AP: Health Care Is One Of The Nation's Most Violent Fields

Associated Press is out this morning with a breathless story about the extent of workplace violence in health care.  The actual story is more nuanced and, when you read the BLS Fact Sheet covering 2018 (which is the entire basis of the AP story), you observe in its Table 1 that work place violence in health care is largely due to incidents at psychiatric and substance abuse treatment venues.  A point completely ignored by AP. The emergency room shootings which garner attention in the media are still uncommon occurrences:

https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm

Fact Sheet | Workplace Violence in Healthcare, 2018 | April 2020

Workplace Violence in Healthcare, 2018

Workplace violence in healthcare is an important public health issue and a growing concern. Workplace violence and healthcare can be defined in different ways. This analysis focuses on intentional injuries¹ caused by another person to workers in the private healthcare and social assistance industry² and will not look at healthcare related occupations.³

In 2018, the private ownership all-worker incidence rate for nonfatal occupational injuries and illnesses involving days away from work resulting from intentional injury by other person in the private healthcare and social assistance industry was 10.4 per 10,000 full-time workers, compared to the all-worker incidence rate of 2.1. The health care and social service industries experience the highest rates of injuries caused by workplace violence and are 5 times as likely to suffer a workplace violence injury than workers overall. Chart 1 shows how the incidence rate for workplace violence to healthcare workers has increased since 2011.

Chart 1. Incidence rate of nonfatal workplace violence to healthcare workers,​2011-18Incidence rate per 10,000 full-time workers20112012201320142015201620172018024681012Click legend items to change data display. Hover over chart to view data.​Source: U.S. Bureau of Labor Statistics.

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Workplace violence due to intentional injuries by other person in the private healthcare and social assistance industry accounted for 2 percent of the 900,380 total nonfatal occupational injuries or illness cases requiring days away from work in 2018.

Healthcare workers accounted for 73 percent of all nonfatal workplace injuries and illnesses due to violence in 2018 (see chart 2). The industry’s number of total workplace violence has grown since 2011, the first year the new OIICS 2.01 event classification was used. You can find the latest data on the types of events and industry make-up of nonfatal cases using resource table 4,  https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables.htm#dafw .

Chart 2. Number of nonfatal workplace violence injuries and illnesses with​days away from work, 2011-18Healthcare industryOther industries2011201220132014201520162017201805,00010,00015,00020,00025,000Click legend items to change data display. Hover over chart to view data.​Source: U.S. Bureau of Labor Statistics.

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The healthcare and social assistance industry is made up of a mix of industry services. Table 1 gives a high level look at the components of the healthcare and social assistance industry, along with their respective incidence rates. If you would like to learn more about a specific sub-sector, the online profiles tool will create industry specific profiles detailing demographics, case circumstances, including event, and occupations for each industry.

Table 1. Incidence rate of nonfatal intentional injury by other person, by selected industries, 2018

Private Industry	NAICS code	Incidence rate of nonfatal intentional injury by other person, per 10,000 full-time workers
All Industry		2.1
Health care and social assistance	62	10.4
Ambulatory health care services	621	3.1
Hospitals	622	12.8
Psychiatric and substance abuse hospitals	6222	124.9
Nursing and residential care facilities	623	21.1
Social Assistance	624	12.4
Child day care services	6244	7.8

Looking briefly at the public sector, in 2018 the incidence rate of intentional injury for nonfatal cases involving days away from work in the health care and social assistance was 13.9 per 10,000 full-time workers (1,050 cases) in local government, and 89.3 (4,850 cases) in state government. The all-worker incidence rate for cases involving days away from work for local government was 163.9 and for state government was 142.6.

Fatal Data

From 2011 to 2018, there were 156 workplace homicides to private healthcare workers, averaging about 20 each year. The most common assailant in workplace homicides to healthcare workers was a relative or domestic partner of the injured worker (see Chart 3).

Chart 3. Workplace homicides to healthcare workers, by assailant, 2011-18Number of fatal injuriesRelative or domestic partnerAll other, including unknownPatientCo-worker or work associateOther client or customerAcquaintanceRobber01020304050Click legend items to change data display. Hover over chart to view data.​Source: U.S. Bureau of Labor Statistics.

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In 2018, workplace homicides in the private healthcare and social assistance industry accounted for 4 percent of the total workplace homicides. For total fatal cases, homicides to healthcare workers made up less than 1 percent of the 5,250 workplace fatalities in 2018. For more information, see the data table for workplace homicides.

Related Publications

Hospital workers: an assessment of occupational injuries and illnesses:  https://www.bls.gov/opub/mlr/2017/article/pdf/hospital-workers-an-assessment-of-occupational-injuries-and-illnesses.pdf

Occupational injuries and illnesses among registered nurses:  https://www.bls.gov/opub/mlr/2018/article/occupational-injuries-and-illnesses-among-registered-nurses.htm

Hospital workers suffered 294,000 nonfatal workplace injuries and illnesses in 2014:  https://www.bls.gov/opub/ted/2016/hospital-workers-suffered-294000-nonfatal-workplace-injuries-and-illnesses-in-2014.htm

A look at violence in the workplace against psychiatric aides and psychiatric technicians:  https://www.bls.gov/opub/mlr/2015/article/a-look-at-violence-in-the-workplace-against-psychiatric-aides-and-psychiatric-technicians.htm

Workplace Homicides:  https://www.bls.gov/iif/factsheets/workplace-homicides-2017.htm

Workplace Safety and Health in the Health Care and Social Assistance Industry, 2003-07:  https://www.bls.gov/opub/mlr/cwc/workplace-safety-and-health-in-the-health-care-and-social-assistance-industry-2003-07.pdf

For technical information and definitions, please see the BLS Handbook of Methods.

You can obtain data from the Injuries, Illnesses, and Fatalities program by using the following tools: Create Customized Tables (Multiple Screens), Create Customized Tables (Single Screen), and the Online Profiles System. Additional tables and charts are on the IIF homepage and the IIF State page.

Source

U.S. Bureau of Labor Statistics. Fatality data are from the Census of Fatal Occupational Injuries. Nonfatal injury and illness data are from the Survey of Occupational Injuries and Illnesses.

Notes

1 The BLS Injuries, Illnesses, and Fatalities (IIF) program has used the Occupational Injury and Illness Classification System (OIICS), version 2.01, when classifying Event or Exposure, Primary Source, Secondary Source, Nature, and Part of Body since 2011. More on OIICS 2.01 can be found here:  https://www.bls.gov/iif/definitions/occupational-injuries-and-illnesses-classification-manual.htm . Event code 1* is the broad category of Violence and other injuries by persons or animals, with the sub categories of 11* (comprised of 111* Intentional injury by other person and 112* Self-inflicted injury—intentional), 12* Injury by person—unintentional or intent unknown, and 13* Animal and insect related incidents.

2 This fact sheet will use the private Healthcare and Social Assistance industry (North American Industry Classification System, NAICS 62*) when referring to healthcare workers unless otherwise noted. For 2009 to 2013 data, the IIF program used the 2007 North American Industry Classification System (NAICS) to classify industry data. Since 2014, the IIF program has used the 2012 NAICS. More on NAICS can be found here:  https://www.bls.gov/bls/naics.htm .

3 If you are interested in specific occupations, such as nurses; social workers; psychiatric, home health, and personal care aides, you may wish to explore nonfatal tables R12 and R100, create a customized table using online profiles, or view the fatal table detailed occupations by homicides. Since 2011, the IIF program has used the 2010 Standard Occupational Classification (SOC) system to classify occupation. More on SOC can be found here:  https://www.bls.gov/soc/ .

BLS released a TED on November 21, 2022 which reported 392 workplace homicides and 37,060 nonfatal injuries in the all workplaces during 2020 resulting from an intentional injury by another person.  It does not break out health care, but lumps them into technical occupations.  It will be a year or two before BLS gives us a more granular report.

https://www.bls.gov/opub/ted/2022/workplace-violence-homicides-and-nonfatal-intentional-injuries-by-another-person-in-2020.htm

 

 

Workplace violence: homicides and nonfatal intentional injuries by another person in 2020

November 21, 2022

There were 392 workplace homicides in 2020. There were also 37,060 nonfatal injuries in the workplace resulting from an intentional injury by another person.

The five occupational groups with the most workplace homicides in 2020 were sales and related, transportation and material moving, management, construction and extraction, and production. Homicides in sales and related occupations accounted for 23.5 percent of all workplace homicides in 2020.

• CHART IMAGE
• CHART DATA

Workplace homicides by selected occupational group, 2020

Occupational group	Number of homicides
Sales and related	92
Transportation and material moving	51
Management	29
Construction and extraction	20
Production	18

Service occupations accounted for about half of all nonfatal intentional injuries by another person that required at least a day away from work in 2020. Service occupations include healthcare support, protective service, food preparation and serving related, building and grounds cleaning and maintenance, and personal care and service occupations. Healthcare practitioners and technical occupations made up about 23 percent of cases.

• CHART IMAGE
• CHART DATA

Nonfatal workplace intentional injuries by another person that required at least a day away from work, selected occupational groups, 2020

These data are from the Injuries, Illnesses, and Fatalities program. Fatal and nonfatal cases shown here represent injuries within the private and public sector. To learn more about fatal injuries, see "National Census of Fatal Occupational Injuries in 2020." We also have more charts on fatal work injuries. To learn more about nonfatal injuries and illnesses, see "Employer-Reported Workplace Injuries and Illnesses – 2020," "Employer-Reported Workplace Injuries and Illnesses – 2021," and charts on nonfatal injuries and illnesses.