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Hospital-based violence intervention: an emerging practice based on public health principles
  1. Rochelle A Dicker
  1. San Francisco General Department of Surgery, University of California, San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Rochelle A Dicker, MD, Rochelle.Dicker{at}

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Violent injury in the USA continues to represent a major public health issue. As reported this year in the American Journal of Medicine, we are 10 times more likely to be killed from violence in the USA than in any other developed country and the rate of gun-related murder is 25 times higher than 22 other high-income countries. According to the CDC, this translated into 492 000 potential life years lost, giving credence to the fact that our young people are significantly affected. Minority populations bear the highest risk: homicide is the leading cause of death in African-Americans 15–34 years old and the second leading cause in Hispanics 15–24 years old. For every homicide, at least seven more people are non-fatally injured from violence.

Largely as a result of the horrific surge in mass casualty events, and the notoriety of police-related shootings, violence, particularly gun-related violence, has squarely captured the public's attention, which has in turn galvanised communities, political leaders, special interests and healthcare providers. Our frequent experiences on the job along with powerful statements from many leading medical associations, including the American College of Surgeons and the American Association for the Surgery of Trauma, have in turn precipitated dialog and action among the membership. Dr Deborah Kuhls recently presented a survey of the members of the Committee on Trauma regarding firearm injury. The vast majority of the membership felt that firearm injury prevention should be a priority. …

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