Police-associated injury not on the rise in U.S.

A member of the police force stands guard in Times Square on New Year's Eve in New York

By Carolyn Crist

(Reuters Health) – Despite increased attention to deaths and injuries resulting from clashes with police, U.S. emergency department visits for police-associated injuries have remained stable at about 51,000 a year since 2006, researchers say.

The majority of those injured were young, uninsured males with minor wounds resulting from being struck, according to data from 2006 to 2012.

“There has been a lot of attention around deaths involving police during the past few years, and deaths represent the tip of a larger iceberg,” said lead study author Elinore Kaufman of New-York Presbyterian Hospital.

“The numbers indicate that it’s a longer-term phenomenon with consistent numbers each year,” she told Reuters Health. “We wanted to understand the broad national view, and next we want to look locally at cities and communities to get a sense of what’s working well in some places.”

Kaufman and colleagues analyzed the Nationwide Emergency Department Sample to find injuries marked with a legal intervention code, meaning law enforcement was involved in the incident. They found a total of 355,677 emergency department visits for legal-intervention injuries between 2006 and 2012. Just 0.3 percent of these resulted in death.

Of all the cases, more than 80 percent of patients were men and the average age was 32. Most lived in zip codes with median household incomes less than the national average and about 80 percent lived in urban areas. Overall, legal intervention injuries were more common in the South and West than in the Northeast and Midwest.

About 98 percent of the injuries were considered minor, and they resulted from being struck or hit, with gunshot and stab wounds accounting for less than 7 percent. About 20 percent of patients had a mental illness and 16 percent of cases included codes for intoxication, with 10 percent involving alcohol and 6 percent involving other substances.

“This study looks at the overall count of injuries, but what we should also look at is exposure,” said Ted Miller of the Pacific Institute for Research and Evaluation in Calverton, Maryland, who wasn’t involved in the study.

“How many people are arrested versus those who are stopped by police and not arrested, and how does that differ by demographics such as race and ethnicity?” he told Reuters Health.

One limitation of the study is that medical coding doesn’t explain the nuance of the situation, and some patients had no cause of injury noted, the authors write in JAMA Surgery. Also, the data don’t include race, ethnicity or geographic areas smaller than region.

“It is difficult to know how to interpret the data. It is unknown the extent to which the medical staff write, for example, ‘patient fell and struck head on pavement’ versus ‘patient fell and struck head on pavement while resisting arrest,’” said Catherine Barber of the Harvard Injury Control Research Center in Boston who wasn’t involved with the study.

Data from the Centers for Disease Control and Prevention estimates 80,000 to 100,000 nonfatal legal intervention-related injuries per year from 2006 to 2015. Although the numbers are higher, they also show a stable trend during the past decade, Barber said by email.

“A lot has happened in law enforcement since 2006, such as in-car cameras, body-worn cameras, wider use of tasers, internal use of force tracking, development of crisis intervention teams and de-escalation training,” said David Zack, president of the New York State Association of Chiefs of Police based in Schenectady and Chief of the Cheektowaga, New York Police Department.

“All have contributed to a reduction in the use of force,” he said.

“An enormous amount of police reform has been undertaken over the last decade. Why ignore it?” Zack, who was not involved in the study, told Reuters Health by email.

“The data does not support the narrative in recent years that police are out of control in their use of force,” said Darrel Stephens, executive director of the Major Cities Chiefs Association and former Chief of Police of the Charlotte-Mecklenburg Police Department in North Carolina.

“Police continue to work on reducing the use of force, and there have been significant improvements in most cities during the past 20 years,” said Stephens, who wasn’t involved in the study. “But police are given the authority to use force because some people will not comply with legal demands and submit peacefully to arrest.”

SOURCE: http://bit.ly/2o9UDU3 JAMA Surgery, online April 19, 2017.