Online Program

Using EMS data to examine firearm-related injury: Implications for surveillance and preventive intervention

Monday, November 4, 2013

Amy Knowlton, MPH, ScD, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Brian W. Weir, MPH, PhD, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Gerald Cochran, MSW, PhD, Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore
Wade Gaasch, MD, Emergency Medicine, University of Maryland School of Medicine
Daniel W. Webster, ScD, MPH, Center for Gun Policy and Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Background: Gun violence is a major threat to US public health. Information systems are needed to improve population surveillance of violence and inform preventive intervention. Emergency medical services (EMS) system data is an understudied potential source for incident-based surveillance of shootings and examination of personal correlates of violent injury. Methods: We reviewed Baltimore City 9-1-1 call dispatch data and Baltimore City Fire Department EMS patient records in a 23 months period 2008-10. We coded health data based on a prior schema, and compared numbers of firearm related incidents to police report data in a similar period, and examined associations with patient demographics, repeat use of EMS, and behavioral (substance use and mental) health problems. Results: We identified 954 gunshot wound incidents linked to EMS patient data, representing 13.3% of violent trauma incidents in the study period. Compared to the city and to the EMS patient population, young Black males were over-represented among gunshot victims. Compared to police reports of shootings in a comparable period, EMS records contained 19.5% fewer shooting incidents. Patients with gunshot wounds had below average levels of EMS utilization and evidence of substance abuse or mental health problems in their EMS records. Conclusions: Our findings suggest that while EMS records undercounted gunshot wound incidents in the city, EMS data may be an important source of real time incident level data to complement current data sources for firearm related injury surveillance. Future research should assess and promote the validity of EMS records on violence-related injury.

Learning Areas:

Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Describe the advantages and disadvantages of EMS data on violent trauma related incident data as a source of information on population violence.

Keyword(s): Violence, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the PI or Co-I of numerous NIH and CDC sponsored research projects examining health services engagement and medical adherence among inner city drug abusing persons living with HIV/AIDS and other vulnerable populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.