Health Care Assault Rates Nearly Double Over Decade As Workplace Violence Spreads Across Industries

Workplace violence has risen steadily across most major industry sectors since 2011, with health care and social assistance remaining the epicenter of the problem, according to the NCCI.
By: | July 29, 2026
violence on aide in residential care facility concept

Workplace assault rates in health care and social assistance climbed to 11.9 per 10,000 full time employees in 2023-24, up from 9.8 in 2021-22, and 6.4 in 2011 , according to a new report from the National Council on Compensation Insurance.

The assault share of all days away from work cases in the sector doubled to 9.6% in 2019 from 4.8% in 2011, NCCI found, before a temporary drop to 3.4% in 2020 that the organization attributed not to fewer assaults but to a surge in COVID-related illness cases that swelled the denominator used to calculate the share. By 2023-24, the assault share had returned to 9.8%, consistent with the pre-pandemic trajectory, the report said.

The analysis is the third installment in NCCI’s series on workplace violence, drawing on Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses data.

Violence Concentrated In A Narrow Set Of Health Care Settings

Within health care and social assistance, violence-by-others cases cluster heavily in a small number of care environments, NCCI found. Hospitals and nursing and residential care facilities together accounted for 75.1% of all such cases in the sector in 2023-24, with hospitals representing 40.2% and nursing and residential care facilities 34.9%, according to the report. General medical and surgical hospitals alone made up 30.5% of the sector total, the largest single contributor by count, NCCI said.

But the highest rates of violence occurred elsewhere, in behavioral-health and residential-care settings rather than general acute care. Psychiatric and substance abuse hospitals posted a rate of 138.8 cases per 10,000 FTE workers, while residential intellectual and developmental disability, mental health, and substance abuse facilities posted a rate of 60.9, the report found.

NCCI also noted that when the analysis expands beyond private industry to include all ownerships, counts rise for every health care occupation. The rates of violence are most pronounced for nursing assistants, orderlies and psychiatric aides, a pattern NCCI attributed to state-run psychiatric hospitals and other public behavioral-health institutions not captured in private industry data alone.

Violence Rises Across Sectors, Not Just In Health Care

The report found that violence’s share of days away from work, and incidence rates have increased across nearly every major industry sector since 2011, including retail trade, educational services, administrative and support and waste management services, and accommodation and food services. NCCI said the broad upward movement across sectors with very different workforces and operating environments indicates the rise in workplace violence is systemic rather than confined to one industry.

Educational services stood out for its concentration: elementary and secondary schools accounted for 91.2% of the sector’s violence cases in 2023-24 and posted a rate of 22.5 cases per 10,000 FTE workers, according to the report. On an all-ownership basis, the broader “other educational, instructional, or library occupations” category, which includes teaching assistants, behavioral aides and substitute teachers, reached a rate of 53.3 cases per 10,000 FTE workers, the highest among education occupations, NCCI found.

Public-Sector Data Reshapes The Picture For Protective Services

NCCI said ownership structure fundamentally alters the apparent distribution of violence in protective services. On an all-ownership basis, police officers and correctional officers together accounted for more than 70% of cases, with correctional officers experiencing violence at a rate exceeding 180 per 10,000 FTE workers and police officers exceeding 100, among the highest rates in the entire dataset, according to the report.

When limited to private industry, the picture shifts entirely: security guards and gambling surveillance officers made up more than 76% of cases, with rates between 21 and 30 per 10,000 FTE workers, while police and corrections rates were largely suppressed due to their limited presence outside government, NCCI found. The report said this contrast illustrates that who appears most exposed to workplace violence depends heavily on whether public-sector employment is included in the analysis.

Obtain the full report here. &

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