Violence is the leading cause of death for young African American women in the United States. Injury rates due to violence are at least 200 times greater than death rates due to violence. However, existing studies of nonfatal violence in women have included few minority groups and have frequently focused only on married couples. Although violence is the leading cause of injury morbidity in inner-city African American women, very little is known about the context of violent injuries experienced in this population or how to identify a high-risk group. We propose to conduct a case-control investigation of violent injuries in African American inner-city women 16 to 45 years of age.
The specific aims of the study are to: 1) provide basic descriptive information on the circumstances and types of violent injuries sustained by women in a defined inner-city community; 2) identify specific risk factors for violent injuries among inner-city African American women; 3) characterize utilization patterns of health and social service agencies to plan optimal strategies to deliver treatment and preventive services; 4) identify specific risk factors for unrecognized violence in an emergency department setting; 5) assess factors associated with intimate partner violence; and 6) to the extent possible, assess factors associated with acquaintance- related violence separately for male and female non-intimates. Four hundred and fifty cases of interpersonal intentional injury coming to participating emergency departments (EDs) will be compared with 450 women seeking care in participating EDs because of other health concerns. Cases and controls must be l6 to 45 years of age, African American, and reside in West Philadelphia, the urban region in which the participating hospitals are located. Interviewers will administer standardized questionnaires to case and controls-in the emergency department. Laboratory assessment will include urine screening for illicit drugs and alcohol use. The type of injury and injury severity will be assessed by review of the medical record. Data analysis will consist of: l) descriptive statistics characterizing cases on types of violence experienced, relationship to perpetrator, previous history of violence and use of health and social services; 2) comparisons of cases and controls regarding neighborhood and individual- level contextual factors (including employment, family constellation, past history of violence); personal factors (self-esteem, pregnancy status); street orientation; and use of health and social services; 3) logistic regression models to identify independent predictors of the risk of violent injuries in this population; 4) comparisons of the subset of cases who did not initially report violence with controls in order to identify predictors of unrecognized violence; and 5) subgroup analyses of intimate- partner and acquaintance-related violence. The results of this study will be essential for the development of educational programs for emergency department staff and other health care providers serving inner-city populations and ultimately for the development for effective prevention programs.
| Hirschinger, Nancy B; Grisso, Jeane Ann; Wallace, Donald B et al. (2003) A case-control study of female-to-female nonintimate violence in an urban area. Am J Public Health 93:1098-103 |
| Grisso, J A; Schwarz, D F; Hirschinger, N et al. (1999) Violent injuries among women in an urban area. N Engl J Med 341:1899-905 |
