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Schaefer RM, Bank EA, Krohmer JR, Haskell A, Taylor AL, Jenkins DH, Holcomb JB. Removing the barriers to prehospital blood: A roadmap to success. J Trauma Acute Care Surg 2024; 97:S138-S144. [PMID: 38689393 DOI: 10.1097/ta.0000000000004378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
ABSTRACT This review describes the necessity, evolution, and current state of prehospital blood programs in the United States. Less than 1% of 9-1-1 ground emergency medical service agencies have been able to successfully implement prehospital blood transfusions as part of a resuscitation strategy for patients in hemorrhagic shock despite estimates that annually between 54,000 and 900,000 patients may benefit from its use. The use of prehospital blood transfusions as a tool for managing hemorrhagic shock has barriers to overcome to ensure it becomes widely available to patients throughout the United States. Barriers include (1) current state Emergency Medical Services clinicians' scope of practice limitations; (2) program costs and reimbursement of blood products; (3) no centralized data collection process for prehospital hemorrhagic shock and patient outcomes; (4) collaboration between prehospital agencies, blood suppliers, and hospital clinicians and transfusion service activities. The following article identifies barriers and a proposed roadmap to reduce death due to prehospital hemorrhage.
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Affiliation(s)
- Randall M Schaefer
- From the Schaefer Consulting, LLC (R.M.S.), New Braunfels; Harris County Emergency Services District 48 (E.A.B.), Katy, Texas; Department of Emergency Medicine (J.R.K.), College of Human Medicine, Michigan State University, Michigan; Oak Ridge Institute for Science and Education Fellow, Biomedical and Advanced Research and Development Authority (A.H.), Washington, District of Columbia; South Texas Blood & Tissue, BioBridge Global (A.L.T.), San Antonio, Texas; Department of Surgery (D.H.J.), University of Texas Health San Antonio, San Antonio, Texas; and Division of Trauma and Acute Care Surgery, Department of Surgery (J.B.H.), University of Alabama at Birmingham, Birmingham, Alabama
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Schleimer JP, Lyons VH, Smith D, Ali F, Averett L, Baugh M, Benson LR, Colon J, Cook J, Davis D, Diandy M, Fox A, Gonzalez E, Johnson A, Lowe AB, Marshall M, Maryman B, McLaurin V, Nehra D, Orozco A, Palmer K, Serrano R, Shrader Z, Thurston C, Watlington E, Waszkewitz L, Westlake E, Jones K, Rowhani-Rahbar A. Codeveloping theories of change for improved community-based violence intervention evaluation. J Trauma Acute Care Surg 2024; 97:278-285. [PMID: 38509040 DOI: 10.1097/ta.0000000000004277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Community-based violence intervention (CVI) programs are considered important strategies for preventing community violence and promoting health and safety. Mixed and inconclusive results from some prior CVI evaluations, as well as our general lack of understanding about the reasons for such varied findings, may be explained in part by misalignment of program theories of change and evaluation measures. Furthermore, most prior evaluations have focused solely on deficit-based outcomes; this narrow focus is inconsistent with the premise of CVI and may fail to capture improvements in health and well-being that are on the hypothesized pathway from intervention to violence reduction. METHODS This article describes the process and results of codeveloping a theory of change for community-based youth firearm violence intervention and prevention programs in Washington state through a community-researcher partnership. We followed a multistep iterative process, involving (1) CVI program documentation review, (2) individual meetings, and (3) a day-long workshop. RESULTS The theory of change included six key domains: (1) root causes, (2) promotive factors, (3) activities, (4) intermediate outcomes, (5) longer-term outcomes, and (6) multilevel context (youth/family, staff/organizational, community, and societal). Root causes were social and structural drivers of community violence. Promotive factors were assets and resources among the community, youth/their families, and community organizations that promote health and safety. Activities were supports and services the program provided to youth and their families, staff, and, potentially, the broader community. Intermediate and longer-term outcomes were the changes among youth, their families, staff, and the community that resulted from program activities. Intermediate outcomes may be felt within 6 months to 1 year, and longer-term outcomes may be felt after 1 to 2 years and beyond. CONCLUSION The theory of change we codeveloped provides a common lens to conceptualize, compare, and evaluate CVI programs in Washington state and may support more rigorous and equity-centered evaluations. LEVEL OF EVIDENCE Diagnostic Test/Criteria; Level V.
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Affiliation(s)
- Julia P Schleimer
- From the Firearm Injury and Policy Research Program (J.P.S., V.L., D.S., K.J.), and Department of Epidemiology (J.P.S., V.H.L., A.R.-R.), School of Public Health, University of Washington; Allies in Healthier Systems for Health and Abundance in Youth (V.L., D.S.); School of Social Work, University of Washington (K.J.); BIPOC Apostrophe (F.A., M.D., A.J., Z.S.); King County Prosecuting Attorney's Office (L.A., B.M., R.S.); Community Passageways (M.B., D.D., K.P.); Harborview Medical Center, University of Washington (L.B., J.C., D.N., L.W.), Seattle; City of Tacoma (J.C., V.M., E.W.), Tacoma; Building Resilience and Violence Education (A.F., M.M.), YMCA of Greater Seattle, Seattle; Walk About Yakima, Dispute Resolution Center (E.G., A.O., C.T.), Yakima; and CHOOSE Freedom, CHOOSE 180 (A.B.L., E.W.), Seattle, Washington
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Baiden P, Park Y, LaBrenz CA, Childress S. Exposure to Neighborhood Violence and Gun Carrying Among Adolescents in the United States: Findings From A Population-Based Study. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:3396-3423. [PMID: 38357885 PMCID: PMC11281864 DOI: 10.1177/08862605241231616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Although studies have investigated and found an association between victimization and weapon carrying, few studies have examined the association between exposure to neighborhood violence (NV) and gun carrying among adolescents. The objective of this study was to examine the cross-sectional association between exposure to NV and gun carrying among adolescents. Data for this study came from the 2021 Youth Risk Behavior Survey. An analytic sample of 17,033 adolescents aged 14 to 18 years old (51.7% male) was analyzed using logistic regression with complementary log-log link function. The outcome variable investigated in this study is gun carrying and was measured as a binary variable, whereas the main explanatory variable examined in this study was exposure to NV, which was also measured as a binary variable. Of the 17,033 adolescents, 4.2% carried a weapon during the past year, and 18.7% were exposed to NV. Controlling for the effects of other factors, adolescents who were exposed to NV had more than double the odds of carrying a gun when compared to their counterparts not exposed to NV (adjusted odds ratio = 2.33, 95% Confidence Intervals [1.69, 3.23]). Other significant factors associated with gun carrying include being a male, non-Hispanic Black, being threatened or injured with a weapon, use of alcohol, cigarette smoking, and misuse of prescription opioids. High parental monitoring was protective against gun carrying. The findings of this study underscore the importance of developing age-appropriate intervention strategies to reduce gun carrying among adolescents. School counselors and other professionals working with adolescents in disadvantaged neighborhoods should actively engage parents in assessments and interventions.
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Ratnasekera A, Harris M, Caplan R, Getchell J, Laughery JT, Mason L, Bradley KM, Chen D, Jurkovitz C. Mental Health Care Resource Utilization of Victims of Interpersonal Violence in the Novel Coronavirus Era. J Surg Res 2024; 301:512-519. [PMID: 39042980 DOI: 10.1016/j.jss.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/29/2024] [Accepted: 06/18/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION Higher incidences of interpersonal violence were reported throughout the country during the coronavirus (COVID) time period. We aimed to compare health-care encounters and resource utilization related to interpersonal violence with mental health (MH) disorders before and during the pandemic within a year of the index visit for interpersonal violence. METHODS A retrospective analysis of the Delaware Healthcare Claims data of all patients aged ≥16 y who suffered interpersonal violence was performed. Patients were followed up for 1 y pre and post their index visit of interpersonal violence episode during the pre-COVID (March 2018 through December 2018) and the COVID (March 2020 through December 2020) period. Census tract information was used to assess social determinants of health. RESULTS There were 431 patients in the COVID period and 527 patients in the pre-COVID period with index violence claim encounters. African American patients were more likely to have a violence encounter during COVID (60.3% versus 47.2%, P < 0.001). Patients in the COVID period were more likely to live in a census tract with public assistance households (median 3.3% versus 2.2%, P = 0.005) and higher unemployment (7.5% versus 7.1%, P = 0.01). In the following year of index violence claim, the mean numbers of MH claim-days for COVID and pre-COVID patients were 19.5 (53.3) and 26.2 (66.2), (P = 0.51). The COVID group had fewer MH claim-days mostly in the second half of the year after the index encounter with an incidence rate ratio of 0.61, 95% CI (0.45-0.83). CONCLUSIONS Racial and socioeconomic disparities were amplified and MH resource utilization was lower during COVID. Further injury prevention efforts should be focused on MH in future pandemics or disasters.
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Affiliation(s)
- Asanthi Ratnasekera
- Division of Trauma and Surgical Critical Care, Department of Surgery, Associate Professor of Surgery, Drexel College of Medicine, Philadelphia PA, Christianacare Health System, Newark, Delaware
| | - Madison Harris
- Department of Surgery, Christianacare Health System, Newark, Delaware.
| | - Richard Caplan
- Institute for Research on Equity and Community Health (iREACH), ChristianaCare Health System, Wilmington, Delaware
| | - John Getchell
- Department of Surgery, Surgical Critical Care Research, Christianacare Health System, Newark, Delaware
| | - James T Laughery
- Institute for Research on Equity and Community Health (iREACH), ChristianaCare Health System, Wilmington, Delaware
| | - Leonard Mason
- Department of Surgery, Division of Trauma and Surgical Critical Care, Christianacare Health System, Newark Delaware
| | - Kevin M Bradley
- Department of Surgery, Division of Trauma and Surgical Critical Care, Christianacare Health System, Newark Delaware
| | - David Chen
- Institute for Research on Equity and Community Health (iREACH), ChristianaCare Health System, Wilmington, Delaware
| | - Claudine Jurkovitz
- Institute for Research on Equity and Community Health (iREACH), ChristianaCare Health System, Wilmington, Delaware
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Rencken CA, Schleimer JP, Miller M, Swanson SA, Rowhani-Rahbar A. Reporting and Description of Research Methodology in Studies Estimating Effects of Firearm Policies. Epidemiology 2024; 35:458-468. [PMID: 38597728 DOI: 10.1097/ede.0000000000001741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Evidence about which firearm policies work, to what extent, and for whom is hotly debated, perhaps partly because variation in research methodology has produced mixed and inconclusive effect estimates. We conducted a scoping review of firearm policy research in the health sciences in the United States, focusing on methodological considerations for causal inference. METHODS We identified original, empirical articles indexed in PubMed from 1 January 2000 to 1 September 2021 that examined any of 18 prespecified firearm policies. We extracted key study components, including policy type(s) examined, policy operationalization, outcomes, study setting and population, study approach and design, causal language, and whether and how authors acknowledged potential sources of bias. RESULTS We screened 7733 articles and included 124. A plurality of studies used a legislative score as their primary exposure (n = 39; 32%) and did not examine change in policies over time (n = 47; 38%). Most examined firearm homicide (n = 51; 41%) or firearm suicide (n = 40; 32%) as outcomes. One-third adjusted for other firearm policies (n = 41; 33%). Three studies (2%) explicitly mentioned that their goal was to estimate causal effects, but over half used language implying causality (n = 72; 58%). Most acknowledged causal identification assumptions of temporality (n = 91; 73%) and exchangeability (n = 111; 90%); other assumptions were less often acknowledged. One-third of studies included bias analyses (n = 42; 34%). CONCLUSIONS We identified a range of methodologic approaches in firearm policy research in the health sciences. Acknowledging the imitations of data availability and quality, we identify opportunities to improve causal inferences about and reporting on the effects of firearm policies on population health.
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Affiliation(s)
- Camerin A Rencken
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
| | - Julia P Schleimer
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
| | - Matthew Miller
- Department of Health Sciences, Northeastern University Bouvé College of Health Sciences, Boston, MA
| | - Sonja A Swanson
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Ali Rowhani-Rahbar
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
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Society for Maternal-Fetal Medicine Position Statement: Gun violence and pregnancy. Am J Obstet Gynecol 2024; 231:B9-B11. [PMID: 38599477 DOI: 10.1016/j.ajog.2024.04.007] [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] [Indexed: 04/12/2024]
Abstract
Position: The Society for Maternal-Fetal Medicine acknowledges gun violence as a public health crisis in the United States, with a substantial impact on pregnant and postpartum people. We recognize the urgent need for a robust, equitable, data-driven approach to mitigate the impact of access to firearms and accompanying violence on pregnant and postpartum individuals and communities. As such, the Society for Maternal-Fetal Medicine endorses the following policy principles.
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Smith RN, Sarumi P, Castater C. Addressing social determinants of health may improve emergency department utilization after firearm violence. Trauma Surg Acute Care Open 2024; 9:e001509. [PMID: 38957621 PMCID: PMC11217995 DOI: 10.1136/tsaco-2024-001509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Affiliation(s)
- Randi N Smith
- Emory University School of Medicine, Atlanta, GA, USA
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Bruns A, Aubel AJ, Zhang X, Buggs SA, Kravitz-Wirtz N. Community exposure to gun homicide and adolescents' educational aspirations. J Adolesc 2024; 96:1137-1152. [PMID: 38584575 DOI: 10.1002/jad.12324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/13/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
INTRODUCTION Witnessing violence and violent victimization have detrimental effects on adolescents' emotional functioning and ability to envision and plan for their futures. However, research is limited on the impact of violence that occurs in adolescents' communities-whether or not it was witnessed or experienced firsthand. This paper investigated the associations between community exposure to gun homicide and adolescents' high school and college graduation aspirations. METHODS We analyzed data from the Future of Families and Child Wellbeing Study (N = 3031), a cohort study of children born 1998-2000 in 20 large US cities, merged with incident-level data on deadly gun violence from the Gun Violence Archive (2014-2017). Outcomes were reported by adolescents (girls and boys) during wave 6 (2014-2017) of the study, conducted when the children were 15 years of age. We employed ordinary least squares regression, ordered logistic regression, and multilevel stratification to examine the average and heterogeneous impacts of community exposure to gun homicide on adolescents' educational aspirations. RESULTS Community exposure to gun homicide was associated with reduced high school graduation aspirations, particularly among adolescents with the lowest risk of exposure to gun homicide. Gun homicide exposure was also associated with increased college graduation aspirations; this association was concentrated among adolescents with moderate-high risk of exposure. CONCLUSIONS Given the importance of education for job opportunities and the better health that accompanies education and occupational attainment, preventing early exposure to gun violence and providing institutional supports to help adolescents facing adversity realize their goals is essential to their long-term health and success.
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Affiliation(s)
- Angela Bruns
- Department of Sociology & Criminology, Gonzaga University, Spokane, Washington, USA
| | - Amanda J Aubel
- Department of Emergency Medicine, Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Xiaoya Zhang
- Department of Family Youth and Community Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, Florida, USA
| | - Shani A Buggs
- Department of Emergency Medicine, Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, Violence Prevention Research Program, University of California Davis School of Medicine, Sacramento, California, USA
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Price JH, Khubchandani J. Fatal Firearm Violence Among American Indians and Alaska Natives. J Community Health 2024; 49:492-498. [PMID: 38127297 DOI: 10.1007/s10900-023-01300-x] [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] [Accepted: 10/20/2023] [Indexed: 12/23/2023]
Abstract
There is a dearth of population-based studies regarding firearm-related deaths and years of potential life lost among American Indians and Alaska Natives (AI/AN). Using the Centers for Disease Control and Prevention's (CDC) We Based Injury Statistics Query and Reporting System (WISQARS) data for the three most recent years (2018-2020), we analyzed the demographic characteristics of AI/ANs who succumbed to firearm violence. AI/ANs averaged almost 500 firearm-related deaths per year. The majority of these deaths were observed among individuals 20-39 years of age (53%), males (84.4%), and in the West (55.3%). A plurality of these firearm-related deaths were suicides (48.9%) followed by homicides (43.5%). During the 3-year study period, the age-adjusted firearm death rate increased almost 5 times the growth of the AI/AN population. Also, a staggering 67,050 years of potential life were lost before the age of 80 years (YPLL80) during this period. Firearm suicides were responsible for the largest proportion of YPLL80s (48.5%). Traditional legal interventions [e.g., child access prevention (CAP) laws and extreme risk protection orders (ERPO)], if expanded to more states could potentially help reduce AI/AN firearm mortality. None of the 10 states with the highest firearm mortality of AI/AN have ERPOs and 8 of the 10 do not have CAP laws. Also, a renewed focus on cultural continuity and indigenous protective factors is essential to ameliorate the level of firearm violence in AI/ANs.
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Barcelona V, Condon EM, Jacoby SF. Leveraging biosocial methods to examine and address structural determinants of health and promote health equity. Nurs Outlook 2024; 72:102195. [PMID: 38810533 DOI: 10.1016/j.outlook.2024.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/26/2024] [Accepted: 04/28/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Biosocial approaches in nursing research have largely focused on the ways that social determinants of health influence individual-level outcomes, including symptom management, family and social support, and educational interventions. PURPOSE Theoretical, methodological, and practical strategies are needed to expand current biosocial methods for nursing science and focus on upstream, structural determinants of health and the policies that underlie health inequities. METHODS This paper summarizes presentations given at the 2023 Council for the Advancement of Nursing Science Advanced Methods Conference, Biosocial Methods to Advance Health Equity, in a panel titled "Individual, community, systems and policy related to biosocial methods." DISCUSSION Nurses are uniquely positioned to examine upstream, structural determinants of health by leveraging expertise in biosocial methods, collaborating with interdisciplinary researchers and community members, and advocating for policy change. By conducting theory-grounded biosocial research, nurse researchers can significantly advance scientific knowledge and promote health equity for individuals and communities. CONCLUSION Nurse scientists are conducting research using biosocial methods and provide recommendations for expansion of this approach in the field.
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Affiliation(s)
| | - Eileen M Condon
- University of Connecticut School of Nursing, Storrs, CT; Department of Pediatrics, University of Connecticut School of Medicine, Storrs, CT
| | - Sara F Jacoby
- Department of Family and Community, University of Pennsylvania School of Nursing, Philadelphia, PA
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Rakshe S, Valek R, Teichman R, Freeman K, DeFrancesco S, Carlson KF. Five Years of Extreme Risk Protection Orders in Oregon: A Descriptive Analysis. Psychol Rep 2024:332941241248599. [PMID: 38676327 DOI: 10.1177/00332941241248599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Extreme Risk Protection Order (ERPO) laws have received increasing attention as a tool to prevent firearm suicide and homicide, including mass shootings. However, important gaps remain in our understanding of ERPO usage and implementation. Using the Oregon Judicial Case Information Network database, we abstracted data from all ERPO petitions filed in Oregon from 2018 to 2022, the first five years after the law took effect (N = 649). ERPO petitions were filed in 29 of 36 counties (81%, range 0-105 per county, median 11), against respondents 17-96 years of age (median: 42). Of ERPOs filed, 78% were initially granted. While only 22% of respondents in initially-granted ERPOs requested a hearing, when a hearing was held, nearly half (44%) of ERPOs were dismissed. The majority of ERPO petitions were motivated by threats of harm to respondents and others (n = 327, 50%), followed by threats of harm to others-only (n = 220, 34%) or respondents-only (n = 81, 12%). During the 5-year period, 72 (11%) ERPO petitions cited threats of mass violence as a motivating factor, including 24 (4%) petitions citing threats to schools or college campuses. The majority of ERPOs were filed by law enforcement officers (60%), and these petitions were significantly more often granted than those filed by family/household members (96% vs. 67%, p < .0001). We also found evidence of important gaps in documentation, including of respondent race (unavailable for 191 respondents, 29%) and of weapon removal or disposition after the ERPO was granted (unavailable in 350 cases, 69%). This study of long-term patterns of ERPO petitions highlights trends in usage and suggests areas where improvement may be possible, with implications for other states that have adopted or are considering similar ERPO laws.
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Affiliation(s)
- Shauna Rakshe
- Oregon Health & Science University Knight Cancer Institute, Portland, OR, USA
| | - Rebecca Valek
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Rebecca Teichman
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathryn Freeman
- University of New Mexico Department of Emergency Medicine, Albuquerque, NM, USA
| | - Susan DeFrancesco
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Kathleen F Carlson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA
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Randolph SD, Gonzalez-Guarda RM, Pearson J. Addressing Systemic Racism and Racialized Violence to Reduce Firearm Injury and Mortality Inequities. JAMA HEALTH FORUM 2024; 5:e241044. [PMID: 38573649 DOI: 10.1001/jamahealthforum.2024.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
This JAMA Forum discusses systemic racism and racialized violence, promising approaches to address inequities in firearm violence, and ways to treat the trauma of gun violence.
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Affiliation(s)
| | | | - Jay Pearson
- Sanford School, Duke University, Durham, North Carolina
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Grimsley EA, Torikashvili JV, Janjua HM, Read MD, Kuo PC, Diaz JJ. Transition to Permitless Open Carry and Association with Firearm-Related Suicide. J Am Coll Surg 2024; 238:681-688. [PMID: 38465793 DOI: 10.1097/xcs.0000000000000959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
BACKGROUND Firearm-related death rates continue to rise in the US. As some states enact more permissive firearm laws, we sought to assess the relationship between a change to permitless open carry (PLOC) and subsequent firearm-related death rates, a currently understudied topic. STUDY DESIGN Using state-level data from 2013 to 2021, we performed a linear panel analysis using a state fixed-effects model. We examined total firearm-related death, suicide, and homicide rates separately. If a significant association between OC law and death rate was found, we then performed a difference-in-difference (DID) analysis to assess for a causal relationship between changing to PLOC and increased death rate. For significant DID results, we performed confirmatory DID separating firearm and nonfirearm death rates. RESULTS Nineteen states maintained a no OC or permit-required law, whereas 5 changed to permitless and 26 had a PLOC before 2013. The fixed-effects model indicated more permissive OC law that was associated with increased total firearm-related deaths and suicides. In DID, changing law to PLOC had a significant average treatment effect on the treated of 1.57 (95% CI 1.05 to 2.09) for total suicide rate but no significant average treatment effect for the total firearm-related death rate. Confirmatory DID results found a significant average treatment effect on the treated of 1.18 (95% CI 0.90 to 1.46) for firearm suicide rate. CONCLUSIONS OC law is associated with total firearm-related death and suicide rates. Based on our DID results, changing to PLOC is indeed strongly associated with increased suicides by firearm.
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Affiliation(s)
- Emily A Grimsley
- From the Department of Surgery, University of South Florida Morsani College of Medicine, Tampa, FL
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Fremery A, Beguinot E, Franchi A, Douchet M, Tertre V, Hamiche K, Adenis A, Pujo JM, Kallel H. Epidemiologic analysis and mortality outcome of firearm injuries in French Guiana (2016-2019). Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02499-7. [PMID: 38512419 DOI: 10.1007/s00068-024-02499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND French Guiana (FG) is a French territory located in South America with the highest rate of armed assaults. FG presents a poorly developed road system and a young and precarious population that makes the geographical and socio-demographic characteristics specific. No data concerning the firearm injury management are available in this country. Studying thesis trauma could permit to improve the management of victims. The objective of this study is to investigate the epidemiology of firearm injuries in FG, to define characteristics of the victims, and to assess factors associated with death. These identified factors could enable target primary prevention and intensification of medical management. METHODS From January 2016 to December 2019, we conducted a retrospective study at the Cayenne General Hospital (CGH), including all patients admitted for firearm injuries in the emergency department, the medical emergency and resuscitation service, and the forensic service. A bivariate analysis was performed to assess relevant clinical data that were entered into a logistic regression model to assess factors associated with death. RESULTS A total of 871 files were analyzed concerning 340 patients included after cross-checking. Victims were mainly males (90%) and young (30 ± 11 years old). The injury occurred mainly at night (60%), in a context of assaults (83%) and with long-barreled guns (82%). Among the 290 patients managed at the CGH, 60% were hospitalized including 12% that were in the intensive care unit, 41% that required surgical treatment, and 7% that died in hospital. The overall average length of stay was 10 ± 18 days. Overall mortality (n = 71, 21%) is statistically associated with male gender (p = 0.007) and suicide context (p < 0.001). In multivariate analysis, the sites of wounds (head and neck, thorax; p < 0.001) as well as induced organ injuries (neurological, respiratory, and vascular; p < 0.005) were independent factors associated to mortality. CONCLUSIONS This work underlines the high incidence of ballistic trauma in FG. This mainly involves a young and male population linked to the use of long arms and assaults. Despite the geographical difficulties of the territory and the technical platform deficits (no neurosurgery, no cardiothoracic surgery, no interventional radiology), the mortality is comparable to other studies, but remains more than twice as high as in mainland France. Finally, despite a change in legislation restricting access to firearms, our results show that gunshot firearm injuries remain a major public health concern requiring greater political actions.
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Affiliation(s)
- Alexis Fremery
- Emergency Department, Cayenne General Hospital, French Guiana, France.
- French Guiana University, French Guiana, France.
| | - Elliott Beguinot
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Angélique Franchi
- Forensic Medical Unit, Cayenne General Hospital, French Guiana, France
| | - Mathilde Douchet
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Victor Tertre
- Emergency Department, Cayenne General Hospital, French Guiana, France
| | - Karim Hamiche
- Forensic Medical Unit, Cayenne General Hospital, French Guiana, France
| | - Antoine Adenis
- French Guiana University, French Guiana, France
- CIC INSERM1424, Cayenne General Hospital, French Guiana, France
| | - Jean Marc Pujo
- Emergency Department, Cayenne General Hospital, French Guiana, France
- French Guiana University, French Guiana, France
| | - Hatem Kallel
- French Guiana University, French Guiana, France
- Intensive Care Unit, Cayenne General Hospital, French Guiana, France
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15
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Semenza DC, Hamilton JL, Testa A, Jackson DB. Individual and cumulative firearm violence exposure: Implications for sleep among Black and American Indian/Alaska Native adults. Ann Epidemiol 2024; 91:18-22. [PMID: 38244953 DOI: 10.1016/j.annepidem.2024.01.006] [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: 10/13/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE We investigated the relationship between various forms of firearm violence exposure and sleep problems among nationally representative samples of Black (N = 3015) and American Indian and Alaska Native (AI/AN) (N = 527) adults, focusing on difficulties falling asleep, staying asleep, and waking too early. Survey data were collected in April and May 2023. METHODS We employed negative binomial regression models to analyze the associations between the different types of firearm violence exposure and sleep problems. We further examined associations between cumulative firearm violence exposure and sleep outcomes. RESULTS A substantial proportion of Black (59%) and AI/AN (56%) adults reported experiencing some form of firearm violence exposure. Being threatened with a firearm emerged as a consistent factor associated with sleep problems for both racial groups. Witnessing or hearing about shootings was linked to sleep problems in the Black sample, while cumulative firearm violence exposure was associated with all sleep problems in both groups. CONCLUSIONS Individual and cumulative firearm violence exposure is associated with increased sleep problems among Black and AI/AN adults.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA; Department of Urban-Global Public Health, Rutgers University, Piscataway, NJ, USA; New Jersey Gun Violence Research Center, Rutgers University, Piscataway, NJ, USA.
| | | | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Maryland, MD, USA
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16
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Wilf S, Reed T, Millet V, Ortiz SM, Wray-Lake L. "We been dying, and you got me on a call helping you stay alive": Black and Latinx youth organizers' experiences of racism in gun violence prevention organizations. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:4-20. [PMID: 37795768 DOI: 10.1111/jora.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/27/2023] [Accepted: 09/08/2023] [Indexed: 10/06/2023]
Abstract
This study explored Black and Latinx youth organizers' experiences of racism within national gun violence prevention organizing spaces. Interview data were analyzed from 17 Black and/or Latinx youth (Mage = 20.17, 47% women) across the United States who organized against gun violence. The findings identified three forms of racism that Black and Latinx organizers experienced in national organizations: (1) being tokenized for their racial identities and experiences without having real decision making power; (2) feeling a burden to educate their white peers about the structural causes of gun violence and how to improve organizing spaces for other youth of color; and (3) being silenced in their racially conscious organizing efforts to address the structural causes of gun violence in their communities. This research highlights how Black and Latinx youth gun violence prevention organizers contend both with structural racism in their everyday lives and racism in organizing spaces.
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Affiliation(s)
- Sara Wilf
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Taylor Reed
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Victoria Millet
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
| | - Stephanie M Ortiz
- Department of Sociology, University of Massachusetts at Lowell, Lowell, Massachusetts, USA
| | - Laura Wray-Lake
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California, USA
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Semenza DC, Daruwala S, Brooks Stephens JR, Anestis MD. Gun Violence Exposure and Suicide Among Black Adults. JAMA Netw Open 2024; 7:e2354953. [PMID: 38319659 PMCID: PMC10848043 DOI: 10.1001/jamanetworkopen.2023.54953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024] Open
Abstract
Importance Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. Objective To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. Design, Setting, and Participants This cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023. Exposures Ever being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting. Main Outcomes and Measures Outcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors. Results The study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]). Conclusions and Relevance In this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.
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Affiliation(s)
- Daniel C. Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, New Jersey
- Department of Urban-Global Public Health, Rutgers University, Piscataway, New Jersey
- New Jersey Gun Violence Research Center, Rutgers University, Piscataway
| | - Samantha Daruwala
- VA Center of Excellence for Suicide Prevention, VA Finger Lakes Health Care System, Canandaigua, New York
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus
| | | | - Michael D. Anestis
- Department of Urban-Global Public Health, Rutgers University, Piscataway, New Jersey
- New Jersey Gun Violence Research Center, Rutgers University, Piscataway
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18
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Paladugu A, Shipley J, Grigorian A, Qazi A, Kong A, Kuza C, Donnelly M, Nahmias J. Trends in Legal Firearm Transactions: A Possible Protective Role of Gun Law Strength. Am Surg 2024:31348241230090. [PMID: 38266390 DOI: 10.1177/00031348241230090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
INTRODUCTION The United States (US) holds the highest personal firearm ownership among industrialized nations, with implications for firearm-related deaths tied to increased per capita gun ownership and varying gun laws. This study examines the influence of gun law strength on legal firearm transactions, positing a correlation between stronger laws and reduced transactions. The analysis, focused on the stress-laden COVID-19 pandemic, evaluates handgun, long gun, and multiple gun transactions in 2020 and 2021 compared to 2018-2019. METHODS The Giffords Gun Law scorecard categorized states into the top 25 "strong" and bottom 25 "weak" gun law groups. Multivariate linear regressions assessed the association between strong gun law states and monthly National Instant Criminal Background Check System (NICS) data from 2018 to 2021. The study queried NICS for handgun, long gun, and multiple gun transactions, comparing median monthly transactions in 2018 and 2019 to 2020 and 2018-2020 to 2021. RESULTS When evaluating gun law strength through multivariate linear regression models, stronger gun law states had fewer monthly NICS transactions for handguns, long guns, and multiple guns in 2020 and 2021 versus all comparison years (all P < .05). However, from 2018-2019 to 2020 and 2018-2020 to 2021, median monthly NICS transactions per 100,000 people for all gun types increased (all P < .05). CONCLUSION Stricter gun laws correlated with decreased firearm transactions in stronger law states, yet handgun, long gun, and multiple gun transactions increased during the pandemic years of 2020 and 2021. Therefore, strengthening firearm legislation may be protective against the proliferation of firearms, which warrants further research.
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Affiliation(s)
- Anushka Paladugu
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Jonathan Shipley
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Areg Grigorian
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Alliya Qazi
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Allen Kong
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Catherine Kuza
- Department of Anesthesiology, University of Southern California, Los Angeles, CA, USA
| | - Megan Donnelly
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Jeffry Nahmias
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
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Wilson RF, Xu L, Betz CJ, Sheats KJ, Blair JM, Yue X, Nguyen B, Fowler KA. Firearm Homicides of US Children Precipitated by Intimate Partner Violence: 2003-2020. Pediatrics 2023; 152:e2023063004. [PMID: 37927118 DOI: 10.1542/peds.2023-063004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 11/07/2023] Open
Abstract
OBJECTIVES Examine characteristics associated with firearm homicides of children aged 0-17 years precipitated by intimate partner violence (IPV). METHODS Data were from the Center for Disease Control and Prevention's National Violent Death Reporting System (49 states, District of Columbia, Puerto Rico; 2003-2020). Logistic regression was used to examine associations between various characteristics and IPV among child firearm homicides. RESULTS From 2003-2020, a total of 11 594 child homicides were captured in the National Violent Death Reporting System, of which 49.3% (n = 5716) were firearm homicides; 12.0% (n = 686) of child firearm homicides were IPV-related. Among IPV-related child firearm homicides, 86.0% (n = 590) were child corollary victims (ie, children whose death was connected to IPV between others); 14.0% (n = 96) were teens killed by a current or former dating partner. Child firearm homicides had greater odds of involving IPV when precipitated by conflict, crises, and cooccurring with the perpetrator's suicide compared with those without these characteristics. Over half of IPV-related firearm homicides of child corollary victims included homicide of the adult intimate partner, of which 94.1% were the child victim's mother. Child firearm homicides perpetrated by mothers' male companions (adjusted odds ratio, 6.9; 95% confidence interval, 3.9-12.1) and children's fathers (adjusted odds ratio, 4.5; 95% confidence interval, 3.0-6.8) had greater odds of involving IPV compared with those perpetrated by mothers. CONCLUSIONS Multiple factors were associated with greater odds of child firearm homicides being IPV-related. Strategies promoting healthy intimate partner relationships starting at a young age; assessment of danger to children in IPV situations; strengthening economic supports for families; creating safe, stable, and nurturing relationships and environments for children; and addressing social and structural inequities are important for preventing firearm homicides of children, including those involving IPV.
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Affiliation(s)
| | - Likang Xu
- Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Xin Yue
- Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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20
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Ghio M, Simpson JT, Ali A, Fleckman JM, Theall KP, Constans JI, Tatum D, McGrew PR, Duchesne J, Taghavi S. Association Between Markers of Structural Racism and Mass Shooting Events in Major US Cities. JAMA Surg 2023; 158:1032-1039. [PMID: 37466952 PMCID: PMC10357360 DOI: 10.1001/jamasurg.2023.2846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/22/2023] [Indexed: 07/20/2023]
Abstract
Importance The root cause of mass shooting events (MSEs) and the populations most affected by them are poorly understood. Objective To examine the association between structural racism and mass shootings in major metropolitan cities in the United States. Design, Setting, and Participants This cross-sectional study of MSEs in the 51 largest metropolitan statistical areas (MSAs) in the United States analyzes population-based data from 2015 to 2019 and the Gun Violence Archive. The data analysis was performed from February 2021 to January 2022. Exposure Shooting event where 4 or more people not including the shooter were injured or killed. Main Outcome and Measures MSE incidence and markers of structural racism from demographic data, Gini income coefficient, Black-White segregation index, and violent crime rate. Results There were 865 MSEs across all 51 MSAs from 2015 to 2019 with a total of 3968 injuries and 828 fatalities. Higher segregation index (ρ = 0.46, P = .003) was associated with MSE incidence (adjusted per 100 000 population) using Spearman ρ analysis. Percentage of the MSA population comprising Black individuals (ρ = 0.76, P < .001), children in a single-parent household (ρ = 0.44, P < .001), and violent crime rate (ρ = 0.34, P = .03) were other variables associated with MSEs. On linear regression, structural racism, as measured by percentage of the MSA population comprising Black individuals, was associated with MSEs (β = 0.10; 95% CI, 0.05 to 0.14; P < .001). Segregation index (β = 0.02, 95% CI, -0.03 to 0.06; P = .53), children in a single-parent household (β = -0.04, 95% CI, -0.11 to 0.04; P = .28), and Gini income coefficient (β = -1.02; 95% CI, -11.97 to 9.93; P = .93) were not associated with MSEs on linear regression. Conclusions and Relevance This study found that major US cities with higher populations of Black individuals are more likely to be affected by MSEs, suggesting that structural racism may have a role in their incidence. Public health initiatives aiming to prevent MSEs should target factors associated with structural racism to address gun violence.
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Affiliation(s)
- Michael Ghio
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - John Tyler Simpson
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Ayman Ali
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Julia M. Fleckman
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Katherine P. Theall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Joseph I. Constans
- Tulane University School of Science & Engineering, New Orleans, Louisiana
| | - Danielle Tatum
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Patrick R. McGrew
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
- University Medical Center, New Orleans, Louisiana
| | - Sharven Taghavi
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
- University Medical Center, New Orleans, Louisiana
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Golisch KB, Tatebe LC. Supporting Victims of Firearm Violence and Structural Racism Beyond the Hospital Walls and Journal Pages. JAMA Surg 2023; 158:1040. [PMID: 37466976 DOI: 10.1001/jamasurg.2023.2853] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Kimberly B Golisch
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Leah C Tatebe
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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22
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Clarke AT, Grassetti SN, Brumley L, Ross KY, Erdly C, Richter S, Brown ER, Pole M. Integrating trauma-informed services in out-of-school time programs to mitigate the impact of community gun violence on youth mental health. J Prev Interv Community 2023; 51:332-351. [PMID: 38349066 DOI: 10.1080/10852352.2024.2313382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Community gun violence disproportionately impacts youth in low-income urban neighborhoods. Integrating trauma-informed mental health care in community-based out-of-school time (OST) programs is an innovative method of service delivery for these youth. This article provides justification for integrating evidence-based, trauma-informed services in OST programs within communities characterized by high rates of violent crime to minimize the impact of violence exposure on youth mental health. We describe the initial feasibility of a model program, the Violence Intervention and Prevention (VIP) Initiative, implemented in a small city in southeastern Pennsylvania. Within the first six months of the VIP Initiative, 95 community residents (90% under age 18; 51% Hispanic) received intervention services, primarily through single-session and short-term weekly group intervention in OST programs, and 80% of OST youth development staff participated in at least one trauma-informed professional development training. Recommendations to enhance and expand the delivery of trauma-informed services in the novel setting of OST programs are provided.
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Affiliation(s)
- Angela T Clarke
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Stevie N Grassetti
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Lauren Brumley
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Kyle Y Ross
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Courtney Erdly
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Sarah Richter
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Emily R Brown
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
| | - Michele Pole
- Department of Psychology, West Chester University, West Chester, Pennsylvania, USA
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23
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Semenza DC, Baker N, Ziminski D. Firearm violence exposure and health in 2 national samples of Black and American Indian/Alaska Native adults. HEALTH AFFAIRS SCHOLAR 2023; 1:qxad036. [PMID: 38756674 PMCID: PMC10986215 DOI: 10.1093/haschl/qxad036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/07/2023] [Accepted: 08/21/2023] [Indexed: 05/18/2024]
Abstract
Exposure to firearm violence is widespread and disproportionately experienced by communities of color, with implications for broad health disparities. Survey data were collected from 2 nationally representative samples of Black (n = 3015) and American Indian/Alaska Native (AI/AN) (n = 527) adults in the United States in April and May 2023. The exposure measures were 4 types of firearm violence exposure. The outcome measures were self-rated health, number of poor physical health days, and number of poor mental health days. Regression results demonstrate that being threatened with a firearm and hearing about or witnessing a shooting were associated with poorer self-rated, mental, and physical health across both samples. Cumulative exposure to firearm violence was particularly associated with increasing harms to health for all outcomes. In general, individual and cumulative firearm violence exposures are linked to poorer health among Black and AI/AN adults in the United States. Significant enhancements and long-term investment are needed for firearm violence prevention to yield improvements to population health, particularly among communities burdened with high levels of exposure to firearm violence.
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Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ 08102, United States
- Department of Urban-Global Public Health, Rutgers University, Piscataway, NJ 08854, United States
- New Jersey Gun Violence Research Center, Rutgers University, Piscataway, NJ 08854, United States
| | - Nazsa Baker
- New Jersey Gun Violence Research Center, Rutgers University, Piscataway, NJ 08854, United States
| | - Devon Ziminski
- New Jersey Gun Violence Research Center, Rutgers University, Piscataway, NJ 08854, United States
- School of Social Work, Rutgers University, New Brunswick, NJ 08901, United States
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24
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Wang K, Ortiz DV, Colón L, Sun F, Falcón L. The moderating role of everyday discrimination on the association between post-traumatic stress and loneliness among older Puerto Ricans. Aging Ment Health 2023; 27:1388-1395. [PMID: 36444946 PMCID: PMC10225478 DOI: 10.1080/13607863.2022.2149695] [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: 06/16/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES This study examines the relationship between post-traumatic stress and loneliness and whether this relationship varies by perceived everyday discrimination among older Puerto Ricans. METHODS A total of 304 Puerto Ricans aged 60 and above from Wave 3 of the Boston Puerto Rican Health Study were included. Ordinary least squares regression examined the association between post-traumatic stress, perceived everyday discrimination, and loneliness. RESULTS Post-traumatic stress was significantly associated with a higher level of loneliness (β = 0.282; p < 0.001; 95% CI: 0.142, 0.423). The interaction effect between post-traumatic stress and perceived everyday discrimination on loneliness was statistically significant (β = 0.083; p < 0.05; 95% CI: 0.062, 0.230). More specifically, the positive association between post-traumatic stress and loneliness becomes more robust with the increase in perceived everyday discrimination. CONCLUSION Given an increase in population size on the U.S. mainland and migration from Puerto Rico due to natural disasters and declining economic conditions, it is essential to better understand the effect of perceived discrimination against older Puerto Ricans on the mainland United States as well as those who immigrated and stayed through older age. Outreach strategies and interventions that address perceived discrimination can help mitigate loneliness among older Puerto Ricans who experienced trauma.
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Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Daniel Vélez Ortiz
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Lisa Colón
- Department of Human Development, Washington State University
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Luis Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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25
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Aubel AJ, Bruns A, Zhang X, Buggs S, Kravitz-Wirtz N. Neighborhood collective efficacy and environmental exposure to firearm homicide among a national sample of adolescents. Inj Epidemiol 2023; 10:24. [PMID: 37296449 DOI: 10.1186/s40621-023-00435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Living near an incident of firearm violence can negatively impact youth, regardless of whether the violence is experienced firsthand. Inequities in household and neighborhood resources may affect the prevalence and consequences of exposure across racial/ethnic groups. FINDINGS Using data from the Future of Families and Child Wellbeing Study and the Gun Violence Archive, we estimate that approximately 1 in 4 adolescents in large US cities lived within 800 m (0.5 miles) of a past-year firearm homicide during 2014-17. Exposure risk decreased as household income and neighborhood collective efficacy increased, though stark racial/ethnic inequities remained. Across racial/ethnic groups, adolescents in poor households in moderate or high collective efficacy neighborhoods had a similar risk of past-year firearm homicide exposure as middle-to-high income adolescents in low collective efficacy neighborhoods. CONCLUSIONS Empowering communities to build and leverage social ties may be as impactful for reducing firearm violence exposure as income supports. Comprehensive violence prevention efforts should include systems-level strategies that jointly strengthen family and community resources.
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Affiliation(s)
- Amanda J Aubel
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, 2315 Stockton Blvd, Sacramento, CA, 95817, USA.
| | - Angela Bruns
- Department of Sociology and Criminology, Gonzaga University, 502 E Boone Ave, Spokane, WA, 99258, USA
| | - Xiaoya Zhang
- Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, University of Florida, 1604 McCarty Drive, PO Box 110310, Gainesville, FL, 32611, USA
| | - Shani Buggs
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, 2315 Stockton Blvd, Sacramento, CA, 95817, USA
| | - Nicole Kravitz-Wirtz
- Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, 2315 Stockton Blvd, Sacramento, CA, 95817, USA
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Buggs SA, Lund JJ, Kravitz-Wirtz N. Voicing narratives of structural violence in interpersonal firearm violence research and prevention in the United States. Front Public Health 2023; 11:1143278. [PMID: 37333568 PMCID: PMC10272797 DOI: 10.3389/fpubh.2023.1143278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Violence is defined as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation." Encompassed in this definition are multiple, interrelated forms of violence, including interpersonal firearm death and injury, but also the systems, policies, and practices enacted by those with power to advantage some groups while depriving others of meaningful opportunities for meeting their basic needs-known as "structural violence". Yet dominant violence prevention narratives too often ignore or deemphasize the deeply intertwined threads of structural violence with other forms of violence, leading to policies and practices that are frequently insufficient, and often harmful, for reducing interpersonal firearm violence and building community safety, particularly in minoritized and structurally marginalized communities. We highlight ways in which limited scrutiny of structural violence, the omission of its defining characteristics-power and deprivation-from functional characterizations and frameworks of interpersonal firearm violence, and the inadequate distribution of power and resources to those most impacted by violence to self-determine narratives of and solutions to interpersonal firearm violence grossly impacts how interpersonal firearm violence is collectively conceived, discussed, and addressed. Expanding dominant narratives of interpersonal firearm violence, guided by the wisdom and determination of those most impacted, such that the goal of prevention and intervention efforts is not merely the absence of violence but rather the creation of a community safety and health ecosystem is essential to meet this critical moment in firearm violence research and prevention.
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Ellyson AM, Martin KD, Bowen D, Gallagher A, Rivara FP. Implicit Racial and Gender Bias About Handguns: A New Implicit Association Test. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5190-5210. [PMID: 36176265 DOI: 10.1177/08862605221123300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
This study measured implicit and explicit racial bias about women and handguns and addressed important perceptions and stereotypes about gun competence and victimization that vary based on race and gender. We administered a national survey to 1,000 US adults using a new Race-Women-Handguns Implicit Association Test (IAT). Survey weighting was used to generate nationally representative estimates on the prevalence of implicit racial bias about women with handguns. The majority of participants (62.5%) associated Black women with handguns and White women with smartphones (weighted-mean IAT = 0.252; 95% CI [0.227, 0.276]) reflecting an anti-Black bias among US adults that is stereotype consistent associating Black women with handguns and White women with smartphones. The proportion that indicated Black and White women were competent with handguns was low (21.6% and 22.4%, respectively), and the proportion of US adults who indicated Black women are more likely to experience intimate partner violence (range: 19.4%-22.9%) and sexual harassment/assault (range: 11.4%-20.4%) was low compared to the prevalence of both forms of violence US among Black women that may impact the decision to possess a handgun. These findings suggest there is an anti-Black implicit bias about women with handguns (associating Black women with handguns) among US adults and support the need for further research measuring racism in systems and structures that intersect with gun possession.
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Affiliation(s)
- Alice M Ellyson
- University of Washington, Seattle, USA
- Seattle Children's Research Institute, WA, USA
| | | | - Deirdre Bowen
- University of Washington, Seattle, USA
- Seattle University, WA, USA
| | | | - Frederick P Rivara
- University of Washington, Seattle, USA
- Seattle Children's Research Institute, WA, USA
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Heterogeneous effects of spatially proximate firearm homicide exposure on anxiety and depression symptoms among U.S. youth. Prev Med 2022; 165:107224. [PMID: 36029922 PMCID: PMC10388845 DOI: 10.1016/j.ypmed.2022.107224] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/18/2022] [Accepted: 08/21/2022] [Indexed: 11/21/2022]
Abstract
The burden of firearm homicide in the United States is not evenly distributed across the population; rather, it disproportionately affects youth in disadvantaged and marginalized communities. Research is limited relevant to the impacts of exposure to firearm violence that occurs near where youth live or attend school - spatially proximate firearm violence - on youths' mental health and whether those impacts vary by characteristics that shape youths' risk for experiencing that exposure in the first place. Using a dataset linking the Fragile Families and Child Wellbeing Study with the Gun Violence Archive (N = 3086), we employed propensity score matching and multilevel stratification to examine average and heterogeneous associations between spatially proximate firearm homicide exposure and anxiety and depression among all youth and then separately for boys and girls. We found a statistically significant average association between firearm homicide exposure and symptoms of depression among youth. Furthermore, heterogeneous effects analyses yielded evidence that the average association is driven by youth, and particularly boys, who are the most disadvantaged and have the highest risk of firearm homicide exposure. The results of this study suggest that the accumulation of stressors associated with structural disadvantage and neighborhood disorder, coupled with exposure to spatially proximate and deadly firearm violence, may make boys and young men, particularly Black boys and young men, uniquely vulnerable to the mental health impacts of such exposure. Ancillary analyses of potential effect moderators suggest possible future areas of investigation.
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