Prevalence of Past Year Assault Among Inner-City Emergency Department Patients

Cunningham, R. M., Murray, R., Walton, M. A., Chermack, S. T., Wojnar, M., Wozniak, P., Booth, B. & Blow, F. C. (2009). Prevalence of past year assault among inner-city emergency department patientsAnnals of emergency medicine53(6), 814-823.

Study objective: We determine the rates of past year nonpartner violent assault, both victimization and aggression, and assess variables associated with nonpartner violent assault, particularly with regard to substance use.

Methods: A cross-sectional computerized standardized survey study was conducted to assess nonpartner violent assault, physical and mental health, and substance use among patients presenting to an inner-city ED during 2 years. Patients (aged 19 to 60 years) with normal vital signs in an urban emergency department (ED) from 9 am to 11 pm were eligible; pregnant patients and those with a chief complaint of psychiatric evaluation were excluded. Logistic regression analyses were conducted to predict any nonpartner violent assault.

Results: Ten thousand seven hundred forty-four patients were enrolled (80% response rate); 14% of the sample reported any past year nonpartner violent assault (9% perpetration; 11% victimization). Findings from regression analyses found that participants with any past year nonpartner violent assault (victimization or aggression) were more likely than their counterparts to be men (2.2), to be single (1.5), to be unemployed (1.1), to present to the ED for injury (1.9), and to report poor physical health (1.3) or poor mental health (1.9). They were less likely to be black (0.8), or older (0.95). Alcohol use (1.7), marijuana use (2.4), cocaine use (3.1), prescription drug use (1.4), and past treatment (1.7) were associated with experiencing past year nonpartner violent assault.

Conclusion: Fourteen percent of patients seeking care in this inner-city ED experience violence with a nonpartner. Substance use-specifically cocaine-was the strongest predictor of any nonpartner violent assault.