Can California's Trauma Centers Prevent Violent Injury Recidivism?

Violence is a major public health issue in California, disproportionately affecting young people of color. In 2009, there were over 13,000 nonfatal and 2,000 fatal hospitalizations for violent injury in California. Homicide is the leading cause of death for African-American youth, whose rate of death by violence is more than 14 times higher than that of white victims. Hispanic victims' rate was nearly four times higher than whites'. Hospitalization presents a unique opportunity to address this. A 1989 study found hospital readmission rates for youth for recurrent violent injuries are as high as 44% due to assault and 20% due to homicide. Without intervention, hospitals discharge violently injured patients to the same violent environments where they were injured, without a prescription for how to stay safe and with community pressure to seek revenge. Too often, this results in a revolving door of violence, causing even more injuries, arrests, incarcerations, and, sadly, deaths. In 1998, the U.S. Department of Justice recommended that hospital-based counseling and prevention programs be established in communities grappling with gang violence. Are there enough hospital-based programs to effectively intervene with violently injured patients in California? This study answered that question by conducting a needs assessment and gap analysis, examining existing data on the patterns of violent injuries and hospitalizations, and collecting new data from medical centers in order to understand the specific resources, barriers, and interests of each in addressing injury prevention.