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Beard JH, Trombley S, Walker T, Roberts L, Partain L, MacMillan J, Midberry J. Public health framing of firearm violence on local television news in Philadelphia, PA, USA: a quantitative content analysis. BMC Public Health 2024; 24:1221. [PMID: 38698393 PMCID: PMC11067069 DOI: 10.1186/s12889-024-18718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Firearm violence is an intensifying public health problem in the United States. News reports shape the way the public and policy makers understand and respond to health threats, including firearm violence. To better understand how firearm violence is communicated to the public, we aimed to determine the extent to which firearm violence is framed as a public health problem on television news and to measure harmful news content as identified by firearm-injured people. METHODS This is a quantitative content analysis of Philadelphia local television news stories about firearm violence using a database of 7,497 clips. We compiled a stratified sample of clips aired on two randomly selected days/month from January-June 2021 from the database (n = 192 clips). We created a codebook to measure public health frame elements and to assign a harmful content score for each story and then coded the clips. Characteristics of stories containing episodic frames that focus on single shooting events were compared to clips with thematic frames that include broader social context for violence. RESULTS Most clips employed episodic frames (79.2%), presented law enforcement officials as primary narrators (50.5%), and included police imagery (79.2%). A total of 433 firearm-injured people were mentioned, with a mean of 2.8 individuals shot included in each story. Most of the firearm-injured people featured in the clips (67.4%) had no personal information presented apart from age and/or gender. The majority of clips (84.4%) contained at least one harmful content element. The mean harmful content score/clip was 2.6. Public health frame elements, including epidemiologic context, root causes, public health narrators and visuals, and solutions were missing from most clips. Thematic stories contained significantly more public health frame elements and less harmful content compared to episodic stories. CONCLUSIONS Local television news produces limited public health coverage of firearm violence, and harmful content is common. This reporting likely compounds trauma experienced by firearm-injured people and could impede support for effective public health responses to firearm violence. Journalists should work to minimize harmful news content and adopt a public health approach to reporting on firearm violence.
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Affiliation(s)
- Jessica H Beard
- Department of Surgery, Division of Trauma Surgery and Surgical Critical Care, Lewis Katz School of Medicine, Temple University, 3401 N. Broad St, 4th Floor, Zone C, Philadelphia, PA, 19140, USA.
| | - Shannon Trombley
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Tia Walker
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Leah Roberts
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Laura Partain
- School of Communication, Ohio State University, Columbus, OH, USA
| | - Jim MacMillan
- Philadelphia Center for Gun Violence Reporting, Philadelphia, PA, USA
| | - Jennifer Midberry
- Department of Journalism and Communication, Lehigh University, Bethlehem, PA, USA
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Dao KD, Gisselman AS, Siegel MB, Hegedus EJ, Wooten LC. Firearm Violence as a Public Health Crisis: A Call to Action for Physical Therapists. Phys Ther 2024; 104:pzad143. [PMID: 37839055 DOI: 10.1093/ptj/pzad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/28/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023]
Affiliation(s)
- Kim D Dao
- Department of Rehabilitation Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | | | - Michael B Siegel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Eric J Hegedus
- Department of Rehabilitation Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Liana C Wooten
- Department of Rehabilitation Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA
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Rivara FP, Hink AB, Kuhls D, Banks S, Agoubi LL, Kirkendoll S, Winchester A, Hoeft C, Patel B, Nathens A. Firearm injuries in Missouri. PLoS One 2023; 18:e0294737. [PMID: 37992058 PMCID: PMC10664957 DOI: 10.1371/journal.pone.0294737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/05/2023] [Indexed: 11/24/2023] Open
Abstract
Firearm deaths continue to be a major public health problem, but the number of non-fatal firearm injuries and the characteristics of patients and injuries is not well known. The American College of Surgeons Committee on Trauma, with support from the National Collaborative on Gun Violence Research, leveraged an existing data system to capture lethal and non-lethal injuries, including patients treated and discharged from the emergency department and collect additional data on firearm injuries that present to trauma centers. In 2020, Missouri had the 4th highest firearm mortality rate in the country at 23.75/100,000 population compared to 13.58/100,000 for the US overall. We examined the characteristics of patients from Missouri with firearm injuries in this cross-sectional study. Of the overall 17,395 patients, 1,336 (7.7%) were treated at one of the 11 participating trauma centers in Missouri during the 12-month study period. Patients were mostly male and much more likely to be Black and uninsured than residents in the state as a whole. Nearly three-fourths of the injuries were due to assaults, and overall 7.7% died. Few patients received post-discharge services.
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Affiliation(s)
- Frederick P. Rivara
- Departments of Pediatrics and Epidemiology and the Firearm Injury and Policy Research Program, University of Washington, Seattle, Washington, United States of America
| | - Ashley B. Hink
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Deborah Kuhls
- Department of Surgery, Kirk Kerkorian School of Medicine at University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
| | - Samantha Banks
- Firearm Injury and Policy Research Program, University of Washington, Seattle, Washington, United States of America
| | - Lauren L. Agoubi
- Harborview Injury Prevention and Research Center and the Department of Surgery, University of Washington, Seattle, Washington, United States of America
| | - Shelbie Kirkendoll
- Department of Surgery, Northwestern Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Alex Winchester
- American College of Surgeons, Chicago, Illinois, United States of America
| | - Christopher Hoeft
- American College of Surgeons, Chicago, Illinois, United States of America
| | - Bhavin Patel
- American College of Surgeons, Chicago, Illinois, United States of America
| | - Avery Nathens
- Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
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Magee LA, Ortiz D, Adams ZW, Marriott BR, Beverly AW, Beverly B, Aalsma MC, Wiehe SE, Ranney ML. Engagement With Mental Health Services Among Survivors of Firearm Injury. JAMA Netw Open 2023; 6:e2340246. [PMID: 37902754 PMCID: PMC10616725 DOI: 10.1001/jamanetworkopen.2023.40246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 09/15/2023] [Indexed: 10/31/2023] Open
Abstract
Importance Despite the prevalence of posttraumatic stress symptoms after firearm injury, little is known about how firearm injury survivors connect with mental health services. Objective To determine facilitators and barriers to mental health care engagement among firearm injury survivors. Design, Setting, and Participants A qualitative study of 1-on-1, semistructured interviews conducted within a community setting in Indianapolis, Indiana, between June 2021 and January 2022. Participants were recruited via community partners and snowball sampling. Participants who survived an intentional firearm injury, were shot within Indianapolis, were aged 13 years or older, and were English speaking were eligible. Participants were asked to discuss their lives after firearm injury, the emotional consequences of their injury, and their utilization patterns of mental health services. Data were analyzed from August 2022 to June 2023. Main Outcomes and Measures Survivors' lived experience after firearm injury, sources of emotional support, mental health utilization, and their desired engagement with mental health care after firearm injury. Results A total of 18 participants (17 were Black [94%], 16 were male [89%], and 14 were aged between 13 and 24 years [77%]) who survived a firearm injury were interviewed. Survivors described family members, friends, and informal networks as their main source of emotional support. Barriers to mental health care utilization were perceived as a lack of benefit to services, distrust in practitioners, and fear of stigma. Credible messengers served as facilitators to mental health care. Survivors also described the emotional impact their shooting had on their families, particularly mothers, partners, and children. Conclusions and Relevance In this study of survivors of firearm injury, findings illustrated the consequences of stigma and fear when seeking mental health care, inadequate trusted resources, and the need for awareness of and access to mental health resources for family members and communities most impacted by firearm injury. Future studies should evaluate whether community capacity building, digital health delivery, and trauma-informed public health campaigns could overcome these barriers to mitigate the emotional trauma of firearm injuries to reduce health disparities and prevent future firearm violence.
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Affiliation(s)
- Lauren A. Magee
- Paul H. O’Neill School of Public and Environmental Affairs, Indiana University Indianapolis
| | - Damaris Ortiz
- Department of Surgery, Indiana University School of Medicine, Indianapolis
- Sidney and Lois Eskenazi Hospital Smith Level One Trauma Center, Indianapolis, Indiana
| | - Zachary W. Adams
- Adolescent Behavior Health Research Program, Indiana University School of Medicine, Indianapolis
- Stop the Violence Indianapolis, Indiana
| | - Brigid R. Marriott
- Adolescent Behavior Health Research Program, Indiana University School of Medicine, Indianapolis
| | | | | | - Matthew C. Aalsma
- Adolescent Behavior Health Research Program, Indiana University School of Medicine, Indianapolis
| | - Sarah E. Wiehe
- Children’s Health Services Research, Department of Pediatric, Indiana University School of Medicine, Indianapolis
| | - Megan L. Ranney
- Yale School of Public Health, Yale University, New Haven, Connecticut
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Lei L, Goldstick JE, Maust DT. Impact of firearm injury in children and adolescents on health care costs and use within a family. Prev Med 2023; 175:107681. [PMID: 37633600 PMCID: PMC10592083 DOI: 10.1016/j.ypmed.2023.107681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/29/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
In 2020, firearm injury became the leading cause of death in U.S. children and adolescents. This study examines sequelae of firearm injury among children and adolescents in terms of health care costs and use within a family over time using an event study design. Using data from a large U.S. commercial insurance company from 2013 to 2019, we identified 532 children and adolescents aged 1-19 years who experienced any firearm-related acute hospitalization or emergency department (ED) encounter and 1667 of their family members (833 parents and 834 siblings). Outcomes included total health care costs, any acute hospitalization and ED visits (yes/no), and number of outpatient management visits, each determined on a quarterly basis 2 years before and 3 years after the firearm injury. Among injured children and adolescents, during the first quarter after the firearm injury, quarterly total health care costs were $24,018 higher than pre-injury; probability of acute hospitalization and ED visits were 27.9% and 90.4% higher, respectively; and number of outpatient visits was 1.8 higher (p < .001 for all). Quarterly total costs continued to be elevated during the second quarter post-injury ($1878 higher than pre-injury, p < .01) and number of outpatient visits remained elevated throughout the first year post-injury (0.6, 0.4, and 0.3 higher in the second through fourth quarter, respectively; p < .05 for all). Parents' number of outpatient visits increased during the second and third years after the firearm injury (0.3 and 0.5 higher per quarter than pre-injury; p < .05). Youth firearm injury has long-lasting impact on health care within a family.
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Affiliation(s)
- Lianlian Lei
- Department of Psychiatry, University of Michigan, United States of America.
| | - Jason E Goldstick
- Injury Prevention Center, University of Michigan, United States of America; Department of Emergency Medicine, University of Michigan, United States of America
| | - Donovan T Maust
- Department of Psychiatry, University of Michigan, United States of America; Institute for Healthcare Policy and Innovation, University of Michigan, United States of America; Center for Clinical Management Research, VA Ann Arbor Healthcare System, United States of America
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Timmer-Murillo SC, Melin SJH, Tomas CW, Geier TJ, Brandolino A, Schramm AT, Larson CL, deRoon-Cassini TA. Mental Health and Health-Related Quality of Life After Firearm Injury: A Preliminary Descriptive Study. Ann Intern Med 2023. [PMID: 37216663 DOI: 10.7326/m23-0309] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023] Open
Affiliation(s)
- Sydney C Timmer-Murillo
- Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Carissa W Tomas
- Division of Epidemiology & Social Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Timothy J Geier
- Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Amber Brandolino
- Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, and Division of Data Surveillance & Informatics, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Andrew T Schramm
- Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christine L Larson
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Terri A deRoon-Cassini
- Division of Trauma and Acute Care Surgery, Medical College of Wisconsin, Milwaukee, and Division of Data Surveillance & Informatics, Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin
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