Defense Date


Document Type


Degree Name

Master of Public Health


Epidemiology & Community Health

First Advisor

Dr. R. Leonard Vance


Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of homicide in Richmond, Virginia. The purpose of this study was to determine if Richmond has become a safer city, with respect to this type of injury over a five year period. Objectives: (1) To determine if the incidence of penetrating trauma has changed significantly over the five year study period. (2) To examine possible trends in descriptive statistics of study variables. (3) To assess trends in the distribution of response location. Methods: This is a retrospective study of data collected from 91 1 calls to Richmond Ambulance Authority in Richmond, Virginia, with a chief complaint of penetrating trauma during the years 2002-2006. Descriptive statistics were completed on all transported patients. Chi-square tests were used to determine trends. GIs was used to spatially examine the distribution of incident locations.Results: There was no significant trend in the incidence by year. Annual distribution of shooting versus stabbings varied significantly over the study period with the proportions of gunshots decreasing while stabbings increased. There was no significant trend in age, gender, number of patients transported or transport protocol over the study period. Level of care varied significantly over the five year period with BLS decreasing while Basic ALS increased. 39% of neighborhoods had no known incidents, while 8% of neighborhoods accounted for 40% of known gunshot and stabbing incidents. Discussion: These findings show that overall, with respect to known penetrating trauma incidents, Richmond has not become much safer over the five year period. A major limitation of this study is that most analyses were completed using only patients transported by the RAA. Future research should examine outcome data to determine if the change in type of penetrating trauma proportions resulted in greater survival rates.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

June 2008

Included in

Epidemiology Commons