Accidental Firearm Injuries May Be Linked to Cycle of Violence, Washington Study Finds

Wednesday, October 26, 2016

Among patients hospitalized for accidental injuries, those harmed by guns are more likely to have a history of violence and are at high risk of committing a violent crime in the future, according to a new study from the University of Washington School of Public Health.

In 2009, a national network of hospital-based violence intervention programs was established to use the in-hospital recovery period as a valuable opportunity to connect patients with community services to help reduce recidivism, the study notes. However, these programs typically focus on patients whose injuries were assault-related.

This study, published online Oct. 18 in the Annals of Internal Medicine, suggests that patients with accidental firearm injuries would also benefit from such intervention programs.

"Nonfatal firearm injuries of any intent, not just those that are assault-related, can result in lasting, negative, physical and psychological effects,” says lead author Ali Rowhani-Rahbar, assistant professor of epidemiology at the UW School of Public Health and adjunct assistant professor of pediatrics at the School of Medicine. “This investigation provides empirical evidence to support the inclusion of some patients with unintentional, or accidental, firearm injury in hospital-based violence intervention programs.”

Such intervention programs might be especially important for patients with other characteristics associated with an increased risk for involvement in the cycle of violence, Rowhani-Rahbar adds.

To examine the relationship between intent-specific firearm injury and violence perpetration, researchers studied clinical and criminal justice data from more than 245,300 patients hospitalized in Washington state between 2006 and 2007. Researchers examined violence perpetration before and after hospitalization for firearm injury based on whether the injury was intentional or accidental.

Results showed that patients with accidental firearm injuries were two times more likely than those with other accidental injuries to have been arrested for a violent crime in the past.

In 2014, more than 41,000 people aged 15 years or older were hospitalized due to nonfatal firearm injuries in the United States, the study notes. About 79 percent of those injuries were intentional, and 11 percent were accidental.

Health care encounters can serve as a valuable opportunity to reduce the risk for future violence, study authors suggest. Hospital-based interventions may help improve self-esteem and social competence as well as skills related to conflict resolution, anger management and problem solving. Interventions may also address drug or alcohol use.

Frederick Rivara, Mary Fan, Joseph Simonetti, Vivian Lyons, Jin Wang and Douglas Zatzick were part of the research team.