Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 814-823.e15, June 2009

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

  • Rebecca M. Cunningham, MD

      Affiliations

    • Department of Emergency Medicine Injury Research Center, University of Michigan, Ann Arbor, MI
    • Hurley Medical Center, Flint, MI
    • University of Michigan School of Public Health, Ann Arbor, MI
    • Corresponding Author InformationAddress for reprints: Rebecca Cunningham, MD, Department of Emergency Medicine Injury Research Center, University of Michigan, Ann Arbor, MI; 734-615-3704
  • ,
  • Regan Murray, PhD

      Affiliations

    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
  • ,
  • Maureen A. Walton, MPH, PhD

      Affiliations

    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
  • ,
  • Stephen T. Chermack, PhD

      Affiliations

    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
  • ,
  • Marcin Wojnar, MD

      Affiliations

    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
    • Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
  • ,
  • Piotr Wozniak, MD

      Affiliations

    • Department of Emergency Medicine Injury Research Center, University of Michigan, Ann Arbor, MI
    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
  • ,
  • Brenda M. Booth, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Division of Health Services Research, College of Medicine, University of Arkansas for Medical Sciences, and the Central Arkansas Veterans Healthcare System, Little Rock, AR
  • ,
  • Frederic C. Blow, PhD

      Affiliations

    • Department of Psychiatry, University of Michigan, Ann Arbor, MI
    • Department of Veterans Affairs, Health Services Research and Development, Ann Arbor, MI

Received 13 August 2008; received in revised form 21 November 2008 and 17 December 2008; accepted 6 January 2009. published online 13 March 2009.

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.

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 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Supervising editor: Debra E. Houry, MD, MPH

 Author contributions: RMC, RM, and MAW wrote the initial draft of the article. MAW, STC, BMB, and FCB conceptualized the study and are investigators on the grant funding this work. MW and PW assisted in editing the article. All authors contributed to and have approved the final article. RMC takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that may create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This work was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (AA014665) and the National Institute on Drug Abuse (DA 016591).

 Publication date: Available online March 12, 2009.

PII: S0196-0644(09)00042-0

doi:10.1016/j.annemergmed.2009.01.016

Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 814-823.e15, June 2009