Homicide Mortality in Iran, 2006–2023: Gender Gaps, Regional Disparities, and the Predominance of Firearms

Background: Homicide is a critical public health concern with significant social, economic, and psychological implications. Despite previous research in Iran, there has been no comprehensive analysis of nationwide homicide trends over the past two decades. Objectives: To investigate the trends and epidemiological patterns of homicide-related mortality in Iran from 2006 to 2023, focusing on gender, geographic, occupational, and method-related disparities. Methods: This cross-sectional study included all homicide cases recorded by the Iranian Legal Medicine Organization from 2006 to 2023 across all provinces. Collected variables included age, sex, nationality, province and year of death, method of homicide, occupational status, and relationship to the perpetrator. Crude mortality rates per 100,000 population were calculated using national census data. Descriptive statistics and non-parametric tests (e.g., Mann–Whitney U) were used to compare groups. Analyses were performed using Stata version 17 and Microsoft Excel 2016. Results: A total of 45,437 homicide deaths were recorded, of which 81.55% were male and 18.45% female. The mean age of victims was 33.6 years, and non-Iranian victims had a significantly lower median age than Iranians (27 vs. 31 years, p < 0.001). The overall homicide mortality rate was 3.22 per 100,000, with a fivefold higher rate in men (5.19) compared to women (1.19). The highest provincial rate was in Sistan and Baluchestan (12.32), while the lowest was in South Khorasan (1.71). Firearms were the most common method of killing (46.25%), particularly among male and non-family-related homicides. However, suffocation was more common among women victims (54.81%). Among female victims, over 51% were killed by first- or second-degree family members. In contrast, most male victims were killed by strangers. The most affected occupational group was the self-employed (34.6%), while among homemakers, who were predominantly women, cold weapons were most used and suffocation was significantly higher (23.14%). The highest annual rate occurred in 2023 (3.95 per 100,000), and although provincial trends varied, there was no consistent national trend over time. Conclusion: Despite being lower than the global average, Iran’s homicide rate remains a pressing concern due to gender disparities, regional inequality, and the prevalent use of firearms. Women’s vulnerability to family-related homicide, particularly through suffocation, calls for urgent attention to domestic violence prevention and protective policies. Future research should include perpetrator characteristics, socioeconomic indicators, and motives for a more nuanced understanding.