Maryland lawmakers discuss impact of violence on healthcare – State of Reform

On January 24thth2023, the first subcommittee meeting for the Maryland Public Health and Minority Health Disparities Subcommittee, which included contributions and briefings from several health care officials on their responsibilities and priority goals for this upcoming legislative session. The focus of the meeting was the discussion of the iEffects of Violence on Public Health Services in Maryland.

The Public Health and Minority Differences Subcommittee is one of four subcommittees of the Maryland Health and Government Operations Committee, along with the Government Operations and Health Facilities Committee, the Health Occupations and Long-Term Care Committee, the Insurance and Pharmaceuticals Committee, and the Public Health and Minority Health Disparities Committee.

The Subcommittee on Public Health and Minority Health Disparities, established in 2015 following the merger and reorganization of other subcommittees, is the senior subcommittee of the Health and Government Operations Committee. The subcommittee consists of 10 delegates, with its chairman Del. Ariana B. Kelly (D – Montgomery County) is.

Martha Nathanson, vice president of government and community relations at LifeBridge Health, provided a brief overview of her position and the coalition that would speak before the subcommittee on how violent behavior correlates with health care inequalities. In particular, she stated that her goal for this subcommittee is to increase the understanding of all members between violence and health outcomes.

Nathanson went on to inform the subcommittee that there are direct and indirect costs associated with criminal or violent acts. Direct costs are easy to quantify, Nathanson said. For example, the cost of gunshot wounds can reach $80,000-$100,000 per person, with the high cost of treatment and the cost of transportation making a significant contribution. The indirect costs are the trauma of violent crimes to the victim, families and communities, she said.

Nathanson’s data showed that after victims of violence were evacuated from their hospitals and stabilized, the most effective factor in keeping those individuals from returning to the streets was finding a job.

Additionally, Nathanson reported that “violence” was the number one concern for their hospitals emanating from them Community Health Needs Assessment (CHNA).

Next, Tarria Stanley, regional advocacy officer at Community Justice and co-chair of the Marylanders to Prevent Gun Violence Coalition, showed the committee more statistics about violence in Maryland.

“I’ve seen gun violence impact my community back home in Dayton, Ohio, and my family personally, and I know many Marylanders feel the same way,” Stanley said.

Stanley reports that since 2019, Maryland has seen an all-time increase in total homicides (35%), black homicides (39%), and teenage homicides (172%). She added that more than 100,000 people are injured or killed each year and that homicide is the leading cause of premature death among black men and youth.

Stanley reported that the annual healthcare cost per homicide ranges from $1 million to $2 million, costing Maryland $5.7 billion annually. These annual costs come from a variety of areas, including crime scene response, hospitalization, rehabilitation, criminal justice proceedings, incarceration, victim and family support, and lost tax revenue.

Finally, Kyle Fischer, policy director of the Health Alliance for Violence Intervention, spoke about hospital-based violence intervention programs (HBVIP), which have been around for over 25 years. Fischer explained that old models of only treating and releasing victims were a failed approach.

HBVIP means that hospitals follow steps including providing trauma-informed care, interventions, aftercare services, and addressing social determinants of health for victims. Fischer said these steps include housing, victim services compensation, safety planning, retaliation, job placement, mental health, and substance abuse assessment/counseling and counseling.

Fischer reported that if nothing is done for the victims, about one in three will be shot again. However, there was only a 5% chance of the victims being shot again if individuals participated in a program after their recovery.

The subcommittee session concluded with a question and answer from delegate Terri Hill (D – Howard County), who asked the panel what she thought the legislature should respond to and whether that includes creating a “Department on Violence” per se.

Nathanson said they brief Maryland’s House Economic Matters Committee on the funding, but reiterated that they wanted to tie the level of violence to health care, which was appropriate for that subcommittee.

Fischer responded to Hill’s question that there are several states that have state violence prevention agencies that can address these issues by connecting government departments related to health, labor and justice.


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