Two young men in their late teens sit in adjacent rooms of an inner-city emergency room. One is getting care for injuries he suffered in a fight, the other, for a sore throat. When the nurse tells each one he can go, both head back out to an environment rampant with violence, poverty and traumatic life experiences.

 
[Photo: Dr. Rebecca Cunningham (left) and Dr. Marc Zimmerman]

But a University of Michigan study finds that the one who had been in a fight will have a nearly 60 percent chance of becoming involved in a violent incident involving a firearm within the next two years. If he does, it will probably happen within the first six months after his ER visit. And despite all the similarities between him and the other young man, his risk of being the victim or perpetrator of this firearm incident will be 40 percent higher.

Published in the journal Pediatrics by a team from the University of Michigan Injury Center and U-M Medical School, the new findings come from a unique long-term study of nearly 600 young men and women between the ages of 14 and 24 living in Flint, Michigan. Researchers — including the School of Public Health’s Dr. Rebecca Cunningham and Dr. Marc Zimmerman — connected with the young people on their initial visit to an emergency department and then again every six months during the next two years.

The findings could help injury researchers, emergency department physicians, and social service agencies focus their intervention efforts to prevent future firearm incidents and other violent incidents among high-risk youth populations.

The researchers, led by U-M emergency physician Dr. Patrick M. Carter, an assistant professor of emergency medicine and member of the U-M Injury Center, say their findings support using the ER as the site for intervention, especially during the “teachable moment” that immediately follows an initial assault or fight.

“This study shows that youth seen and treated in urban emergency departments for an assault also have an elevated risk for severe forms of violence, including firearm violence, over the next two years,” says Dr. Carter. “The data also provides information on associated factors that increase this risk, and provides a roadmap for constructing evidence-based interventions to reduce the risk for severe firearm-related injury or death among high-risk youth populations.”

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