• M G Gilliland, P R Spence, and R L Spence.
• Dept. of Clinical Pathology, Brody School of Medicine, ECU, Greenville 27834, USA.
• N C Med J. 2000 Sep 1; 61 (5): 287-90.

AbstractStrategies for preventing domestic violence can be tailored to a particular geographic or socioeconomic area if the patterns of domestic violence in the area are known. National statistics, although widely available, may not be applicable to a specific region. We reviewed homicide deaths in Eastern North Carolina between 1978 and 1999 to identify patterns in this rural area. Approximately 20% of the homicide deaths in eastern North Carolina are caused by intimate partners. Women accounted for 53% of the victims in 1976, similar to national figures but not rising to 72% as seen nationally in 1998. Latinos are an increasing presence in the area, but had only one recorded episode of lethal violence against an intimate partner. Gunshots accounted for most of the deaths (59% in men, 72% in women). Knowledge of such patterns can assist in selecting prevention strategies for this particular area. Over the last 25 years increasing attention has been devoted to domestic violence (DV), initially defined as abuse committed against a spouse, former spouse, fiancée, boy- or girlfriend, or cohabitant. As time has passed, the definition has been broadened to include other family members--elders, children, and siblings. The Centers for Disease Control and Prevention (CDC) now uses the term "intimate partner violence" for intentional emotional or physical abuse inflicted by a spouse, ex-spouse, a present or former boy- or girlfriend, or date. For the purposes of this paper, we consider DV interchangeable with intimate partner violence. There has been a national concern that abusive events are under-reported. The National Crime Victimization Survey, an anonymous household survey, indicated nearly 1 million incidents of non-lethal intimate partner violence per year between 1992 and 1996. The number decreased from 1.1 million in 1993 to 840,000 in 1996. Attempts to validate such data for a given geographic area often require subjects to violate anonymity--this may account for lower reports of violence. A recent national report from the Justice Department found a decline in both lethal and non-lethal DV. The number of men murdered by wives or girlfriends "plunged 60% from 1976 through 1998". FBI data on homicides showed that "intimate partners committed fewer murders each year during 1996, 1997, and 1998 than in any other year since 1976". Nationally, intimate partners caused 3000 deaths in 1976, 1590 (53%) in women; in 1998, they caused 1830 deaths, 1320 (73%) in women. But fatal cases of DV are only the tip of the iceberg, and may pertain only to a particular geographic area. We undertook the present study to assess the prevalence of lethal domestic violence in the 29 counties of eastern North Carolina (ENC) that make up the catchment area for the University Health Systems of Eastern Carolina (UHSEC). UHSEC includes the Brody School of Medicine at East Carolina University (BSM-ECU; previously known as East Carolina University-SOM) and Pitt County Memorial Hospital.

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