Workplace Assaults Are Rising, With Health Care Bearing the Greatest Share

Workplace violence is changing unevenly: nonfatal assaults have climbed, while workplace homicides have remained essentially flat over the past two decades. For workers’ compensation, that distinction matters. The frequency and setting of nonfatal injuries point to sustained exposure in certain jobs, while fatal incidents have a different profile and are dominated by firearms.

A three-part series from the National Council on Compensation Insurance (NCCI) reviewed fatal and nonfatal workplace violence trends and their potential implications for workers’ compensation. The reported figures show why employers and insurers may need to look beyond a single, broad measure of workplace violence: risk varies sharply by industry, job setting and type of incident.

Assaults have risen across the workforce

Workplace assault cases increased at an annualized rate of 5.3% from 2011 through 2021–2022, based on the latest assault case data cited from the U.S. Bureau of Labor Statistics. Over that period, the assault rate per 10,000 full-time equivalent workers rose 62%. The nationwide aggravated assault rate increased 13% over the same span.

Those figures describe different measures, but together they show that workplace assaults grew substantially faster than the broader aggravated assault rate during the period. The change also wasn’t limited to one corner of the economy: the source reports rising risk across most major industry sectors. That makes industry-specific exposure useful context for employers and workers’ compensation professionals assessing where prevention efforts may have the greatest relevance.

Health care and social assistance accounts for the greatest number of assault cases. Its annual total is 10 times the count in retail trade, the next-largest sector. Frequent direct contact with patients and clients is one reason workers in these settings face elevated exposure compared with workers in many other fields.

Care settings show different kinds of exposure

Within health care and social assistance, hospitals and nursing or residential care facilities together account for 75.1% of violence-by-others cases. General medical and surgical hospitals make up 30.5% of the sector total, the largest share for any single industry in the group.

Counts alone don’t show where an individual worker faces the highest rate. On that measure, behavioral health and residential care stand out. Psychiatric and substance abuse hospitals recorded 138.8 cases per 10,000 full-time equivalent workers. Residential facilities serving people with intellectual and developmental disabilities, mental health needs or substance abuse needs recorded 60.9 cases per 10,000 workers.

The difference between case counts and rates is practical: large workplaces can account for many incidents because they employ many people, while a smaller setting can have a higher rate relative to its workforce. Reading both measures gives a fuller picture of where cases are concentrated and where workers experience greater exposure per worker.

Education has its own concentration. Elementary and secondary schools account for 91.2% of the sector’s cases, with a rate of 22.5 per 10,000 full-time equivalent workers. The figures point to the importance of considering the specific work environment when examining a sector-wide trend.

Fatal incidents have a different profile

Women account for a disproportionate share of nonfatal assault cases and experience rates nearly three times those of men, even though women and men participate in the workforce in roughly equal numbers. The source links much of that gap to the types of jobs workers hold: women are strongly represented in health care and social assistance and in education, where nonfatal assaults are more common.

Workplace homicide victims, by contrast, are nearly 83% men. The source likewise points to occupational composition: men are more concentrated in protective services and transportation and material-moving work, where fatal violence is most common. Public interaction, cash handling and, in some jobs, enforcement duties can contribute to exposure in these occupations.

Shooting by another person accounted for more than four-fifths of workplace homicides in 2023–2024, far more than any other method. The source characterizes these deaths as predominantly criminal events involving firearms, rather than escalations of routine workplace interactions. That distinction cautions against treating nonfatal assaults and fatal incidents as interchangeable measures of the same workplace risk.

What the trends mean for workers’ compensation

Workplace violence can be an occupational hazard in health care, retail, protective services and education, among other fields. The source describes a layered prevention approach: written plans, work-site risk assessments, changes to the physical environment and equipment, administrative controls, and employee training. It also recommends monitoring those measures and updating them over time.

For employers, the reported patterns offer a reason to examine incident experience by work setting and type, rather than relying only on broad industry averages. A hospital, a residential care facility and a school face different day-to-day conditions; prevention measures need to account for the work being done and the interactions employees have. For workers’ compensation professionals, separating incident frequency from fatality patterns can help clarify which exposures are driving the claims picture.

The central takeaway is that assault cases are rising, but the burden is concentrated unevenly and the profile differs from fatal workplace violence. Reviewing site-level risks and keeping prevention measures current are concrete steps for employers seeking to address the exposures described in the data.

Read the source article.