BACKGROUND: Trauma surgeons have observed an increased rate of penetrating trauma during periods of increased unemployment.
METHODS: During a 10-year period, the rate of unemployment in a metropolitan area was compared with the rate of intentional penetrating trauma at two Level I trauma centers. The total number of trauma cases was recorded. Assaults, derived from police records, were examined as an additional indicator of violent behavior. Pearson correlation coefficients were calculated to identify significant correlation between study variables. Stepwise maximum-likelihood estimation was used to derive a model predicting percent penetrating trauma.
RESULTS: The rate of unemployment and percent penetrating trauma of individuals presenting to the emergency department were significantly correlated (P = 0.014). After stepwise estimation, a model was derived (r2 = 0.846, P = 0.014) that estimated percent penetrating trauma on the basis of percent unemployment and total number of trauma admissions.
CONCLUSION: This long-term ecological study confirms that rates of penetrating trauma increase with increasing unemployment rates. This should inspire further research to identify areas of greatest need to improve delivery of resources and current public policy with the ultimate goal of decreasing the incidence of penetrating trauma.