What to Know About the Key Costs of HVIPs

On April 22, 2024, Everytown for Gun Safety Support Fund (Everytown) and the Health Alliance for Violence Intervention (HAVI) released a how-to guide about the key costs and components of hospital-based violence intervention programs (HVIPs).

Every year in the United States, 18,000 people die from gun homicides,¹Everytown Research analysis of Centers for Disease Control and Prevention, National Center for Health Statistics, WONDER, Underlying Cause of Death. A yearly average was developed using four years of the most recent available data: 2018 to 2021. Homicide includes shootings by police. and nonfatal gun assaults wound at least two times more.²Kathryn Schnippel et al., “Nonfatal Firearm Injuries by Intent in the United States: 2016-2018 Hospital Discharge Records from the Healthcare Cost and Utilization Project,” Western Journal of Emergency Medicine 22, no. 3 (May 2021): 462–70, https://doi.org/10.5811/westjem.2021.3.51925. This violence carries an immense human and economic toll. Survivors face lifelong physical, emotional, and financial challenges.³William Aaron Marshall et al., “Recidivism Rates Following Firearm Injury as Determined by a Collaborative Hospital and Law Enforcement Database,” Journal of Trauma and Acute Care Surgery 89, no. 2 (August 2020): 371–76, https://doi.org/10.1097/ta.0000000000002746; Andrew M. McCoy et al., “A Novel Prospective Approach to Evaluate Trauma Recidivism: The Concept of the Past Trauma History,” Journal of Trauma and Acute Care Surgery 75, no. 1 (July 2013): 116–21, https://doi.org/10.1097/TA.0b013e31829231b7; Caitlin Delong and Jessica Reichert, “The Victim-Offender Overlap: Examining the Relationship Between Victimization and Offending,” Illinois Criminal Justice Information Authority, Research and Analysis Unit, January 9, 2019, https://icjia.illinois.gov/researchhub/articles/the-victim-offender-overlap-examining-the-relationship-between-victimization-and-offending; Everytown for Gun Safety Support Fund, “The Economic Cost of Gun Violence,” July 19, 2022, https://everytownresearch.org/report/the-economic-cost-of-gun-violence/; Everytown for Gun Safety Support Fund, “Invisible Wounds.” May 27, 2021, https://everytownresearch.org/report/invisible-wounds-gun-violence-and-community-trauma-among-black-americans/. Prior violent injuries are also a risk factor for future ones⁴Ali Rowhani-Rahbar et al., “Firearm-Related Hospitalization and Risk for Subsequent Violent Injury, Death, or Crime Perpetration.” Annals of Internal Medicine 162, no. 7 (April 7, 2015), https://doi.org/10.7326/M14-2362.—and these costs can balloon quickly without intervention.

Hospital-based violence intervention programs (HVIPs) work to break this cycle. HVIPs connect survivors at their hospital bedsides to violence prevention professionals (VPPs).

In the vulnerable months following a violent injury, HVIPs follow survivors beyond the hospital walls. These programs address the social determinants and root causes of violence. They do so by providing survivors with sustained engagement and access to resources. 

With this guide, Everytown and the HAVI aim to help cities and funders understand the key costs of implementing HVIPs. This work builds on Everytown’s community violence intervention costing series and the HAVI’s standards and indicators for HVIPs.

Everytown and the HAVI estimate that a program operating out of a midsize city hospital’s emergency department and serving 100 participants each year will cost just under $1.1 million for each of the first three years. This averages to slightly less than $10,800 per participant.

Everytown and the HAVI recognize that local needs and resources vary among communities. A costing tool is included in the guide to assist with tailoring the costs of implementing HVIPs to specific circumstances.

Compared to the medical costs of treating gun assaults, investing in an HVIP is a cost-effective way to help prevent violence in cities. Learn more in the full resource: “Hospital-Based Violence Intervention Programs: A Guide to Implementation and Costing.“