A paradigm shift to interrupt the bidirectional flow driving community violence
Community violence is a downstream consequence of root causes upstream, such as a lack of employment, income, opportunities for wealth building, education, access to healthy affordable food, and other determinants of health and thriving such as economically stable communities. EDs that are located in urban centers are exposed disproportionately to the unfortunate outcomes of community violence and thus have unique opportunities to intervene. But there is no formal curricular requirement for ED staff to learn about treating victims of community violence beyond treating their physical injuries. When ED providers and staff lack broader formal education about treating victims of community violence, there is a high likelihood that they will lack insight into its roots: the emotional and psychological damage that both grows from and results from violence, and the interrelatedness of other social determinants of health. This knowledge and insight is invaluable in clinical emergency medicine. Such an awareness enables providers and staff to view the trauma of community violence through a critical lens and enables them to deliver best-practice care to victims of community violence and to their families. A gap in this education leads to missed opportunities for EDs to execute influential interventions for community violence and risks inadvertent harm to individuals who are victims when they are in our care.In this essay, I explore how EDs and hospitals can provide upstream and downstream interventions to mitigate downstream cycles of community violence.
This article is part of a special supplement: Inventing Social Emergency Medicine: A Consensus Conference to Establish the Intellectual Underpinnings of Social Emergency Medicine.
James T. A paradigm shift to interrupt the bidirectional flow driving community violence. Ann Emerg Med. 2019;74(5):S47-S51. DOI: https://doi.org/10.1016/j.annemergmed.2019.08.444