Citation

Jones V, Becote-Jackson M, Parnham T, Lewis Q, Ryan LM. J. Pediatr. X 2021; 6: e100064.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.ympdx.2021.100064

PMID

unavailable

Abstract

Youth violence, a major cause of morbidity and mortality, is a pressing issue in need of targeted action given its negative impact on population health, well-being and equity. Homicide is currently the third leading cause of death for young people ages 10-24.1 Although youth violence impacts all communities, youth of color are disproportionately affected. Specifically, homicide is the leading cause of death for African Americans and the second leading cause of death for Hispanics in this 10-24 age group.2 According to the Centers for Disease Control and Prevention, the known costs of these assault-related injuries nationally, including medical and work loss, are $18.2 billion per year.2 The Healthy People 2020 objectives identify injury and violence as leading health indicators and critical objectives for youth, which includes reducing homicides, physical fighting, and weapon carrying.3 There are many prevention strategies that have demonstrated success in reducing youth violence.4 The purpose of this Medical Progress article is to highlight promising partnerships between emergency departments (EDs) and community-based organizations to decrease youth violence through mentoring.

Two key factors support the use of the ED as a setting for violence prevention strategies and interventions. First, this setting is a common point of contact between health care professionals and youth who experience violence. Every day, approximately 1300 youth are treated in EDs for nonfatal assault-related injuries.2 Youth involved with violence are more likely to be seen in the ED than in other settings.5 Such assault-injured youth are at risk for negative health outcomes; a prior violent injury is a strong risk factor for future assault-related injuries and homicide.6, 7, 8, 9 Intentionally injured youth are significantly more likely to commit violent offenses compared with youth treated for unintentional injuries.10 For example, in bullying-related peer assaults, youth who have bullied and youth who have been victims of bullying often have similar risk profiles.11 In addition, the majority of youth who identified as bullies also report previously being victims of bullying.11 Furthermore, the risk for violence retaliation is greatest in the initial weeks after a violence-related injury.12 Because of this, intervening when youth present to the ED can be critical to preventing future violence. Second, the ED may provide an opportunity for a "teachable moment" during a time of introspection and vulnerability after an injury event.13 Providers in EDs have a unique opportunity to refer young people during this likely "aha" moment where the seriousness of a violent event becomes unavoidably real. Research has characterized the concept of the "teachable moment" of the ED visit to decrease retaliatory attitudes and eliminate revenge-seeking intentions among youth and their parents.13, 14, 15 Thus, an ED visit for an intentional injury may be a prime opportunity to identify at-risk youth, initiate violence prevention interventions, and potentially interrupt this cycle...

Language: en

Keywords

emergency department; mentoring; peer assault-injured youth; youth violence