Maryland lawmakers discuss the impact of violence on healthcare


James Sklar


On January 24th, 2023, the first subcommittee meeting for Maryland’s Public Health and Minority Health Disparities Subcommittee took place, featuring input and briefings from a few healthcare advocates regarding their responsibilities and priority goals for this upcoming legislative session. The focus of the meeting was to discuss the impact of violence on healthcare in Maryland.


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The Public Health and Minority Disparities Subcommittee is one of four subcommittees under Maryland’s 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 Public Health and Minority Health Disparities Subcommittee, which was created in 2015 after combining and reorganizing other subcommittees, is the oldest subcommittee under the Health and Government Operations Committee. The subcommittee consists of 10 delegates, which is chaired by Del. Ariana B. Kelly (D – Montgomery County).

Martha Nathanson, vice president of government and community relations at LifeBridge Health, gave a brief overview about her position and the coalition that would speak to the subcommittee regarding how violent behaviors correlate with healthcare disparities. Specifically, she explained that her goal for this subcommittee was to deepen each of the members’ understanding between violence and health outcomes.

Nathanson continued by informing the subcommittee that when there are criminal or violent acts, there is a direct and indirect cost. Direct costs are easy to quantify, Nathanson said. For example, the cost of gunshot wounds can reach $80,000 to $100,000 per individual, with high treatment costs and the cost of transportation contributing significantly. The indirect cost, she said, is the trauma from the acts of violence for the victim, the families, and communities.

Nathanson’s data showed that after victims of violence were cleared and stabilized from their hospitals, the most effective factor for keeping those individuals from going back into the streets was to acquire a job.

Furthermore, Nathanson reported that “violence” was the top concern for their hospitals, which came from their community health needs assessment (CHNA).

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

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

Stanley reports that since 2019, Maryland has seen historic increases in total homicides (35%), Black individuals who commit homicide (39%), and teens who commit homicide (172%). She added that more than 100,000 individuals are injured or killed every year, and that homicide is the leading cause of premature death for Black men and youth.

Stanley reported that the annual healthcare cost per homicide is anywhere between $1-2 million, which costs Maryland $5.7 billion annually. This annual cost comes from a variety of areas, which include crime scene response, hospitalization, rehabilitation, the criminal justice process, incarceration, victim and family support, and lost tax revenue.

Lastly, Kyle Fischer, policy director for Health Alliance for Violence Intervention discussed hospital-based violence intervention programs (HBVIP), which have been around for over 25 years. Fischer explained that old models of just treating and releasing victims is a failed approach.  

HBVIP is when hospitals follow steps including providing trauma informed care, intervention, follow up services, and address social determinants of health for victims. Fischer said these steps include housing, victim services compensation, safety planning, retaliation, job placement, mental health, and evaluation/counseling, substance abuse counseling.

Fischer reported that if nothing is done for the victims, roughly one out of three individuals end up being shot again. However, victims’ chances of being shot again was as low as 5% if individuals took part in a program after recovering.

The subcommittee meeting ended with a question and answer from Delegate Terri Hill (D – Howard County), who asked the panel what they wanted the legislature to act on and if that includes creating a “department of violence” per se.

Nathanson said they are briefing Maryland’s House Economic Matters Committee for financing but reiterated that they wanted to connect the violence levels to healthcare, which was appropriate for this subcommittee to address.

Fischer answered Hill’s question by saying that there are several states that have state offices of violence prevention, which are able to solve these problems by connecting government departments around healthcare, labor, and justice.