Comparing Risks of Firearm-Related Death and Injury Among Young Adult Males in Selected US Cities With Wartime Service in Iraq and Afghanistan

The roles of vicarious trauma exposure and perceived social support in codeine syrup misuse among Black men living in prisons

Using General Strain Theory, this study investigates the effects of vicarious trauma exposure and perceived social support on nonmedical codeine syrup misuse among Black incarcerated men nearing community re-entry. Data were drawn from the Helping Incarcerated Men project, a study examining mental health, substance misuse, and human immunodeficiency virus (HIV) risk behaviors among Black men living in prisons who were within 180 days of release. A total of 200 Black men self-reported demographics (i.e., age and length of incarceration after age 18), vicarious trauma exposure (e.g., ever witnessing an assault with a weapon and a sudden accidental death), perceived social support, and nonmedical codeine syrup misuse. Findings from the logistic regression analysis showed witnessing an assault with a weapon and a sudden accidental death increased the likelihood of codeine syrup misuse. Perceived social support was not associated with codeine syrup misuse. Implications for practice and future research are discussed.

Factors Associated With Recurrent Pediatric Firearm Injury : A 10-Year Retrospective Cohort Analysis

BACKGROUND

Firearm injuries are the leading cause of death among children aged 0 to 17 years in the United States.

OBJECTIVE

To examine the factors associated with recurrent firearm injury among children who presented with acute (index) nonfatal firearm injury in the St. Louis region.

DESIGN

Multicenter, observational, cohort study.

SETTING

2 adult and 2 pediatric level I trauma hospitals in St. Louis, Missouri.

PARTICIPANTS

Pediatric patients aged 0 to 17 years presenting with an index firearm injury between 2010 and 2019.

MEASUREMENTS

From the St. Louis Region-Wide Hospital-Based Violence Intervention Program Data Repository, we collected data on firearm-injured patient demographics, hospital and diagnostic information, health insurance status, and mortality. The Social Vulnerability Index was used to characterize the social vulnerability of the census tracts of patients' residences. Analysis included descriptive statistics and time-to-event analyses estimating the cumulative incidence of experiencing a recurrent firearm injury.

RESULTS

During the 10-year study period, 1340 children presented with an index firearm injury. Most patients were Black (87%), non-Hispanic (99%), male (84%), and between the ages of 15 and 17 years (67%). The estimated risk for firearm reinjury was 6% at 1 year and 14% at 5 years after initial injury. Male children and those seen at an adult hospital were at increased risk for reinjury.

LIMITATION

Our data set does not account for injuries occurring outside of the study period and for reinjuries presenting to nonstudy hospitals.

CONCLUSION

Children who experience an initial firearm injury are at high risk for experiencing a recurrent firearm injury. Interventions are needed to reduce reinjury and address inequities in the demographic and clinical profiles within this cohort of children.

PRIMARY FUNDING SOURCE

National Institutes of Health.

"I am a survivor!": Violently Injured Black Men's Perceptions of Labeling After a Violent Firearm Injury

Self-appraisal after a life-altering event is a critical process for individuals, often comprised by assigned labels that may not align with an individuals' perceptions of themselves or of their situation. Existing research within this victim-survivor dichotomy largely rests in the interpersonal violence space, with a victim assuming legal recourse and wrongdoing, and a survivor associating with positive personal characteristics like grit and resilience. Much existing literature on self-appraisal after interpersonal injury is heavily concentrated within the sexual violence literature, and this study applies these concepts to a sample of Black men injured by firearms. Ten Black men enrolled in a hospital-based violence intervention program (HVIP) were interviewed to understand how they label their experience of firearm injury, and if their perceptions aligned with common labels seen among other populations and/or in other areas of study (e.g., cancer, domestic violence). Each participant assigned themselves their own label, with three labels emerging: survivor, victim and survivor, and neither victim nor survivor. The results illustrate the nuance of experiences beyond the victim-survivor dichotomy, and how labels and personal identities may shift following injury into new terms and considerations of resilience and trauma processing. More research is warranted to understand the factors that shape self-labeling within this population, including influences of masculine norms, racialized stereotypes, community context, and availability of services. Findings support public awareness campaigns to reframe surviving violence as a strength, and for community partners and practitioners to increase access to culturally competent and trauma-informed mental healthcare.

POLICING IN THE AGE OF THE GUN

This Article examines how the rapid deregulation and rampant possession of firearms is likely going to impact policing, and the constitutional law that governs it. For the longest time, lawful gun carry, concealed or open, was exceedingly rare. For a police officer to see a gun was both to see danger, and a crime in progress. This link among guns, danger, and unlawful possession has shaped much of the law of policing. But now, this understanding of the world is in its last stages of unraveling. In nearly all states, guns are no longer unlawful to own and carry by default. In many, they are barely regulated. Recent Supreme Court Second Amendment decisions like New York State Rifle & Pistol Association v. Bruen serve only to hasten where state laws already were headed. For police, however, the harm guns can do exists irrespective of what the law has to say about the legality of carrying them. As a result, the nation's gun laws are on a collision course with the practice and law of policing. This Article explores how the constitutional law governing policing is changing and will change in the face of gun legalization. Part I of this Article explains the ubiquitous role guns play in the life of a police officer, and what actions guns lead police to take. Part II is about the legal doctrine of policing, both before and after firearm legalization. It details how the law shaped what police could do in order to protect themselves and others, and how that law is changing to accommodate legalization. Police now must operate in a terrain that increasingly is uncertain as to their lawful authority, and that in many instances may put them or others in jeopardy. Part III examines how the shifting laws of guns and policing might impact police behavior, likely resulting in ad hoc carve-outs for police authority that-if history is any guide-overwhelmingly will be imposed on Black and Brown communities.

Inequalities in Exposure to Firearm Violence by Race, Sex, and Birth Cohort From Childhood to Age 40 Years, 1995-2021

Importance

The past quarter-century has seen both sharp declines and increases in firearm violence in the United States. Yet, little is known about the age of first exposure to firearm violence and how it may differ by race, sex, and cohort.

Objective

To examine race, sex, and cohort differences in exposure to firearm violence in a representative longitudinal study of children who grew up in periods with varying rates of firearm violence in the United States and to examine spatial proximity to firearm violence in adulthood.

Design, Setting, and Participants

This population-based representative cohort study included multiple cohorts of children followed-up from 1995 through 2021 in the Project on Human Development in Chicago Neighborhoods (PHDCN). Participants included Black, Hispanic, and White respondents from 4 age cohorts of Chicago, Illinois, residents, with modal birth years of 1981, 1984, 1987, and 1996. Data analyses were conducted from May 2022 to March 2023.

Main Outcomes and Measures

Firearm violence exposure, including age when first shot, age when first saw someone shot, and past-year frequency of fatal and nonfatal shootings within 250 m of residence.

Results

There were 2418 participants in wave 1 (in the mid-1990s), and they were evenly split by sex, with 1209 males (50.00%) and 1209 females (50.00%). There were 890 Black respondents, 1146 Hispanic respondents, and 382 White respondents. Male respondents were much more likely than female respondents to have been shot (adjusted hazard ratio [aHR], 4.23; 95% CI, 2.28-7.84), but only moderately more likely to have seen someone shot (aHR, 1.48; 95% CI, 1.27-1.72). Compared with White individuals, Black individuals experienced higher rates of all 3 forms of exposure (been shot: aHR, 3.05; 95% CI, 1.22-7.60; seen someone shot: aHR, 4.69; 95% CI, 3.41-6.46; nearby shootings: adjusted incidence rate ratio [aIRR], 12.40; 95% CI, 6.88-22.35), and Hispanic respondents experienced higher rates of 2 forms of violence exposure (seen someone shot: aHR, 2.59; 95% CI, 1.85-3.62; nearby shootings: aIRR, 3.77; 95% CI, 2.08-6.84). Respondents born in the mid-1990s who grew up amidst large declines in homicide but reached adulthood during city and national spikes in firearm violence in 2016 were less likely to have seen someone shot than those born in the early 1980s who grew up during the peak of homicide in the early 1990s (aHR, 0.49; 95% CI, 0.35-0.69). However, the likelihood of having been shot did not significantly differ between these cohorts (aHR, 0.81; 95% CI, 0.40-1.63).

Conclusions and Relevance

In this longitudinal multicohort study of exposure to firearm violence, there were stark differences by race and sex, yet the extent of exposure to violence was not simply the product of these characteristics. These findings on cohort differences suggest changing societal conditions were key factors associated with whether and at what life stage individuals from all race and sex groups were exposed to firearm violence.