Homicides among people with disabilities, United States, 2003–2022

Abstract Background People with disabilities (PwD) are at an increased risk of experiencing nonfatal violence; however, the risk of fatal violence victimization (i.e., homicide) among this population is less well established. Methods We used National Violent Death Reporting System (NVDRS) data for homicide victims with disabilities for 2003 to 2022 in 50 states, the District of Columbia, and Puerto Rico. NVDRS is a surveillance system that collects data on violent deaths, linking information from death certificates, coroner or medical examiner records, and law enforcement reports. NVDRS does not currently include standard variables on disability status or disability type; these decedent characteristics were identified using a literal text search of textual data. Descriptive statistics were used to characterize homicides among PwD. Results From 2003 to 2022, NVDRS collected 1,498 homicides among people with disabilities. The largest proportion of victims had a neurological disability (36.7%), followed by cognitive disability (35.5%), physical disability (22.4%), or unspecified disability type (5.4%); 18.2% had multiple disability types. Those aged ≥ 65 years accounted for 45.1% of all victims; the largest proportion of victims were ≥ 75 years old (29.7%). A firearm was used in 38.5% of these homicides. The top three precipitating circumstances of these homicides were: caregiver abuse and neglect (27.0%), argument (26.0%), and intimate partner violence (IPV; 24.0%). Caregiver abuse or neglect precipitated 38.1% of homicides among female victims, versus 19.1% of male victims. IPV precipitated 43.7% of female homicides, versus 9.1% of male homicides. Half (49.5%) of all victims had a mental health problem at the time of death; 23.3% had a history of ever being treated for a mental health problem; 17.8% were receiving mental health treatment at the time of death. Conclusion This study characterized homicides among PwD. Older adults accounted for nearly half of all victims, and mental health conditions such as dementia and Alzheimer’s disease were frequently present among decedents, especially female victims. Among older adults and child victims, caregiver abuse/neglect was common. Our results underscore the importance of supporting caregivers of PwD, creating protective environments for PwD, systematically collecting data on violence against PwD, and tailoring prevention strategies to address the needs of PwD.