Racial and Ethnic Disparities in Violent Penetrating Injuries and Long-Term Adverse Outcomes

Area of Science:

• Public Health
• Trauma Surgery
• Health Disparities

Background:

• Violent injury is a recurrent issue with high recidivism rates.
• Disparities in violence impact are evident, particularly among young Black men.
• Understanding race/ethnicity-specific risk factors is key for effective violence intervention.

Purpose of the Study:

• To examine the risk of violent penetrating injury and long-term adverse outcomes stratified by race and ethnicity.
• To identify distinct patterns of re-injury and mortality across different racial and ethnic groups following violent injury.

Main Methods:

• Retrospective study of patients with violent penetrating injury at Boston Medical Center (2006-2016).
• Cox proportional hazards regression models used to assess risks of mortality and re-injury at 1 and 3 years.
• Analysis included 4191 patients: 70% Black, 18% Hispanic, 12% White.

Main Results:

• Black patients had the highest risk of violent re-injury within 3 years (vs. Hispanic HR=1.46, vs. White HR=1.89), particularly from gun violence.
• White patients showed a 2.03 times higher risk of all-cause mortality at 3 years.
• White patients had a 4.96 times greater risk of death from drug/alcohol overdose compared to Black patients.

Conclusions:

• Black survivors of violent injury are at significantly higher risk for violent re-injury, especially gun violence.
• White survivors face a greater risk of mortality, primarily due to drug and alcohol overdose.
• Violence intervention programs should consider collaborations with drug treatment programs to address these disparities.