Interpersonal Violence Research Articles

Interactive associations of cannabis and alcohol outlet densities with assault injuries in California: A spatiotemporal analysis.

Recreational cannabis outlets may influence rates of interpersonal violence, but research has yielded inconsistent findings. Modification by alcohol outlet density may help explain inconsistencies. We estimated the impacts of recreational cannabis outlets on neighborhood-level assault injury rates in California and evaluated whether alcohol outlet density moderated these associations. We applied Bayesian spatiotemporal analyses to ZIP code-level statewide data on alcohol outlets, recreational cannabis outlets, and injuries and deaths due to firearm and nonfirearm assault, 2017-2019, accounting for confounders and spatial autocorrelation. Using the model posteriors, we estimated parameters corresponding to hypothetical shifts in outlet densities, overall and by age, sex, and race/ethnicity. If recreational cannabis outlets were never introduced, we estimated that nonfirearm assault injuries would have been 1.63 per 100,000 lower (95%CI: -3.08, 0.01) but we observed no association with firearm assault injuries (RD per 100,000: -0.07; 95%CI: -0.34, 0.21). These associations did not depend on alcohol outlet density, but a hypothetical 20% reduction in alcohol outlet densities was associated with fewer firearm (RD per 100,000: -1.89; 95%CI: -0.46, 0.09) and nonfirearm (RD per 100,000: -5.67; 95%CI: -7.44, -3.95) assault injuries. The introduction of recreational cannabis outlets may have contributed to a small increase in nonfirearm assault injuries.

An Empirical Investigation of Disability-Related Interpersonal Violence Through an Intersectional Research Paradigm: Methodological Considerations and Implications.

The study uses an econometric approach to disaggregate data on disability-related violence reported in Accident and Emergency departments in London to investigate the extent to which the intersections of gender, ethnicity, and age characteristics of disabled people increase their risk of experiencing interpersonal violence. Our empirical findings suggest that females and older individuals are generally more likely to be interpersonal violence victims. The disability dummy is positive and significant, irrespective of gender or ethnicity. This implies that persons with disabilities are more likely to be victims of interpersonal violence than individuals without disabilities, regardless of gender and ethnicity. The most important discovery concerns the magnitude of the dummy coefficient regarding the disability of individuals. The coefficient is the largest for females of Black origin with disabilities, followed by Asians, with white origin exhibiting the smallest coefficient. This suggests that people with disabilities of Black origin are more likely to experience interpersonal violence than the Asian or white community. The study outcomes provide novel and rigorous empirically validated knowledge of the intersectional vectors of power that impact the risk of experiencing disability-related interpersonal violence while informing the development of intersectionality-based policy approaches to tackling disability-related interpersonal violence.

A multilevel latent class analysis of adolescent engagement in interpersonal violence: The role of stressful life events, school climate, and school characteristics.

A multilevel latent class analysis of adolescent engagement in interpersonal violence: The role of stressful life events, school climate, and school characteristics.

Internalized poverty-related stigma and interpersonal violence among women living with HIV in the US

Background: Interpersonal violence (IPV) affects half of women living with HIV (WLHIV) in the US and has important consequences for mental health and HIV outcomes. While different types of stigmas (e.g., HIV- or sexual identity-related) are associated with increased risk of IPV, the relationship between poverty-related stigma and IPV is unclear, even though poverty frequently co-occurs with IPV. Methods: Data from up to four annual visits (2016-2020) were collected from 374 WLHIV enrolled in a sub-study of the Women’s Interagency HIV Study (WIHS; now known as MACS/WIHS Combined Cohort Study) at four sites across the US. A validated measure of the perceived stigma of poverty was used, along with questions on recent experiences of IPV. We used a mixed-effects model to assess the association between internalized poverty stigma and IPV. Results: The unadjusted model with internalized poverty-stigma and recent IPV as independent and dependent variables, respectively, suggested that the two were associated (prevalence ratio 1.29 [95% CI 1.02-1.62, p=0.033]). After adjusting for income and education, we found an independent association between internalized poverty-related stigma and recent IPV, with a prevalence ratio of 1.35 (95% CI 1.07-1.71, p=0.011). Conclusion: Our findings suggest that reducing the psychological consequences of poverty may better situate WLHIV to escape or avoid IPV. The usefulness of screening WLHIV who may be experiencing poverty-related stigma for IPV should be investigated. Interventions that address internalized poverty-related stigma may provide an avenue for reducing the harms caused by IPV in addition to interventions aiming to reduce violence itself.

Intimate Partner Violence Among Three Key Populations at Risk of HIV in Panama

This study aims to estimate the prevalence of interpersonal personal violence (IPV) among three key populations at an increased risk of HIV in Panama (namely, transgender women, sex workers, and men who have sex with men [MSM]) and to estimate the positivity rate of four sexually transmitted infections (STIs), including HIV. Participants from the 2018 PEMAR study with a stable primary partner completed a 31-item survey with demographic data, the Spanish version of the four-item HITS questionnaire (being physically Hurt, Insulted, Threatened, or Screamed at; Cronbach’s α = .816), and an optional blood draw for STI testing. Prevalence rates of IPV were estimated with their respective 95% CIs after imputing 3.93% of missing values. The analytic sample (N= 356) included 76.0% MSM, 15.5% sex workers, and 9.3% transgender women, most of whom were in their 30s, married, and Latinx; completed some college; and worked full time. The most frequent forms of IPV were screams and insults. The IPV prevalence rates were estimated for transgender women (19.05%), sex workers (10.53%), and MSM (2.36%). Among participants who consented to blood samples (n= 291), transgender women who experienced IPV had a significantly (P= .03) higher syphilis positivity rate and MSM who did not experience IPV had a significantly (P< .001) higher HIV positivity rate. Among key populations, transgender women experienced the highest rate of IPV and significantly higher syphilis rates. Paradoxically, HIV rates were higher among MSM who do not experience IPV. While societal roles and other contextual factors play a partial role in these syndemic findings, more studies are warranted.

Perceived Vulnerability to Disability-Related Victimization in People With Multiple Sclerosis: Community Survey on Risk and Protective Factors.

The perception that one is at increased risk of interpersonal victimization or violence can deleteriously affect community participation and quality of life. Race, sex, and disability status, often associated with use of an assistive mobility device (AD), are known correlates of perceived risk of victimization; however, almost no research has explored how these variables intersect for individuals with multiple sclerosis (MS), and none have sought to identify potential risk and protective factors. Data for the present study come from a single time point derived from a 10-year longitudinal survey of 446 individuals with MS. Lifetime trauma exposure, personal resilience and self-efficacy, control over participation, and perceived risk of interpersonal victimization due to disability were all assessed via self-report. Statistical analyses included analysis of covariance with participants stratified by race/ethnicity, sex, and AD use. After controlling for lifetime trauma exposure and severity of physical impairment, the use of an AD was significantly associated with greater perceived risk of victimization due to disability. Further, people with MS from racial and ethnic minority groups who used ADs had the highest perceived risk relative to all other groups. Higher levels of perceived risk were associated with a lower sense of control over community participation, lower resilience, and lower disease management self-efficacy. Visible indicators of disability may contribute to perceptions of vulnerability, especially among people with MS who are racially and ethnically marginalized. Clinicians should be aware of how perceived vulnerability may impact a sense of control over community participation, particularly when educating patients on AD use.

Occurrence of potentially traumatic events, type, and severity in undergraduate students

ABSTRACT Background Trauma exposure can have significant mental health impacts on students that impair academic performance and engagement. It is therefore important to describe the occurrence of trauma experiences and associated symptoms among undergraduate students. Objective This study aimed to 1) assess the rates of potentially traumatic experiences, 2) examine the frequency of different trauma experience types, and 3) compare post-traumatic stress (PTS) symptom severity across experience subtypes in a large sample of undergraduate students. Methods Participants were 806 undergraduate students from three Australian universities who completed online self-report measures of trauma exposure, psychological distress, and PTS symptoms. Results Approximately two-thirds of students (64%) reported having experienced at least one potentially traumatic event. The most common experience types were the unexpected death of a loved one and accidents. Students reporting exposure to potential trauma had significantly higher general distress than non-exposed students. Events involving interpersonal violence were associated with greater PTS symptom severity. Conclusions This study provides evidence that the occurrence of potentially traumatic events is high among university students and may carry negative effects for mental health and functioning. Results highlight the need for trauma-informed educational approaches and robust counselling services to support students managing trauma histories.

Research related to preventing interpersonal violence impacting children and youth (CDC)

Research related to preventing interpersonal violence impacting children and youth (CDC)

The scale of myths of romantic love: Evidence of validity and reliability of a brief scale in Peru.

The study aimed to provide validity evidence and reliability of the Scale of Myths of Romantic Love (SMRL) in Peru among young and adult individuals. Focusing on how romantic love myths affect relationship satisfaction and their ties to interpersonal violence, sexism, and gender inequality, the methodology involved 308 participants, mainly females (75%), using the SMRL and Relationship Assessment Scale. Bayesian Confirmatory Factor Analysis (BCFA) assessed the scale's structure and reliability, complemented by descriptive statistics and correlation analyses to examine the myths' impact on intimate relationships. Results showed the SMRL's two-dimensional structure, confirming its robust psychometric properties and satisfactory internal consistency. Descriptive findings revealed a skeptical view of traditional romantic myths among participants, indicating the scale's good reliability and successful adaptation to the Peruvian context. This validation highlights how debunking romantic love myths can improve relationship dynamics and satisfaction and addresses their wider societal effects.

Assessment of the HIV Enhanced Access Testing in the Emergency Department (HEATED) program in Nairobi, Kenya: a quasi-experimental prospective study

Background Persons seeking emergency injury care are often from higher-risk and underserved key populations (KPs) and priority populations (PPs) for HIV programming. While facility-based HIV Testing Services (HTS) in Kenya are effective, emergency department (ED) delivery is limited, despite the potential to reach underserved persons. Methods This quasi-experimental prospective study evaluated implementation of the HIV Enhanced Access Testing in Emergency Departments (HEATED) at Kenyatta National Hospital ED in Nairobi, Kenya. The HEATED program was designed as a multi-component intervention employing setting appropriate strategies for HIV care sensitization and integration, task shifting, resource reorganization, linkage advocacy, skills development and education to promote ED-HTS with a focus on higher-risk persons. KPs included sex workers, gay men, men who have sex with men, transgender persons and persons who inject drugs. PPs included young persons (18–24 years), victims of interpersonal violence, persons with hazardous alcohol use and persons never HIV tested. Data were obtained from systems-level records, enrolled injured patient participants and healthcare providers. Systems and patient-level data were collected during a pre-implementation period (6 March − 16 April 2023) and post-implementation (period 1, 1 May − 26 June 2023). Additional, systems-level data were collected during a second post-implementation (period 2, 27 June − 20 August 2023). HTS data were evaluated as facility-based HIV testing (completed in the ED) and distribution of HIV self-tests independently, and aggregated as ED-HTS. Evaluation analyses were completed across reach, effectiveness, adoption, implementation and maintenance framework domains. Results All 151 clinical staff were reached through trainings and sensitizations on the HEATED program. Systems-level ED-HTS among all presenting patients increased from 16.7% pre-implementation to 23.0% post-implementation periods 1 and 2 (RR = 1.31, 95% CI: 1.21–1.43; p < 0.001). Among 605 enrolled patient participants, facilities-based HTS increased from 5.7% pre-implementation to 62.3% post-implementation period 1 (RR = 11.2, 95%CI: 6.9–18.1; p < 0.001). There were 440 (72.7%) patient participants identified as KPs (5.6%) and/or PPs (65.3%). For enrolled KPs/PPs, facilities-based HTS increased from 4.6% pre-implementation to 72.3% post-implementation period 1 (RR = 13.8, 95%CI: 5.5–28.7, p < 0.001). Systems and participant level data demonstrated successful adoption and implementation of the HEATED program. Through 16 wk post-implementation a significant increase in ED-HTS delivery was maintained as compared to pre-implementation. Conclusions The HEATED program increased overall ED-HTS and augmented delivery to KPs/PPs, suggesting that broader implementation could improve HIV services for underserved persons already in contact with health systems.

Bioarchaeology and evidence of violence from a precolonial later stone age communal burial in South Africa.

This study reports on the bioarchaeology and evidence of interpersonal violence in a group of archaeological skeletons found near Ladismith, Western Cape, South Africa. The co-mingled skeletal remains derive from at least ten individuals of varying ages and both sexes. Overlapping radiocarbon dates on three individuals place them in the first half of the 15th century CE, pre-dating first European contact at the end of that century. Three juvenile crania have perimortem perforations, the locations of which indicate violent deaths. The sizes and shapes of the lesions suggest impact by a blade at least 110mm long and 50mm wide but with edges only 2mm thick. Based on these dimensions, we hypothesise that this was a metal-tipped spear. The nearest metal-working communities at this time lived approximately 500 km away, implying long-distance trade or exchange. δ13C, δ15N and 87Sr/86Sr values indicate that this was a heterogenous group of individuals who had spent their early lives in different locations and consumed varied diets, who had come together and were living in or travelling through the Ladismith area at the time of their deaths. This finding extends the timeframe and location for the practice of communal burial in the Holocene of southern Africa and provides additional support for the hypothesis that communal burials in this region tend to be associated with violence.

Trauma Theory and Abuse, Neglect and Violence Across the Life Course.

A literature review of recent prevalence and prospective studies on interpersonal violence (IPV) identifies a link among child abuse, intimate partner violence, and elder abuse that had not emerged from life-stage-specific studies on abuse, neglect, and violence against older persons. In line with a developmental understanding of IPV from a life course perspective, early life trauma is emerging as an explanatory theory of IPV across the life course. This paradigm shift in the field of elder abuse challenges more traditional explanations of IPV in old age, such as ageism, but opens up new opportunities for interventions leading to prevention and treatment of abuse, neglect, and violence against older adults. Prevalence studies that include older subjects and questions about violence experienced as children and younger adults consistently identify child abuse as a risk factor for IPV experienced in old age. Similarly, prospective studies on IPV that follow subjects from childhood to old age identify lifetime patterns of abuse. Qualitative studies of IPV in old age that include retrospective data suggest a link as well. IPV perpetrated against children and adults of all ages by persons in positions of trust can lead to trauma that has adverse lifelong behavioral and relational implications. This provides a link between trauma theory and violence against older people. Until recently, abuse, neglect, and violence were conceptualized differently based on the life stage of the victim. While historically the definitions for partner and non-partner violence diverged based on the life stage of victims, more recently this has begun to converge. Understanding violence from a life course and trauma-informed perspective better identifies risk factors and interventions for IPV against older adults. Intersectionality of age and gender variables demonstrate differences and similarities among populations studied.

Interpersonal Violence Against Indigenous Sámi and Non-Sámi Populations in Arctic Sweden and the Mediating Effect of Historical Losses and Discrimination.

The prevalence of interpersonal violence has been reported at higher levels among Indigenous than non-Indigenous populations worldwide, but has not been thoroughly investigated among the Sámi population in Sweden. The aims of this study were to investigate: (1) the prevalence of emotional, physical, and sexual violence and violence by intimate partners, family members, acquaintances, and strangers among participants identifying as Sámi or Swedish, (2) whether reporting experiences of historical losses and discrimination mediated the anticipated association between identifying as Sámi and reporting experiences of violence, and (3) whether background characteristics were associated with reporting experiences of violence. Cross-sectional questionnaire data collected in 2021 for the "Health and Living conditions in Sápmi" study were used. All adults in an arctic region in Sweden were invited to participate (response rate: 41%). Respondents self-identifying as Sámi (n = 375; 24.7%) or Swedish (n = 1,144; 75.3%) were included in this study. Sámi respondents of both sexes more often reported violence by an acquaintance or stranger. Likewise, more Sámi than Swedish women reported family violence (16.4% vs. 9.2%), but there was no difference concerning intimate partner violence (13.3% vs. 15.4%). Mediation analyses revealed strong positive indirect effects of historical losses and discrimination on the different types of violence. Being female was the strongest predictor of reporting intimate partner violence, and younger age was associated with violence by all perpetrators except family members. In conclusion, interpersonal violence was more often reported by Sámi respondents, but the association was explained in full by experiences of historical losses and discrimination. The results underline the importance of a life-course and even intergenerational and historical perspectives when investigating interpersonal violence.

Primary Open Reduction and Internal Fixation of Isolated Compound Depressed Nasal Fractures.

The aim of this study was to assess the efficacy of primary open reduction and internal fixation (ORIF) utilizing the existing dorsal wound for the management of isolated nasal fractures characterized by significant depression and to determine its effectiveness in preventing the need for subsequent nasal revisions. A retrospective review was conducted on patients who underwent ORIF of nasal bone for isolated compound depressed nasal fractures from January 2018 to January 2024. The primary outcomes included the assessment of clinical and radiographic results postoperatively, focusing on nasal symmetry, projection, airway patency, and the incidence of secondary surgical interventions. The study included 15 patients, predominantly males (60%), with an average age of 39.33 years. The mechanisms of injury included motor vehicle accidents (40%), falls (26.7%), interpersonal violence (20%), and occupational injuries (13.3%). All patients were treated on the first (73.3%) or second day (26.7%) after the injury. All patients had satisfactory esthetic and functional outcomes and did not require secondary rhinoplasty. The hardware was removed in 4 patients (26.7%). Primary ORIF through an existing dorsal wound for significantly depressed isolated nasal fractures was effective in obviating the necessity for subsequent nasal revisions.

Interpersonal Violence in Five Regions in Asia: Ecological Risk Factors Associated with Perceptions of Justifiability of Violence.

In Asia, rates of interpersonal violence are increasing, with significant regional disparities. However, long-term, continental-scale research considering regional differences across the Asia regions is limited. Guided by the ecological model, we examined five ecological risk factors (low life satisfaction/happiness, economic hardship, neighborhood disadvantage, patriarchal values, and religiosity) associated with perceptions of justification of interpersonal violence (i.e., intimate partner violence [IPV] against wife, child physical abuse, and violence against others) in five regions in Asia (i.e., East, West, Central, South, and Southeast). Using the World Values Survey (n = 32,307), a multigroup multiple regression model was used with robust maximum likelihood estimation using Mplus ver. 8. In the entire Asia sample model, perceptions of justifiability of IPV against wife were positively associated with low life satisfaction/happiness; economic hardship; neighborhood disadvantage; and patriarchal values, while they were negatively associated with religiosity. Perceptions of justifiability of child abuse were positively associated with low life satisfaction/happiness; neighborhood disadvantage; and patriarchal values, while they were negatively associated with economic hardship and religiosity. Perceptions of justifiability of violence against others were positively associated with economic hardship and neighborhood disadvantage, while they were negatively associated with religiosity. Each region presented unique risk factor associations. Considering the high rates of interpersonal violence in Asia, understanding the risk factors associated with perceptions of justifying specific types of interpersonal violence can provide an initial insight into preventing violence in Asia. Further, as many Asians dwelling outside Asian regions are still influenced by their culture, religion, language, and norms of the region of origin, the study findings may shed light on future studies to consider in the interpersonal violence literature.

Socioeconomic disparities based on shooting intent in pediatric firearm injury.

Pediatric firearm injury is often associated with socioeconomically disadvantaged neighborhoods. Most studies only include fatal injuries and do not differentiate by shooting intent. We hypothesized that differences in neighborhood socioeconomic disadvantage would be observed among shooting intents of fatal and nonfatal cases. A linked integrated database of pediatric fatal and nonfatal firearm injuries was developed from trauma center and medical examiner records in Harris County, Texas (2018-2020). Geospatial analysis was utilized to map victim residence locations, stratified by shooting intent. Area Deprivation Index (ADI), a composite measure of neighborhood socioeconomic disadvantage at the census tract level was linked to shooting intent. Differences in high ADI (more deprived) versus low ADI among the shooting intents were assessed. Unadjusted and adjusted regression models assessed differences in ADI scores across shooting intent, adjusted models controlled for age, gender, and race/ethnicity. Of 324 pediatric firearm injuries, 28% were fatal; 77% were classified as interpersonal violence, 15% unintentional, and 8% self-harm. Differences were noted among shooting intent across the ADI quartiles; with increases in ADI score, the odds of interpersonal violence injuries compared with self-harm injuries significantly increased by 5%; however, when adjusting for individual-level variables of age, gender, and race and ethnicity, no significant differences in ADI were noted. Our results suggest that children living in disadvantaged neighborhoods are more likely to be affected by interpersonal firearm violence compared with self-harm; however, when differences in race/ethnicity are considered, the differences attributable to neighborhood-level disadvantage disappeared. Resources should be dedicated to improving structural aspects of neighborhood disadvantage, which disproportionately impact racial/ethnic minoritized populations. Furthermore, firearm self-harm injuries occurred among children living in the less disadvantaged neighborhoods. Understanding the associations among individual and neighborhood-level factors are important for developing streamlined injury prevention interventions by shooting intent. Prognostic and Epidemiological; Level IV.

Factors Associated with Interpersonal Violence and Depression Symptoms in Adolescent Students from Jalisco during the COVID-19 Pandemic

Introduction. Violence is a major public health problem, which increased during the Covid-19 pandemic, affecting the physical and mental development of adolescents. Objective. To analyze factors associated with interpersonal violence and depressive symptoms in adolescent students in the south of Jalisco. Methods. Data were drawn from an online survey of 3,046 adolescents (ages 12-19) conducted between September and December 2021. The Beck Depression Inventory was used to assess depression symptoms. Self-reports of neglect, physical, psychological, sexual, and digital violence in the previous 12 months were analyzed. Bivariate and multivariate logistic regression models explored factors associated with depression and violence. Results. A total of 28.8% of the sample reported depression symptoms, 46.9% physical violence, 42.7% psychological violence, 34.9% neglect, 12.3% digital violence, and 5.2% sexual violence. The odds of depression were higher for those who had experienced physical violence (adjusted odds ratio [aOR] = 1.3 CI 95% [1.1-1.6]), psychological violence (aOR = 4.1 CI 95% [3.4-5.1]), digital violence (aOR = 2.0 CI 95% [1.5-2.5]); and neglect (aOR = 1.6 CI 95% [1.3-1.9]). Girls and adolescents aged 15-19 had higher odds of experiencing sexual, digital, and psychological violence. Poor school performance was associated with lower odds of reporting neglect (aOR = .6 CI 95% [.5-.8]) and sexual violence (aOR = .5 CI 95% [.3-.8]), while being employed was associated with reporting higher odds of physical violence (aOR = 1.5 CI 95% [1.3-1.8]) and neglect (aOR = 1.3 CI 95% [1.1-1.5]). Greater use of social media and videogames was associated with higher odds of physical, psychological, and digital violence. Conclusion. It is necessary to implement comprehensive public programs and policies to address violence and implement intersectoral social intervention strategies in mental health.

Working "With" Not "On" Disabled People: The Role of Hate Crime Research within the Community.

For many disabled people, violence can become an unwanted, yet ordinary part of everyday life. Often, these crimes are attributed to understandings of disabled people as vulnerable and largely, passive victims. Attending to the aims of this special issue, this paper aims to dismantle these stereotypes and attend to the unique ways that disabled people can resist and respond to hate crime through creative and collaborative research practices. Building upon this, I argue that there is a pressing need for hate studies researchers to work "with" and not "on" those who have experienced targeted violence. Working in this way builds upon long-standing efforts of disabled activists and disabilities studies researchers to challenge reductive research practices by working in more collective and inclusive ways. To demonstrate this, I reflect upon a project working in partnership with disabled people to create a disability hate crime toolkit. The toolkit, now published, shares accessible and informative resources that can be used to raise awareness about disability hate crime. While the focus of this paper is disability, I consider methods of collaboration, co-production and participation that can be drawn upon by researchers to respond to hate crime and interpersonal violence more broadly.

Assessing the national and subnational firearm violence trends in Mexico from 1990 to 2019: secondary data analysis from the Global Burden of Disease study

BackgroundMexico is among the countries with the highest mortality rates by firearms worldwide. We aimed to analyse the trend in the burden of firearm violence (FV) by age and sex...

Paediatric maxillofacial fractures have increased in incidence and their nature and aetiology have changed during three decades

The safety of children’s living environment is affected by several factors. Safer living environments have been offered as one explanation to decreases in children’s fractures. Earlier studies provide evidence of a decreasing trend in children’s fractures in the past decades. The objective of this study was to investigate demographic and clinical features of paediatric maxillofacial fractures during three time periods. A retrospective cross-sectional single-centre study was designed. The study included 474 patients aged ≤ 15 years admitted to Helsinki University Hospital in Finland with maxillofacial fractures during 1980–1989, 1993–2002 and 2013–2018. Maxillofacial fractures increased by 25% during the study period. The increase was greater in boys (28%) than in girls (19%), and significant in age groups 0–5 years (71%) and 13–15 years (32%). Exclusively mandibular fractures decreased by 20%, while exclusively midfacial fractures increased more than four-fold and exclusively upper-third fractures five-fold. Being hit by object and falls from height increased more than two-fold. A temporary increase in assaults and decrease in bicycle accidents in the middle period of the study was observed. During the three decades, paediatric maxillofacial fractures have increased and both fracture type and underlying aetiology have changed. These findings reflect improvements in diagnostics, traffic safety, regulations and technology. The role of factors such as interpersonal violence and economic fluctuation on the incidence of childhood maxillofacial fractures is discussed.