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Medical advances may explain homicide decline

Improvements at all stages of postassault care have improved outcomes, but physicians say achievements may be threatened by trauma center and emergency department closures.

By Victoria Stagg Elliott, amednews staff. Sept. 2, 2002.

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Homicide rates are dropping. At least that is what the statistics indicate. But behind the numbers is an interesting question.

Is there less violence out there causing injury and death, or has medicine made such strides in treating the victims of this violence that fewer people die of gunshot wounds, stabbings and other forms of trauma?

A group of researchers based in Massachusetts is now suggesting that the latter very well could be the case -- that developments in medical infrastructure may explain why the homicide rate has dropped despite increases in aggravated assault and a proliferation of ever more dangerous weapons.

According to a paper the group published in the May issue of Homicide Studies, assault victims are getting to the hospital faster, and the quality of care received has improved. As a result, they are more likely to survive and less likely to become another homicide statistic.

"Medical advances haven't really been taken seriously as making a difference in this, but improvements have probably made a huge difference," said Anthony Harris, PhD, lead author of the paper and professor of sociology at the University of Massachusetts in Amherst.

The group estimated that without these improvements the U.S. murder rate would be 45,000 to 70,000 annually rather than the current 15,000 to 20,000. Physicians concurred that the theory is plausible.

"I tend to agree," said Doug Hill, DO, an emergency physician at North Suburban Medical Center, a HealthONE hospital in Thorton, Colo. "We always talk about the 'golden hour' of trauma, and if you can get somebody into a trauma center that deals with knife and gun wounds quickly or have them treated appropriately by paramedics out of the hospital, you either die right away or can be saved right away." [...]