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This study compared data from death certificates (DC), medical examiner (ME) reports, and Uniform Crime Reporting (UCR) Program for homicides among children age 5 years or younger in Jefferson County, Alabama between 1988 and 1998. Records from each source were matched independently to records from the other two sources. Kappa coefficients measured the chance-corrected agreement between sources. The strongest correlations were for victim's gender and race. Correlations were weakest for victim's relationship to the offender and offender's gender. DC and ME data demonstrated excellent agreement and provided a comprehensive count of homicides in Jefferson County, whereas UCR comparisons had lower correlations. However, the UCR is a valuable source of child homicide data in the United States that is underutilized in public health research.

Objective: The purpose of this study was to present the epidemiology of homicide among children younger than 6 years of age in Jefferson County, Alabama. This study focused On obtaining great detail on homicides and suspicious deaths occurring within a fixed population. Methods: For purposes of this study, cases included Jefferson County deaths attributed to 'homicide' or that were 'undetermined' as noted in the coroner files among 'children younger than 6 years of age who were born and died between January 1, 1988 and December, 31, 1998, Victim and offender characteristics were obtained from the Jefferson County Coroner Medical Examiner Office records. Environmental factors and circumstances surrounding the death were noted as well. Results: The 53 study subjects were mainly female (55%), Black (69%), younger than 2 years of age (85%), had single mothers (38%), and a history of abuse (53%). Offenders were more likely to be male (64%), Black (73%), and a parent of the victim (53%). Homicides primarily resulted from an angry impulse (61%), with hands the most common weapon (61%). Conclusions: The majority of deaths in this study occurred among children younger than age 2, with a high proportion of fatalities among Black children of unmarried mothers. The offender most often knew the victim, with half of all homicides and two-thirds of all infant homicides involving a parent. More than half of the homicides resulted from an angry impulse, while the most common scenario for deaths with undetermined intent involved the caretaker finding the child unresponsive. Keywords: Epidemiology; Homicide; Children; Coroner data