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Am J Public Health. 2005 May;95(5):816-24.

Pathways to recurrent trauma among young Black men: traumatic stress, substance use, and the "code of the street".

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Department of Medicine, Boston University School of Medicine, and the Boston Public Health Commission, MA, USA. <>


Recurrent interpersonal violence is a major cause of death and disability among young Black men. Quantitative studies have uncovered factors associated with reinjury, but little is known about how these factors work together. We interviewed young Black male victims to understand their experience of violence. Qualitative analysis of their narratives revealed how their struggle to reestablish safety shaped their response to injury. Aspects of the "code of the street" (including the need for respect) and lack of faith in the police combined with traumatic stress and substance use to accentuate their sense of vulnerability. Victims then reacted to protect themselves in ways that could increase their risk of reinjury. We describe a model with implications for reducing rates of recurrent violent injuries.

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