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The Lancet: Black women in the USA were murdered six times more often than White women between 1999 and 2020, state-level analysis indicates

( Analysis of racial disparities in US homicide rates indicates Black women were on average six times more likely to die by homicide than White women between 1999 and 2020. Homicide rates among Black women were significantly higher than for White women in all 30 states analysed, with some evidence suggesting the biggest differences are in states with the highest racial inequities. The greatest disparity in homicide rates was in Wisconsin in 2019-2020, when Black women were 20 times more likely to be murdered than White women. Black women in the USA were more likely than White women to be killed by a firearm, particularly those in the Northeast and Midwest.  *Data on the 30 individual states included in the analysis can be found in Table 1 in the Article.* 

Black women in the USA were, on average, six times more likely to be murdered than their White peers over the past 20 years, according to a new analysis published in The Lancet. 

The study is the first to analyse homicide trends spanning two decades among women aged 25 to 44 – the ages when women are most likely to be murdered. It also indicates that Black women are more likely than White women to be killed by guns. 

It is well known that homicide rates among Black women in the USA are disproportionately high compared to White women, and that Black women tend to be murdered at younger ages and at higher rates than other women of colour in the USA, including Native American and Alaska Native women. Despite this, data on the disparities remains limited. 

“As a scholar whose research examines intimate partner violence, I have long known that there were disparities in homicide rates between Black and White women. To uncover the fact that Black women are murdered at rates as high as 20 to 1 in some states is heart-breaking and underscores the urgent need to make substantive structural shifts,” says Dr Bernadine Waller, lead author of the paper and a National Institute of Mental Health (NIMH) postdoctoral research fellow in the Psychiatry Department at Columbia University Irving Medical Center with a dual appointment at New York State Psychiatric Institute. [2]

Recent evidence suggests a strong link exists between higher homicide rates and the effects of deeply entrenched racial inequities – which manifest through factors such as educational attainment, unemployment, and wealth distribution – across the USA [1]. This suggests that measures to reduce structural racism in the USA could help prevent elevated rates of homicide among Black women. Understanding how disparities in homicide rates change over time at state and regional levels may help identify areas where intervention is needed most. 

To address this gap in knowledge, the authors used CDC WONDER public health data to carry out a cross-sectional analysis of homicide death rates for Black and White women in the USA between 1999 and 2020. The analysis focused on women aged 25-44 years in the 30 states with enough homicides (more than nine in any year) for analysis. 

Results were produced for five time periods: 1999-2003; 2004-2008; 2009-2013; 2014-2018; and 2019-2020. The method of homicide was analysed for four US regions: South, Midwest, West, and Northeast. 

The findings indicate that Black women in the USA overall had higher homicide rates compared to White women between 1999 and 2020. The overall homicide rate among Black women in 2020 was 11.6 per 100,000 population, compared with 3 per 100,000 among White women. This was virtually unchanged from 1999, when the rate among Black women was 11.6 per 100,000 compared to 2.9 per 100,000 in White women. While disparities in homicide rates fell between 1999 and 2013 – due to a decrease in homicide rates in Black women – they increased from 2013 to 2020. At the state level, there were also differences in how disparities in homicide rates decreased or increased between 1999 and 2020 (see Figure 2). 

Homicide rates among Black women were higher than their White peers during all periods in every state analysed. Overall, the greatest disparities were in the Midwest, where Black women in 2020 were over seven times more likely to be murdered than White women. The greatest inequities in homicide rates were in Wisconsin in 2019-2020, when Black women were 20 times more likely to be murdered than White women. 

Notably, states with the greatest disparities in homicide rates were in parts of the country with a high proportion of people of low socioeconomic status living close together. These areas also tend to have histories of slavery and lynching, and are places where especially tense Black Lives Matter protests took place at the height of the COVID-19 pandemic. However, there are also many underlying factors involved, such as gender – males are more often responsible for intimate partner violence and shootings – but these were not investigated in the study.

“Our findings indicate that the greatest inequities are in the areas of the country where concentrated disadvantage is pronounced. Thus, focusing on historical structural racism’s long-lasting legacy in the USA is imperative. Efforts aimed at reducing disproportionate homicide deaths among Black women can be implemented through addressing the role of structural racism when it comes to policies and practices that increase Black women’s risk and lessen Black women’s access to much needed resources,” said Victoria A. Joseph, a co-author of the paper and Data Analyst at Mailman School of Public Health Epidemiology, Columbia University. [2]

Gun deaths among Black and White women in the USA increased, with women in general more than twice as likely (odds of 2.44) to be killed by firearms in 2019-2020 compared to 1999-2003. However, Black women were more likely than White women to be killed by a firearm (odds of 1.38). 

The odds of gun deaths among Black women increased over time compared to White women. In 2020, Black women in the Northeast were three times more likely than White women (odds of 3.30) to be killed by a firearm, while firearm homicides among Black women in the Midwest were more than seven times higher (odds of 7.22) than among White women. In the South, Black women were around one and a half times (odds of 1.51) more likely to be killed by a firearm. The West’s sample size was too small to be included in this part of the analysis.  

“Available data indicate that homicides in the USA continued to escalate in many areas of the country during the COVID-19 pandemic, which also intersected with widespread national protests after the murder of George Floyd. These trends reflect systems that have long disserviced communities of colour, and underscore that sustained investment and vision to support underserved communities are critical to reverse racial injustices that impact health and wellbeing.” said Katherine Keyes, senior author of the paper and Professor of Epidemiology at Mailman School of Public Health, Columbia University. [2]

The authors acknowledge some limitations to their study. Data was not available for all 50 US states as the number of homicides in some states was too low for analysis. Therefore, the findings apply only to the states analysed. Homicides are reported to have increased substantially between 2019 and 2020, particularly among Black populations. However, the study may underestimate current disparities in homicide rates as data for 2019 and 2020 was combined for reporting purposes. Evidence from previous studies indicates that violence caused by a current or former partner – especially against women – increased during the COVID-19 pandemic [3], but data beyond 2020 was not available in this study. Black women are a diverse group, including African American women, African, Afro Caribbean, Black Hispanic, and Black European women, but reporting methods did not allow for analysis of disparities within subgroups.

Writing in a Linked Comment, Rebecca F Wilson and Janet M Blair, of the U.S. Centers for Disease Control and Prevention (CDC), who were not involved in the study, said: “All homicides, including those of women, are preventable. The findings from Waller and colleagues’ study provide the visibility needed to address the public health crisis of homicides of women and the inequities in homicide experienced by Black women.” They highlight the importance of enacting state-level legislation to tackle the disparities in homicide rates among Black women, saying: “These legislative efforts offer a beacon of hope that the disproportionate homicide of Black women will be addressed as a crisis of epidemic scale alongside the already recognised epidemic of homicides among Black men and boys.”


This study was funded by the U.S. National Institutes of Health. It was conducted by researchers from Columbia University.

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: if you have any questions or feedback, please contact The Lancet press office 

[2] Quote direct from author and cannot be found in the text of the Article.



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[] The Lancet: Black women in the USA were murdered six times more often than White women between 1999 and 2020, state-level analysis indicates