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Marie Ann Marino, EdD, RN, FAAN
Dean and Professor, Jefferson College of Nursing

Pandemic Deaths Have Overshadowed Our Longer-Term Plague: Violence

The past year’s headlines often have focused on COVID-19 death rates, as hundreds of thousands of Americans succumbed to the deadly plague. But other headlines detailed a separate pandemic that was underway well before this respiratory malady struck – the surge of deadly person-to-person violence, much of it involving firearms.

Last summer, Time magazine noted that even amidst the COVID-19 onslaught, young Americans were more likely to die of violence than the virus. Philadelphia witnessed almost 120 homicides during the first three months of 2021; that surpassed the pace of 2020, which ended with 499 homicides – a 40% increase from 2019 and the second most since 1960. Philadelphia County’s leading cause of death for people ages 5-24 is assault and homicide. 

In 2018, the most recent year for which data is available, the Centers for Disease Control and Prevention's (CDC's) National Center for Health Statistics reported 13,958 homicides involving firearms—and of course many thousands of others are wounded annually, often needing short- and long-term physical and psychological rehabilitation. According to a 2019 analysis in Health Affairs, violence in 2017 led to about 2.3 million emergency department visits and 376,500 hospitalizations, at a medical cost of about $8.7 billion. 

What’s behind the current violence surge? Here in Philadelphia, researchers led by Dr. Jessica Beard, assistant professor of surgery and director of trauma research at Temple University’s Lewis Katz School of Medicine, attributed at least some of the uptick in gun violence to the COVID-19 lockdowns.

No doubt, the stress of restricted personal movement – sometimes to a crowded house or apartment, with tensions further inflamed by job loss or the death of a loved one from COVID-19 – drove some over the edge, emotionally. In vulnerable communities, that stress was worsened by poverty, unemployment, and racism.

All too often, the issue and its potential solutions are couched purely as political or criminal justice matters. But violence is really a public health problem, like COVID-19, infant mortality, and annual flu outbreaks.  It must be addressed in a broad, aggressive manner just as we handle those other threats to our general health and well-being.

And nurses can be at the heart of both finding and implementing solutions.

The American Association of Colleges of Nursing (AACN) recognizes domestic violence as a special form of violence with a high incidence and prevalence requiring health care interventions. AACN recommends that students in baccalaureate and higher-degree nursing programs be given full factual information and clinical experience regarding domestic violence.  AACN encourages nurse researchers to identify factors associated with violent behavior, as well as interventions effective in primary, secondary, and tertiary prevention.

As recently mentioned in MedScape, “On the Front Lines: Violence Against Nurses,” violence against healthcare workers has reached epidemic proportions. According to the Emergency Nurses Association, healthcare workers account for approximately 50% of all victims of workplace violence.

As we approach Nurses Week here at Jefferson, we have many celebratory events planned to honor our nurses and recognize their perseverance through the challenges of their daily work lives. But most importantly, we look forward to joining forces with our frontline nurses, to collaborate on scholarly work and develop initiatives that deal with workplace violence. 

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