Race, Ethnicity, and Language of Patients Screened for Violence against Persons at a Safety-Net Hospital

ABSTRACT

Differences in violent victimization and screening implementation across demographic groups expand the health disparities gap for persons of color. This study evaluated disparities across racial/ethnic identities and languages by comparing the prevalence of types of violence against persons (VAP) and assessing screening/referral patterns of a safety-net patient population. The sample included patients with an emergency department visit during VAP screening protocol implementation in January–July, 2021. Electronic health records were used to assess screening rates and victim services utilization with univariate and bivariate statistics across patient characteristics. Seventy-one percent (71.19%) of encounters (n = 45,376) across 63,737 unique adults were screened for VAP. Most patients screened were Hispanic (52.02%) and English was the most common language spoken (65.74%). Two percent of encounters had a positive screen for VAP (n = 1,312). Spanish-speaking patients were more likely to agree to engage in victim services. Hispanic and Spanish-speaking patients had the greatest odds of screening positive across all types of victimization compared to Non-Hispanic white. Black patients had higher odds of nursing staff indicating an appearance-based (OR = 3.42) and injury-based (OR = 2.14) sign of abuse. Addressing disparities in screening/referral processes can aid in identifying missed victims and improving access to services amongst diverse communities within healthcare settings.

KEYWORDS:

• Racial disparities
• trauma screening
• interpersonal violence
• victim services

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical Standards and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation [institutional and national] and with the Helsinki Declaration of 1975, as revised in 2000. A waiver of informed consent was obtained for all de-identified patients included in the study.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Notes on contributors

Alaina M Beauchamp

Alaina M. Beauchamp, MPH, is a PhD candidate in Epidemiology at the University of Texas Health Science Center at Houston School of Public Health. Her research focuses on the health of vulnerable populations, injury and violence epidemiology, and she has a specialty in geospatial information science.

Sitara M Weerakoon

Sitara M. Weerakoon MPH, PhD is a postdoctoral fellow with the Yale School of Medicine in Substance Abuse Prevention and the SASH Lab at the School of Public Health. Her research interests are substance use epidemiology with a life course approach and racial/ethnic health disparities. She is now at Yale School of Medicine, New Haven, CT.

Madhuri B Nagaraj

Madhuri B. Nagaraj, MD, MS is a general surgery resident at the University of Texas Southwestern Medical Center. She is currently in dedicated professional development time with a focus on education and simulation and has a particular interest in patient access to care, health disparities, and preventable violence.

Heather Scroggins

Heather Scroggins, MSN, RN-BC is the Sr Clinical Informaticist Specialist at Parkland Health. She has been part of development of two different screening tools for violence against persons using the Electronic Health Record.

Brittany Pahl

Brittany Pahl, BSN, RN, CA-SANE is the Nursing Director for Forensic Nursing and Community Programs at Parkland Health. Previously a Trauma Critical Care Nurse, she became interested in care of patient populations who experienced sexual assault trauma, interpersonal violence, and trafficking.

Amanda Pitt

Amanda Pitt, MBA, BSN, RN, RN-BC is the current Magnet Program Manager and a nursing leader with over 15 years of healthcare experience. Her experience includes direct care, clinical education, nursing and business administration, and professional practice and nursing research.

Andrea Skaliks

Andrea Skaliks, LPC-S, NCC is a Senior Bilingual Counselor at the Victims Intervention Program/Rape Crisis Center at Parkland Health. She has 11 years’ experience as a licensed counselor and clinical supervisor working with individuals who have experienced trauma, mood disorders, anxiety disorders, and chronic pain.

Katelyn K Jetelina

Katelyn K. Jetelina, MPH, PhD is the Director of Population Health Analytics at Meadows Mental Health Policy Institute. For the past 10 years, she has conducted research with vulnerable populations exposed to violence, like victims of child abuse, human trafficking, intimate partner violence, gun violence, and police officers. Katelyn K. Jetelina is now at Meadows Mental Health Policy Institute, Dallas, TX.