Homicide Epidemic in Cali, Colombia: A Surveillance System Data Analysis, 1993-2018

Objectives. To examine homicide rates in Cali, Colombia, during the 1993-2018 period, using information derived from an interagency surveillance system. Methods. We used homicide data from Cali's Epidemiological Surveillance System to examine homicide trends by victim's age and sex, time, and type of method used. We estimated trend changes and the annual percentage changes using joinpoint regression analyses. Results. Homicide rates per 100 000 inhabitants dropped from 102 in 1993 to 47.8 in 2018. We observed reductions in homicide rates across age and sex groups. Most homicide victims were men aged 20 to 39 years from poor, marginalized areas. Firearms were used in 84.9% of all cases. The average annual percentage change for the entire period was -3.6 (95% confidence interval = -6.7, -0.4). Conclusions. Fluctuations in homicide rates in Cali show a clear epidemic pattern, occurring concurrently with the "crack epidemic" in different countries. Reliable and timely information provided by an Epidemiological Surveillance System allowed opportune formulation of public policies to reduce the impact of violence in Cali.