firearm Homicides of US Children Precipitated by Intimate Partner Violence: 2003–2020

We used data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System (NVDRS) for 2003 to 2020 from 49 states, the District of Columbia, and Puerto Rico (See Appendix 1 for list of states/jurisdictions included in this study and years of coverage for each). NVDRS is a state-based active surveillance system that captures data on violent deaths in all states/jurisdictions within the United States.⁴  Data from death certificates and LE and C/ME reports are entered into the NVDRS Web-based system by trained abstractors and linked into 1 incident record, using Centers for Disease Control and Prevention guidance.⁴  Extensive details on NVDRS methodology can be found elsewhere.⁴  Child firearm homicides were defined using the World Health Organization’s International Classification of Diseases, 10th Revision, underlying cause of death codes X85-Y09, Y87.1²⁰  for children aged 0 to 17 years and with a weapon type of firearm (defined as a weapon that uses a powder charge to fire a projectile; excludes nonpowder guns such as BB or pellet guns and air or gas rifles). IPV-related was defined as a death that is related to immediate or ongoing conflict or violence between current or former intimate partners, including homicides that are associated with IPV that are not deaths of the intimate partners themselves (eg, a father kills his child[ren] because of conflict with his estranged wife).²¹ 

To identify child firearm homicides precipitated by IPV (both within dating relationships [limited to teens] and as child corollary victims), we used the standard NVDRS IPV-related circumstance, which yielded 405 cases. C/ME and LE narratives for non-IPV–related cases were reviewed if they had 1 of the other following characteristics commonly associated with IPV: Jealousy (between intimate partners), the perpetrator was the father of the victim or mother’s male companion, the incident was a multiple homicide or homicide–suicide, or >1 person was nonfatally shot in the incident. This yielded an additional n = 281 cases. A total of 686 child firearm homicides were identified as IPV-related.

In NVDRS, child custody dispute, relationship dissolution between intimate partners (eg, impending or recent divorce, separation), and an existing domestic violence restraining order against the perpetrator are contextual factors subsumed under the circumstance IPV-related.²¹  To separate out these circumstances for IPV-related child homicide victims, we conducted a literal text search using SAS to find words and terms that matched an a priori list (Appendix 2). Each narrative, matching 1 or more terms, was reviewed by the lead author to determine the absence or presence of these additional circumstances.

Child and perpetrator demographic characteristics, victim–perpetrator relationship, precipitating circumstances (eg, family relationship problems) that initiated the chain of events leading directly to or significantly contributing to the child’s death, and other incident characteristics (eg, homicide-suicide [defined as child’s homicide cooccurring with the perpetrator’s suicide]) were examined. Race is a social construct and not a biological marker for disparities²² ; therefore, we examined child's race and ethnicity as indicators, not drivers, of inequities.

Although the focus of this study was on IPV-related firearm homicides of children aged 0 to 17 years, we included all firearm homicides of children in the analysis to understand how firearm homicides precipitated by IPV compare with non-IPV–related firearm homicides of children.

All analyses were performed using SAS Version 9.4 (SAS Institute Inc). Descriptive analyses of the number and percentage of homicides by demographic characteristics and a range of circumstances were conducted. Bivariable and multivariable logistic regression analyses were used to estimate the crude odds ratios and adjusted odds ratios (aOR) with 95% confidence intervals (CIs) for the association between characteristics and the outcome variable. Each model controlled for child's sex, age, and race/ethnicity. Statistical significance was set at α = .05.

From 2003 to 2020, a total of 11 594 homicides of children aged 0 to 17 years were captured in NVDRS, of which 49.3% (n = 5716) were firearm homicides. Most firearm homicides were among boys (80.1%; n = 4579) and Black, non-Hispanic children (62.4%; n = 3568). IPV was a precipitating circumstance in 12.0% (n = 686) of all child firearm homicides. See Tables 1 and 2 for full results.

Among child firearm homicides precipitated by IPV, the majority (86.0%; n = 590) were corollary (nonintimate partner) victims; the other 14.0% (n = 96) were among teens aged 13 to 17 years killed by a current or former dating partner (Table 1). Girls accounted for 52.8% (n = 362) of all IPV-related child firearm homicide victims (Table 1); this proportion was higher among teens killed by a current or former dating partner (girls [89.6%; n = 86] versus boys [10.4%; n = 10]; data not shown). Most (92.4%) IPV-related child firearm homicide victims were 1 of 3 racial and ethnic groups: Black non-Hispanic (29.0%; n = 199), Hispanic (13.8%; n = 95), and White non-Hispanic (49.6%; n = 340). IPV-related child firearm homicide victims were statistically, significantly younger (9.7 years; SE, 0.2) than non-IPV–related child firearm homicide victims (14.7 years; SE, 0.1). Males were the predominant perpetrators of IPV-related child firearm homicides (88.3%; n = 606). When the perpetrator was known, biological fathers were the most common perpetrators of IPV-related child firearm homicides (46.1%; n = 316), followed by mother’s male companion (ie, boyfriend, stepfather; 15.5%; n = 106) and biological mother (9.6%; n = 66). Among IPV-related firearm homicides of child corollary victims, 51.9% (n = 306; data not shown) of the incidents included homicide of the adult intimate partner, of which 94.1% (data not shown) were the child victim’s mother. Arguments and family relationship problems precipitated 44.0% (n = 302) and 22.2% (n = 92) of IPV-related child firearm homicides, respectively (Table 2). Almost two-thirds (62.1%; n = 426) of IPV-related child firearm homicides cooccurred with suicide of the perpetrator. See Tables 1 and 2 for full results.

After controlling for child demographics, child firearm homicides perpetrated by mother’s male companion (aOR, 6.9; 95% CI, 3.9–12.1) or father (aOR, 4.5; 95% CI, 3.0–6.8) had significantly greater odds of involving IPV compared with homicide perpetrated by mothers of the victim(s) (Table 1). Child firearm homicides perpetrated by those aged 25 to 44 years (aOR, 4.1; 95% CI, 3.1–5.4) and 45 years and older (aOR, 5.1; 95% CI, 3.6–7.3) had significantly greater odds of involving IPV compared with those with perpetrators aged 18 to 24 years. Child firearm homicides precipitated by an argument (aOR, 4.5; 95% CI, 3.6–5.5), family relationship problems (aOR, 2.1; 95% CI, 1.5–3.0), crisis during the previous or upcoming 2 weeks (aOR, 2.4; 95% CI, 1.7–3.5), and/or history of child abuse and/or neglect (aOR, 3.3; 95% CI, 1.4–7.7) had significantly greater odds of involving IPV compared with those without these characteristics (Table 2). Child firearm homicide victims who experienced interpersonal violence in the month preceding their death had 2.8 times greater odds of their deaths involving IPV compared with those without this characteristic (aOR, 2.8; 95% CI, 1.2–6.5). Incidents that cooccurred with the perpetrator’s suicide had 16.9 times greater odds of being IPV-related compared with those that did not cooccur with the perpetrator’s suicide (aOR, 16.9; 95% CI, 13.1–21.7). See Tables 1 and 2 for full results.

Family relationship problems and jealousy were crises during the previous or upcoming 2 weeks before the death in 6.8% (n = 28) and 1.7% (n = 7) IPV-related child firearm homicides, respectively (Table 3). Furthermore, as indicated in the narratives, 38.3% (n = 261) of IPV-related child firearm homicides were precipitated by relationship dissolution between intimate partners. A small proportion (4.3%; n = 29) of perpetrators of IPV-related child firearm homicides were known to be under a domestic violence restraining order at the time of the fatal incident. Child custody disputes were a precipitating circumstance in 6.7% (n = 46) of IPV-related child firearm homicides as indicated in the narratives.

This study examined characteristics associated with child firearm homicides precipitated by IPV. The majority (86.0%) of IPV-related child firearm homicides were among child corollary victims whose homicides were related to immediate or ongoing conflict between current or former intimate partners. This finding is consistent with other studies that show IPH often includes additional homicide victims,^9,11,12  many times with the female intimate partner as the primary target and her child(ren) as corollary victims.^3,23 

Boys accounted for 80.1% of all child firearm homicide victims, but girls killed with firearms had 6.1 times greater odds of their deaths involving IPV. These findings reflect the disproportionate occurrence of firearm homicides of males in community violence,^24,25  whereas females bear the greatest burden of firearm homicides involving IPV.^3,23,26  Furthermore, although child firearm homicide victims across all other racial and ethnic groups had greater odds of their deaths involving IPV compared with Black children, Black children accounted for almost two-thirds (62.4%; n = 3568) of all child firearm homicides in the current study, a finding reflective of the unequal burden of community-related firearm violence on children of color.^24,25  Taken together, these findings underscore the importance of employing multiple strategies to prevent all child firearm homicides, including, but not limited to: Promoting healthy intimate partner relationships starting at a young age, changing social norms and risk for escalation of violence and retaliatory violence through street outreach and violence interruption, strengthening economic supports for families and youth, and addressing social and structural inequities at the root of youth firearm violence.^25,27–29 

Consistent with the extant literature on adult IPH,^{3,9,12,23,26,30}  males were the most common perpetrators of IPV-related child firearm homicides in this study. The predominance of males as perpetrators of child firearm homicides involving IPV might largely explain why, compared with mothers, fathers and mothers’ male companions (ie, boyfriend, stepfather) had greater odds of being perpetrators of IPV-related child firearm homicides. Previous research found that having perpetrator’s nonbiologically-related (step) children in the home increased risk of IPH,⁸  which might partly explain the elevated risk associated with mother’s male companions in IPV-related child firearm homicides. In addition, fathers accounted for nearly half of perpetrators of IPV-related firearm homicides of children in the current study. Fathers who kill their own children have been found to more often have a history of family violence,³¹  kill multiple family members,³²  and these homicides tend to be motivated by revenge,³³  relationship conflict,³⁴  disproportionately committed with firearms,³⁵  and frequently cooccur with the perpetrator’s suicide.^32,36–38  Teaching fathers about the consequences of IPV for children’s well-being has been proposed as an effective strategy in motivating them to increase engagement in services designed to prevent and address IPV in the home.³⁹ 

Child firearm homicides that cooccurred with suicide of the perpetrator had almost 17 times the odds of being IPV-related compared with those that did not cooccur with perpetrator’s suicide. Studies show homicide–suicide is more uniquely associated with IPH than any other type of homicide, with firearms being the primary weapon used in these incidents.^40,41  One study found that nearly half of male-perpetrated IPH that included child victims also cooccurred with suicide of the perpetrator.⁴¹  Others report homicide–suicide is a characteristic more commonly associated with fathers as perpetrators of IPV-related homicides.^37,38  Firearms provide limited opportunity for intervention and have high case-fatality rates.⁴²  Studies suggest that creating protective environments by reducing access to firearms among persons at risk for harming themselves, their children, and/or their intimate partner might be effective in preventing suicide and IPV-related firearm homicides.^27,37,43 

In this study, 96 teens aged 13 to 17 years were killed by a current or former dating partner. We did not examine characteristics and circumstances for this group separately from child corollary (nonintimate partner) victims, because others have discussed the circumstances surrounding teen IPHs in detail.¹⁷  A recent study, specific to IPH of adolescents and teens, found the majority of victims were female and killed with a firearm, with broken desired relationship or jealousy, argument or altercation, reckless firearm behavior, and pregnancy-related factors being noted as the most common precipitators.¹⁷  School-based programs that provide dating violence awareness, prevention, and intervention services to youth, as part of the curriculum, have been recognized as effective in reducing teen dating violence victimization and perpetration.^27,44,45 

Similar to past studies that identified relationship conflict as a common precipitator in adult IPH,^26,46  we found child firearm homicides precipitated by family relationship problems, crises, and arguments had significantly greater odds of involving IPV compared with those without these characteristics. High levels of conflict and stress between intimate partners can foster violence.⁴⁷  In this regard, the relationship may be characterized by frequent arguments, child custody disputes, relationship or marital discord, and IPV, all known precipitators of both IPH and child homicides.^{15,16,26,31,48}  One study found the majority (62.1%) of perpetrators in homicide–suicide incidents with child victims were experiencing intimate partner problems before killing the child.¹⁶  Further findings, specific to adolescents and teens, indicated one-quarter of IPH incidents were precipitated by an argument or altercation.¹⁷ 

Furthermore, children might also be killed as a form of revenge or retaliation against the intimate partner, often for leaving or attempting to leave the relationship.^48–50  Some suggest, in these homicides, the perpetrator reacts to the loss of a significant relationship by displacing their feelings of anger for the spouse onto the child.⁵⁰  Others posit anger and a loss of a sense of identity might be the main motivating factors for fathers killing their children, and this anger may stem from a loss of social power caused by the dissolution of a significant relationship.⁵¹  In the current analysis, 38.3% of IPV-related firearm homicides of children were precipitated by relationship dissolution between intimate partners. The most dangerous time for IPV victims is when the victim attempts to leave or has recently ended the relationship with the abuser.^8,52  Risk to the victim’s personal safety and that of their children might influence decisions as to whether to remain in the abusive relationship. This is particularly relevant given that we found in IPV-related firearm homicides of child corollary (nonintimate partner) victims, over half included homicide of the adult intimate partner, with 94.1% of fatal intimate partner victims being the child victim’s mother. Taken together, these findings show the safety of the mother is closely linked to that of her children, underscoring the importance of taking the needs of both adult victims and their children into consideration when assessing risk of lethal danger in IPV situations. Multiple tools exist for assessing lethal danger in IPV situations, yet many do not include risk of lethal danger to children living in the household as a central element.^37,53  Knowledge of the range of risks posed to children exposed to IPV in the home might be useful in court determinations regarding child custody, social services assessments, and the development of a safety plan with adult victims and their children,^53,54  and in turn might prevent IPV-related firearm homicides of children.

Firearm homicides of children who had a history of abuse and/or neglect and experienced interpersonal violence in the month preceding their death had greater odds of involving IPV compared with those without these characteristics. Studies show children in homes with IPV are at greater risk of experiencing multiple forms of abuse,^55,56  with 1 earlier study reporting an estimated 30% to 60% cooccurrence of child abuse and neglect and children’s exposure to IPV in the home.⁵⁷  Approaches that target multiple forms of violence in families might aid in preventing harm to children.⁵⁸ 

Firearm violence in all its forms, including that which is IPV-related, is preventable. A broad range of evidence-based programs, policies, and practices have been developed to help prevent IPV in general and that which involves the use of firearms.^27,59  Evidence from these programs highlights the importance of:

1. teaching safe and healthy relationship skills and conflict resolution;

2. disrupting the developmental pathways toward partner violence;

3. creating safe, stable, and nurturing relationships, environments, and communities for children and youth;

4. creating protective environments; and

5. supporting IPV survivors to increase safety and lessen harms, as strategies to reduce IPV across the lifespan.^27,58 

Furthermore, a variety of federal and state laws focused on reducing access to firearms for individuals with a history of domestic violence have been implemented.⁵⁹  For example, a recent review of the evidence concluded that prohibitions associated with domestic violence restraining orders have been associated with decreases in total and firearm-related IPH⁵⁹ ; this may also translate into a reduced risk of harm to children in IPV situations. In addition, assessment of IPV in pediatric settings has been recommended as a practice-based approach to help identify and address child safety issues, including exposure to IPV.⁶⁰  One study that used screening for child safety issues among parents at an outpatient pediatric clinic found that 15% of children screened had been exposed to IPV.⁶¹  These strategies show prevention of IPV-related firearm homicides among children requires a multifaceted approach.

This study had several limitations. First, NVDRS data abstractors are limited to information included in investigative reports; there may have been incidents wherein some characteristics were present for the decedent but not captured in NVDRS. Second, in NVDRS, some precipitating circumstances (eg, child custody dispute) are subsumed under the circumstance IPV-related and might have been absent from LE and/or C/ME narratives used in the literal text search. Consequently, there may have been instances wherein these circumstances were not included in the narratives. Third, examining prespecified circumstances via the literal text search may have led to the exclusion of other factors associated with IPV-related child firearm homicides. Fourth, NVDRS does not systematically capture perpetrator motives, limiting our ability to present this additional context. Finally, states/jurisdictions joined NVDRS in different years, so data were not available from all states/jurisdictions for all years, limiting generalizability. Despite these limitations, our findings provide insights into the role IPV plays in firearm homicides of children, converging with patterns seen in IPH among adults.

This study adds to the existing literature on IPH involving adult intimate partners, providing additional evidence that IPV threatens the safety and well-being of children, including teens in dating relationships. In this study, conflict, crises, and other contributors emerged as factors associated with greater odds of IPV being a precipitator in firearm homicides of children. Furthermore, although the focus of this study was on children, over half of IPV-related firearm homicides of child corollary (nonintimate partner) victims included homicide of the adult intimate partner, mostly the child victim’s mother. Consequently, it is important to consider results from this study in combination with findings that emerge from studies on adult IPH. Moreover, although this study included teen IPH victims, most IPV-related child firearm homicides were corollary victims; future studies might consider disaggregating firearm homicides among child corollary victims and teen IPH victims. Firearm violence is a preventable public health crisis affecting countless children, families, and communities in the United States. Addressing multiple contributors of firearm violence, and those specific to IPV, is important for preventing firearm homicides of children.^27,28 

aOR

adjusted odds ratio

CI

confidence interval

C/ME

coroner or medical examiner

IPH

intimate partner homicide

IPV

intimate partner violence

LE

law enforcement

NVDRS

National Violent Death Reporting System

SE

Standard error