Amplifying inequity: The compounding impact of COVID-19 and violence

Abstract

While "stay-at-home" orders for COVID-19 were in effect, many American cities witnessed a rise in community and interpersonal violence. Our own institution, the largest regional trauma facility and Boston's safety net hospital, saw a paradoxical rise in penetrating violent trauma admissions despite decreases in other hospital admissions, leading to our most violent summer in five years. It has been established that minoritized and marginalized communities have faced the harshest impacts of the pandemic. Our findings suggest that the conditions created by the COVID-19 pandemic have amplified the inequities that exist in communities of color that place them at risk for exposure to violence. The pandemic has served to potentiate the impacts of violence already plaguing the communities and patients we serve.

Keywords: COVID-19; Health inequity; Interpersonal violence; Penetrating trauma.

Fig. 1

Changes in overall trauma and penetrating trauma cases in January - September of 2020 compared to the previous year. After an initial decrease at the start of the COVID-19 pandemic, all-cause and penetrating trauma rose to higher levels than the year prior. The horizontal axis represents the studied timeframe in both 2019 and 2020. The vertical axis on the left represents total all-cause trauma case counts. Trends in the overall number of all-cause trauma cases in 2019 is represented with the light gray line and, in 2020, with the black line. The vertical axis on the right represents total penetrating trauma case counts. Trends in number of penetrating trauma cases in 2019 is represented with the light gray bars and, in 2020, with the black bars.