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Fatalities related to intimate partner violence: towards a comprehensive perspective
  1. Julie M Kafka1,
  2. Kathryn E Moracco1,
  3. Belinda-Rose Young1,
  4. Caroline Taheri2,
  5. Laurie M Graham3,
  6. Rebecca J Macy4,
  7. Scott K Proescholdbell5
  1. 1 Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  2. 2 Department of Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
  3. 3 University of Maryland Baltimore, Baltimore, Maryland, USA
  4. 4 School of Social Work at the Univeristy of North Carolina Graduate School, Chapel Hill, NC, USA
  5. 5 Injury and Violence Prevention Branch: North Carolina Division of Public Health, Raleigh, North Carolina, USA
  1. Correspondence to Julie M Kafka, Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC 27599, USA; julie.kafka{at}


Background In 2015, 1350 people in the US were killed by their current or former intimate partner. Intimate partner violence (IPV) can also fatally injure family members or friends, and IPV may be a risk factor for suicide. Without accounting for all these outcomes, policymakers, funders, researchers and public health practitioners may underestimate the role that IPV plays in violent death.

Objective We sought to enumerate the total contribution of IPV to violent death. Currently, no data holistically report on this problem.

Methods We used Violent Death Reporting System (VDRS) data to identify all IPV-related violent deaths in North Carolina, 2010–2017. These included intimate partner homicides, corollary deaths, homicide-suicides, single suicides and legal intervention deaths. We used the existing IPV variable in VDRS, linked deaths from the same incident and manually reviewed 2440 suicide narratives where intimate partner problems or stalking were a factor in the death.

Results IPV contributes to more than 1 in 10 violent deaths (10.3%). This represents an age-adjusted rate of 1.97 per 100 000 persons. Of the IPV-related violent deaths we identified, 39.3% were victims of intimate partner homicide, 17.4% corollary victims, 11.4% suicides in a homicide-suicide event, 29.8% suicides in a suicide-only event and 2.0% legal intervention deaths.

Implications If researchers only include intimate partner homicides, they may miss over 60% of IPV-related deaths. Our novel study shows the importance of taking a comprehensive approach to prevent IPV and decrease violent deaths. IPV is a risk factor for suicide as well as homicide.

  • firearm
  • violence
  • surveillance
  • mortality
  • gender

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  • Contributors JK managed the data, completed the analyses and led the writing. BM conceived of the study and was also actively involved in the writing. JK, BM, B-RY and CT were the four coders for the 2400 suicide narratives. LMG helped to conceive and operationalise the initial idea for the study and contributed to revisions of the manuscript. RM assisted with interpretation of the findings and revisions of the manuscript. SKP assisted with data interpretation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This project was deemed non-human subjects research by the Institutional Review Board (IRB) of the University of North Carolina, Chapel Hill.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. North Carolina Violent Death Reporting System data (NC-VDRS) are housed at the North Carolina Department of Public Health in Raleigh, North Carolina. De-identified data were used for this project and provided to the study team under a Data Use Agreement (DUA) with oversight from the UNC Chapel Hill Institutional Review Board (IRB). A detailed study and data plan was submitted as part of the DUA process. Additional details can be found at the NC-VDRS website (