PROBLEM/CONDITION: In 2022, homicide was the second leading cause of death for Hispanic and Latino persons aged 15-24 years in the United States, the third leading cause of death for those aged 25-34 years, and the fourth leading cause of death for those aged 1-14 years. The majority of homicides of females, including among Hispanic and Latino persons, occur in the context of intimate partner violence (IPV). This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on IPV-related homicides of Hispanic and Latino persons in the United States. PERIOD COVERED: 2003-2021. DESCRIPTION OF SYSTEM: NVDRS collects data regarding violent deaths in the United States and links three sources: death certificates, coroner or medical examiner reports, and law enforcement reports. IPV-related homicides include both intimate partner homicides (IPHs) by current or former partners and homicides of corollary victims (e.g., children, family members, and new partners). Findings describe victim and suspect sex, age group, and race and ethnicity; method of injury; type of location where the homicide occurred; precipitating circumstances (i.e., events that contributed to the homicide); and other selected characteristics. Deaths related to each other (e.g., an ex-partner kills the former partner and their new partner) are linked into a single incident. State participation in NVDRS has expanded over time, and the number of states participating has varied by year; data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were used for this report. Of the 49 states that collect data, all except California and Texas collect data statewide; Puerto Rico and District of Columbia data are jurisdiction wide. Florida was excluded because the data did not meet the completeness threshold for circumstances. RESULTS: NVDRS collected data on 24,581 homicides of Hispanic and Latino persons, and data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were examined. Among homicides with known circumstances (n = 17,737), a total of 2,444 were classified as IPV-related (13.8%). Nearly half of female homicides (n = 1,453; 48.2%) and 6.7% (n = 991) of male homicides were IPV-related; however, among all Hispanic and Latino homicides, most victims were male (n = 20,627; 83.9%). Among the 2,319 IPV-related homicides with known suspects, 85% (n = 1,205) of suspects were current or former partners for female victims, compared with 26.2% (n = 236) for male Hispanic and Latino victims. Approximately one fifth (71 of 359 [19.8%]) of female IPV-related homicide victims of childbearing age with known pregnancy status were pregnant or ≤1 year postpartum. Approximately 5% of IPV-related homicide victims were identified as Black Hispanic or Latino persons (males: n = 67; 6.8%; females: n = 64; 4.4%). A firearm was used in the majority of Hispanic and Latino IPV-related homicides (males: n = 676; 68.2%; females: n = 766; 52.7%). INTERPRETATION: This report provides a detailed summary of NVDRS data on IPV-related homicides of Hispanic and Latino persons in the United States during 2003-2021. This report found heterogeneity of characteristics and circumstances of Hispanic and Latino IPV-related homicides. Whereas most Hispanic and Latino homicide victims were male, nearly 60% of Hispanic and Latino IPHs and IPV-related homicide victims were female. Additional research is needed to better understand the relation between IPHs and IPV-related homicides and race (distinct from ethnicity) and pregnancy. PUBLIC HEALTH ACTION: NVDRS provides critical and ongoing data on IPV-related homicides of Hispanic and Latino persons in the United States that can be used to identify existing strategies and develop new early intervention strategies to prevent IPV and the escalation of IPV to IPH. Strategies that have demonstrated promise in reducing rates of IPH include expanded availability of low-income housing units; sanctuary policies that outline the relation between immigration enforcement and law officers; state laws prohibiting firearm access to those subject to domestic violence restraining orders; improvement of community relations with police to implement risk-based interventions; and comprehensive social, economic, medical, and legal safety nets to create pathways out of abusive relationships, including for pregnant women. Community, local, state, and Federal leaders can combine data on IPV-related deaths and the best available evidence-based programming and policy to create community-engaged solutions that reflect the experience of their Hispanic and Latino communities, including historical and societal factors that increase risk for violence.

Intimate partner violence (IPV) can include emotional, physical, or sexual violence. IPV during pregnancy is a preventable cause of injury and death with negative short- and long-term impacts for pregnant women, infants, and families. Using data from the 2016-2022 Pregnancy Risk Assessment Monitoring System in nine U.S. jurisdictions, CDC examined associations between IPV during pregnancy among women with a recent live birth and the following outcomes: prenatal care initiation, health conditions during pregnancy (gestational diabetes, pregnancy-related hypertension, and depression), substance use during pregnancy, and infant birth outcomes. Overall, 5.4% of women reported IPV during pregnancy. Emotional IPV was most prevalent (5.2%), followed by physical (1.5%) and sexual (1.0%) IPV. All types were associated with delayed or no prenatal care; depression during pregnancy; cigarette smoking, alcohol use, marijuana or illicit substance use during pregnancy; and having an infant with low birth weight. Physical, sexual, and any IPV were associated with having a preterm birth. Physical IPV was associated with pregnancy-related hypertension. Evidence-based prevention and intervention strategies that address multiple types of IPV are important for supporting healthy parents and families because they might reduce pregnancy complications, depression and substance use during pregnancy, and adverse infant outcomes.

Objective: Reproductive coercion has been associated with adverse reproductive health experiences. This study examined the relationship between nonuse of contraception due to partner objection, one aspect of reproductive coercion, and selected pregnancy-related outcomes. Methods: We used 2016-2020 data from the Pregnancy Risk Assessment Monitoring System in 22 jurisdictions to assess the prevalence of nonuse of contraception due to a partner objection by select characteristics among individuals with a recent live birth who reported an unintended pregnancy. We calculated adjusted prevalence ratios (aPRs) to understand associations with health care utilization, postpartum behaviors and experiences, postpartum contraceptive use, and infant birth outcomes. Results: Among people with a recent live birth in the study jurisdictions (n = 29,071), approximately 5% reported nonuse of contraception due to a partner objection and unintended pregnancy. This experience was associated with lower prevalence of attending a health care visit before pregnancy (aPR 0.8, 95% confidence interval [CI] 0.7-0.9), first trimester prenatal care, and attending a postpartum checkup (aPR 0.7, 95% CI 0.6-0.9 for both). Higher prevalence was observed for postpartum depressive symptoms (aPR 1.3, 95% CI 1.1-1.6) and partner objecting to using birth control postpartum (aPR 2.8, 95% CI 2.1-3.9). Conclusions: Nonuse of contraception due to a partner objection at conception was associated with poor mental health and lower health care utilization around the time of pregnancy. Prevention efforts may include strategies that ensure provider screening for intimate partner violence, and evidence-based approaches that teach about healthy relationships, enhance self-efficacy, and address underlying drivers of violence.

OBJECTIVES: Public health emergencies can elevate the risk for intimate partner violence (IPV). Our objectives were 2-fold: first, to assess the prevalence of physical IPV and increased aggression from a husband or partner that occurred during pregnancy and was perceived to be due to the COVID-19 pandemic; second, to examine associations between these experiences and (1) COVID-19-related stressors and (2) postpartum outcomes. METHODS: We used data from the Pregnancy Risk Assessment Monitoring System that were collected in 29 US jurisdictions among individuals with a live birth in 2020. We estimated the prevalence of violence during pregnancy by demographic characteristics and COVID-19-related stressors. We calculated adjusted prevalence ratios (APRs) to examine associations of physical IPV or increased aggression with COVID-19-related stressors, postpartum outcomes, and infant birth outcomes. RESULTS: Among 14 154 respondents, 1.6% reported physical IPV during pregnancy, and 3.1% reported increased aggression by a husband or partner due to the COVID-19 pandemic. Respondents experiencing any economic, housing, or childcare COVID-19-related stressors reported approximately twice the prevalence of both types of violence as compared with those without COVID-19-related stressors. Physical IPV and increased aggression were associated with a higher prevalence of postpartum depressive symptoms (APRs, 1.73 and 2.28, respectively) and postpartum cigarette smoking (APRs, 1.74 and 2.19). Physical IPV was associated with a lower prevalence of attending postpartum care visits (APR, 1.84). CONCLUSIONS: Our findings support the need for ongoing efforts to prevent IPV during pregnancy and to ensure the availability of resources during public health emergencies.

Few studies have examined associations between parental incarceration (PI) and violence perpetration in adulthood. We used Wave I and Wave IV of the National Longitudinal Study of Adolescent to Adult Health to investigate such associations with intimate partner violence (IPV) perpetration. Exposure to PI was found significantly associated with increased risk of all IPV perpetration behaviors in adulthood, except forced sex. The association of PI exposure with issuing threats, pushing, and throwing objects did not differ by race/ethnicity or sex. Associations of PI exposure with slapping, hitting, or kicking and injuring a partner were stronger for non-Hispanic White persons than for non-Hispanic Black persons. Differing patterns of elevated violence risk in adults with PI history suggest tailored preventive strategies may be of value. © 2023 International Association for Correctional and Forensic Psychology.

OBJECTIVE: Women who have direct exposure to incarceration or indirect exposure through their partner are at high risk for poor health behaviors and outcomes, which may have lasting impacts on their children. The objectives of this study were to estimate the prevalence of recent incarceration exposure among women with a recent live birth and assess the relationship between incarceration exposure and maternal and child health. METHODS: We used data from the Pregnancy Risk Assessment Monitoring System (36 states and New York City, 2012-2015; N = 146 329) to estimate the prevalence of women reporting that they or their husband/partner spent time in jail during the 12 months before giving birth. We used multivariable logistic regression to assess associations between incarceration exposure and maternal and infant health conditions. RESULTS: The prevalence of incarceration exposure shortly before or during pregnancy was 3.7% (95% CI, 3.6%-3.9%). Women with incarceration exposure had increased odds of prepregnancy hypertension (adjusted odds ratio [aOR] = 1.51; 95% CI, 1.26-1.81), prepregnancy and postpartum depressive symptoms (aOR = 1.95 [95% CI, 1.73-2.19] and 1.49 [95% CI, 1.32-1.67], respectively), and having an infant admitted to the neonatal intensive care unit (aOR = 1.18; 95% CI, 1.04-1.33). CONCLUSION: Because a parent's incarceration exposure is an adverse childhood experience with the potential to disrupt important developmental periods and have negative impacts on the socioemotional and health outcomes of children, it is critical for researchers and health care providers to better understand its impact on maternal and infant health. Prenatal and postnatal care may provide opportunities to address incarceration-related health risks.

Intimate partner violence (IPV) during pregnancy presents a risk for maternal mental health problems, preterm birth, and having a low birthweight infant. We assessed the prevalence of self-reported physical, emotional, and sexual violence during pregnancy by a current partner among women with a recent live birth. We analyzed data from the 2016–2018 Pregnancy Risk Assessment Monitoring System in six states to calculate weighted prevalence estimates and 95% confidence intervals for experiences of violence by demographic characteristics, health care utilization, and selected risk factors. Overall, 5.7% of women reported any type of violence during pregnancy. Emotional violence was most prevalent (5.4%), followed by physical violence (1.5%), and sexual violence (0.9%). Among women who reported any violence, 67.6% reported one type of violence, 26.5% reported two types, and 6.0% reported three types. Reporting any violence was highest among women using marijuana or illicit substances, experiencing pre-pregnancy physical violence, reporting depression, reporting an unwanted pregnancy, and experiencing relationship problems such as getting divorced, separated, or arguing frequently with their partner. There was no difference in report of discussions with prenatal care providers by experience of violence. The majority of women did not report experiencing violence, however among those who did emotional violence was most frequently reported. Assessment for IPV is important, and health care providers can play an important role in screening. Coordinated prevention efforts to reduce the occurrence of IPV and community-wide resources are needed to ensure that pregnant women receive needed services and protection. © 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.

OBJECTIVES: Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged <2 years. METHODS: We conducted difference-in-difference analyses (ie, pre- and postdifferences in intervention vs control groups) of annual rates of states' hospital admissions attributed to abusive head trauma among children aged <2 years (ie, using aggregate data). We conducted analyses in 14 states with, and 13 states without, an EITC from 1995 to 2013, differentiating refundable EITCs (ie, tax filer gets money even if taxes are not owed) from nonrefundable EITCs (ie, tax filer gets credit only for any tax owed), controlling for state rates of child poverty, unemployment, high school graduation, and percentage of non-Latino white people. RESULTS: A refundable EITC was associated with a decrease of 3.1 abusive head trauma admissions per 100 000 population in children aged <2 years after controlling for confounders ( P = .08), but a nonrefundable EITC was not associated with a decrease ( P = .49). Tax refunds ranged from $108 to $1014 and $165 to $1648 for a single parent working full-time at minimum wage with 1 child or 2 children, respectively. CONCLUSIONS: Our findings with others suggest that policies such as the EITC that increase household income may prevent serious abusive head trauma.

Responses from N=60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types - household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5-2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups.

Black men who have sex with men (BMSM) are a population at the intersection of two minority statuses-racial minority and sexual minority. Membership in either group, compared to white or heterosexual group membership, may increase one's risk of negative childhood and adult experiences. Baseline data from an HIV intervention efficacy trial (the Black Men Evolving Study) were used to explore the prevalence of adverse childhood experiences (ACEs) among 536 BMSM and associations between ACEs and adult mental and physical health outcomes. Overall, the prevalence of ACEs was high among this sample of BMSM with almost 90% experiencing at least one ACE. Findings revealed that ACE score was significantly associated with adult mental health (AOR = 1.21, 95% CI [1.12, 1.30]), but not with adult physical health. All ACEs were significantly associated with mental health, but only physical neglect and household substance abuse were significantly associated with physical health (AOR = 1.69, 95% CI [1.02, 2.74] and AOR = 1.57, 95% CI [1.03, 2.40], respectively). The findings support the need for interventions targeting improved adult health outcomes, particularly for minority groups, to consider the impact of early adversity on health and wellness.

PURPOSE: We examined whether intimate partner relationships in general, and satisfying and stable intimate partner relationships in particular, protect victims of child maltreatment from depressive symptoms during young adulthood. METHODS: Prospective, longitudinal data on 485 parents, 99 maltreated during childhood, were used. Longitudinal multilevel models (12 annual interviews, conducted from 1999 to 2010, nested in individuals) were specified to estimate the effects of relationship characteristics on depressive symptomatology by maltreatment status. RESULTS: Relationship characteristics operated as direct protective factors for maltreated and not maltreated individuals. Higher relationship satisfaction and stability were prospectively predictive of less depressive symptomatology. Models of inter and intraindividual variability were also consistent with significant direct protective effects. Between persons, a more satisfying and stable relationship was associated with fewer depressive symptoms. Within person, periods when an individual moved into a relationship and periods of enhanced satisfaction and stability were associated with fewer depressive symptoms. Relationship satisfaction and stability operated as significant buffering protective factors for the effect of maltreatment on depressive symptoms in most models, suggesting that positive intimate partner relationships may reduce the risk that childhood maltreatment poses for adult depressive symptoms. CONCLUSIONS: The Centers for Disease Control and Prevention identifies safe, stable, and nurturing relationships as key in preventing maltreatment and its consequences. This study adds to the evidence on the protective role of safe, stable, and nurturing relationships by identifying intimate partner relationship factors that may protect parents who were maltreated during childhood from depressive symptoms.

PURPOSE: The present paper summarizes findings of the special issue papers on the intergenerational continuity of child maltreatment and through meta-analysis explores the potential moderating effects of safe, stable, nurturing relationships (SSNRs). METHODS: Studies were selected for inclusion in this meta-analysis if they (1) were published in peer-reviewed journals; (2) tested for intergenerational continuity in any form of child maltreatment, using prospective, longitudinal data; and (3) tested for moderating effects of any variable of SSNRs on intergenerational continuity of child maltreatment. The search revealed only one additional study beyond the four reports written for this special issue that met inclusion criteria for the meta-analysis. RESULTS: Estimates of intergenerational stability of child maltreatment from the studies included in this special issue are consistent with several other studies, which find that child maltreatment in one generation is positively related to child maltreatment in the next generation. Furthermore, meta-analytic results from the five studies that met the inclusion criteria suggest a protective, moderating effect of SSNRs on intergenerational continuity of child maltreatment. The calculated fail-safe index indicated that 49 unpublished intergenerational studies with an average null effect would be required to render nonsignificant the overall moderation effect of SSNRs on child maltreatment. CONCLUSIONS: This special issue expanded the examination of SSNRs beyond the caregiver-child dyad. That is, these studies considered SSNRs in adult relationships as well as parent-child relationships. Results suggest that certain types of SSNRs between parents and other adults (e.g., romantic partner, co-parent, or adult social support resource) may decrease maltreatment continuity.

This special issue is the result of a successful collaboration between the Centers for Disease Control and Prevention (CDC) and researchers leading four important longitudinal studies on intergenerational patterns of violence: The Environmental Risk Longitudinal Twin Study (E-Risk) [1]; the Family Transitions Project (FTP) [2]; the Lehigh Longitudinal Study [3]; and the Rochester Youth Development Study [4]. The papers that follow investigate the role of safe, stable, and nurturing relationships and social contexts in the lives of children and their caregivers, provide insight into complex relationship factors that influence the intergenerational continuity of child maltreatment, and point to a number of important avenues to improve the lives of children and families by preventing violence and promoting health and well-being. | Child maltreatment is a significant public health problem that requires a multifaceted approach to prevention. It is estimated that one out of every ten children in the United States experiences one or more forms of physical, sexual, or emotional abuse or neglect by a parent or other caregiver at some point during their lifetime [5], [6], [7]. In 2011, social service workers identified 681,000 children1 in the United States as substantiated victims of maltreatment. This equates to an overall victimization rate of 9.1 per 1,000 children in the U.S. population [8]. It is well-established that experiencing child maltreatment is associated with a variety of negative physical, emotional, and psychological outcomes, including subsequent harsh and/or neglectful parenting in adulthood [9], [10], [11], [12], [13]. Yet, it is also clear that not all maltreated children grow up to become maltreating parents [14], [15]. Thus, identifying factors that distinguish families in which the cycle of violence is maintained from families in which it is interrupted is critical for violence prevention and optimal child development.

PURPOSE: We examine two research questions. First, does a history of child maltreatment victimization significantly increase the likelihood of maltreatment perpetration during adulthood? Second, do safe, stable, and nurturing relationships (SSNRs) during early adulthood serve as direct protective factors, buffering protective factors, or both to interrupt intergenerational continuity in maltreating behaviors? METHODS: Data come from the Rochester Youth Development Study that followed a community sample from age 14 to 31 with 14 assessments. Maltreatment victimization records covering birth through age 17 were collected from Child Protective Services records as were maltreatment perpetration records from age 21 to 30. Data on five SSNRs were measured during three interviews from ages 21 to 23. RESULTS: There is a significant relationship between maltreatment victimization and maltreatment perpetration (odds ratio = 2.57; 95% confidence interval = 1.47-4.50). Three of the five SSNRs investigated-relationship satisfaction, parental satisfaction, and attachment to child-served as direct protective factors, significantly reducing risk for those who had been maltreated. However, none of the interaction terms-between maltreatment victimization and the SSNR-was statistically significant, indicating that the SSNRs did not serve as buffering protective factors CONCLUSIONS: Although a history of maltreatment significantly increases the risk of subsequent perpetration of maltreatment, enhancing SSNRs with intimate partners and with children during early adulthood can decrease the odds that a victim of maltreatment will become a perpetrator. Mandated reporters and service providers should be aware of the risk posed by earlier maltreatment and be prepared to ameliorate that risk, in part by strengthening supportive social relationships.

OBJECTIVES: We investigated the relationship between parental incarceration history and young adult physical and mental health outcomes using Wave 1 and Wave 4 data from the National Longitudinal Study of Adolescent Health. METHODS: Dependent variables included self-reported fair/poor health and health diagnoses. The independent variable was parental incarceration history. Cross-tabulations and logistic regression models were run. RESULTS: Positive, significant associations were found between parental incarceration and 8 of 16 health problems (depression, posttraumatic stress disorder, anxiety, cholesterol, asthma, migraines, HIV/AIDS, and fair/poor health) in adjusted logistic regression models. Those who reported paternal incarceration had increased odds of 8 mental and physical health problems, whereas those who reported maternal incarceration had increased odds of depression. For paternal incarceration, with the exception of HIV/AIDS, larger associations were found for mental health (odds ratios range 1.43-1.72) as compared with physical health (odds ratios range 1.26-1.31) problems. The association between paternal incarceration and HIV/AIDs should be interpreted with caution because of the low sample prevalence of HIV/AIDs. CONCLUSIONS: This study suggests exposure to parental incarceration in childhood is associated with health problems in young adulthood. Extant literature suggests underlying mechanisms that link parental incarceration history to poor outcomes in offspring may include the lack of safe, stable, nurturing relationships and exposure to violence. To prevent poor health in offspring of the incarcerated, additional studies are needed to (1) confirm the aforementioned associations and (2) assess whether adverse experiences and violence exposure in childhood mediate the relationship between parental incarceration history and offspring health problems.

The development of work on direct protective factors for youth violence has been delayed by conceptual and methodologic problems that have constrained the design, execution, and interpretation of prevention research. These problems are described in detail and actively addressed in review and analytic papers developed by the CDC's Expert Panel on Protective Factors for youth violence. The present paper synthesizes findings from these papers, specifies their implications for public health research and prevention strategies to reduce youth violence, and suggests directions for future research.

The CDC Expert Panel on Protective Factors for Youth Violence Perpetration was convened to review and advance the status of etiologic and prevention research on direct protective and buffering protective factors for youth violence perpetration. The current paper introduces Phase One of the panel's work, which focuses on direct protective factors and includes the papers in this supplement to the American Journal of Preventive Medicine. This paper provides the context for the panel's work, describes its practical and theoretic importance, and summarizes why independently defined direct protective factors and risk factors are important for the advancement of our understanding of youth violence and its prevention. Lastly, this paper briefly describes the organization of the work of the panel as well as the research products that comprise the contents of the supplement.