Interpersonal violence causes substantial morbidity and mortality worldwide and poses a considerable economic burden, equivalent to 4%-5% of the gross national product in certain countries (1). The Commonwealth of Puerto Rico is a U.S. territory with a 2004 population of approximately 3.9 million (2). In Puerto Rico, homicides were the 12th leading cause of death overall in 2003, ranking fifth among males and 15th among females (3). This report summarizes an analysis of death certificate data on violent deaths of children and young adults in Puerto Rico during 1999-2003, ...

<30 years in Puerto Rico during 1999-2003 and examined the data by age group, sex, and method (e.g., assault by firearm discharge or assault by sharp object) for each year (4). Homicide was defined as death resulting from an injury purposefully inflicted by another person (including legal intervention) for which the underlying cause listed on the death certificate corresponded to codes X85-Y09, Y35, and Y89.0 * of the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (5). Death rates were determined on the basis of the decedent's county of residence. Categorization of rural versus urban was based on application of codes developed by the U.S. Department of Agriculture to the 2000 U.S. Census population assessment. Intercensal population estimates for 1999-2003 obtained from the Census Office of the Puerto Rico Planning Board were used to calculate rates (6). Rates based on fewer than 20 deaths or with a coefficient of variation of>

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