Traumatic Injuries among Persons in Custody of Law Enforcement Restricted; Files Only

Abstract

Introduction:

Individuals in police custody represent a vulnerable subset of trauma patients at risk for disparate care. Though the literature on mortality of persons in police custody is growing, less research exists on morbidity. Hence, we sought to characterize traumatic injuries of persons in police custody at a single urban trauma center. We hypothesized that the majority of injuries would be from assaults and other blunt force trauma such as motor vehicle collisions.

Methods:

We analyzed the institutional trauma registry of a nationally verified Level 1 trauma center in Atlanta, Georgia. Hospitalized adults (18 years or older) who arrived to the emergency department and/or were discharged from the hospital in police custody between Jan. 2016 and Dec. 2020 were included. Patient demographics, injury patterns, clinical characteristics and outcomes were collected and analyzed. Descriptive statistics were performed. Logistic regressions were used to compare the two cohorts.

Results:

There were 24,695 hospitalized trauma patients over the study period. Of these, 738 (3%) individuals were under custody of law enforcement, of which 79.7% (n=588) were Black with mean age of 34.7 years (95% CI 22.7–46.7; SD +/- 12). Two-thirds (n=302, 40.9%) were injured on the street and the leading causes of injury were firearm (n=192, 26%), assault (n=184, 25%), and motor vehicle collision (n=155, 21%). Emergent operations were required in 428 (58%) patients and 27% (n=202) were admitted to the intensive care unit (ICU). Injured patients in custody were more likely to be Black or African American (OR 1.64; 95%CI 1.33–2.02), male (OR 2.98; 95%CI 2.29–3.88), have a self-inflicted injury (OR 2.48; 95%CI 1.54–4.01), and have a major psychiatric illness (OR 2.14; 95%CI 1.27–3.60).

Conclusion:

Interactions with law enforcement, either prior to arrival in the ED/hospital or with subsequent discharge to custody, represent an important subset of trauma victims. Injury in this population is associated with significant healthcare and societal costs as evident by the need for emergent operations and ICU level care. Further studies will be required to explore community factors, understand health disparities, and identify potential targets for intervention in this population. 

Table of Contents

Distribution Agreement....................................... 1

Acknowledgments............................................... 6

Introduction....................................................... 8

Review of Literature............................................ 9

Traumatic Injury Epidemiology............................ 9

   Trauma Centers................................................ 10

   Americans in Custody....................................... 12

   Health Within Correctional Facilities................. 13

   Injuries Within Correctional Facilities................ 15

Methods............................................................. 16

Results............................................................... 17

   Demographics.................................................. 17

   Patient Transport............................................. 18

   Injury Characteristics....................................... 19

   Clinical Findings & Health Characteristics......... 21

   Hospital Outcomes........................................... 22

Discussion.......................................................... 23

Conclusions........................................................ 25

Resources........................................................... 26

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health
关键词	correctional healthcare emergency medicine incarceration traumatic injury police custody
Committee Chair / Thesis Advisor	Anne C. Spaulding M.D., MPH , Emory University
Committee Members	Anwar Osborne M.D., MPM, FACEP, Emory University Randi N. Smith M.D., MPH, Emory University

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