Inequities in Intimate Partner Homicide: Social Determinants of Health Mediate Racial/Ethnic Disparities.

Abstract

Intimate partner violence accounts for up to one half of all homicides of women in the U.S. Rates of intimate partner homicide are associated with both race/ethnicity and social determinants of health, but their relative contribution is incompletely understood. The authors used negative binomial regression to model the relationship between counties' racial/ethnic composition and their rates of intimate partner homicide of women, controlling for urbanicity, median income, gender pay gap, unemployment, school funding, and violent crime rate. Data from 49 states and the District of Columbia between 2016 and 2021 were used. Analyses were conducted in 2024. In unadjusted analysis, counties with a lower proportion of White residents experienced higher rates of intimate partner homicide (incidence rate ratios [IRR]=1.11; 95% CIs=1.08, 1.13). When controlling for social determinants of health, this association was not observed (IRR=1.01; 95% CI=0.97, 1.04). Median income, school funding, and violent crime rate were independent predictors of intimate partner homicide in the multivariate model. Racial/ethnic composition of a population does not independently predict its rate of intimate partner homicide when controlling for social determinants of health. Racial/ethnic inequities in intimate partner homicide are largely attributable to structural factors, which may be modifiable through policy changes.