A Revolving Door: Researching Recurring Violent Injuries Among Urban Black Men

A Revolving Door: Researching Recurring Violent Injuries Among Urban Black Men

Research from the Department of African American Studies (AASD) at the University of Maryland sheds light on the reasons black men treated for violent injuries—gunshot wounds, stabbings and beatings—are likely to make return visits to the hospital for similar traumatic injuries. The research team also emphasizes the importance of hospital-based violence intervention programs (HVIPs) in addressing this growing public health issue.

Led by AASD Associate Professor Dr. Joseph Richardson and Dr. Carnell Cooper, Professor of Surgery at the UMD School of Medicine and Director of the Violence Intervention Program at the University of Maryland R. Adams Cowley Shock Trauma Center, findings from the research study were published in the Journal of Surgical Research. 

Researchers studied nearly 200 patients – black males 18 years of age or older—treated at the University of Maryland Medical System Shock Trauma Center in Baltimore between 1998 and 2011 and identified several risk factors contributing to the repeat injuries, known as trauma recidivism. 

“Trauma recidivism is a growing public health problem in the United States, particularly among low-income black men,” Dr. Richardson said. “In an effort to break this cycle of violence, we wanted to identify risk factors that make these men vulnerable to being violently wounded multiple times.”

Well over half (58 percent) of the participants in this study reported two or more hospitalizations for violent injury. Of that population, nearly all (97 percent) reported being previously incarcerated.

“Our study reinforces previous research that shows a disproportionate number of black men have experienced criminal justice involvement,” Dr. Richardson said. “Specifically, however, it highlights the collateral consequences associated with a history of incarceration and its impact on the likelihood of repeat violent injury.”

Another main factor victims cited for trauma recidivism was a perceived lack of disrespect and a “code of the street,” which dictates that disrespect must be responded to violently.

“Among many young, low-income, marginalized black men, respect and status is a valued commodity on the street,” the study authors note. “Protecting this commodity at any cost may increase the likelihood of carrying a weapon and getting into fights and altercations, which in turn, may increase the likelihood of hospitalization for violent injuries.” 

Substance abuse, housing instability and a previous altercation involving a weapon were also identified as prevalent risk factors for recurrent violent injuries in the study. The key to addressing these risks and reducing trauma recidivism, researchers say, lies in HVIPs, which provide victims with assessment, counseling and social support from multi-disciplinary teams to help make critical changes in their lives.

Dr. Cooper initiated an HVIP at Maryland Shock Trauma in 1998. Building on that model, Dr. Richardson launched the Capital Regional Violence Intervention Program at Prince George’s Hospital Trauma Center in the fall of 2015. 

The research team plans to use the risk factors they’ve identified to create a violent injury scale, which would help ensure victims who are the most vulnerable to recidivism receive top priority for resources provided through intervention programs. 

“Effective violence interventions can save lives and reduce the enormous health care costs associated with violent injury,” researchers note. “The revolving door of black male victims of violent injury poses tremendous social and economic costs on society and the health care system. We believe that the structural and direct violence that disproportionately impacts low-income young black men is preventable.” 

Other authors of the study include: Dr. Tanya Sharpe, Associate Professor at the University of Maryland Baltimore School of Social Work; Dr. Christopher St. Vil, Assistant Professor in the School of Social Work at the State University of New York at Buffalo; and Dr. Mike Wagner, Data Analyst at the UMD Center for Substance Abuse Research. 

July 25, 2016