In light of ongoing, tragic events, violence is one of the most pressing public health concerns for nearly every American. Beyond the human toll, a report released at the end of July by Milliman aims to demonstrate the tremendous resources hospitals and health systems put toward anticipating violent events and caring for its victims. Cost estimates are $2.7 billion in 2016.

"Keeping people healthy is at the heart of healthcare, and violence runs counter to that," said Rick Pollack, president and CEO of the American Hospital Association. "It's our hope that quantifying the resources hospitals and health systems commit illustrates the enormity of this issue as a public health problem, while giving hospitals the chance to highlight their efforts to keep their communities and workplaces safer."

The report found community resources fall into both proactive and reactive categories. Hospitals are partnering with their communities on violence prevention efforts and with their staff and safety experts on preparedness drills, de-escalation training and a host of other initiatives that vary but are intended to meet the needs of their communities and their colleagues. They also treat victims of violence that erupts in their communities and inevitably find its way to the emergency room doors.

The report separates costs into different categories, first focusing on prevention, preparedness and post-incident costs for violence that occurs in the community and then focusing on those same costs for violence that occurs in the workplace. The report found that in 2016 hospitals and health systems spent:

• $280 million on preparedness and prevention of community violence including emergency preparedness training, community-based prevention programs and staff training for violence-related trauma
• $852 million caring for victims of violence
• $1.1 billion in security and training costs to prevent violence within hospitals, and
• $429 million in medical care, staffing, indemnity and other costs related to violence against hospital employees.

The AHA sought to quantify resources hospitals and health systems expend to deal with violence in their communities to better demonstrate the tremendous impact violence has on communities. Officials with the AHA said the hope is that this study prompts more discussion and validates the need for violence to be recognized and tackled as a leading public health problem. To learn more about the report's methodologies and other findings, visit aha.org/HAVhope.