Nonfatal Assaults Research Articles

Evaluating Firearm Violence After New Jersey’s Cash Bail Reform

Reducing the pretrial detention population has been a cornerstone of movements to end mass incarceration. Across many US cities, there are ongoing public debates on policies that would end pretrial detention due to the inability to afford bail, with some raising concerns that doing so would increase community violence. To evaluate changes in firearm violence after New Jersey's 2017 bail reform policy that eliminated financial barriers to avoiding pretrial detention. This case-control study used synthetic control methods to examine changes in firearm mortality and combined fatal and nonfatal shootings in New Jersey (2014-2019). New Jersey was chosen because it was one of the first states to systematically implement cash bail reform. Outcomes in New Jersey were compared with a weighted combination of 36 states that did not implement any kind of reform to pretrial detention during the study period. Data were analyzed from April 2023 to March 2024. Implementation of New Jersey's cash bail reform law in 2017. Quarterly rates of fatal and nonfatal firearm assault injuries and firearm self-harm injuries per 100 000 people. Although New Jersey's pretrial detention population dramatically decreased under bail reform, the study did not find evidence of increases in overall firearm mortality (average treatment effect on the treated, -0.26 deaths per 100 000) or gun violence (average treatment effect on the treated, -0.24 deaths per 100 000), or within racialized groups during the postpolicy period. Incarceration and gun violence are major public health problems impacting racially and economically marginalized groups. Cash bail reform may be an important tool for reducing pretrial detention and advancing health equity without exacerbating community violence.

The Health and Economic Impact of Youth Violence by Injury Mechanism

Violence is a leading cause of morbidity and mortality among U.S. youth. More information on the health and economic burden of the most frequent assault mechanisms-or, causes (e.g., firearms, cut/pierce)-can support the development and implementation of effective public health strategies. Using nationally representative data sources, this study estimated the annual health and economic burden of U.S. youth violence by injury mechanism. In 2023, CDC's WISQARS provided the number of homicides and nonfatal assault ED visits by injury mechanism among U.S. youth aged 10-24 years in 2020, as well as the associated average economic costs of medical care, lost work, morbidity-related reduced quality of life, and value of statistical life. The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample provided supplemental nonfatal assault incidence data for comprehensive reporting by injury mechanism. Of the $86B estimated annual economic burden of youth homicide, $78B was caused by firearms, $4B by cut/pierce injuries, and $1B by unspecified causes. Of the $36B billion estimated economic burden of nonfatal youth violence injuries, $19B was caused by struck by/against injuries, $3B by firearm injuries, and $365M by cut/pierce injuries. The lethality of assault injuries affecting youth when a weapon is explicitly or likely involved is high-firearms and cut/pierce injuries combined account for nearly all youth homicides compared to one-tenth of nonfatal assault injury ED visits. There are numerous evidence-based policies, programs, and practices to reduce the number of lives lost or negatively impacted by youth violence.

Community-Level Risk Factors for Firearm Assault and Homicide: The Role of Local Firearm Dealers and Alcohol Outlets.

Identifying community characteristics associated with firearm assault could facilitate prevention. We investigated the effect of community firearm dealer and alcohol outlet densities on individual risk of firearm assault injury. In this density-sampled case-control study of Californians, January 2005-September 2015, cases comprised all residents with a fatal or nonfatal firearm assault injury. For each month, we sampled controls from the state population in a 4:1 ratio with cases. Exposures were monthly densities of county-level pawn and nonpawn firearm dealers and ZIP code-level off-premises alcohol outlets and bars and pubs ("bars/pubs"). We used case-control-weighted G-computation to estimate risk differences (RD) statewide and among younger Black men, comparing observed exposure densities to hypothetical interventions setting these densities to low. We estimated additive interactions between firearm and alcohol retailer density. Secondary analyses examined interventions targeted to high exposure density or outcome burden areas. There were 67,850 cases and 268,122 controls. Observed (vs. low) densities of pawn firearm dealers and off-premises alcohol outlets were individually associated with elevated monthly risk of firearm assault per 100,000 people (RD pawn dealers : 0.06, 95% CI: 0.05, 0.08; RD off-premises outlets : 0.01, 95% CI: 0.01, 0.03), but nonpawn firearm dealer and bar/pub density were not; models targeting only areas with the highest outcome burden were similar. Among younger Black men, estimates were larger. There was no interaction between firearm and alcohol retailer density. Our results are consistent with the hypothesis that limiting pawn firearm dealers and off-premises alcohol outlet densities can reduce interpersonal firearm violence.

Addressing health disparities using multiply imputed injury surveillance data

BackgroundAssessing disparities in injury is crucial for injury prevention and for evaluating injury prevention strategies, but efforts have been hampered by missing data. This study aimed to show the utility and reliability of the injury surveillance system as a trustworthy resource for examining disparities by generating multiple imputed companion datasets.MethodsWe employed data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) for the period 2014–2018. A comprehensive simulation study was conducted to identify the appropriate strategy for addressing missing data limitations in NEISS-AIP. To evaluate the imputation performance more quantitatively, a new method based on Brier Skill Score (BSS) was developed to assess the accuracy of predictions by different approaches. We selected the multiple imputations by fully conditional specification (FCS MI) to generate the imputed companion data to NEISS-AIP 2014–2018. We further assessed health disparities systematically in nonfatal assault injuries treated in U.S. hospital emergency departments (EDs) by race and ethnicity, location of injury and sex.ResultsWe found for the first time that significantly higher age-adjusted nonfatal assault injury rates for ED visits per 100,000 population occurred among non-Hispanic Black persons (1306.8, 95% Confidence Interval [CI]: 660.1 – 1953.5), in public settings (286.3, 95% CI: 183.2 – 389.4) and for males (603.5, 95% CI: 409.4 – 797.5). We also observed similar trends in age-adjusted rates (AARs) by different subgroups for non-Hispanic Black persons, injuries occurring in public settings, and for males: AARs of nonfatal assault injury increased significantly from 2014 through 2017, then declined significantly in 2018.ConclusionsNonfatal assault injury imposes significant health care costs and productivity losses for millions of people each year. This study is the first to specifically look at health disparities in nonfatal assault injuries using multiply imputed companion data. Understanding how disparities differ by various groups may lead to the development of more effective initiatives to prevent such injury.

Analyzing Child Firearm Assault Injuries by Race and Ethnicity During the COVID-19 Pandemic in 4 Major US Cities

This cross-sectional study examines changes in rates and disparities of fatal and nonfatal firearm assaults among children in New York, Los Angeles, Chicago, and Philadelphia before and during the COVID-19 pandemic.

The Pursuit of Medical Care for Female Victims of Nonfatal Strangulation at the Time of Police Response.

Survivors of nonfatal strangulation face a number of physical health consequences, some of which can be fatal if untreated. Despite the known health risks and connections to delayed fatalities, little is known about strangulation and victims' pursuit of medical care. Using data collected from prosecutors' case files (n = 143), this study attempts to understand what factors contribute to victims receiving medical attention following a nonfatal strangulation assault reported to police. Findings indicate that the suspect disrupting an emergency call increases the likelihood of the victim pursuing medical care. Implications are discussed.

Reprint of “Using multiple imputation by super learning to assign intent to nonfatal firearm injuries”

The number of nonfatal firearm injuries in the US by intent (e.g., due to assault) is not reliably known: First, although the largest surveillance system for hospital-treated events, the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS), provides accurate data for the number of nonfatal firearm injuries, injury intent is not coded reliably. Second, the system that reliably codes intent, the CDC's National Electronic Injury Surveillance System – Firearm Injury Surveillance Study (NEISS-FISS), while large enough to produce stable estimates of the distribution of intent, is too small to produce stable estimates of the number of these events. Third, a large proportion of cases in NEISS-FISS, notably in early years of the system, are coded as of “undetermined intent.” Trends in the proportion of nonfatal firearm injuries by intent in NEISS-FISS thus depend on whether these cases are treated as a distinct category, or, instead, can be re-classified through imputation.We contrast the distributions of nonfatal firearm injury by intent generated using multiple imputation with those generated using complete-case analyses and analyses that consider “undetermined intent” as a distinct category. We produce estimates of the annual number of firearm injuries by intent in a two-step process. First, we impute intent for cases coded as “undetermined” using Multiple Imputation by Super Learning (MISL). Second, we apply MISL-derived distributions to aggregate count data from HCUP-NEDS.The proportion of non-fatal firearm assaults appears to increase over time when injuries coded as undetermined are included as a category. By contrast, the proportion of assaults remains relatively constant over time in complete-case and multiply imputed analyses. Differences between complete-case and multiple imputation approaches become apparent in subgroup analyses. Trends in the number of nonfatal firearm injuries by intent, 2006–2016, derived in our two-step process, are relatively flat.Multiple imputation strategies recovered intent distribution trends that differed from trends derived using methods that are not designed to account for the multiple complex relationships of missingness present in NEISS – FISS data. When applied to NEISS – FISS, MISL imputation produces plausible distributional estimates of firearm injury by intent.

Using multiple imputation by super learning to assign intent to nonfatal firearm injuries

The number of nonfatal firearm injuries in the US by intent (e.g., due to assault) is not reliably known: First, although the largest surveillance system for hospital-treated events, the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS), provides accurate data for the number of nonfatal firearm injuries, injury intent is not coded reliably. Second, the system that reliably codes intent, the CDC's National Electronic Injury Surveillance System – Firearm Injury Surveillance Study (NEISS-FISS), while large enough to produce stable estimates of the distribution of intent, is too small to produce stable estimates of the number of these events. Third, a large proportion of cases in NEISS-FISS, notably in early years of the system, are coded as of “undetermined intent.” Trends in the proportion of nonfatal firearm injuries by intent in NEISS-FISS thus depend on whether these cases are treated as a distinct category, or, instead, can be re-classified through imputation.We contrast the distributions of nonfatal firearm injury by intent generated using multiple imputation with those generated using complete-case analyses and analyses that consider “undetermined intent” as a distinct category. We produce estimates of the annual number of firearm injuries by intent in a two-step process. First, we impute intent for cases coded as “undetermined” using Multiple Imputation by Super Learning (MISL). Second, we apply MISL-derived distributions to aggregate count data from HCUP-NEDS.The proportion of non-fatal firearm assaults appears to increase over time when injuries coded as undetermined are included as a category. By contrast, the proportion of assaults remains relatively constant over time in complete-case and multiply imputed analyses. Differences between complete-case and multiple imputation approaches become apparent in subgroup analyses. Trends in the number of nonfatal firearm injuries by intent, 2006–2016, derived in our two-step process, are relatively flat.Multiple imputation strategies recovered intent distribution trends that differed from trends derived using methods that are not designed to account for the multiple complex relationships of missingness present in NEISS – FISS data. When applied to NEISS – FISS, MISL imputation produces plausible distributional estimates of firearm injury by intent.

Firearm Violence Following the Implementation of California’s Gun Violence Restraining Order Law

California's gun violence restraining order (GVRO) law, implemented beginning in 2016, allows for people at high risk of harming themselves or others with a firearm to be temporarily disarmed and prevented from purchasing firearms for 3 weeks to 1 year; many states have recently enacted similar laws. The research to date is on older and more limited risk-warrant laws. To determine whether implementation of the California GVRO law was associated with decreased rates of firearm assault or firearm self-harm in a large metropolitan county between 2016 and 2019. This serial cross-sectional study including data from 28 counties used the synthetic control method to evaluate differences in firearm violence between San Diego County and its synthetic control following implementation of the California law from 2016 to 2019. San Diego County was used as the treated unit because it issued substantially more GVROs than any other county in California during the study period. A total of 27 California counties that issued no or very few gun violence restraining orders from 2016 to 2019 and that had stable rates of firearm violence between 2005 and 2015 were included in the control pool. Data were analyzed from February 2021 to July 2021. Implementation of the statewide GVRO law in 2016 in San Diego County. Annual rates of fatal and nonfatal firearm assault injuries and firearm self-harm injuries per 100 000 people. In the study period, there were 355 GVROs in San Diego county, and a median (IQR) total of 8 (3-20) GVROs per donor county. The mean difference between the observed rate in San Diego County and the estimated rate in the synthetic San Diego County, 2016-2019, was -0.74 firearm assaults per 100 000 (-13% difference) and 0.13 firearm self-harm injuries per 100 000 (3% difference). Results from in-space placebo tests suggested that these differences cannot be distinguished from variation due to chance (pseudo-P values from a 1-sided test: P for assault = .35, P for self-harm = .67). To our knowledge, this study was the first to analyze the association between GVRO implementation and firearm violence in California and the first to evaluate the association between risk-based firearm removal laws and firearm assault in any state. GVROs were not associated with reduced population-level rates of firearm violence in San Diego County, but this may change as the number of orders increases over time; the association between GVROs and firearm violence at the individual level cannot be inferred from our findings and should be the subject of future studies.

Gun Victimization in the Line of Duty: Fatal and Non-Fatal Firearm Assaults on Police Officers in the United States, 2014-2019

Gun Victimization in the Line of Duty: Fatal and Non-Fatal Firearm Assaults on Police Officers in the United States, 2014-2019

Identifying nonfatal firearm assault incidents through linking police data and clinical records: Cohort study in Indianapolis, Indiana, 2007–2016

Nonfatal firearm assault incidents are more prevalent than gun homicides, however, little is understood about nonfatal firearm assault incidents due to a lack of accurate data in the United States. This is a descriptive study of all nonfatal firearm assault incidents identified through police and clinical records from 2007 to 2016 in Indianapolis, Indiana. Records were linked at the incident level to demonstrate the overlap and non-overlap of nonfatal firearm assault incidents in police and clinical records and describe differences in demographic characteristics of the victims. Incidents were matched within a 24-h time window of the recorded date of the police incident. Data were analyzed in fall 2020. There were 3797 nonfatal firearm assault incidents identified in police reports and 3131 clinical encounters with an ICD 9/10 diagnosis-based nonfatal firearm-related injury. 62% (n = 2366) of nonfatal firearm assault incidents matched within 24 h to a clinical encounter, 81% (n = 1905) had a firearm related ICD code: 40% (n = 947) were coded as a firearm-related assault, 32% (n = 754) were coded as a firearm-related accident; and 8.6% (n = 198) were coded as undetermined, self-inflicted or law enforcement firearm-related. The other 20% (n = 461) did not have an ICD firearm related diagnosis code. Results indicate most nonfatal firearm assault incidents overlap between police and clinical records systems, however, discrepancies between the systems exist. These findings also demonstrate an undercounting of nonfatal firearm assault incidents when relying on clinical data systems alone and more efforts are needed to link administrative police and clinical data in the study of nonfatal firearm assaults.

Neighborhood disadvantage and firearm injury: does shooting location matter?

BackgroundFirearm violence is a public health problem that disparately impacts areas of economic and social deprivation. Despite a growing literature on neighborhood characteristics and injury, few studies have examined the association between neighborhood disadvantage and fatal and nonfatal firearm assault using data on injury location. We conducted an ecological Bayesian spatial analysis examining neighborhood disadvantage as a social determinant of firearm injury in Seattle, Washington.MethodsNeighborhood disadvantage was measured using the National Neighborhood Data Archive disadvantage index. The index includes proportion of female-headed households with children, proportion of households with public assistance income, proportion of people with income below poverty in the past 12 months, and proportion of the civilian labor force aged 16 and older that are unemployed at the census tract level. Firearm injury counts included individuals with a documented assault-related gunshot wound identified from medical records and supplemented with the Gun Violence Archive between March 20, 2016 and December 31, 2018. Available addresses were geocoded to identify their point locations and then aggregated to the census tract level. Besag-York-Mollie (BYM2) Bayesian Poisson models were fit to the data to estimate the association between the index of neighborhood disadvantage and firearm injury count with a population offset within each census tract.ResultsNeighborhood disadvantage was significantly associated with the count of firearm injury in both non-spatial and spatial models. For two census tracts that differed by 1 decile of neighborhood disadvantage, the number of firearm injuries was higher by 21.0% (95% credible interval: 10.5, 32.8%) in the group with higher neighborhood disadvantage. After accounting for spatial structure, there was still considerable residual spatial dependence with 53.3% (95% credible interval: 17.0, 87.3%) of the model variance being spatial. Additionally, we observed census tracts with higher disadvantage and lower count of firearm injury in communities with proximity to employment opportunities and targeted redevelopment, suggesting other contextual protective factors.ConclusionsEven after adjusting for socioeconomic factors, firearm injury research should investigate spatial clustering as independence cannot be able to be assumed. Future research should continue to examine potential contextual and environmental neighborhood determinants that could impact firearm injuries in urban communities.

Patterns and Trends of Gun Violence Against Women in the United States.

To examine patterns and trends of firearm injuries in a nationally representative sample of US women. Gun violence in the United States exceeds rates seen in most other industrialized countries. Due to the paucity of data little is known regarding demographics and temporal variations in firearm injuries among women. Data were extracted from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (2001-2017) for women 18 years and older. Number of nonfatal firearm assaults and homicide per year were extracted and crude population-based injury rates were calculated. Sub-stratification by age-group and time period were performed. Between 2001 and 2017, there were 88,823 nonfatal firearm assaults involving women and 29,106 firearm homicides. There were 4116 victims of nonfatal firearm assault in 2001 (3.8 per 105) and 12,959 by 2017 (10.0 per 105). Homicide rates were 1.5 per 105 in 2001 and 1.7 per 105 in 2017. Sub-stratification by age-group and time period showed that there were no significant changes in nonfatal firearm assault rates between 2001 and 2010 (P-trend = 0.132 in 18-44 yo; 0.298 in 45-64 yo). However between 2011 and 2017, nonfatal assault rates increased from 7.10 per 105 to 19.24 per 105 in 18-44 yo (P-trend = 0.013) and from 1.48 per 105 to 3.93 per 105 in 45-64 yo (P-trend = 0.003). Similar trends were seen with firearm homicide among 18-44 yo (1.91 per 105 to 2.47 per 105 in 2011-2017, P-trend = 0.022). However, the trends among 45-64 yo were not significant in both time periods. Female victims of gun violence are increasing and more recent years have been marked with higher rates of firearm injuries, particularly among younger women. These data suggest that improved public health strategies and policies may be beneficial in reducing gun violence against US women.

Firearm Instrumentality: Do Guns Make Violent Situations More Lethal?

One of the central debates animating the interpretation of gun research for public policy is the question of whether the presence of firearms independently makes violent situations more lethal, known as an instrumentality effect, or whether determined offenders will simply substitute other weapons to affect fatalities in the absence of guns. The latter position assumes sufficient intentionality among homicide assailants to kill their victims, irrespective of the tools available to do so. Studies on the lethality of guns, the likelihood of injury by weapon type, offender intent, and firearm availability provide considerable evidence that guns contribute to fatalities that would otherwise have been nonfatal assaults. The increasing lethality of guns, based on size and technology, and identifiable gaps in existing gun control policies mean that new and innovative policy interventions are required to reduce firearm fatalities and to alleviate the substantial economic and social costs associated with gun violence.

Targeting Knife-Enabled Homicides for Preventive Policing: A Stratified Resource Allocation Model

Research QuestionHow can police translate differing risk levels for knife homicide into a resource allocation model that follows the evidence?DataThe data for this publication are taken from the open access tables published in this journal by Massey et al. Cambridge Journal of Evidence-Based Policing, 3:1-20, (2019). Those data show the linear relationship between the number of non-fatal knife assaults in a lower super output area (LSOA) in 1 year and the risk of a knife-enable homicide in the subsequent year, as well as how many of the 4835 LSOAs fell into each of five levels of increasing homicide risk.MethodsThe data from Massey’s research are re-calculated to show how a hypothetical number of 15-min police patrols could be allocated across all areas on the basis of a combination of knife-enabled (KE) homicide risk level and the volume of LSOAs at each of the five levels of knife homicide risk. We display these results using both tables and multi-layered “wedding cake” images to show the size of different dimensions of each level, including proportion of total homicides and directed patrol frequency per LSOA at each of the five risk levels.FindingsBased on the hypothetical allocation of 10,000 patrol visits of 15 min in length, the highest risk group, with a forecasted 6% of all KE homicides, would receive 600 police patrols, divided by the 41 LSOAs at that risk level = 15 patrols across every 10 days. At the lowest level of risk, the 2787 LSOAs would share the 3000 patrols that a group of LSOAs would recieve for having 30% of homicides, which equals 1.1 patrols every 10 days. The hypothetical premise is that every LSOA gets some patrol, but the highest risk areas get 15 times more patrol to follow the evidence of risk. The formula is to (1) allocate resources by proportion of homicide at each risk level; (2) divide the allocated resources by the number of areas in each risk level group; and (3) allocate the resulting resources per day to each area in each of the 5 levels.ConclusionPolice face difficult tradeoffs between targeting more policing to fewer areas of higher risk (with more efficiency) or to more areas of lower risk (with more effectiveness). The use of a formula combining risk and volume can help guide such decisions, illustrated by a layered “wedding cake” visualization for gaining clarity and legitimacy in communications.

Consent and the ‘Rough Sex’ Defence in Rape, Murder, Manslaughter and Gross Negligence

When women die at the hands of men, a not infrequent defence is that she consented to, or initiated, the beating, strangulation and penetration which contributed to her death. While strangulation has been a typical method of killing in male on female intimate partner homicide 1 for many decades (‘thou little recognised), what has changed is men’s excuses for their violence. Excuses such as ‘She made me lose my self-control in an argument’ or ‘She was unfaithful to me’ are being supplanted by ‘She consented to rough sex’. 2 Since the dead cannot speak, nor is there any property in the dead, the defendant’s tactic of impugning the deceased’s character cannot be easily rebutted, and he, while maligning her in this way, may profit from a lighter sentence. Law reformers, politicians, academics and activists 3 are pressing for legal reform to shut down this misogyny. On 16 June 2020, during the Public Committee stage of the Domestic Abuse Bill, 4 cls 4 and 5 were approved. Clause 4, ‘No defence for consent to death’, provides ‘(1) If a person (“A”) wounds, assaults or asphyxiates another person (“B”) to whom they are personally connected as defined in section 2 of this Act causing death, it is not a defence to a prosecution that B consented to the infliction of injury. (2) Subsection (1) applies whether or not the death occurred in the course of a sadomasochistic encounter’. Clause 5, ‘No defence for consent to injury’, provides ‘(1) If a person (“A”) wounds, assaults or asphyxiates another person (“B”) to whom they are personally connected as defined in section 2 of this Act causing actual bodily harm or more serious injury, it is not a defence to a prosecution that B consented to the infliction of injury or asphyxiation. (2) Subsection (1) applies whether or not the actual bodily harm, non-fatal strangulation, or more serious injury occurred in the course of a sadomasochistic encounter’. These two new clauses would prevent the alleged consent of the victim from being used as a defence to a prosecution in intimate partner homicides and non-fatal assault which result in s 47 assault occasioning actual bodily harm, Offences Against the Person Act 1861, or more serious injury. Additional new clauses including, proposing that consent of the Director of Public Prosecutions would be required, in the case of death, to accept a charge to anything less than murder (cl 6); the requirement to consult with the family of the deceased regarding charges (cl 7); the prohibition of reference to sexual history of the deceased in domestic homicide trials (cl 10); anonymity of victims of domestic homicide (cl 11); and anonymity of domestic violence survivors (cl 14); the Parliamentary Under-Secretary of State for Justice (Alex Chalk), while sympathetic, said there were difficulties with the clauses in their present form. 5 Of the proposal to make non-fatal strangulation 6 (cl 8) a standalone offence, he considered that ‘creating a new offence could limit the circumstances covered, and create additional evidential burdens’. 7 These motions reflect the several debates since October 2019, when MPs, Harriet Harman and Mark Garnier, introduced the ‘No defence for consent’ amendment to the second reading of the Domestic Abuse Bill. 8 Since men also plead the ‘sexual consent defence’ on ‘first dates’, which may fall outside the definition of ‘domestic abuse’ as set out in the Bill, 9 a loophole also recognised by Alex Chalk at the Public Committee stage, 16 June 2020, this too will be addressed. 10 The murder of Grace Millane, in New Zealand 11 in 2018, murdered on a ‘first date’ provides such an example.

Gun victimization in the line of duty: Fatal and nonfatal firearm assaults on police officers in the United States, 2014-2019.

Using open-source data from the Gun Violence Archive (GVA), we analyze national- and state-level trends in fatal and nonfatal firearm assaults of U.S. police officers from 2014 to 2019 (N = 1,467). Results show that (a) most firearm assaults are nonfatal, (b) there is no compelling evidence that the national rate of firearm assault on police has substantially increased during the last 6 years, and (c) there is substantial state-level variation in rates of firearm assault on police officers. GVA has decided strengths relative to existing data sources on police victimization and danger in policing. We consider the promises and pitfalls of this and other open-source data sets in policing research and recommend that recent state-level improvements in use-of-force data collection be replicated and expanded to include data on violence against police.

Risk factors for assaultive reinjury and death following a nonfatal firearm assault injury: A population-based retrospective cohort study

Individuals with a firearm injury are at high risk of subsequent firearm victimization, but characteristics associated with sustaining recurrent firearm injuries are not well understood. In this retrospective cohort study, we sought to quantify the hazards of sustaining subsequent assaultive firearm injuries among people with an initial firearm assault injury and to identify characteristics associated with recurrent victimization. Using hospital discharge, emergency department, and mortality records, we identified and followed all individuals aged ≥15 years with a nonfatal firearm assault injury resulting in an emergency department visit or hospital admission in California, 2005–2013. We model transitions from one injury to the next and from injury to death, accounting for event history, covariates, and competing risks using multistate models. 29,156 people had an index nonfatal firearm assault injury. Among individuals with 1 such injury, 3.1% had additional nonfatal firearm assault injuries and 1.0% subsequently died from firearm homicide. Among individuals with 2+ nonfatal firearm assaults, 2.0% died from firearm homicide. The estimated transition probability for 1 to 2+ nonfatal injuries reached 10% by 8.5 years post-index injury. The rate of subsequent nonfatal firearm assault injury was highest among men (hazard ratio [HR]: 3.87; 95% confidence interval [CI]: 2.63–5.69) and Blacks (vs. whites) (HR: 2.69; 95% CI: 1.99–3.64). Identification of additional risk markers will require more detailed individual-level data; nonetheless, this study supports the generalizability of findings from smaller studies, provides broad guidance for allocating scarce resources, and suggests that interventions on root causes of violence disparities may have downstream effects on recurrence.

Predictors of non-fatal violence or assault among adolescents in rural Bangladesh: cross-sectional study

ObjectiveTo determine the predictors of non-fatal violence or assault among adolescents in rural Bangladesh to inform evidence-based interventions.DesignCross-sectional study.SettingHousehold survey and national census in 51 unions of rural Bangladesh.Participants, methods...

Extending Research on the “War on Cops”: The Effects of Ferguson on Nonfatal Assaults Against U.S. Police Officers

This study tests whether violence directed toward American law enforcement has increased in the wake of events in Ferguson, Missouri, in summer 2014. Using monthly data from the Federal Bureau of Investigation’s (FBI) Law Enforcement Officers Killed and Assaulted (LEOKA) reports (2010–2016), we carried out time-series analyses to examine trends in nonfatal assaults on police officers in a sample of 4,921 agencies. Neither injurious nor noninjurious assaults on officers increased following Michael Brown’s death in August 2014. The findings are robust across a variety of model specifications and estimation techniques, providing little evidence of a “War on Cops” through 2016. The study adds empirical rigor to an ongoing national debate based largely on speculation/anecdotes. The impact and potential consequences of the current climate for officers’ perceptions of safety/risk are discussed.