The Epidemiology of Violent Mortality in Nairobi: A Study on Homicides, Accidents, and Suicides

Abstract

Background: Violent deaths, including accidents, homicides, and suicides, are major contributors to mortality in Nairobi, Kenya. The high prevalence of these fatalities presents a significant public health challenge, necessitating a better understanding of their distribution and contributing factors to inform effective intervention strategies.
Objectives: This study aimed to determine the prevalence, causes and socio-demographic distribution of violent deaths in Nairobi, identify the main causes of these deaths (accidents, homicides, and suicides), and assess their relative impact on the city’s overall mortality.
Methodology: A descriptive prospective study was conducted at the City Mortuary in Nairobi from June 1, 2009, to May 31, 2010. A total of 2,566 autopsies were performed during the study period, of which 2,278 (88.8%) were attributed to violent causes.
Results: The study showed that violent deaths constituted 88.8% of all autopsies conducted. Accidents were the leading cause of violent deaths, accounting for 46.7% (1,064 cases), followed by homicides at 43.5% (990 cases) and suicides at 9.8% (224 cases). The overall prevalence of violent deaths in Nairobi was 61.6 per 100,000 population. Prevalence rates for specific categories were 28.8 per 100,000 for accidental deaths, 26.8 per 100,000 for homicides, and 5.4 per 100,000 for suicides.Statistical analysis using chi-square tests showed that violent deaths were significantly more common than natural deaths (χ² = 1857.89, p < 0.01). ANOVA results further indicated significant differences across the three categories of violent deaths (F = 57.32, p < 0.01).Violent deaths affected both males and females aged 10–60 years, with notable variation in age and gender distribution across accidents, homicides, and suicides. The mean age of victims was 32.8 years (range: 10–59). Males accounted for 2,095 (92%) of the 2,278 violent deaths, while females accounted for 183 (8%), resulting in an overall male-to-female ratio of 11.4:1.The 30–39 age group was the most affected, representing 914 deaths (40.1%), followed closely by the 20–29 age group with 844 deaths (37.1%). Together, these two age groups made up more than 77% of all violent deaths. The male-to-female ratio was highest in the 20–29 age group (17.7:1), followed by the 30–39 age group (10.4:1).
Conclusion: Violent deaths are a significant public health issue in Nairobi, with accidents and homicides being the leading causes. The findings emphasize the need for targeted public health interventions, including improved road safety measures, strengthened law enforcement, and expanded mental health services to prevent suicides.
Recommendations: To reduce violent deaths, efforts should focus on enhancing road safety through better infrastructure and law enforcement, improving crime prevention via effective policing and addressing socio-economic disparities, expanding mental health services, and investing in programs to alleviate poverty, unemployment, and social inequality.