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Racial disparities in traumatic injuries sustained in prison: A multicenter retrospective cohort study
David Bar-Or1, Stephanie Jarvis1, David Acuna2
1Injury Outcomes Network (ION) Research, 601 E. Hampden Ave., Suite 100, Englewood, CO 80113, United States of America.
The American Journal of Emergency Medicine
|June 5, 2026
Summary
Racial disparities exist in prison injuries. Black and Hispanic individuals have higher odds of injury, often from assault, while White individuals are more prone to self-harm.
Area of Science:
- Public Health
- Trauma Surgery
- Health Disparities
Background:
- Incarcerated populations face higher injury risks, but racial data are scarce.
- Understanding racial differences in prison injuries is crucial for targeted interventions.
Purpose of the Study:
- To investigate racial disparities in the occurrence, characteristics, and outcomes of traumatic prison injuries.
- To compare injury patterns and outcomes among non-Hispanic White, Black, and Hispanic incarcerated patients.
Main Methods:
- Retrospective cohort study of adult trauma patients (01/2016-07/2022) across five Level I trauma centers.
- Patients classified as non-Hispanic White, Black, or Hispanic.
- Primary outcome: proportion of prison injuries; secondary outcomes: length of stay, ICU admission, discharge disposition.
Main Results:
- Prison injuries occurred in 0.35% of trauma admissions (187/53,872).
- Black (0.8%) and Hispanic (0.4%) patients had significantly higher odds of prison injuries compared to non-Hispanic White patients (0.3%).
- Assaults were more common in Black patients, while self-harm was more prevalent in non-Hispanic White patients.
Conclusions:
- Black and Hispanic patients face elevated risks for prison injuries compared to non-Hispanic White patients.
- Distinct injury mechanisms (assault vs. self-harm) by race suggest underlying systemic issues.
- Observed differences in length of stay and discharge patterns indicate potential structural inequities within correctional facilities and post-release care.
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