South Africa’s male homicide rate is an epidemic hiding in plain sight

By Richard Matzopoulos and Morna Cornell

3 Dec 2023

Our study confirms the massive, disproportionate and enduring homicide risk among South African men, which highlights their relative neglect in the country’s prevention and policy responses.

Interpersonal violence is a major cause of morbidity and mortality worldwide, predominantly among young black men, yet remains largely neglected as a critical public health issue.

Globally, among 475,000 homicides in 2012, 60% were males aged 15 to 44 years, making homicide the third-leading cause of death for males in this age group. While interpersonal violence is a global health issue, low- and middle-income countries bear the heaviest burden, accounting for more than 90% of deaths overall.

South Africa has one of the highest homicide rates and disease burdens from interpersonal violence of any country in the world, with an overall homicide rate six times the global average.

The country has responded proactively to violence against women with interventions and policy measures, culminating in a National Strategic Plan on Gender-based Violence and Femicide.

In stark contrast, men’s disproportionate burden of homicide has largely been ignored, and – as is the case globally – has not resulted in targeted, meaningful prevention.

Two previous nationally representative homicide studies only explored the situational contexts of homicide for women and child victims, in line with global directives such as the 67th World Health Assembly Resolution that prioritised prevention efforts to reduce violence against women regardless of the far higher rates of violence against men. Little seems to have changed the prevailing social construct that men are neither vulnerable to, nor the victims of, trauma, despite the body of evidence.

It is argued that this limited engagement with evidence of men’s vulnerability has inadvertently pathologised black males and prevented us from recognising that boys and men are legitimate recipients of violence prevention interventions.

We know that men are overwhelmingly the perpetrators of violence against men, women and children, but a gender imbalance in homicide is apparent even in very young age groups.

The massive, disproportionate and enduring homicide risk among South African men highlights their relative neglect in the country’s prevention and policy responses.

It is critical that we better understand these data so that we can identify key communities at risk and develop appropriate interventions.

As part of the country’s first study of male homicide we reported sex-disaggregated data as an important first step in highlighting the massive, disproportionate and enduring homicide risk borne by adult South African men – similar to other low- and middle-income countries but with far higher rates – and highlighting the negligible prevention response.

In our recent study published in PLoS Global Public Health we compared male and female victim profiles from 2017 against global averages and previous estimates for 2009. Our major findings were:

Males accounted for 87% of homicides in 2017;

This equates to seven male deaths for every female (and more than 11:1 in the Western Cape);

Sharp force and firearm discharge were the most common external causes;

Rates were higher among males than females at all ages, and up to eight times higher among males aged 15 to 44;

Male homicides peaked during December and were highest on weekends, underscoring the prominent role of alcohol as a risk factor; and

Significantly more males tested positive for alcohol than females.

It is important to note that this is the most recent and extensive source of accurate and nationally representative data on injury mortality from any African country. These empirically derived estimates have not been presented elsewhere and are considerably more accurate than other 2017 estimates.

Our findings have implications for other countries with high rates of homicide generally, particularly low- and middle-income countries. In the second phase of the study we will provide more detailed information from ancillary police documentation and interviews with investigating officers describing the personal and situational risks for male homicide.

There is an urgent need to recognise that many men are marginalised and vulnerable, largely through poverty and inequality. Our study confirms the massive, disproportionate and enduring homicide risk among South African men, which highlights their relative neglect in the country’s prevention and policy responses.

Read more in Daily Maverick: Murder on the rise in South Africa’s ‘big four’ provinces

We need to address the insidious effects of societal norms alongside implementing structural interventions to overcome the root causes of poverty and inequality, and to better control alcohol and firearms.

This study is an important and necessary – if belated – first step to identify groups at increased homicide risk who could benefit from specific interventions and policies. Only through challenging the perceived invulnerability of males can we begin to address the enormous burden of violence borne by men. DM

Professor Richard Matzopoulos is director of the South African Medical Research Council’s Burden of Disease Research Unit and Honorary Professor at the University of Cape Town’s Division of Public Health Medicine.

Dr Morna Cornell is Senior Researcher at the University of Cape Town’s Centre for Infectious Disease Epidemiology and Research.

Both authors are affiliated to the University of Cape Town Faculty of Health Sciences Trauma Advocacy Group.

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