Social networks and the risk of gunshot injury

Youth Violence Does not Discriminate: Inclusive Violence Prevention Support Services Focused on Counseling and Peer Support are Essential for Youth and Young Adults

BACKGROUND

Violence disproportionately affects individuals of low socioeconomic status, and rates of injury amongst youth and young adults (YYAs) are rising. Little is known about how the social needs of this high-risk subgroup compared to the overall violently injured population.

METHODS

This is a retrospective review of an intake assessment of violently injured victims admitted to a level I trauma center (Jan 2022-Aug 2023). Data collected include race, age, mechanism of injury, and protective and predisposing factors for violent injury. We compared the risk factors of YYAs (=≤ 24 years) to those of adults (>24) and evaluated rates and types of violence prevention services requested by age group.

RESULTS

Of 350 individuals surveyed, 94 (27%) were <= 24 years and 256 (73%) were >24 years. Younger patients were less likely to be male (77% vs 86%, P = .03) and experienced more firearm injury (76% vs 51%, P < .001). They reported less alcohol use (20% vs 38%, P < .001), similar rates of mental illness (25% vs 26%, P = .62), less housing instability (5% vs 22%, P < .001), and similar access to government benefits (20% vs 29%, P = .2) compared to the older cohort. Services were requested by 41% of the study population (N = 142); the younger cohort was 2.9 times more likely to request non-financial services (P = .042).

DISCUSSION

Violently injured youth and young adults (YYAs) experience disproportionately high rates of gun violence. Efforts should be made to prioritize legal, peer support, and mental health services over financial services for this population.

Shirtsleeves to shirtsleeves in three research generations. A project on the science of science and the exceedingly rare circumstances that sustain research legacies from a mentor to mentee and to theirs: A case study on firearm research

Background

In the 50 years since public health firearm research began, the decades have witnessed several pioneering investigators, followed by NRA backlash and a CDC funding moratorium, then increasing firearm mortality punctuated by mass shootings, and finally an unprecedented release of funding dedicated for research and to support trainees. Motivated by my own efforts to stay productive in firearm research, by the shirtsleeves-to-shirtsleeves cautionary lesson that wealth - for us this a researcher's funding, infrastructure, and capacity - amassed by one generation will soon diminish, and by my worry that we are not adequately dedicated to growing new investigators, I set out to document researcher lineages in this field.

Methods

I created a multigenerational lineage map to find authors using "gun" or "firearm" in the title/abstract as a way to find peer-reviewed publications on firearms as a public health issue. I designated the first author as Gen1 if the manuscript was sole authored or the senior author had never been first author on a firearm publication. I plotted each Gen1 author at the year of their first first-authored publication, and pointed from them to subsequent "first-time first-author investigators" (Gen2) for whom they were senior author, and so on for a Gen2 serving as senior author for a Gen3, and so on in that lineage.

Results

Gen1 authors numbered 91 by 2023, the first being Rushforth in 1974.3 Rushforth, 14 years later, produced the first and his only Gen2 author, Paulson,4 who produced no Gen3 authors. The field had produced 6 Gen2 authors when the first Gen3 author appeared in 1993, who produced the first Gen4 author in 1998, 14 years after Kraus5 that initiated that lineage in 1984. To date, only 5 lineages have produced a Gen4 author and among those only one lineage, from Schwab in 2002,6 has produced a Gen5. Twenty-four Gen3 authors have emerged. Only 35% of Gen2 authors produced a Gen3.

Conclusion

I hope this motivates years-long strategies to help trainees become established, informed by modeling quantitative and qualitative data to identify characteristics underlying the investigator network related to productivity and shortcomings alike. Without dedication to understand the science of science, shirtsleeves-to-shirtsleeves in three generations may be the fate of firearm research.

Local gun violence, mental health, and sleep: A neighborhood analysis in one hundred US Cities

RATIONALE

Community gun violence significantly shapes public health and collective well-being. Understanding how gun violence is associated with community health outcomes like mental health and sleep is crucial for developing interventions to mitigate disparities exacerbated by violence exposure.

OBJECTIVE

This study examines the associations between community gun violence , insufficient sleep, and poor mental health across neighborhoods in the United States.

METHODS

We utilized a novel database covering nearly 16,000 neighborhoods in 100 US cities from 2014 through 2019. Correlated trait fixed-effects models were employed to conduct all analyses while considering various neighborhood covariates such as concentrated disadvantage, demographic composition, population density, and proximity to trauma centers.

RESULTS

Our analysis revealed that greater gun violence is associated with both insufficient sleep and poor mental health in subsequent years. There is a reciprocal relationship between poor mental health and insufficient sleep, with each partially mediating the other's association with community gun violence. Notably, gun violence exhibits the strongest direct association with poor sleep rather than with poor mental health. We found a consistent reciprocal relationship between sleep and mental health at the community level.

CONCLUSIONS

The findings highlight a complex interplay between community violence, sleep, and mental health, underlining the importance of reducing community violence through numerous long-term interventions to address health disparities across the US.

Investing in family-centered early childhood education: A conceptual model for preventing firearm homicide among Black male youth in the United States

INTRODUCTION

Firearms are now the number one killer of children and adolescents in the United States. Firearm homicides among Black male youth are the driver of this increase. Prevention requires a multi-faceted life course approach. Academic achievement has been identified as a protective factor. Early childhood education, which is linked to later achievement, is thus an intervention area of interest. Conceptualizing the potential links between early childhood education and reduced risk for youth firearm homicide is important for guiding policy advocacy and informing future research.

METHODS

This paper presents a conceptual model linking early childhood education to reduced risk for firearm homicide. Each link in the model is discussed, and a corresponding review of the literature is presented. The need for anti-racist policies to strengthen the impact of early childhood education is highlighted.

RESULTS

Early education and firearm homicide research are each well-established but largely disconnected. There are clear immediate benefits of early childhood education; however, these effects wane with time, particularly for youth of color. At the same time, juvenile delinquency-a major risk factor for firearm homicide-is influenced by educational inequities.

CONCLUSIONS

Effective interventions to reduce firearm homicides among Black male youth in the United States are needed. Early childhood education shows promise as an intervention. However, to have an impact, this education needs to be accessible and affordable for all, particularly families of color and low income. Societal structures and policies must also better support the positive gains seen through early childhood education to avoid dissipation.

Mechanisms of traumatic injury by demographic characteristics: an 8-year review of temporal trends from the National Trauma Data Bank

BACKGROUND/PURPOSE

This 8-year retrospective study of the National Trauma Data Bank describes temporal trends of traumatic injury by mechanism of injury (MOI) by demographic characteristics from 2012 to 2019 for adult patients 18 years and older.

METHODS

Overall, 5 630 461 records were included after excluding those with missing demographic information and International Classification of Disease codes. MOIs were calculated as proportions of total injury by year. Temporal trends of MOI were evaluated using two-sided non-parametric Mann-Kendall trend tests for (1) all patients and (2) within racial and ethnic groups (ie, Asian, 2% of total patient sample; Black, 14%; Hispanic or Latino, 10%; Multiracial, 3%; Native American, <1%; Pacific Islander, <1%; White, 69%) and stratified by age and sex.

RESULTS/OUTCOMES

For all patients, falls increased over time (p=0.001), whereas burn (p<0.01), cut/pierce (p<0.01), cyclist (p=0.01), machinery (p<0.001), motor vehicle transport (MVT) motorcyclist (p<0.001), MVT occupant (p<0.001) and other blunt trauma (p=0.03) injuries decreased over time. The proportion of falls increased across all racial and ethnic groups and significantly for those aged 65 and older. There were further differences in decreasing trends of MOI by racial and ethnic categories and by age groups.

CONCLUSIONS

These results suggest that falls are an important injury prevention target with an ageing US population across all racial and ethnic groups. Differing injury profiles by racial and ethnic identity indicate that injury prevention efforts be designed accordingly and targeted specifically to individuals most at risk for specific MOIs.

STUDY TYPE

Level I, prognostic/epidemiological.

The effect of the COVID-19 pandemic on community violence in Connecticut

INTRODUCTION

Natural disasters may lead to increases in community violence due to broad social disruption, economic hardship, and large-scale morbidity and mortality. The effect of the COVID-19 pandemic on community violence is unknown.

METHODS

Using trauma registry data on all violence-related patient presentations in Connecticut from 2018 to 2021, we compared the pattern of violence-related trauma from pre-COVID and COVID pandemic using an interrupted time series linear regression model.

RESULTS

There was a 55% increase in violence-related trauma in the COVID period compared with the pre-COVID period (IRR: 1.55; 95%CI: 1.34-1.80; p-value<0.001) driven largely by penetrating injuries. This increase disproportionately impacted Black/Latinx communities (IRR: 1.61; 95%CI: 1.36-1.90; p-value<0.001).

CONCLUSION

Violence-related trauma increased during the COVID-19 pandemic. Increased community violence is a significant and underappreciated negative health and social consequence of the COVID-19 pandemic, and one that excessively burdens communities already at increased risk from systemic health and social inequities.

Utilizing a combined hospital and criminal justice database to identify risk factors for repeat firearm injury or violent-crime arrest among firearm victims

Introduction: Identifying firearm victims with the greatest risk of repeat-firearm exposure and offering interventions has the potential to disrupt recurrent violence. This study explored risk factors associated with repeat violence among survivors of intentional firearm injury in a unique clinical and criminal justice (CJ) dataset. Methods: This study analyzed a retrospective cohort (n = 4058) of persons injured by nonfatal intentional firearm violence from 2013 to 2016 in one metropolitan area. Data were collected from a single level I trauma center, city police records, and state CJ databases from 1948 to 2019. The primary outcome of interest was another firearm injury or violent-crime arrest (defined as a violent or firearm felony offense). Results: Among 4058 nonfatal intentional firearm victims, 1202 (29.6%) individuals had a repeat-firearm injury or violent-crime arrest. In a bivariate analysis, history of mental, physical, and/or emotional abuse (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.40-1.86), mental health diagnosis (OR, 1.88; 95% CI, 1.51-2.35), or illegal substance use (OR, 2.87; 95% CI, 2.48-3.32) was associated with increased risk of repeat-firearm injury or violent-crime arrest. Prior felony arrest (OR, 3.68; 95% CI, 3.19-4.24), prior incarceration (OR, 3.72; 95% CI, 3.04-4.56), prior firearm charge (OR, 4.06; 95% CI, 3.33-4.96), and suspected gang membership (OR, 8.69; 95% CI, 6.14-12.32) demonstrated the greatest association with significant repeat violence. Conclusions: Thirty percent of those who experienced an intentional firearm injury were found to have a repeat-firearm injury or violent-crime arrest multi-disciplinary interventions that address the complex needs of a CJ-involved population are needed to mitigate significant repeat violence.

Examining risky firearm behaviors among high-risk gun carriers in New York City

Precarious firearm conduct among inexperienced gun possessors has the potential to intensify firearm-related fatalities and injuries. The current study involves face-to-face interviews with 51 high-risk (and prohibited) residents of Brooklyn and the Bronx, NY, each of whom have either been shot or shot at. We analyze study participants' lived experiences regarding urban gun violence (including as victims and perpetrators), firearm handling, sharing, and improper storage. Despite claiming to be knowledgeable about firearm fundamentals, the vast majority of respondents acknowledged never having received professional instruction, but rather "figured it out" by "playing around" with available guns. These informal methods were shaped by respondents' desire to arm themselves despite inadequate access to firearm training. Study participants also described routinely stashing firearms in unsecure, easily accessible locations. Our study findings have important implications for informing community-based harm reduction and safety strategies among persons within high-risk networks.

The COVID-19 pandemic and associated increases in experiences of assault violence among black men with low socioeconomic status living in Louisiana

Background

The COVID-19 pandemic has had mental health, social, and economic implications among communities with high levels of social disadvantage; this may have impacted community violence rates. The objective of this study was to characterize overall trends in assault and social disadvantage of patients experiencing assault before and during the COVID-19 pandemic.

Methods

All trauma activations at a level one trauma center serving the entire southeast Louisiana region were included during March–August pre-COVID (2018–2019) and during COVID (2020). ICD-10 E-codes were used to identify trauma intent (assault vs. other). Assaults in this context are defined as physical injuries caused by an act of violence wherein the perpetrator was suspected or confirmed to have intended harm, injury, or death to the victim. Social disadvantage was assessed using the Area Deprivation Index (ADI). Change in the monthly rate of assault-trauma activations was assessed using negative binomial regression with adjustment for race, gender, and injury intent. The study was reviewed and approved by the Louisiana State University Health Sciences Institutional Review Board.

Results

A total of 4,233 trauma activations were included. The majority of activations occurred among men. Assaults increased from 27.5% of all activations pre-Covid to 35.6% during the pandemic. Penetrating trauma similarly increased from 29.5% to 35.7% of all activations. Negative binomial regression demonstrated that in addition to this increase in proportion of assaults relative to all activations, the monthly assault rate also increased by 20% during the pandemic. These increases were driven primarily by increased assaults among Black men. ADI rank did not change between study periods.

Conclusions

Health disparities in violence worsened during the pandemic: increased cases of assault occurred disproportionately among Black men, and assaults persisted in occurring primarily among low-ADI communities where burden had been high pre-pandemic. There is a critical need for resources and support to Black men, to mitigate violence and improve racial heath equity.

Trends in Hospital Care for Intentional Assault Gunshot Wounds Among Residents of Cook County, Illinois, 2018-2020

Objectives. To examine gun violence with respect to hospital visits for treatment of intentional assault gunshot wounds (IGWs). Methods. IGW-coded visits among residents of Cook County, Illinois, were matched to census zip code tabulation areas (ZCTAs) to map changes in IGW visit frequencies between 2018 and 2020. Patient characteristics were compared across years, and Poisson regression models for the likelihood of an inpatient admission or in-hospital death were estimated. Results. Over the study period, Cook County residents made 7122 IGW-coded hospital visits to 89 Illinois hospitals, resulting in $342 million in charges and 24 894 hospital days. The number of visits almost doubled between 2018 and 2020, from 1553 to 3031; 6 ZCTAs had increases of more than 60 visits. Approximately one third of patients with a visit were admitted, and 6.5% died. Conclusions. Hospital statistics do not include the full toll of nonfatal gun injuries or the costs of related community-level trauma. The health care system remains crucial in implementing epidemiological approaches to violence prevention. Addressing the national spike in shootings will require large investments in community economic development and a professional public safety workforce. (Am J Public Health. 2022;112(5):795-802. https://doi.org/10.2105/AJPH.2022.306747).

A descriptive exploration of the geographic and sociodemographic concentration of firearm homicide in the United States, 2004-2018

This study examined the population-based incidence of firearm homicide in the United States to identify geographic concentrations and to determine whether such concentrations have changed over time. It further examined the simultaneous associations of urbanization, poverty, and ethnicity/race with firearm homicide incidence. Using county-level data from the National Vital Statistics System and the U.S. Census Bureau for the years 2004-2018, the findings show geographic patterns not commonly recognized, including several lengthy and continuous corridors with a high incidence of firearm homicide, traversing both metro and non-metro areas. While the data clearly show a strongly disproportionate concentration of firearm homicide incidence in a subset of the population defined by geography, they do not suggest increasing concentration over time. The study findings also generally indicate increasing firearm homicide incidence with increasing levels of surrounding poverty, a phenomenon observed for both metro and non-metro areas.

Violent trauma as an indirect impact of the COVID-19 pandemic: A systematic review of hospital reported trauma

INTRODUCTION

The COVID-19 pandemic has exacerbated many social conditions associated with violence. The objective of this systematic review was to examine trends in hospital reported violent trauma associated with the pandemic.

METHODS

Databases were searched in using terms "trauma" or "violence" and "COVID-19," yielding 4,473 records (2,194 de-duplicated). Exclusion criteria included non-hospital based studies and studies not reporting on violent trauma. 44 studies were included in the final review.

RESULTS

Most studies reported no change in violent trauma incidence. Studies predominately assessed trends with violent trauma as a proportion of all trauma. All studies demonstrating an increase in violent trauma were located in the United States.

CONCLUSIONS

A disproportionate rise in violence has been reported within the US. However, most studies examined violent trauma as a proportion of all trauma; results may reflect relative changes from lockdowns. Future studies should examine rates of violent trauma to provide additional context.

Underground Gun Markets and the Flow of Illegal Guns into the Bronx and Brooklyn: A Mixed Methods Analysis

New York City (NYC) has experienced large reductions in violent crime over the last two decades, but gun-related violence continues to pose a threat to public safety. Despite strong gun laws, high-risk individuals in NYC neighborhoods are unfortunately still able to access and misuse firearms. This research analyzes NYC's underground gun market by closely examining the flow of guns into the two boroughs where gun violence and crime gun recoveries are most prevalent: the Bronx and Brooklyn. A mixed methods approach is utilized that consists of an assessment of firearms trace data and in-depth interviews with individuals considered to be at high risk for involvement in gun violence. Findings suggest that guns recovered in the Bronx and Brooklyn were significantly more likely to originate in states with less restrictive gun laws and more likely to have changed ownership in unregulated transactions relative to guns recovered elsewhere in NYC. Interviews revealed three primary avenues for illegal guns reaching Bronx and Brooklyn neighborhoods: high-volume gun brokers, middlemen, and individuals who make episodic low-level acquisitions from straw purchasers in other states. No subjects identified theft as a meaningful source of crime guns.

Developmental Comorbidity of Substance Use and Handgun Carrying Among U.S. Youth

INTRODUCTION

This study identifies the longitudinal trajectories of multiple forms of substance use and handgun carrying and examines their comorbidity over time.

METHODS

In a cohort study of 6,748 youth from a U.S. nationally representative sample (51% male, 49% female; 69% White, 16% Black, 14% Hispanic, and 1% other race/ethnicity; born between 1980 and 1984), individuals self-reported their substance-use status (i.e., smoking, drinking, marijuana use, and hard drug use), handgun carrying, and other covariates between 1997 and 2013. Group-based trajectory modeling was used to identify distinct patterns of substance use and handgun carrying over time. Chi-square tests were used to determine the bivariate associations between substance-use and handgun-carrying trajectories, and a multinomial logistic regression examined the associations while adjusting for covariates. Analyses were conducted in 2020.

RESULTS

Trajectories of all the 4 forms of substance use were associated with handgun-carrying trajectories. Specifically, the risk of being in the declining trajectory of handgun carrying (compared with that of being in the very-low trajectory) was higher for participants who were in the decreasing trajectories of smoking, drinking, marijuana use, and hard drug use and lower for those who were in the increasing trajectory of drinking. Inversely, the risks of being in the low and high-increasing trajectories of handgun carrying (compared with that of being in the very-low trajectory) were higher for participants who were in the increasing trajectory of hard drug use.

CONCLUSIONS

Both substance use and gun carrying are developmentally heterogeneous phenomena. Varied forms of substance use should be targeted to counter the distinct gun carrying patterns.

"The cops didn't make it any better": Perspectives on police and guns among survivors of gun violence

BACKGROUND

Survivors of gun violence in the United States (US) are twenty times more likely to be re-injured with a firearm and three times more likely to be arrested under a violence or a weapons-related charge. The mechanisms for these outcomes are multifactorial and remain largely understudied. We aimed to examine perspectives on both the police and guns among survivors of guns violence.

METHODS

We conducted a secondary analysis of qualitative data from a study that examined the post-hospitalization recovery experience of survivors of firearm violence. Using a conceptual framework derived from sociology literature and a coding team made up of researchers, community members and former police officers, we used directed content analysis to construct themes.

RESULTS

The data set included interviews with 20 survivors of gun violence that were all Black males, aged 20-51 years. The recurring themes around the police included: (1) Legal cynicism: "I don't like police, none of them"; (2) Interactions with the police in a medical setting: "The cops didn't make it any better" and (3) Ambivalence around police presence within the community: "That's their job to protect me, too." Themes related to guns in the community encompassed: (1) The availability of guns: "Getting a gun is about as easy as buying a pair of sneakers"; (2) Symbolic meaning: "Guns give them courage"; (3) Social meaning: "I just let them know: I have a gun, too." and (4) Strategic meaning: "It's just for protection."

CONCLUSIONS

Survivors of gun violence describe distrust for the police and an ecology of guns that confers symbolic, social and strategic meaning to owning a gun. Interventions to decrease gun violence should address the cultural value of a gun as well as focus on improving police relations with the community.

Management of Civilian Low-Velocity Gunshot Injuries to an Extremity

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Despite an increasing rate of civilian low-velocity gunshot injuries, there remains a lack of evidence-based treatment standards.

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Most low-velocity gunshot-induced fractures of the extremity can be managed similarly to non-gunshot-induced fractures, with the goals of restoring function and minimizing complications.

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There are a limited number of high-quality studies to support the use of prophylactic antibiotics for nonoperatively treated gunshot wounds.

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Intra-articular retained bullets should be removed, while prophylactic irrigation and debridement for a transarticular bullet is not routinely warranted for infection prevention.

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Much of the literature on low-velocity gunshot wounds is Level-III or IV evidence, warranting the need for higher-powered, randomized, prospective investigations.

Educational Attainment of Male Homicide Victims Aged 18 to 24 Years in Chicago: 2006 to 2015

Homicide is a preventable public health issue that has detrimental effects on both victims and witnesses and increases health care costs. From 2006 to 2015, homicide has been the second leading cause of death for youth aged 15 to 24 years in the United States. Educational attainment has been widely regarded as a protective factor against justice system involvement and violent injury. We conducted a time-trend analysis examining educational attainment levels for male victims of homicide aged 18 to 24 years in the City of Chicago, 2006 to 2015, to describe the educational attainment of youth homicide victims in Chicago. We used data from the Illinois Violent Death Reporting System and the United States Census Bureau from 2006 to 2015. Cases included male victims of homicide, 18 to 24 years of age, the injury leading to death occurred in the City of Chicago, injury leading to death occurred between 2006 and 2015, and whether or not a high school degree or equivalent had been obtained. Data were described over time using percentages and rates per 100,000 with 95% confidence intervals. Chicago male homicide victims aged 18 to 24 years were less likely to have at least a high school degree than the general population of males aged 18 to 24 years in Chicago. The homicide rate for males aged 18 to 24 years without a high school degree was significantly higher than those with a high school degree or equivalent for every time point, except 2007, and also in four of the seven Chicago Planning Regions when compared with the other three. We found there is a concentrated risk pool for undereducated male youth in Chicago.

Predicting Violent Victimization Using Social Network Analysis From Police Data

Extant research suggests that membership in crime networks explains vulnerability to violent crime victimization. Consequently, identifying deviant social networks and understanding their structure and individual members' role in them could provide insight into victimization risk. Identifying social networks may help tailor crime prevention strategies to mitigate victimization risks and dismantle deviant networks. Social network analysis (SNA) offers a particular means of comprehending and measuring such group-level structures and the roles that individuals play within them. When applied to research on crime and victimization, it could provide a foundation for developing precise, effective prevention, intervention, and suppression strategies. This study uses police data to examine whether individuals most central to a deviant social network are those who are most likely to become victims of violent crime, and which crime network roles are most likely to be associated with vulnerability to violent victimization. SNA of these data indicates that network individuals who are in a position to manage the flow of information in the network (betweenness centrality), regardless of their number of connections (degree centrality), are significantly more likely to be homicide and aggravated assault victims. Implications for police practice are discussed.

Social network theory-an underutilized opportunity to align innovative methods with the demands of the opioid epidemic

It has been almost 3 years since the opioid epidemic was declared a national public health emergency under federal law. Solutions have focused on supply-reduction strategies. These approaches, however, have failed to significantly curtail opioid overdose and related death. Demand for opioid use arising from social networks and environment is an important contributing factor to the current opioid epidemic. Adoption of existing underused methods is needed to drive further progress. This Perspective proposes the social contagion model as a promising framework through which to operationalize evaluation of the influence of social networks and environment in the opioid epidemic and argues for its greater application. Comparing the current epidemic with previous opioid epidemics reiterates the utility of the social contagion model. This model acknowledges social network influence on individual behavior. It leverages tools from epidemiology, permits evaluation of interpersonal influence, facilitates consideration of disproportionate and collateral effects, and overcomes limitations of traditional models and geographic assumptions inherent to many approaches surrounding the current opioid epidemic. Analyzing the opioid epidemic within a social contagion framework will enhance evaluation methods and enable the design of interventions to reflect the actual demands of the current crisis. If the influence of social networks and environment is not considered, the devastating toll of the opioid epidemic could grow.

Victims, offenders and victim-offender overlaps of knife crime: A social network analysis approach using police records

Knife crime is a source of concern for the police in England and Wales, however little published research exists on this crime type. Who are the offenders who use knives to commit crime, when and why? Who are their victims, and is there a victim-offender overlap? What is the social network formation for people who are exposed to knife crime? Using a multidimensional approach, our aim is to answer these questions about one of England and Wales’ largest jurisdictions: Thames Valley. We first provide a state-of-the-art narrative review of the knife crime literature, followed by an analysis of population-level data on central tendency and dispersion of knife crimes reported to the police (2015–2019), on offences, offenders, victims, victim-offender overlaps and gang-related assaults. Social network analysis was used to explore the formations of offender-victim networks. Our findings show that knife crime represents a small proportion of crime (1.86%) and is associated largely with violence offenses. 16–34 year-old white males are at greatest risk of being the victims, offenders or victim-offenders of knife crime, with similar relative risks between these three categories. Both knife offenders and victims are likely to have a criminal record. Knife crimes are usually not gang-related (less than 20%), and experienced mostly between strangers, with the altercation often a non-retaliatory ‘one-off event’. Even gang-related knife crimes do not follow ‘tit-for-tat’ relationships—except when the individuals involved have extensive offending histories and then are likely to retaliate instantaneously. We conclude that while rare, an incident of knife crime remains predicable, as a substantial ratio of offenders and victims of future knife crime can be found in police records. Prevention strategies should not be focused on gang-related criminals, but on either prolific violent offenders or repeat victims who are known to the police—and therefore more susceptible to knife crime exposure.

Patterns of adolescent gun carrying and gun-related crime arrests in Indianapolis, Indiana over an 11-year time period

Adolescent males are disproportionately affected by homicide as both victims and offenders. Indianapolis has seen increases in youth homicides over the past few years; gun carrying increases an individual's risk for involvement in firearm violence. It is unclear how often youth are arrested for gun carrying and gun-related crimes. Examining these patterns may identify an opportunity for intervention. This study is a descriptive epidemiology analysis that examines patterns of gun carrying and gun-related crime arrests among justice involved youth in Marion County (Indianapolis), Indiana. We accessed juvenile court records from January 1, 2006 to December 31, 2016 on all individuals arrested for a gun carrying offense (i.e., illegal possession of a firearm or gun; n = 711) and all individuals arrested for a gun-related crime (i.e., homicide, robbery, aggravated assault; n = 150). Data were analyzed in fall 2019. Proportions of juvenile arrests for both gun carrying (47.0 per 1000 arrests) and gun-related crime (25.4 per 1000 arrests) have substantially increased compared to ten-years ago (4.5 per 1000 arrests and 2.0 per 1000 arrests, respectively). Of those arrested, 27.7 per 100,000 population were arrested for a repeated gun-related offense; of which 21.5 per 100,000 were first arrested for gun carrying and 6.2 per 100,000 were arrested for a gun-related crime. The majority of gun-related repeat offenders were first arrested for gun carrying; therefore, these gun-carrying arrests may be an opportunity to intervene on an individual level by providing treatment, other needed resources, and discussing safe firearm storage with families and communities.

Forecasting Organized Crime Homicides: Risk Terrain Modeling of Camorra Violence in Naples, Italy

Mafia homicides are usually committed for retaliation, economic profit, or rivalry among groups. The variety of possible reasons suggests the inefficacy of a preventive approach. However, like most violent crimes, mafia homicides concentrate in space due to place-specific social and environmental features. Starting from the existing literature, this study applies the Risk Terrain Modeling approach to forecast the Camorra homicides in Naples, Italy. This approach is based on the identification and evaluation of the underlying risk factors able to affect the risk of a homicide. This information is then used to predict the most likely location of future events. The findings of this study demonstrate that past homicides, drug dealing, confiscated assets, and rivalries among groups make it possible to predict up to 85% of 2012 mafia homicides, identifying 11% of city areas at highest risk. By contrast, variables controlling for the socio-economic conditions of areas are not significantly related to the risk of homicide. Moreover, this study shows that, even in a restricted space, the same risk factors may combine in different ways, giving rise to areas of equal risk but requiring targeted remedies. These results provide an effective basis for short- and long-term targeted policing strategies against organized crime- and gang-related violence. A similar approach may also provide practitioners, policy makers, and local administrators in other countries with significant support in understanding and counteracting also other forms of violent behavior by gangs or organized crime groups.

A human-machine partnered approach for identifying social media signals of elevated traumatic grief in Chicago gang territories

There is a critical need to improve trauma-informed services in structurally marginalized communities impacted by violence and its associated traumatic grief. For community residents, particularly gang-associated youth, repeated exposure to traumatic grief causes serious adverse effects that may include negative health outcomes, delinquency, and future violent offenses. The recent proliferation of digital social media platforms, such as Twitter, provide a novel and largely underutilized resource for responding to these issues, particularly among these difficult-to-reach communities. In this paper, we explore the potential for using a human-machine partnered approach, wherein qualitative fieldwork and domain expertise is combined with a computational linguistic analysis of Twitter content among 18 gang territories/neighborhoods on Chicago's South Side. We first employ in-depth interviews and observations to identify common patterns by which residents in gang territories/neighborhoods express traumatic grief on social media. We leverage these qualitative findings, supplemented by domain expertise and computational techniques, to gather both traumatic grief- and gang-related tweets from Twitter. We next utilize supervised machine learning to construct a binary classification algorithm to eliminate irrelevant tweets that may have been gathered by our automated query and extraction techniques. Last, we confirm the validity, or ground truth, of our computational findings by enlisting additional domain expertise and further qualitative analyses of the specific traumatic events discussed in our sample of Twitter content. Using this approach, we find that social media provides useful signals for identifying moments of increased collective traumatic grief among residents in gang territories/neighborhoods. This is the first study to leverage Twitter to systematically ground the collective online articulations of traumatic grief in traumatic offline events occurring in violence-impacted communities. The results of this study will be useful for developing more effective tools-including trauma-informed intervention applications-for community organizations, violence prevention initiatives, and other public health efforts.

The influence of firearms trafficking on gunshot injuries in a co-offending network

Individuals at the greatest risk of gunshot victimization are often prohibited from legally acquiring guns in the U.S. due to prior felony convictions or other disqualifications. Prohibited persons often rely on others - such as friends, family members, fellow gang members, and gun brokers - to acquire firearms. This study examines whether the sources of guns recovered from high-risk individuals differ relative to the sources of guns recovered more generally in a major U.S. city, and whether illegally-diverted guns are associated with increased gunshot victimization risk. Using official data, we recreate the co-offending network of individuals in Boston who were arrested or contacted by the police with at least one other person between 2007 and 2014. Firearms trace data are then used to develop measures of the shortest distance between individuals and firearms in their immediate network. Results suggest guns with markers of illegal diversion are more likely to be recovered in the highest risk sector of the network and that the probability of gunshot victimization increases with decreased distance to an individual linked to firearms with markers of illegal trafficking.

Reducing gunshot victimization in high-risk social networks through direct and spillover effects

More than 60,000 people are victimized by gun violence each year in the United States. A large share of victims cluster in bounded and identifiable social networks. Despite a growing number of violence reduction programmes that leverage networks to broaden programmatic effects, there is little evidence that reductions in victimization are achieved through spillover effects on the peers of participants. This study estimates the direct and spillover effects of a gun violence field intervention in Chicago. Using a quasi-experimental design, we test whether a desistance-based programme reduced gunshot victimization among 2,349 participants. The study uses co-arrest network data to further test spillover effects on 6,132 non-participants. Direct effects were associated with a 3.2-percentage point reduction in victimization among seeds over two years, while potential spillover was associated with a 1.5-percentage point reduction among peers. Findings suggest that peer influence and the structure of networks might be leveraged to amplify gun violence reduction efforts.

Risk and protective factors related to youth firearm violence: a scoping review and directions for future research

To conduct our scoping review of risk and protective factors for firearm violence among youth, we searched PubMed, Scopus, EMBASE, and Criminal Justice Abstracts for English-language research articles published between January 1985 and May 2018. We included studies of modifiable risk or protective factors associated with intentional (including suicide) or unintentional firearm victimization or perpetration with samples that included youth ≤ 17. Among the 28 included studies, 15 explored risk/protective factors for victimization, five focused on perpetration, five did not differentiate between victimization and perpetration, and five focused on suicide. Most studies examined individual-level risk factors. The few that explored factors beyond the individual were limited by methodological weaknesses and inconsistent findings. Protective factors for youth firearm outcomes were understudied. We need more research on youth firearm violence using longitudinal data and robust statistical methods. Future research is needed to understand the underlying mechanisms by which risk/protective factors influence firearm violence.

Longitudinal Heterogeneity in Handgun-Carrying Behavior Among Urban American Youth: Intervention Priorities at Different Life Stages

PURPOSE

To determine longitudinal patterns of handgun-carrying behavior among urban American youth and identify modifiable risk factors associated with distinct carrying patterns that should be targeted at different life stages.

METHODS

Using panel data from the National Longitudinal Survey of Youth 1997, we estimated longitudinal trajectories of handgun carrying among urban Americans, who carried a handgun at least once between 1997 and 2011 (N = 1,574). Multinomial logistic regression analyses examined risk factors associated with handgun-carrying trajectory groups during late adolescence (ages 16-20), emerging adulthood (ages 20-24), and young established adulthood (ages 24-28).

RESULTS

Group-based trajectory analyses identified four groups: Declining (35.0%, N = 560), bell-shaped (35.5%; N = 561), late-initiating (19.6%; N = 303), and high-persistent (9.9%; N = 150). During late adolescence, lower risks of mental health problems, hard drug use, police arrest, and presence of a gang in the neighborhood or school differentiated the late-initiating group from the other higher risk groups. During emerging and young established adulthood, higher risks of alcohol use, police arrest, and presence of a gang in the neighborhood or school were associated with trajectory groups with higher likelihood of handgun carrying than the declining group.

CONCLUSIONS

There are more than one profile of adolescents and young adults who carry handguns. Preventive interventions should have distinct priorities that address different patterns of handgun-carrying behavior at different life stages.

Nonfatal Firearm Violence Trends on the Westside of Chicago Between 2005 and 2016

This paper examines the epidemiology of nonfatal firearm violence (NFFV) on the Westside of Chicago over three finite time periods: 2005–2008, 2009–2012, and 2013–2016. The trend analysis will look at any significant changes over the time periods and describe the demographic characteristics of NFFV. A descriptive analysis of Mount Sinai Hospital (MSH) Emergency Department (ED) data was conducted. NFFV patients were identified by specific firearm ICD-9 primary eCode injury categories: accident, assault, legal intervention, undetermined intent, suicide or self-inflicted injury, and legal intervention. The Pearson Chi-square test was conducted to statistically compare the categorical frequencies of the Chicago metropolitan region of injury, cause of firearm related injury, and place of injury by time period. There were a total of 3962 nonfatal hospitalizations at MSH between the three time periods due to gun violence related injuries. Overall, nonfatal hospitalizations were most frequent for those between age groups 16–24 (52.5%). The number of nonfatal hospitalizations decreased with increasing age for the age groups 35–44 (9.7%), 45–54 (3.2%), and > 54 (1.2%). There were significantly more nonfatal hospitalizations in males (n = 3649) than females (n = 312) across the three time periods. However, there was a 74.7% increase in female nonfatal hospitalizations from 2009–2012 to 2013–2016. There were significant racial differences in nonfatal hospitalizations between the three time periods. NFFV continues to be problem on the Westside of Chicago, particularly for young, Black men. The incidence of gun violence however has not changed significantly between 2005 and 2016.

Spatio-temporal patterns of gun violence in Syracuse, New York 2009-2015

Gun violence in the United States of America is a large public health problem that disproportionately affects urban areas. The epidemiology of gun violence reflects various aspects of an infectious disease including spatial and temporal clustering. We examined the spatial and temporal trends of gun violence in Syracuse, New York, a city of 145,000. We used a spatial scan statistic to reveal spatio-temporal clusters of gunshots investigated and corroborated by Syracuse City Police Department for the years 2009-2015. We also examined predictors of areas with increased gun violence using a multi-level zero-inflated Poisson regression with data from the 2010 census. Two space-time clusters of gun violence were revealed in the city. Higher rates of segregation, poverty and the summer months were all associated with increased risk of gun violence. Previous gunshots in the area were associated with a 26.8% increase in the risk of gun violence. Gun violence in Syracuse, NY is both spatially and temporally stable, with some neighborhoods of the city greatly afflicted.

Predictors of mortality in pediatric urban firearm injuries

BACKGROUND

Although firearms account for less than 5 % of all pediatric injuries, they have the highest associated case fatality rate.

METHODS

The registry at a Level-1 trauma center was used to identify firearm injuries (<18 years of age) from 1991 to 2011. Descriptive statistics and risk-adjusted multivariate analyses (MVA) were performed.

RESULTS

Overall, 1085 patients were identified. Immediate operations were performed in 33 % (n = 358) of patients with most having abdominal surgery (n = 214). Survival was 86 %, but higher for African Americans (OR = 1.92) than for Hispanics (p = 0.006). African Americans were more likely to sustain extremity (OR = 2.26) and less head (OR = 0.36) injuries than Hispanics (p < 0.001). Analysis by injury location showed that head (OR = 14.1) had the highest associated mortality. Other significant predictors included multiple major injury (defined by Abbreviated Injury Scale) with central nervous system involvement (OR = 7.30) and single injuries to the chest (OR = 2.68). These findings were compared to abdominal injuries as the baseline (p < 0.02). MVA demonstrated that Caucasian children had higher mortality (OR = 6.12) vs. Hispanics (p = 0.031). Children admitted with initial pH ≤ 7.15 (OR = 14.8), initial hematocrit ≤30 (OR = 3.24), or Injury Severity Score (ISS) > 15 (OR = 1.08) had higher mortality rates (p < 0.05).

CONCLUSION

Independent significant indicators of mortality include low initial pH or hematocrit, Caucasian race, high ISS, and those who sustain head injuries.

The Contagious Spread of Violence Among US Adolescents Through Social Networks

OBJECTIVES

To test the hypothesis that violence among US adolescents spreads like a contagious disease through social networks.

METHODS

Participants were a nationally representative sample of 90 118 US students aged 12 to 18 years who were involved in the National Longitudinal Study of Adolescent Health. Violence was assessed by having participants report the number of times in the preceding 12 months they had been involved in a serious physical fight, had hurt someone badly, and had pulled a weapon on someone.

RESULTS

Participants were 48% more likely to have been involved in a serious fight, 183% more likely to have hurt someone badly, and 140% more likely to have pulled a weapon on someone if a friend had engaged in the same behavior. The influence spread up to 4 degrees of separation (i.e., friend of friend of friend of friend) for serious fights, 2 degrees for hurting someone badly, and 3 degrees for pulling a weapon on someone.

CONCLUSIONS

Adolescents were more likely to engage in violent behavior if their friends did the same, and contagion of violence extended beyond immediate friends to friends of friends.

Gun violence in Americans' social network during their lifetime

INTRODUCTION

The overall burden of gun violence death and injury in the US is now well understood. However, no study has shown the extent to which gun violence is associated with the individual lives of Americans.

METHODS

We used fatal and non-fatal gun injury rates in 2013 from Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) and generally accepted estimates about the size of an American's social network to determine the likelihood that any given person will know someone in their personal social network who is a victim of gun violence during their lifetime. We derived estimates in the overall population and among racial/ethnic groups and by gun-injury intent.

RESULTS

The likelihood of knowing a gun violence victim within any given personal network over a lifetime is 99.85% (99.8% to 99.9%). The likelihood among non-Hispanic white, black, Hispanic and other race Americans were 97.1%, 99.9%, 99.5% and 88.9% respectively.

CONCLUSION

Nearly all Americans of all racial/ethnic groups are likely to know a victim of gun violence in their social network during their lifetime.

A Geospatial Analysis of Severe Firearm Injuries Compared to Other Injury Mechanisms: Event Characteristics, Location, Timing, and Outcomes

OBJECTIVES

Relatively little is known about the context and location of firearm injury events. Using a prospective cohort of trauma patients, we describe and compare severe firearm injury events to other violent and nonviolent injury mechanisms regarding incident location, proximity to home, time of day, spatial clustering, and outcomes.

METHODS

This was a secondary analysis of a prospective cohort of injured children and adults with hypotension or Glasgow Coma Scale score ≤ 8, injured by one of four primary injury mechanisms (firearm, stabbing, assault, and motor vehicle collision [MVC]) who were transported by emergency medical services to a Level I or II trauma center in 10 regions of the United States and Canada from January 1, 2010, through June 30, 2011. We used descriptive statistics and geospatial analyses to compare the injury groups, distance from home, outcomes, and spatial clustering.

RESULTS

There were 2,079 persons available for analysis, including 506 (24.3%) firearm injuries, 297 (14.3%) stabbings, 339 (16.3%) assaults, and 950 (45.7%) MVCs. Firearm injuries resulted in the highest proportion of serious injuries (66.3%), early critical resources (75.3%), and in-hospital mortality (53.5%). Injury events occurring within 1 mile of a patient's home included 53.9% of stabbings, 49.2% of firearm events, 41.3% of assaults, and 20.0% of MVCs; the non-MVC events frequently occurred at home. While there was geospatial clustering, 94.4% of firearm events occurred outside of geographic clusters.

CONCLUSIONS

Severe firearm events tend to occur within a patient's own neighborhood, often at home, and generally outside of geospatial clusters. Public health efforts should focus on the home in all types of neighborhoods to reduce firearm violence.

The Transmission of Gun and Other Weapon-Involved Violence Within Social Networks

Fatal and nonfatal injuries resulting from gun violence remain a persistent problem in the United States. The available research suggests that gun violence diffuses among people and across places through social relationships. Understanding the relationship between gun violence within social networks and individual gun violence risk is critical in preventing the spread of gun violence within populations. This systematic review examines the existing scientific evidence on the transmission of gun and other weapon-related violence in household, intimate partner, peer, and co-offending networks. Our review identified 16 studies published between 1996 and 2015 that suggest that exposure to a victim or perpetrator of violence in one's interpersonal relationships and social networks increases the risk of individual victimization and perpetration. Formal network analyses find high concentrations of gun violence in small networks and that exposure to gun violence in one's networks is highly correlated with one's own probability of being a gunshot victim. Physical violence by parents and weapon use by intimate partners also increase risk for victimization and perpetration. Additional work is needed to better characterize the mechanisms through which network exposures increase individual risk for violence and to evaluate interventions aimed at disrupting the spread of gun and other weapon violence in high-risk social networks.

Firearm injuries in the United States

OBJECTIVE

This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact.

METHOD

Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries.

RESULTS

More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995.

CONCLUSION

Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence.

Mental illness, mass shootings, and the politics of American firearms

Four assumptions frequently arise in the aftermath of mass shootings in the United States: (1) that mental illness causes gun violence, (2) that psychiatric diagnosis can predict gun crime, (3) that shootings represent the deranged acts of mentally ill loners, and (4) that gun control "won't prevent" another Newtown (Connecticut school mass shooting). Each of these statements is certainly true in particular instances. Yet, as we show, notions of mental illness that emerge in relation to mass shootings frequently reflect larger cultural stereotypes and anxieties about matters such as race/ethnicity, social class, and politics. These issues become obscured when mass shootings come to stand in for all gun crime, and when "mentally ill" ceases to be a medical designation and becomes a sign of violent threat.

Saving Human Lives: What Complexity Science and Information Systems can Contribute

We discuss models and data of crowd disasters, crime, terrorism, war and disease spreading to show that conventional recipes, such as deterrence strategies, are often not effective and sufficient to contain them. Many common approaches do not provide a good picture of the actual system behavior, because they neglect feedback loops, instabilities and cascade effects. The complex and often counter-intuitive behavior of social systems and their macro-level collective dynamics can be better understood by means of complexity science. We highlight that a suitable system design and management can help to stop undesirable cascade effects and to enable favorable kinds of self-organization in the system. In such a way, complexity science can help to save human lives.

Statistical physics of crime: a review

Containing the spread of crime in urban societies remains a major challenge. Empirical evidence suggests that, if left unchecked, crimes may be recurrent and proliferate. On the other hand, eradicating a culture of crime may be difficult, especially under extreme social circumstances that impair the creation of a shared sense of social responsibility. Although our understanding of the mechanisms that drive the emergence and diffusion of crime is still incomplete, recent research highlights applied mathematics and methods of statistical physics as valuable theoretical resources that may help us better understand criminal activity. We review different approaches aimed at modeling and improving our understanding of crime, focusing on the nucleation of crime hotspots using partial differential equations, self-exciting point process and agent-based modeling, adversarial evolutionary games, and the network science behind the formation of gangs and large-scale organized crime. We emphasize that statistical physics of crime can relevantly inform the design of successful crime prevention strategies, as well as improve the accuracy of expectations about how different policing interventions should impact malicious human activity that deviates from social norms. We also outline possible directions for future research, related to the effects of social and coevolving networks and to the hierarchical growth of criminal structures due to self-organization.

A GIS-based spatiotemporal analysis of violent trauma hotspots in Vancouver, Canada: identification, contextualisation and intervention

BACKGROUND

In 2002, the WHO declared interpersonal violence to be a leading public health problem. Previous research demonstrates that urban spaces with a high incidence of violent trauma (hotspots) correlate with features of built environment and social determinants. However, there are few studies that analyse injury data across the axes of both space and time to characterise injury-environment relationships. This paper describes a spatiotemporal analysis of violent injuries in Vancouver, Canada, from 2001 to 2008.

METHODS

Using geographic information systems, 575 violent trauma incidents were mapped and analysed using kernel density estimation to identify hotspot locations. Patterns between space, time, victim age and sex and mechanism of injury were investigated with an exploratory approach.

RESULTS

Several patterns in space and time were identified and described, corresponding to distinct neighbourhood characteristics. Violent trauma hotspots were most prevalent in Vancouver's nightclub district on Friday and Saturday nights, with higher rates in the most socioeconomically deprived neighbourhoods. Victim sex, age and mechanism of injury also formed strong patterns. Three neighbourhood profiles are presented using the dual axis of space/time to describe the hotspot environments.

CONCLUSIONS

This work posits the value of exploratory spatial data analysis using geographic information systems in trauma epidemiology studies and further suggests that using both space and time concurrently to understand urban environmental correlates of injury provides a more granular or higher resolution picture of risk. We discuss implications for injury prevention and control, focusing on education, regulation, the built environment and injury surveillance.

Network exposure and homicide victimization in an African American community

OBJECTIVES

We estimated the association of an individual's exposure to homicide in a social network and the risk of individual homicide victimization across a high-crime African American community.

METHODS

Combining 5 years of homicide and police records, we analyzed a network of 3718 high-risk individuals that was created by instances of co-offending. We used logistic regression to model the odds of being a gunshot homicide victim by individual characteristics, network position, and indirect exposure to homicide.

RESULTS

Forty-one percent of all gun homicides occurred within a network component containing less than 4% of the neighborhood's population. Network-level indicators reduced the association between individual risk factors and homicide victimization and improved the overall prediction of individual victimization. Network exposure to homicide was strongly associated with victimization: the closer one is to a homicide victim, the greater the risk of victimization. Regression models show that exposure diminished with social distance: each social tie removed from a homicide victim decreased one's odds of being a homicide victim by 57%.

CONCLUSIONS

Risk of homicide in urban areas is even more highly concentrated than previously thought. We found that most of the risk of gun violence was concentrated in networks of identifiable individuals. Understanding these networks may improve prediction of individual homicide victimization within disadvantaged communities.

New developments and implications for understanding the victimization of gang members

Despite a long line of research establishing a connection between gang membership and delinquent or criminal behavior, less is known about gang members' exposure to victimization. Among the few published studies that have recently investigated the gang-victimization link, findings are mixed and our understanding of this relationship remains unclear. This study offers a synthesis of the emerging gang-victimization literature by highlighting methodological and theoretical advancements and limitations within the field. Specific recommendations are presented to guide future research.