Beiter Kaylin, Danos Denise, Conrad Erich, Broyles Stephanie, Zabaleta Jovanny, Mussell Jason, Phillippi Stephen
Louisiana State University Health Sciences Center, 70112, New Orleans, Louisiana, USA.
Heliyon. 2022 Jul 19;8(7):e09974. doi: 10.1016/j.heliyon.2022.e09974. eCollection 2022 Jul.
The COVID-19 pandemic has had mental health, social, and economic implications among communities with high levels of social disadvantage; this may have impacted community violence rates. The objective of this study was to characterize overall trends in assault and social disadvantage of patients experiencing assault before and during the COVID-19 pandemic.
All trauma activations at a level one trauma center serving the entire southeast Louisiana region were included during March-August pre-COVID (2018-2019) and during COVID (2020). ICD-10 E-codes were used to identify trauma intent (assault vs. other). Assaults in this context are defined as physical injuries caused by an act of violence wherein the perpetrator was suspected or confirmed to have intended harm, injury, or death to the victim. Social disadvantage was assessed using the Area Deprivation Index (ADI). Change in the monthly rate of assault-trauma activations was assessed using negative binomial regression with adjustment for race, gender, and injury intent. The study was reviewed and approved by the Louisiana State University Health Sciences Institutional Review Board.
A total of 4,233 trauma activations were included. The majority of activations occurred among men. Assaults increased from 27.5% of all activations pre-Covid to 35.6% during the pandemic. Penetrating trauma similarly increased from 29.5% to 35.7% of all activations. Negative binomial regression demonstrated that in addition to this increase in proportion of assaults relative to all activations, the monthly assault rate also increased by 20% during the pandemic. These increases were driven primarily by increased assaults among Black men. ADI rank did not change between study periods.
Health disparities in violence worsened during the pandemic: increased cases of assault occurred disproportionately among Black men, and assaults persisted in occurring primarily among low-ADI communities where burden had been high pre-pandemic. There is a critical need for resources and support to Black men, to mitigate violence and improve racial heath equity.
新冠疫情对社会弱势群体社区的心理健康、社会和经济产生了影响；这可能影响了社区暴力发生率。本研究的目的是描述新冠疫情之前和期间遭受袭击患者的袭击总体趋势以及社会劣势情况。
纳入了2018 - 2019年新冠疫情前（3月至8月）和2020年新冠疫情期间在为路易斯安那州东南部整个地区服务的一级创伤中心的所有创伤激活病例。使用国际疾病分类第十版（ICD - 10）E编码来确定创伤意图（袭击与其他）。在此背景下，袭击被定义为由暴力行为导致的身体伤害，其中犯罪者被怀疑或确认有意对受害者造成伤害、损伤或死亡。使用地区剥夺指数（ADI）评估社会劣势。使用负二项回归评估袭击 - 创伤激活的月发生率变化，并对种族、性别和伤害意图进行调整。该研究经路易斯安那州立大学健康科学机构审查委员会审查并批准。
共纳入4233例创伤激活病例。大多数激活病例发生在男性中。袭击在所有激活病例中的占比从新冠疫情前的27.5%增加到疫情期间的35.6%。穿透性创伤在所有激活病例中的占比同样从29.5%增加到35.7%。负二项回归表明，除了袭击在所有激活病例中的比例增加外，疫情期间月袭击率还增加了20%。这些增加主要是由黑人男性中袭击事件的增加推动的。研究期间ADI排名没有变化。
疫情期间暴力方面的健康差距恶化：袭击病例增加在黑人男性中不成比例，并且袭击仍然主要发生在疫情前负担就很高的低ADI社区。迫切需要为黑人男性提供资源和支持，以减轻暴力并改善种族健康公平性。
