Hospital-based interventions to reduce violence and recidivism: Wraparound programs

Abstract

Violence is the second most common cause of death among youth aged 15-24 years. As with other major public health issues, the risk factors associated with violence are modifiable. The public health framework allows for a process by which we can develop measures to address violence. Many of the risk factors for violent injury fall under the social determinants of health. The disparities in violence are very clear because vulnerable populations carry the majority of this burden. This inequity, however, is increasingly being addressed by trauma centers through hospital-based violence intervention programs (HVIPs). These programs focus on mitigating the risk factors associated with violence while providing long-term, culturally competent case management. There are data supporting risk factor reduction and reduction of recidivism rates through these programs. The number of these HVIPs is growing, and the American College of Surgeons Committee on Trauma has endorsed this model as a best practice in violence intervention. Guidelines for starting and sustaining these programs are readily available, as is mentorship through the National Network of Hospital-based Violence Intervention Programs (NNHVIP). HVIPs assist individuals but also frequently work as part of a citywide effort in violence prevention. Ultimately, it is through these efforts that health inequities are addressed and communities can build social capital.