Intentional violence against another person is classified as assault (injury) or homicide (death).

Males are more likely than females to be hospitalised from an assault or die by homicide. Hospitalised injuries from assault are most often caused by bodily force, such as punching and kicking. Fracture is the most common injury sustained in assaults that result in hospitalisation.

In 2019–20, assault and homicide resulted in:

22,300 hospitalisations

87 per 100,000 population

245 deaths

1.0 per 100,000 population

This represents 4.2% of hospitalised injuries and 1.8% of injury deaths.

People who seek health care following an assault may choose not to disclose the cause of their injuries. This may be because they know the perpetrator and want to avoid criminal proceedings. For this reason, assault injuries are probably not all identified as such in hospital statistics—they may instead be coded as an unintentional injury such as a Fall or Contact with an object—or details of the assault may be incomplete or unspecified. For more information, see Technical notes.

Causes of injury in assault hospitalisations

In 2019–20:

  • 3 in 5 hospitalised assault injuries (58%) were caused by bodily force (Table 1)
  • 1 in 7 (15%) were caused by a blunt object.
Table 1: Causes of injury in assault hospitalisations, 2019–20

Cause

Number

%

Rate
(per 100,000)

Bodily force (includes sexual assault) (Y04–05)

13,009

58

50.9

Blunt object (Y00)

3,274

15

12.8

Sharp object (X99)

2,708

12

10.6

Other or unspecified (X85–93, X95–98, Y01–03, Y06–09, Y35–36)

3,261

15

12.8

Total

22,252

100

87.2

Notes

  1. Rates are crude per 100,000 population, calculated using estimated resident population as at 31 December of the relevant year.
  2. Percentages may not total 100 due to rounding.
  3. Codes in brackets refer to the ICD-10-AM (11th edition) external cause codes (ACCD 2019).

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data tables B29–30.

Causes of injury in homicide deaths

In 2019–20, 2 in 5 homicide deaths (41%) were caused by a sharp object such as a knife or glass (Table 2).

Table 2: Causes of injury in homicide deaths, 2019–20

Cause

Number

%

Rate
(per 100,000)

Sharp object (X99)

100

41

0.4

Assault by firearm discharge or explosive material (X93–X96)

27

11

0.1

Bodily force (includes assault and sexual assault) (Y04–05)

26

11

0.1

Other or unspecified (X85–93, X95–98, Y01–03, Y06–09, Y35–36)

92

38

0.4

Total

245

100

1.0

Notes

  1. Rates are crude per 100,000 population, calculated using estimated resident population as at 31 December of the relevant year.
  2. Percentages may not total 100 due to rounding.
  3. Codes in brackets refer to the ICD-10 external cause codes (WHO 2011).

Source: AIHW National Mortality Database.

For more detail, see Data tables E42–44.

Seasonality and COVID-19

Hospital admissions due to assault show some patterns over the year. Hospitalisations due to assaults are highest over the period November to February and lowest from May to September.

In March 2020 the first lockdowns and social distancing measures associated with COVID-19 interrupted the usual activity of many Australians. The restrictions to movement and activity coincided with a marked drop in overall injury hospitalisations. For injuries due to assault, there were 13% fewer admissions from March to May than the same period of the previous year (Figure 1). As initial restrictions eased, assault hospitalisations rose and by June were higher than in prior periods.

See the interactive COVID-19 display for data and further discussion about the impact of COVID-19 on hospital admissions.

Figure 1: Assault hospitalisations by month, 2017–18 to 2019–20

Notes
1. Months have been standardised to 31 days.
2. A scale up factor has been applied to June admissions to account for cases not yet separated.

Source: AIHW National Hospital Morbidity Database.

Trends over time

The age-standardised rate of hospitalisations due to assault in 2019–20 was 0.6% lower than the previous year. This decrease is likely due to the effects of COVID-19 lockdowns and social distancing.

There was a downward trend in hospitalised assaults between 2009–10 and 2014–15. This was followed by an upward trend to 2016–17 – resulting in an overall average decrease of 1.9% per year for the period from 2009–10 to 2016–17. Figure 2 shows that, when examined by sex, the overall decrease is largely accounted for by the rate for males. The age-standardised rate for females in fact increased (at a more gentle slope).

There is a break in the time series for hospitalisations between 2016–17 and 2017–18 due to a change in data collection methods (see the Technical notes for details).

The homicide death rate showed an average annual decrease of 1.7% between 2010–11 and 2019–20. There were notable flucations, however, over this period. (Figure 2).

Figure 2: Hospitalised assault injuries and homicide deaths, by sex, 2010–11 to 2019–20

The visualisation features 2 matching line graphs on separate tabs, 1 for hospitalisations and 1 for deaths. The 3 lines represent the trend for males, females and persons from 2010–11 to 2019–20. The reader can select to display rate per 100,000 population or number.

For more detail, see Data tables C1–7 and F1–4.

Variation by age and sex

Rates of hospitalisation for assault injuries and rates of death by homicide differ for males and females, especially for certain age groups (Figure 3).

In 2019–20:

  • 62% of hospitalisated assault injuries and 70% of homicides were for males
  • the age-standardised rates of hospitalisation were 112 cases per 100,000 males and 69 per 100,000 females
  • the age-standardised rates of homicide death were 1.4 per 100,000 males and 0.6 per 100,000 females
  • rates of assault injury peaked in early to mid-adulthood—156 per 100,000 people aged 25–44 were hospitalised and 1.3 per 100,000 died due to assault injuries.

Figure 3: Hospitalised assault injuries and homicide deaths, by age group and sex, 2019–20

The visualisation features 2 matching column graphs on separate tabs, 1 for hospitalisations and 1 for deaths. The columns represent sex within 6 life-stage age groups. The reader can select to display either age-specific rate per 100,000 population or number. The default displays males and females and the reader can also select to display persons.

For more detail, see Data tables A1–3 and D1–3.

Relationship to perpetrator

Key differences between males and females can be seen in statistics about the relationship of the victim to the perpetrator responsible for the hospitalised assault. For female victims, the perpetrator was a domestic partner in almost 6 out of 10 of the cases where the relationship was specified. For male victims, it was more likely to be a person or persons unknown, or an acquaintance, than a family member (Figure 4).

The perpetrator was unspecified in a large proportion of cases (45% for male victims and 15% for female victims). This information may be unavailable for a number of reasons, including because it was not reported by, or on behalf of, victims, or not recorded in the patient’s hospital record (AIHW 2019).

A range of factors may influence disclosure of the perpetrator in a hospital setting, for example: personal feelings such as fear of further abuse, or shame; and factors specific to the setting, including sufficient privacy and time to disclose, and appropriate staff training and procedures which support disclosure.

Figure 4: Relationship of perpetrator to victim in hospitalised assaults, 2019–20

Bar graph representing categories of relationship of perpetrator to victim, by sex. For males the most common category was unspecified person, followed by person unknown to the victim followed by acquaintance or friend. For females it was spouse or domestic partner, followed by unspecified person followed by other family member.

For more detail, see Data tables B31–32.

Severity

There are many ways that the severity, or seriousness, of an injury can be assessed. Using available data, three measures of the severity of hospitalised injuries are:

  • number of days in hospital
  • time in an intensive care unit (ICU)
  • time on a ventilator.

The average number of days in hospital for assault injuries was shorter than for all hospitalised injuries. The percentage of assault cases that included time in an ICU was similar, while the percentage that involved continuous ventilatory support was slightly higher than for all hospitalised injuries (Table 2).

Table 3: Severity of hospitalised assault cases, 2019–20

 

Assault

All injuries

Average number of days in hospital

2.2

4.5

% of cases with time in an ICU

2.3

2.4

% of cases involving continuous ventilatory support

1.5

1.4

Note: Average number of days in hospital (length of stay) includes admissions that are transfers from 1 hospital to another or transfers from 1 admitted care type to another within the same hospital, except where care involves rehabilitation procedures.

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data table A12–13.

Nature of injuries sustained

In 2019–20, the head and neck was the body part most often identified as the principal site of injury in hospitalised assaults (Figure 5). In part, this may reflect the inherently serious nature of head and neck injuries—injuries to other parts of the body may be less likely to lead to admission to hospital.

Figure 5: Hospitalised assaults by principal body part injured, 2019–20

The visualisation features an outline of a person with labels for body parts accounting for hospitalisations due to assault. Injuries to the head and neck accounted for the most hospitalisations while the ankle and foot accounted for the fewest.

Note: Body part refers to the principal reason for hospitalisation. Number and percentage of injuries classified as Other, multiple and incompletely specified body regions or Injuries not described in terms of body region not shown—see Data table A11.

Source: AIHW National Hospital Morbidity Database.

For more detail, see Data table A11.

Fractures and open wounds were the most common type of principal injury for people who were hospitalised for injury due to assault (Figure 6).

Figure 6: Hospitalised assaults, by principal injury type, by sex, 2019–20

Bar graph showing type of injury sustained by category and by sex. Fracture was the most common for males and females. The reader can select to display either the crude rate per 100,000 population or the number of cases. The default display shows data for males and females, and the reader can also select to display for persons.

For more detail, see Data table A10.

Aboriginal and Torres Strait Islander people

In 2019–20, among Aboriginal and Torres Strait Islander people:

  • there were 7,001 assault hospitalisations and 33 homicide deaths (Tables 4 and 5)
  • hospitalisation rates were higher among people aged 25–44, compared with other life-stage age groups (Figure 6).
Table 4: Number and rate of hospitalised assault injuries by sex, Indigenous Australians, 2019–20

 

Males

Females

Persons

Number

     3,104

3,897

7,001

Rate (per 100,000)

728

912

820

Note: Rates are crude per 100,000 population.

Source: AIHW National Hospital Morbidity Database.

Table 5: Number and rate of homicide deaths by sex, Indigenous Australians, 2019–20

 

Males

Females

Persons

Number

22

11

33

Rate (per 100,000)

5.9

2.9

4.4

Notes

  1. Rates are crude per 100,000 population.
  2. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.

Source: AIHW National Mortality Database.

Indigenous and non-Indigenous Australians

In 2019–20, Indigenous Australians, after adjusting for differences in population age structure, were:

  • 15 times as likely as non-Indigenous Australians to be hospitalised due to assault (Table 6)
  • Over 6 times as likely as non-Indigenous Australians to die due to homicide, however caution is advised when using this figure due to the relatively small numbers involved (Table 7).
Table 6: Age-standardised rates (per 100,000) of hospitalised assault injuries by Indigenous status and sex, 2019–20

 

Males

Females

Persons

Indigenous Australians

830

1,021

925

Non-Indigenous Australians

87

38

63

Notes

  1. Rates are age-standardised to the 2001 Australian population (per 100,000).
  2. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.

Source: AIHW National Hospital Morbidity Database.

Table 7: Age-standardised rates (per 100,000) of homicide deaths by Indigenous status and sex, 2019–20

 

Males

Females

Persons

Indigenous Australians

8.1

n.p.

5.4

Non-Indigenous Australians

1.1

0.5

0.8

n.p. Not publishable because of small numbers, confidentiality or other concerns about the quality of the data.

Notes

  1. Rates are age-standardised to the 2001 Australian population (per 100,000).
  2. ‘Non-Indigenous Australians’ excludes cases where Indigenous status is missing or not stated.
  3. Deaths data only includes data for New South Wales, Queensland, Western Australia, South Australia, and the Northern Territory.

Source: AIHW National Mortality Database.

For more detail, see Data tables A4–6 and D4–8.

The age-specific rate of hospitalised assaults was highest among the 25–44 age group for Indigenous Australians and the 15–24 age group for non-Indigenous Australians (Figure 7). Deaths data are not presented because of small numbers.

Figure 7: Hospitalised assault injuries by Indigenous status, by age group and sex, 2019–20

Column graph representing hospitalisation data for Indigenous and non-Indigenous Australians by 6 life-stage age groups. The reader can select to display age-specific rate per 100,000 population or number. The reader can also select to display data for persons, males or females.

For more detail, see Data tables A4–6 and D4–8.

Remoteness

In 2019–20, people living in Australia’s Very remote areas, compared with those living in Major cities, were 18 times as likely to be hospitalised due to assault (age-standardised) (Table 8). These differences in assault injury hospitalisations rates partly reflect the higher proportion of Indigenous Australians living in remote areas of Australia.

Table 8: Age-standardised rates (per 100,000) of hospitalised assault injury, by remoteness and sex, 2019–20

 

Males

Females

Persons

Major cities

86

42

64

Inner regional

106

47

76

Outer regional

180

130

155

Remote

491

668

578

Very remote

872

1,550

1,179

Note: Rates are age-standardised per 100,000 population.

Source: AIHW National Hospital Morbidity Database.

The highest age-specific rate of hospitalised assaults was among the 25–44 age group living in Very remote areas of Australia (Figure 8).

Deaths data are not presented because of small numbers.

Figure 8: Hospitalised assault injuries, by remoteness, by age group and sex, 2019–20

Column graph representing hospitalisation data for each of the 5 remoteness categories by 6 life-stage age groups. The reader can select to display age-specific rate per 100,000 population or number. The reader can also select to display data for persons, males or females.

For more detail, see Data tables A7–9 and D9–10.

To read how statistics by remoteness are calculated, see the Technical notes.

More information

Defining injury hospitalisations and deaths: how injuries were counted

Technical notes: how the data were calculated

Data tables: download the full tables

Glossary