Objective To analyze urban/rural fluctuations of homicide in Colombia, 1992–2015, and compare those changes with the contextual setting in which them ocurred.
Methods Ecological study of time trends using individual records of homicides and population aggregated data for those aged 15–64. Age-standardized homicide rates (ASHR) were calculated in men and women separately by year, sex, age and Urban/Rural area. Urban/Rural (Ref.) Rate Ratios (RR) were calculated adjusting also by regions. Joinpoint analyzes in ASHR and RR were performed to identify inflection points and Annual Percent Change (APC) between them.
Results For the whole period larger homicide rates were found among men than among women (ASMR=95.4 and 7.3 homicides per 1000 population respectively). Urban/Rural ASMR were respectively 107.1/91.5 among men and 9.8/6.6 per 1000 population among women. Four joinpoints are vastly coincident in total, urban and rural homicide: A peak in 1992 was followed by a lessening until 1997 only significant in urban areas (APC=−9.0% among men and −9.8 among women) and then a strong increase up to 2002. From this point a steady reduction in ASHR follows up to 2015, which slightly curbed from 2005. For almost the entire period, higher rates of rural homicide were found, and at the end of the period this ratio equated.
Conclusions Contrasting with other countries we found larger homicide in rural areas. Fluctuations of homicide in Colombia coincided with dynamics of the internal armed conflict. In recent years, we found an increasing burden of urban lethal violence, mainly pushed by homicides in younger men, conveying a new challenge for post-conflict in Colombia.