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Abstract
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A survey of jail inmates done by J P May, D Hemenway, and A Hall indicated that, among those who admitted to having been shot, 91% reported having gone to the hospital for treatment. This comment explains why this finding cannot be taken seriously.
Put yourself in the position of a jail inmate who was part of this survey. Most jail inmates are awaiting trial. They are the most legally vulnerable of all criminals - unlike uncaught criminals they are subject to legal punishment, yet unlike prison inmates, the punishment they will receive is still to be determined - the hammer has not yet come down. This is a set of criminals who are understandably obsessed with not looking any more criminal to the authorities than they already appear. How is this relevant to the jail survey conducted by May et al.? Suppose you were a jail inmate who had been shot, but did not seek medical treatment because you were shot while committing a crime, and knew that if did go to the hospital, police would interrogate you as to how you got shot and possibly connect you to the crime....
In sum, (1) the subsample of jail inmates who had admitted having been shot is likely to have excluded most of those who had avoided hospital treatment because they were committing a crime when they were shot, and (2) among those who admitted being shot, few inmates were foolish enough to admit they had not sought medical treatment. Consequently, the claim that 90% of the inmates who had been shot had gone to the hospital cannot be given much credence.
The implicit underlying assumption of the researchers was that one could expect truthful answers from jail inmates who had powerful reasons to not be truthful. To be sure, those who had been shot as innocent victims could afford to seek hospital treatment and could be truthful about doing so when surveyed. These inmates probably account for most of the 316 inmates who reported seeking treatment. In contrast, it is extremely unrealistic to expect truthful answer from those who were shot by their victims while committing crimes that the authorities either did not know about, or did not know the inmate had committed. Inmates have no reason to conceal crimes that the authorities already know about, and prior research shows that they are indeed willing to self-report these offenses in surveys. Crimes for which the offender was never arrested are another matter entirely.
Open access letter: http://injuryprevention.bmj.com/content/8/3/236/reply#injuryprev_el_10587 |