Injuries from police encounters likely undercounted, UIC analysis finds

A recent analysis from researchers at the University of Illinois Chicago found that for every death in Illinois involving interaction with police, there are between 35 to 50 non-fatal injuries to civilians that require hospital treatment.

These injuries are a focus of a new annual report from the UIC School of Public Health's Law Enforcement Epidemiology Project examining nearly 7,700 cases of civilians treated in Illinois hospitals after being injured during encounters with law enforcement, termed legal intervention injuries by the coding system used in hospital data.

For decades, the Bureau of Justice Statistics and the FBI have collected data on deaths and injuries to law enforcement personnel, said Lee Friedman, professor of environmental and occupational health sciences in the UIC School of Public Health and an author of the report. However, "There's no real formal data collection involving civilian injuries," Friedman said. "That's really the main impetus for this report, because there's just an absence of information, in Illinois, Chicago and across the entire country."

Drawing on a decade of hospital data statewide, the study explores who is most affected, the types of injuries sustained, where injuries occurred and how trends have changed over time.

To learn more about law enforcement-intervention injuries in Illinois, UIC today spoke with Friedman and co-author Alfreda Holloway, research assistant professor in the in the School of Public Health and director of epidemiology at Cook County Department of Public Health.

How do you define legal intervention injuries in the study?

Alfreda Holloway: Legal intervention injuries are injuries to civilians occurring during interactions with law enforcement personnel - officers, municipal officers, sheriff's officers, even security guards - that are medically treated. It comes from a simple billing code that hospitals utilize to help bill for the work that they do. It's only counted if they were medically treated and billed or assigned that diagnosis.

How common are these injuries?

Holloway: We found over the last 10 years or so that for every death in Illinois involving interaction with law enforcement, there are 35-50 non-fatal injuries that require treatment in the hospital.

That number, I think, is a bit bigger than people expect. But we know that it is an undercount of the full number - that just represents those who are getting seen at hospitals. A Bureau of Justice Statistics study from 1996 found that only about 37% of people who were injured in these interactions were going to doctors. That study has not been replicated yet.

Lee Friedman: In Illinois we have about 800 injuries on average per year that require medical treatment in the hospital. Nationally, we're looking at around 80,000 injuries treated in a hospital each year.

What did your analysis reveal about which civilians are most likely to be affected by these injuries, and why?

Friedman: While it's a universal problem and anyone can be affected by it, the highest rates are involving Black men. Other high-risk groups are people with mental health issues, people with disabilities, people with substance use disorders and people experiencing homelessness.

There's structural racism and over-policing within communities of color that explains to a large degree the very high rates among Black men. For those that have disabilities, mental health conditions and behavioral health disorders, that comes down to interaction with police, as well as how they are perceived as threats by law enforcement. And people experiencing homelessness are overly targeted because of loitering ordinances and public complaints.

What types of injuries are most common, and what do those data reveal about how law enforcement is interacting with the public?

Friedman: It's consistent with control tactics that are used by law enforcement. You see a lot of injuries to the upper extremities, to the back and to the head. People are being restrained from behind; often they're being slammed to the ground. There's a strategy of using multiple people to overwhelm an individual. We see a lot of injuries to the spinal column as well as to the head because of that strategy.

Head injuries are a particular concern. About 4% to 5% of all civilians injured every year suffer traumatic brain injuries, and some research out there shows that about 90% of people with traumatic brain injuries suffer some type of neurologic deficits one year after the incident. It can really have a long-term effect.

Does the report look at the inverse, at injuries that law enforcement sustained during their work?

Holloway: It does. We looked at workers' compensation claims as a data source to see when law enforcement are trying to recover funds and resources for their injuries. We used that data source to split out the types of officers, looking at municipal police, sheriff personnel, and correctional officers.

What we find is what you probably suspect: Officers who are working closest with people are more likely to get injured and hurt, like the correctional officers. They have contact with people on a daily basis, and they have a lot more injuries.

What policy changes do your findings support?

Holloway: De-escalation tactics are the No. 1 thing our findings support, and training not only for law enforcement but for civilians. I don't think most people know how to interact with the police. If we have some sort of standardized training for both civilians and law enforcement in a shared understanding, I think that could be helpful.

Friedman: There are many interventions that we suggest and the report supports. These include strengthening police accountability through independent oversight, public transparency, enhanced whistleblower protections and performance-based accountability; improving officer hiring, training, wellness and compensation; eliminating quota-driven policing; expanding civilian-led responses to mental health and other non-violent incidents and implementing disability-informed policing practices.