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Haines KL, Gorenshtein L, Kaur K, Leraas H, Tripoli T, Freeman J, Fernandez-Moure J, Montgomery S, Feliz A, Agarwal S. Firearm Ownership: A Key Factor to Consider in Firearm Suicide Deaths in Children, Despite State Gun Laws. J Surg Res 2024; 301:191-197. [PMID: 38941715 DOI: 10.1016/j.jss.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/20/2024] [Accepted: 04/29/2024] [Indexed: 06/30/2024]
Abstract
INTRODUCTION Firearm-related suicides among children present a significant public health concern and a tragic loss of young lives. This study explores the relationship between firearm-related suicides, gun ownership, and state-specific gun laws. METHODS This retrospective cohort study collected data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research on children under 18 who died by firearm-related suicides between 2009 and 2016 in all 50 states and D.C. It also utilized data from the RAND State-Level Estimates of Household Firearm Ownership. The study focused on the rate of child firearm suicide deaths per 100,000 individuals. The key variable of interest was the percentage of guns owned per household in each state. Univariable analysis was conducted to examine the association between individual gun laws and child firearm suicide mortalities, while multivariable regression, adjusting for household gun ownership and significant firearm legislation, was employed to assess connection to child firearm suicide mortality. RESULTS From 2009 to 2016, 3903 children died from firearm-related suicides in the United States. In our analysis, 15 out of 44 firearm laws were found to be associated with reducing the rates of firearm suicides among children (P < 0.05). However, multivariable regression showed that higher state gun ownership rates were the primary predictor of increased child fatalities from firearms, with children in such states being 325% more likely to die when analyzing handgun laws and 337% more likely when analyzing long gun laws, as indicated by coefficients of 4.25 and 4.37, respectively. No state laws alone notably improved death rates. CONCLUSIONS Gun ownership has a stronger association with child suicide rates than state-specific gun laws. Given the weight of gun ownership, future research should prioritize comprehensive public health initiatives to prevent child firearm-related suicides.
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Affiliation(s)
- Krista L Haines
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
| | - Laura Gorenshtein
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kavneet Kaur
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Surgery Baylor Scott & White All Saints Medical Center, Fort Worth, Texas
| | - Harold Leraas
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Todd Tripoli
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Jennifer Freeman
- Department of Surgery Baylor Scott & White All Saints Medical Center, Fort Worth, Texas
| | - Joseph Fernandez-Moure
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Sean Montgomery
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Alexander Feliz
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Suresh Agarwal
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Bleyer A, Siegel SE, Estrada J, Thomas CR. Fallacy of attributing the U.S. firearm mortality epidemic to mental health. PLoS One 2024; 19:e0290138. [PMID: 39102407 PMCID: PMC11299823 DOI: 10.1371/journal.pone.0290138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/18/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Annual global data on mental disorders prevalence and firearm death rates for 2000-2019, enables the U.S. to be compared with comparable counties for these metrics. METHODS The Institute for Health Metrics and Evaluation (IHME) Global Health Burden data were used to compare the prevalence of mental disorders with overall, homicide and suicide firearm death rates including homicides and suicides, in high sociodemographic (SDI) countries. RESULTS Overall and in none of the nine major categories of mental disorders did the U.S. have a statistically-significant higher rate than any of 40 other high SDI countries during 2019, the last year of available data. During the same year, the U.S. had a statistically-significant higher rate of all deaths, homicides, and suicides by firearm (all p<<0.001) than all other 40 high SDI countries. Suicides accounted for most of the firearm death rate differences between the U.S. and other high SDI countries, and yet the prevalence of mental health disorders associated with suicide were not significantly difference between the U.S. and other high SDI countries. CONCLUSION Mental disorder prevalence in the U.S. is similar in all major categories to its 40 comparable sociodemographic countries, including mental health disorders primarily associated with suicide. It cannot therefore explain the country's strikingly higher firearm death rate, including suicide. Reducing firearm prevalence, which is correlated with the country's firearm death rate, is a logical solution that has been applied by other countries.
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Affiliation(s)
- Archie Bleyer
- Knight Cancer Institute and Department of Radiation Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
- McGovern Medical School, University of Texas, Houston, Texas, United States of America
| | - Stuart E. Siegel
- AYA Cancer Coalition and CureSearch, Los Angeles, California, United States of America
| | - Jaime Estrada
- Texas Doctors for Social Responsibility, San Antonio, Texas, United States of America
| | - Charles R. Thomas
- Radiation Oncology, Geisel School of Medicine @ Dartmouth, Hanover, New Hampshire, United States of America
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Daraklis M, Pol M, Johnson L, Salvatora C, Kerns L. A Statistical Analysis of the Impact of Gun Ownership on Mass Shootings in the USA Between 2013 and 2022. J Urban Health 2024; 101:571-583. [PMID: 38831155 PMCID: PMC11189892 DOI: 10.1007/s11524-024-00881-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/05/2024]
Abstract
Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings-both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase-that is, for every 12.5% increase-in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.
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Affiliation(s)
- Madison Daraklis
- Department of Mathematics, Westminster College, New Wilmington, PA, USA
| | - Mehul Pol
- Department of Statistics, The University of Virginia, Charlottesville, VA, USA
| | - Lindsey Johnson
- Department of Mathematics, Westminster College, New Wilmington, PA, USA
| | - Cianna Salvatora
- Department of Mathematics, Wellesley College, Wellesley, MA, USA
| | - Lucy Kerns
- Department of Mathematics & Statistics, Youngstown State University, One University Plaza, Youngstown, OH, 44555, USA.
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Dholakia A, Burdick KJ, Kreatsoulas C, Monuteaux MC, Tsai J, Subramanian SV, Fleegler EW. Historical Redlining and Present-Day Nonsuicide Firearm Fatalities. Ann Intern Med 2024; 177:592-597. [PMID: 38648643 DOI: 10.7326/m23-2496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Redlining began in the 1930s with the Home Owners' Loan Corporation (HOLC); this discriminatory practice limited mortgage availability and reinforced concentrated poverty that still exists today. It is important to understand the potential health implications of this federally sanctioned segregation. OBJECTIVE To examine the relationship between historical redlining policies and present-day nonsuicide firearm fatalities. DESIGN Maps from the HOLC were overlaid with incidence of nonsuicide firearm fatalities from 2014 to 2022. A multilevel negative binomial regression model tested the association between modern-day firearm fatalities and HOLC historical grading (A ["best"] to D ["hazardous"]), controlling for year, HOLC area-level demographics, and state-level factors as fixed effects and a random intercept for city. Incidence rates (IRs) per 100 000 persons, incidence rate ratios (IRRs), and adjusted IRRs (aIRRs) for each HOLC grade were estimated using A-rated areas as the reference. SETTING 202 cities with areas graded by the HOLC in the 1930s. PARTICIPANTS Population of the 8597 areas assessed by the HOLC. MEASUREMENTS Nonsuicide firearm fatalities. RESULTS From 2014 to 2022, a total of 41 428 nonsuicide firearm fatalities occurred in HOLC-graded areas. The firearm fatality rate increased as the HOLC grade progressed from A to D. In A-graded areas, the IR was 3.78 (95% CI, 3.52 to 4.05) per 100 000 persons per year. In B-graded areas, the IR, IRR, and aIRR relative to A areas were 7.43 (CI, 7.24 to 7.62) per 100 000 persons per year, 2.12 (CI, 1.94 to 2.32), and 1.42 (CI, 1.30 to 1.54), respectively. In C-graded areas, these values were 11.24 (CI, 11.08 to 11.40) per 100 000 persons per year, 3.78 (CI, 3.47 to 4.12), and 1.90 (CI, 1.75 to 2.07), respectively. In D-graded areas, these values were 16.26 (CI, 16.01 to 16.52) per 100 000 persons per year, 5.51 (CI, 5.05 to 6.02), and 2.07 (CI, 1.90 to 2.25), respectively. LIMITATION The Gun Violence Archive relies on media coverage and police reports. CONCLUSION Discriminatory redlining policies from 80 years ago are associated with nonsuicide firearm fatalities today. PRIMARY FUNDING SOURCE Fred Lovejoy Housestaff Research and Education Fund.
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Affiliation(s)
- Ayesha Dholakia
- Department of Pediatrics, Boston Children's Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts (A.D., K.J.B.)
| | - Kendall J Burdick
- Department of Pediatrics, Boston Children's Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts (A.D., K.J.B.)
| | | | - Michael C Monuteaux
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts (M.C.M.)
| | - Jennifer Tsai
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, and St. Joseph's Medical Center in Stockton, Stockton, California (J.T.)
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.V.S.)
| | - Eric W Fleegler
- Department of Emergency Medicine, Massachusetts General Hospital, and Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts (E.W.F.)
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Rossheim ME, Khoshhal B, Karon S, Cheskin LJ, Trangenstein PJ, Frankenfeld CL, Ramezani N, Cuellar AE. Substance use and firearm access among college freshmen. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1001-1005. [PMID: 35549821 DOI: 10.1080/07448481.2022.2068959] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 03/02/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Examine the proportion of students with rapid firearm access and associations with recent alcohol and marijuana use. PARTICIPANTS Cross-sectional data from college freshmen (n = 183) in 2020 who participated in the Mason: Health Starts Here study. METHODS Using logistic regression, associations were examined between past 30-day substance use and access to firearms within 15-min. RESULTS More than 10% of students could rapidly access a firearm, 53% of whom were current binge drinkers, compared to 13% of those who could not rapidly access firearms. Non-Hispanic White students (AOR = 4.1, 95%CI = 1.3,12.7) and past 30-day binge drinkers (AOR = 6.4, 95%CI = 2.1,19.7) had greater odds of having rapid firearm access. Age, sex, and past 30-day marijuana use were not associated with rapid access. CONCLUSIONS A notable proportion of students had rapid firearm access, which was strongly associated with recent binge drinking. Campus prevention programs should consider how their alcohol and firearm policies could be enhanced to prevent violence/self-harm.
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Affiliation(s)
- Matthew E Rossheim
- School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Bita Khoshhal
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Samantha Karon
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lawrence J Cheskin
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | | | - Cara L Frankenfeld
- Public Health Program, University of Puget Sound, Tacoma, Washington, USA
| | - Niloofar Ramezani
- College of Engineering and Computing, George Mason University, Fairfax, Virginia, USA
| | - Alison E Cuellar
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
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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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Sah E, Asher A, Houtsma C, Constans JI. The Firearm Implicit Association Test: A Validation Study. J Pers Assess 2023; 105:770-778. [PMID: 36507628 DOI: 10.1080/00223891.2022.2153253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/17/2022] [Indexed: 12/15/2022]
Abstract
Firearm violence causes significant public health burden, but there is a lack of research concerning motivations for firearm access despite clear epidemiological risk. Developing robust tools to measure attitudes toward firearms and firearm-related behaviors can improve our ability to conduct firearm violence research. We aimed to develop a feasible and effective tool that could indirectly measure firearm beliefs. A total of 274 undergraduates were recruited from two southern universities and completed an implicit association test (IAT) designed to indirectly assess attitudes toward firearms (Firearm IAT). Participants also completed self-report measures, including Attitude Toward Guns Scale (ATGS) and Gun Beliefs and Behavior Scale (GBBS) to examine explicit attitudes toward firearms. Demographic and firearm-related data were also assessed. The Firearm IAT revealed an association between firearms and negatively valenced words. The Firearm IAT had a good internal consistency and construct validity with a D score that is significantly different from 0 and a reliability score of 0.84. The Firearm IAT showed significant positive correlations with ATGS and GBBS suggesting this measure could serve as an indirect assessment of firearm attitudes.
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Affiliation(s)
- Eric Sah
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Annie Asher
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- School of Science and Engineering, Tulane University, New Orleans, Louisiana
| | - Claire Houtsma
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- Education and Clinical Center (MIRECC), South Central Mental Illness Research, New Orleans, Louisiana
- School of Medicine, Louisiana State University, New Orleans, Louisiana
- School of Medicine, Tulane University, New Orleans, Louisiana
| | - Joseph I Constans
- Southeast Louisiana Veterans Health Care System (SLVHCS), New Orleans, Louisiana
- School of Medicine, Louisiana State University, New Orleans, Louisiana
- School of Medicine, Tulane University, New Orleans, Louisiana
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Pear VA, Wintemute GJ, Jewell NP, Cerdá M, Ahern J. Community-Level Risk Factors for Firearm Assault and Homicide: The Role of Local Firearm Dealers and Alcohol Outlets. Epidemiology 2023; 34:798-806. [PMID: 37708491 PMCID: PMC10538383 DOI: 10.1097/ede.0000000000001670] [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: 01/11/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Identifying community characteristics associated with firearm assault could facilitate prevention. We investigated the effect of community firearm dealer and alcohol outlet densities on individual risk of firearm assault injury. METHODS In this density-sampled case-control study of Californians, January 2005-September 2015, cases comprised all residents with a fatal or nonfatal firearm assault injury. For each month, we sampled controls from the state population in a 4:1 ratio with cases. Exposures were monthly densities of county-level pawn and nonpawn firearm dealers and ZIP code-level off-premises alcohol outlets and bars and pubs ("bars/pubs"). We used case-control-weighted G-computation to estimate risk differences (RD) statewide and among younger Black men, comparing observed exposure densities to hypothetical interventions setting these densities to low. We estimated additive interactions between firearm and alcohol retailer density. Secondary analyses examined interventions targeted to high exposure density or outcome burden areas. RESULTS There were 67,850 cases and 268,122 controls. Observed (vs. low) densities of pawn firearm dealers and off-premises alcohol outlets were individually associated with elevated monthly risk of firearm assault per 100,000 people (RD pawn dealers : 0.06, 95% CI: 0.05, 0.08; RD off-premises outlets : 0.01, 95% CI: 0.01, 0.03), but nonpawn firearm dealer and bar/pub density were not; models targeting only areas with the highest outcome burden were similar. Among younger Black men, estimates were larger. There was no interaction between firearm and alcohol retailer density. CONCLUSIONS Our results are consistent with the hypothesis that limiting pawn firearm dealers and off-premises alcohol outlet densities can reduce interpersonal firearm violence.
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Affiliation(s)
- Veronica A. Pear
- From the Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Garen J. Wintemute
- From the Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine
| | - Nicholas P. Jewell
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine
| | - Jennifer Ahern
- Division of Epidemiology, School of Public Health, University of California, Berkeley
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Song IH, Lee JH, Shin JS. Firearm Possession Rates in Home Countries and Firearm Suicide Rates Among US- and Foreign-Born Suicide Decedents in the United States: Analysis of Combined Data from the National Violent Death Reporting System and the Small Arms Survey. JMIR Public Health Surveill 2023; 9:e44211. [PMID: 37773604 PMCID: PMC10576231 DOI: 10.2196/44211] [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: 11/10/2022] [Revised: 07/02/2023] [Accepted: 09/05/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Suicide by firearms is a serious public health issue in the United States. However, little research has been conducted on the relationship between cultural backgrounds and suicide by firearms, specifically in those born and raised in the United States compared to those who have immigrated to the United States. OBJECTIVE To better understand the relationship between cultural backgrounds and suicide, this study aimed to examine firearm suicide rates among US- and foreign-born suicide decedents based on the firearm possession rate in the decedent's home country. METHODS Multivariate logistic regression was performed to analyze data of 28,895 suicide decedents from 37 states obtained from the 2017 National Violent Death Reporting System data set. The firearm possession rate in the home countries of foreign-born suicide decedents was obtained from the 2017 Small Arms Survey. RESULTS The firearm suicide rate was about twice as high among US-born suicide decedents compared to their foreign-born counterparts. Meanwhile, suicide by hanging was about 75% higher among foreign-born compared to US-born suicide decedents. Those from countries with a low-to-medium firearm possession rate were significantly less likely to use firearms compared to US-born suicide decedents (adjusted odds ratio [AOR]=0.45, 95% CI 0.31-0.65, and AOR=0.46, 95% CI 0.39-0.53, respectively). Meanwhile, firearm suicide rates were not different between US- and foreign-born suicide decedents from countries with a similarly high firearm possession rate. CONCLUSIONS The results suggest that there is an association between using firearms as a means of suicide and the firearm possession rate in the decedent's home country. Suicide by firearms in the United States needs to be understood in the sociocultural context related to firearm possession.
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Affiliation(s)
- In Han Song
- ICONS Convergence Academy, Yonsei University, Seoul, Republic of Korea
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jin Hyuk Lee
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Jee Soo Shin
- Interdisciplinary Program of Social Welfare Policy, The Graduate School, Yonsei University, Seoul, Republic of Korea
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Hemenway D, Azrael D, Zhang W, Miller M. Black Household gun ownership and black suicide rates across U.S. States. J Natl Med Assoc 2023:S0027-9684(23)00043-3. [PMID: 37069017 DOI: 10.1016/j.jnma.2023.03.008] [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: 02/15/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
INTRODUCTION Ecologic studies have examined the relationship across states between levels of household gun ownership and suicide rates using household gun ownership data from the Behavioral Risk Factor Surveillance System (BFRSS) or proxies. However, no study has examined how race-specific survey-based or proxy measures of gun ownership are related to race-specific suicide rates. METHODS We use cross-sectional state-level race-specific data to examine how well various proxies correlate with race-specific BRFSS gun ownership rates. We examine whether BRFSS measures of household gun ownership are correlated with firearm suicide, non-firearm suicide, and total suicide rates, for Black and for White adults, and repeat these assessments with select proxies. The core BRFSS only included gun questions in 2001, 2002, and 2004, but not since; mortality data are collapsed 2001-2010. RESULTS Among a set of proxies, the race-specific fraction of suicides that are firearm suicides (FS/S) is the measure most highly correlated with BRFSS household gun ownership. Across states, White adult BFRSS household gun ownership levels are highly correlated with White adult firearm suicide rates (correlation coefficient .82) and moderately correlated with White overall suicide rates (.63). However, for Black adults, we find that while the state-level Black gun ownership levels are moderately correlated with Black firearm suicide rates (.67)-more strongly for older (.70) than for younger (.47) Black adults-Black BRFSS gun ownership levels are only weakly correlated with Black overall suicide rates (.17) owing to a moderate inverse correlation with Black non-firearm suicide rates (-.45). For Black adults, the relationship between FS/S and suicide is similar to the relation between BRFSS and suicide. CONCLUSION For White adults, states with higher levels of measured household gun ownership have higher overall suicide rates. This relationship does not hold for Black adults, largely due to a more attenuated correlation between these measures of firearm availability and firearm suicide rates coupled with a more substantial countervailing (inverse) relationship between these measures and non-firearm suicide rates. Future efforts using individual level data might help determine why this puzzling difference exists, especially for young Black adults.
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Affiliation(s)
- David Hemenway
- Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA.
| | - Deborah Azrael
- Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Wilson Zhang
- Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Matthew Miller
- Northeastern University, 360 Huntington Avenue, Boston, MA 02115 USA
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The role of firearm and alcohol availability in firearm suicide: A population-based weighted case-control study. Health Place 2023; 79:102969. [PMID: 36681063 PMCID: PMC10153632 DOI: 10.1016/j.healthplace.2023.102969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/09/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023]
Abstract
Firearm availability has been linked to firearm self-harm, but the joint relationship with alcohol availability, while supported by theory, has not been examined. This study sought to quantify the separate and joint relations of community firearm and alcohol availability with individual-level risk of (fatal and nonfatal) firearm self-harm. We conducted a case-control study of California residents, 2005-2015, using statewide mortality, hospital, firearm transfer, and alcohol license data. We estimated monthly marginal risk differences per 100,000 in the overall population and in white men aged 50+ under various hypothetical changes to firearm and alcohol availability and assessed additive interactions using case-control-weighted g-computation. In the overall population, non-pawn shop firearm dealer density was associated with firearm self-harm (RD: 0.02, 95% CI: 0.003, 0.04) but pawn shop firearm dealer and alcohol outlet densities were not. Secondary analyses revealed a relationship between firearm sales density and firearm self-harm (RD: 0.07, 95% CI: 0.04, 0.10). There were no additive interactions between measures of firearm and alcohol availability. Among older white men, generally the same exposures were related to self-harm as in the overall population, but point estimates were substantially larger. Findings suggest community-level approaches to reducing firearm sales may help mitigate suicide risk.
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Neiman PU, Flaherty MM, Salim A, Sangji NF, Ibrahim A, Fan Z, Hemmila MR, Scott JW. Evaluating the complex association between Social Vulnerability Index and trauma mortality. J Trauma Acute Care Surg 2022; 92:821-830. [PMID: 35468113 DOI: 10.1097/ta.0000000000003514] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Social determinants of health are known to impact patient-level outcomes, but they are often difficult to measure. The Social Vulnerability Index was created by the Centers for Disease Control to identify vulnerable communities using population-based measures. However, the relationship between SVI and trauma outcomes is poorly understood. METHODS In this retrospective study, we merged SVI data with a statewide trauma registry and used three analytic models to evaluate the association between SVI quartile and inpatient trauma mortality: (1) an unadjusted model, (2) a claims-based model using only covariates available to claims datasets, and (3) a registry-based model incorporating robust clinical variables collected in accordance with the National Trauma Data Standard. RESULTS We identified 83,607 adult trauma admissions from January 1, 2017, to September 30, 2020. Higher SVI was associated with worse mortality in the unadjusted model (odds ratio, 1.72 [95% confidence interval, 1.30-2.29] for highest vs. lowest SVI quintile). A weaker association between SVI and mortality was identified after adjusting for covariates common to claims data. Finally, there was no significant association between SVI and inpatient mortality after adjusting for covariates common to robust trauma registries (adjusted odds ratio, 1.10 [95% confidence interval, 0.80-1.53] for highest vs. lowest SVI quintile). Higher SVI was also associated with a higher likelihood of presenting with penetrating injuries, a shock index of >0.9, any Abbreviated Injury Scale score of >5, or in need of a blood transfusion (p < 0.05 for all). CONCLUSION Patients living in communities with greater social vulnerability are more likely to die after trauma admission. However, after risk adjustment with robust clinical covariates, this association was no longer significant. Our findings suggest that the inequitable burden of trauma mortality is not driven by variation in quality of treatment, but rather in the lethality of injuries. As such, improving trauma survival among high-risk communities will require interventions and policies that target social and structural inequities upstream of trauma center admission. LEVEL OF EVIDENCE Prognostic / Epidemiologic, Level IV.
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Affiliation(s)
- Pooja U Neiman
- From the Department of Surgery (P.U.N., A.S.), Brigham and Women's Hospital, Boston, Massachusetts; Center for Healthcare Outcomes and Policy (P.U.N., N.F.S., A.I., Z.F., M.R.H., J.W.S.), National Clinical Scholars Program (P.U.N.), University of Michigan Medical School (M.M.F.), and Department of Surgery (A.I., M.R.H., J.W.S.), University of Michigan, Ann Arbor, Michigan
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Temko JE, Grigorian A, Barrios C, Lekawa M, Nahmias L, Kuza CM, Nahmias J. Race, Age, and Lack of Insurance Increase Risk of Suicide Attempt in Trauma Patients. Arch Suicide Res 2022; 26:846-860. [PMID: 33186511 DOI: 10.1080/13811118.2020.1838370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The overall rate of suicide between 1999 and 2017 increased by 33% in the United States. We sought to examine suicide attempts in the trauma patient population, hypothesizing that in adult trauma patients race and lack of insurance status would be predictors of suicide attempt. METHOD The Trauma Quality Improvement Program (2010-2016) was queried for trauma patients ≥18 years old. The primary outcome was suicide attempt. A multivariable logistic regression model was performed including covariates that influence risk of suicide attempt. RESULTS From 1,403,466 adult trauma admissions, 16,263 (1.2%) patients attempted suicide. Death after suicide attempt occurred in 30.2% of patients. Independent predictors of suicide attempt were age < 40 years old (odds ratio [OR] = 1.46, 95% confidence interval [CI] [1.41, 1.51], p < .001) and no insurance (OR = 1.92, 95% CI [1.85, 2.00], p < .001). Black (vs. White) race was associated with decreased risk of suicide attempt (OR = 0.63, 95% CI [0.60, 0.67], p < .001). Hispanic (versus non-Hispanic) patients demonstrated lower associated risk of suicide attempt by gun (OR = 0.50, 95% CI [0.45, 0.54], p < .001), while Asian (vs. White) patients exhibited higher risk of suicide attempt overall (OR = 1.25, 95% CI [1.12, 1.39], p < .001) and more specifically by knife (OR = 2.55, 95% CI [2.16, 3.00], p < .001). CONCLUSIONS Age younger than 40 years and lack of insurance were associated with higher risk of suicide attempt in adult trauma patients. Asian race was associated with the highest risk of suicide, with >2.5 times increased risk of attempt by knife. Awareness of these demographic-specific risk factors for suicide attempt, and in particular violent mechanisms of suicide attempt, is critical to implementation of effective suicide prevention efforts.HighlightsAge younger than 40 and no insurance were associated with risk of suicide attempt.Black (vs. White) race was associated with decreased risk of suicide attempt.Asian race was associated with an increased risk of suicide attempt with a knife.
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Reeping PM, Klarevas LJ, Rajan S, Rowhani-Rahbar A, Heinze J, Zeoli AM, Goyal MK, Zimmerman M, Branas CC. State firearm laws, gun ownership, and K-12 school shootings: Implications for school safety. JOURNAL OF SCHOOL VIOLENCE 2022; 21:132-146. [PMID: 35449898 PMCID: PMC9017402 DOI: 10.1080/15388220.2021.2018332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
Limited research has been conducted on the state-level factors that may be associated with intentional school shootings. We obtained school shooting data from the Washington Post that identified any act of intentional interpersonal gunfire in a K-12 school over the course of two decades. We also compiled new data on active school shootings during the same twenty-year time period, which identified any attempted mass shooting incident in a K-12 school. We conducted a time-series analysis to measure the association of permissiveness of state firearm laws and state gun ownership with K-12 school shootings and active shootings. More permissive firearm laws and higher rates of gun ownership were associated with higher rates of both school shootings and active school shootings after controlling for critical covariates. Specific recommendations for K-12 schools to consider as they seek to prevent acts of intentional gunfire on school grounds are presented.
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Affiliation(s)
- Paul M. Reeping
- Department of Epidemiology, Columbia University, Mailman School of Public Health; New York, New York
| | | | - Sonali Rajan
- Department of Epidemiology, Columbia University, Mailman School of Public Health; New York, New York
- Department of Health and Behavior Studies, Columbia University, Teachers College; New York, New York
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington; Seattle, Washington
| | - Justin Heinze
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan; Ann Arbor, Michigan
| | - April M. Zeoli
- School of Criminal Justice, Michigan State University; East Lansing, Michigan
| | - Monika K. Goyal
- Department of Pediatrics, Division of Emergency Medicine, Children’s National Health System; Washington D.C
| | - Marc Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan; Ann Arbor, Michigan
| | - Charles C. Branas
- Department of Epidemiology, Columbia University, Mailman School of Public Health; New York, New York
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Matthay EC, Farkas K, Goin DE, Rudolph KE, Pear VA, Ahern J. Associations of firearm dealer openings with firearm self-harm deaths and injuries: A differences-in-differences analysis. PLoS One 2021; 16:e0248130. [PMID: 33735181 PMCID: PMC7971548 DOI: 10.1371/journal.pone.0248130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Firearm dealer density is correlated with firearm interpersonal violence, but no quasi-experimental studies have assessed whether changes in dealer density lead to changes in firearm self-harm injuries and deaths. We assessed whether openings of firearm dealers are associated with short-term changes in local firearm self-harm injury rates. METHODS We identified 718 openings of firearm dealers in California using licensing data, 2014-2016. We defined exposure regions based on aggregations of zip codes defined by proximity to firearm dealer openings and matched each opening to four control regions on time and determinants of firearm injury. We applied a differences-in-differences approach to compare rates of firearm self-harm, in the month before and after each opening, in places with and without openings. RESULTS Firearm dealer openings were not associated with acute, local changes in firearm self-harm relative to places without openings (ratio of rate ratio: 0.90 [95% CI:0.68-1.19]). Results were robust to numerous sensitivity and secondary analyses. CONCLUSION We found no associations of firearm dealer openings with acute, localized firearm self-harm deaths and injuries. Our focus on acute, local effects; broad availability of dealers and firearms; durability of firearms; or strong confounding-control may explain these null findings.
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Affiliation(s)
- Ellicott C. Matthay
- Center for Health and Community, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Kriszta Farkas
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Dana E. Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Kara E. Rudolph
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Veronica A. Pear
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Jennifer Ahern
- Division of Epidemiology & Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
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Affiliation(s)
- Dana E Goin
- From the Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, CA
| | - Kara E Rudolph
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
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Gomez DB, Xu Z, Saleh JH. From Regression Analysis to Deep Learning: Development of Improved Proxy Measures of State-Level Household Gun Ownership. PATTERNS 2020; 1:100154. [PMID: 33336203 PMCID: PMC7733878 DOI: 10.1016/j.patter.2020.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/05/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Abstract
In the absence of direct measurements of state-level household gun ownership (GO), the quality and accuracy of proxy measures for this variable are essential for firearm-related research and policy development. In this work, we develop two highly accurate proxy measures of GO using traditional regression analysis and deep learning, the former accounting for non-linearities in the covariates (portion of suicides committed with a firearm [FS/S] and hunting license rates) and their statistical interactions. We subject the proxies to extensive model diagnostics and validation. Both our regression-based and deep-learning proxy measures provide highly accurate models of GO with training R2 of 96% and 98%, respectively, along with other desirable qualities-stark improvements over the prevalent FS/S proxy (R2 = 0.68). Model diagnostics reveal this widely used FS/S proxy is highly biased and inadequate; we recommend that it no longer be used to represent state-level household gun ownership in firearm-related studies.
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Affiliation(s)
- David Benjamin Gomez
- School of Aerospace Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Zhaoyi Xu
- School of Aerospace Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Joseph Homer Saleh
- School of Aerospace Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Dollar NT, Gutin I, Lawrence EM, Braudt DB, Fishman SH, Rogers RG, Hummer RA. The persistent southern disadvantage in US early life mortality, 1965-2014. DEMOGRAPHIC RESEARCH 2020; 42:343-382. [PMID: 32317859 PMCID: PMC7173329 DOI: 10.4054/demres.2020.42.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Recent studies of US adult mortality demonstrate a growing disadvantage among southern states. Few studies have examined long-term trends and geographic patterns in US early life (ages 1 to 24) mortality, ages at which key risk factors and causes of death are quite different than among adults. OBJECTIVE This article examines trends and variations in early life mortality rates across US states and census divisions. We assess whether those variations have changed over a 50-year time period and which causes of death contribute to contemporary geographic disparities. METHODS We calculate all-cause and cause-specific death rates using death certificate data from the Multiple Cause of Death files, combining public-use files from 1965-2004 and restricted data with state geographic identifiers from 2005-2014. State population (denominator) data come from US decennial censuses or intercensal estimates. RESULTS Results demonstrate a persistent mortality disadvantage for young people (ages 1 to 24) living in southern states over the last 50 years, particularly those located in the East South Central and West South Central divisions. Motor vehicle accidents and homicide by firearm account for most of the contemporary southern disadvantage in US early life mortality. CONTRIBUTION Our results illustrate that US children and youth living in the southern United States have long suffered from higher levels of mortality than children and youth living in other parts of the country. Our findings also suggest the contemporary southern disadvantage in US early life mortality could potentially be reduced with state-level policies designed to prevent deaths involving motor vehicles and firearms.
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Affiliation(s)
| | - Iliya Gutin
- University of North Carolina at Chapel Hill, USA
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Rehder K, Lusk J, Chen JI. Deaths of Despair: Conceptual and Clinical Implications. COGNITIVE AND BEHAVIORAL PRACTICE 2019; 28:40-52. [PMID: 34168422 DOI: 10.1016/j.cbpra.2019.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Since the late 1990s, mortality rates for middle-aged (45-55), White non-Hispanic (WNH) Americans began to rise while rates declined for all other demographic and age groups. Coinciding with the rise in mortality, rates of death due to suicide, drug- and alcohol-related overdoses, and alcohol-related liver diseases increased as well for this demographic. Research suggests these causes of death (i.e., suicide, poisoning, alcohol-related liver disease) are driving the overall mortality rate for middle-aged WNHs and have been described as "deaths of despair" in the literature. In the current paper, we describe the social and clinical features of "deaths of despair," explore theoretical models of psychopathology (e.g., depression, posttraumatic stress disorder) that may inform our understanding of mechanisms of risk for negative mental health outcomes, and propose an initial conceptual model of "deaths of despair" to identify intervention targets. We then review an applied case example demonstrating how this model could be used for clinical application. We conclude our paper by describing how current cognitive-behavioral interventions may address these mechanisms of "despair."
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Affiliation(s)
- Kristoffer Rehder
- Pacific University, Salem Vet Center Information, HSR&D Center to Improve Veteran Involvement in Care and Oregon Health & Science University
| | - Jaimie Lusk
- Pacific University, Salem Vet Center Information, HSR&D Center to Improve Veteran Involvement in Care and Oregon Health & Science University
| | - Jason I Chen
- Pacific University, Salem Vet Center Information, HSR&D Center to Improve Veteran Involvement in Care and Oregon Health & Science University
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Sabbath EL, Hawkins SS, Baum CF. State-Level Changes in Firearm Laws and Workplace Homicide Rates: United States, 2011 to 2017. Am J Public Health 2019; 110:230-236. [PMID: 31855477 DOI: 10.2105/ajph.2019.305405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To test whether year-over-year strengthening of state-level firearm laws is associated with decreases in workplace homicide rates.Methods. In this time-series ecological study of working people in all 50 US states, we used federal data on workplace homicides by state and year from 2011 to 2017, linked to an index of state-year firearm laws, to characterize the regulatory environment (overall and within legislative categories). We used generalized linear regression to model associations between changes in firearm laws and changes in workplace homicide rates the following year.Results. From 2011 to 2017, more than 3000 people died as a result of workplace homicides; over that period, 23 states strengthened firearm regulations and 23 weakened them. We modeled the impact of states strengthening laws within the interquartile range (IQR; equivalent to adding 20.5 firearm laws). This change was associated with a 3.7% reduction in the workplace homicide rate (95% confidence interval [CI] = -3.86, -3.51). Positive IQR changes in specific categories of firearm laws-concealed carry permitting (-5.79%; 95% CI = -6.09, -3.51), domestic violence-related restrictions (-5.31%; 95% CI = -5.57, -5.05), and background checks (-5.07%; 95% CI = -5.32, -4.82)-were also associated with significant reductions.Conclusions. Strengthening state-level firearm laws may reduce the population-level mortality and morbidity burden posed by workplace homicides.
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Affiliation(s)
- Erika L Sabbath
- Erika L. Sabbath and Summer Sherburne Hawkins are with the School of Social Work, Boston College, Chestnut Hill, MA. Christopher F. Baum is with the Department of Economics, Boston College
| | - Summer Sherburne Hawkins
- Erika L. Sabbath and Summer Sherburne Hawkins are with the School of Social Work, Boston College, Chestnut Hill, MA. Christopher F. Baum is with the Department of Economics, Boston College
| | - Christopher F Baum
- Erika L. Sabbath and Summer Sherburne Hawkins are with the School of Social Work, Boston College, Chestnut Hill, MA. Christopher F. Baum is with the Department of Economics, Boston College
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Gearhart MC, Berg KA, Jones C, Johnson SD. Fear of Crime, Racial Bias, and Gun Ownership. HEALTH & SOCIAL WORK 2019; 44:241-248. [PMID: 31665433 DOI: 10.1093/hsw/hlz025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 06/14/2019] [Accepted: 06/24/2019] [Indexed: 06/10/2023]
Abstract
Firearm-related violence is a significant threat to public health and safety in America. However, research highlights a critical disparity in firearm-related deaths by race. Researchers often cite racial bias as a contributing factor for the racial disparity in firearm-related deaths. To provide a foundation for potential social work interventions, the present article discusses the results of an assessment of whether explicit racial biases toward four racial and ethnic groups (white, black, Asian, Hispanic/Latino), fear of crime, and the quantity and quality of interactions with neighbors of a different race are predictors of gun ownership. Findings suggest that explicit racial bias toward black, Asian, and Hispanic/Latino individuals is a significant predictor of gun ownership. Fear of crime and more frequent interactions with neighbors of a different race are also significant predictors of gun ownership. Taken as a whole, findings suggest that gun owners are more likely to be more vigilant toward people of color because of stereotypical assumptions that racial and ethnic minorities are more likely to be involved with crime. Social work practice and policy implications include developing interventions aimed at reducing implicit bias and identifying policies that are associated with lower levels of implicit bias among gun owners.
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Kapoor R, Benedek E, Bonnie RJ, Gandhi T, Gold L, Judd S, Pinals DA. Resource Document on Risk-Based Gun Removal Laws. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2019; 17:443-451. [PMID: 32015728 DOI: 10.1176/appi.focus.17403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
(Reprinted with permission from APA Resource Document, June 2018).
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Licensed firearm dealer availability and intimate partner homicide: A multilevel analysis in sixteen states. Prev Med 2019; 126:105739. [PMID: 31152829 DOI: 10.1016/j.ypmed.2019.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/01/2019] [Accepted: 05/28/2019] [Indexed: 11/21/2022]
Abstract
This paper investigates the association between legal access to firearms in the community through licensed dealers and homicides perpetrated by intimate partners (IPH). We conducted a series of multilevel negative binomial models to assess the relationship between the rate of county-level federally licensed firearm dealers and intimate partner homicides, by gender and age, controlling for leading macro-level correlates of IPH. The rate of county-level federally licensed firearm dealers is significantly associated with intimate partner homicides in urban counties, regardless of gender and age. Although data cannot discern that the rate of licensed firearm dealers is linked to greater legal firearm access, our findings focus attention on the role of community factors, including gun stores, as significant risk factors for violence. Policies to reduce legal options to purchase firearms, especially for those with prior domestic violence offenses, may help to decrease intimate partner homicide, but better data tracking is needed to help us understand how guns move from purchase into the hands of IPH perpetrators.
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Knopov A, Sherman RJ, Raifman JR, Larson E, Siegel MB. Household Gun Ownership and Youth Suicide Rates at the State Level, 2005-2015. Am J Prev Med 2019; 56:335-342. [PMID: 30661885 PMCID: PMC6380939 DOI: 10.1016/j.amepre.2018.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Determining whether the prevalence of gun ownership is associated with youth suicide is critical to inform policy to address this problem. The objective of this study is to investigate the relationship between the prevalence of household gun ownership in a state and that state's rate of youth suicide. METHODS This study, conducted in 2018, involved a secondary analysis of state-level data for the U.S. using multivariable linear regression. The relationship between the prevalence of household gun ownership and youth (aged 10-19 years) suicide rates was examined in a time-lagged analysis of state-level household gun ownership in 2004 and youth suicide rates in the subsequent decade (2005-2015), while controlling for the prevalence of youth suicide attempts and other risk factors. RESULTS Household gun ownership was positively associated with the overall youth suicide rate. For each 10 percentage-point increase in household gun ownership, the youth suicide rate increased by 26.9% (95% CI=14.0%, 39.8%). CONCLUSIONS Because states with high levels of household gun ownership are likely to experience higher youth suicide rates, these states should be especially concerned about implementing programs and policies to ameliorate this risk.
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Affiliation(s)
- Anita Knopov
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Rebecca J Sherman
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Julia R Raifman
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Elysia Larson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michael B Siegel
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
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Sipsma HL, Canavan ME, Rogan E, Taylor LA, Talbert-Slagle KM, Bradley EH. Spending on social and public health services and its association with homicide in the USA: an ecological study. BMJ Open 2017; 7:e016379. [PMID: 29025831 PMCID: PMC5652551 DOI: 10.1136/bmjopen-2017-016379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine whether state-level spending on social and public health services is associated with lower rates of homicide in the USA. DESIGN Ecological study. SETTING USA. PARTICIPANTS All states in the USA and the District of Columbia for which data were available (n=42). PRIMARY OUTCOME MEASURE Homicide rates for each state were abstracted from the US Department of Justice Federal Bureau of Investigation's Uniform Crime Reporting. RESULTS After adjusting for potential confounding variables, we found that every $10 000 increase in spending per person living in poverty was associated with 0.87 fewer homicides per 100 000 population or approximately a 16% decrease in the average homicide rate (estimate=-0.87, SE=0.15, p<0.001). Furthermore, there was no significant effect in the quartile of states with the highest percentages of individuals living in poverty but significant effects in the quartiles of states with lower percentages of individuals living in poverty. CONCLUSIONS Based on our findings, spending on social and public health services is associated with significantly lower homicide rates at the state level. Although we cannot infer causality from this research, such spending may provide promising avenues for homicide reduction in the USA, particularly among states with lower levels of poverty.
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Affiliation(s)
- Heather L Sipsma
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Public Health, Benedictine University, Lisle, IL, USA
| | - Maureen E Canavan
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Erika Rogan
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | | | - Kristina M Talbert-Slagle
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
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Alban RF, Nuño M, Ko A, Barmparas G, Lewis AV, Margulies DR. Weaker gun state laws are associated with higher rates of suicide secondary to firearms. J Surg Res 2017; 221:135-142. [PMID: 29229119 DOI: 10.1016/j.jss.2017.08.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/20/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Firearm-related suicides comprise over two-thirds of gun-related violence in the United States, and gun laws and policies remain under scrutiny, with many advocating for revision of the regulatory map for lawful gun ownership, aiming at restricting access and distribution of these weapons. However, the quantitative relationship between how strict gun laws are and the incidence of firearm violence with their associated mortality is largely unknown. We therefore, sought to explore the impact of firearm law patterns among states on the incidence and outcomes of firearm-related suicide attempts, utilizing established objective criteria. METHODS The National Inpatient Sample for the years 1998-2011 was queried for all firearm-related suicides. Discharge facilities were stratified into five categories (A, B, C, D, and F, with A representing states with the most strict and F representing states with the least strict laws) based on the Brady Campaign to prevent Gun Violence that assigns scorecards for every state. The primary outcomes were suicide attempts and in-hospital mortality per 100,000 populations by Brady state grade. RESULTS During the 14-year study period, 34,994 subjects met inclusion criteria. The mean age was 42.0 years and 80.1% were male. A handgun was utilized by 51.8% of patients. The overall mortality was 33.3%. Overall, 22.0% had reported psychoses and 19.3% reported depression. After adjusting for confounding factors and using group A as reference, there were higher adjusted odds for suicide attempts for patients admitted in group C, D, and F category states (1.73, 2.09, and 1.65, respectively, all P < 0.001). CONCLUSIONS Firearm-related suicide attempt injuries are more common in states with less strict gun laws, and these injuries tend to be associated with a higher mortality. Efforts aimed at nationwide standardization of firearm state laws are warranted, particularly for young adults and suicide-prone populations. LEVEL OF EVIDENCE III. STUDY TYPE Trauma Outcomes study.
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Affiliation(s)
- Rodrigo F Alban
- Division of Acute Care Surgery, Department of Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California.
| | - Miriam Nuño
- Center for Neurosurgical Outcomes Research, Maxine Dunitz Neurosurgical Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Ara Ko
- Division of Acute Care Surgery, Department of Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California
| | - Galinos Barmparas
- Division of Acute Care Surgery, Department of Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California
| | - Azaria V Lewis
- Division of Acute Care Surgery, Department of Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California
| | - Daniel R Margulies
- Division of Acute Care Surgery, Department of Surgery, Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California
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Geier DA, Kern JK, Geier MR. A longitudinal ecological study of household firearm ownership and firearm-related deaths in the United States from 1999 through 2014: A specific focus on gender, race, and geographic variables. Prev Med Rep 2017; 6:329-335. [PMID: 28451519 PMCID: PMC5403795 DOI: 10.1016/j.pmedr.2017.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 11/07/2022] Open
Abstract
Firearms have a longstanding tradition in the United States (US) and are viewed by many with iconic stature with regards to safety and personal freedom. Unfortunately, from a public health point of view, firearm-related deaths (FRDs) in the US have reached a crisis point with an estimated > 31,000 deaths and 74,000 nonfatal injuries resulting from firearms each year. This longitudinal ecological study analyzed variations in FRDs following firearm assaults (FAs) and law enforcement incidents involving a firearm (LEIF) in comparison to variations in household firearm ownership (HFO) among different geographic and demographic groups in the US from 1999 to 2014. The Underlying Cause of Death database was examined on the CDC Wonder online interface. Records coded with ICD-10 codes: FA (X93 – assault by handgun discharge, X94 – assault by rifle, shotgun, and larger firearm discharge, or X95 – assault by other and unspecified firearm discharge) and LEIF (Y35.0) were examined, and the prevalence of HFO was determined using the well-established proxy of the percentage of suicides committed with a firearm. Gender, ethnicity, Census Division, and urbanization significantly impacted the death rates from FA and LEIF. Significant direct correlations between variations in HFO and death rates from FAs and LEIF were observed. Understanding the significant impacts of gender, race, Census Division, and urbanization status may help shape future public health policy to promote increased firearm safety.
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Affiliation(s)
- David A Geier
- The Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA.,CoMeD, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA
| | - Janet K Kern
- The Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA.,CoMeD, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA.,CONEM US Autism Research Group, 408 N Allen Dr., Allen, TX 75013, USA
| | - Mark R Geier
- The Institute of Chronic Illnesses, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA.,CoMeD, Inc., 14 Redgate Ct, Silver Spring, MD 20905, USA
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Chu J, Khoury O, Ma J, Bahn F, Bongar B, Goldblum P. An Empirical Model and Ethnic Differences in Cultural Meanings Via Motives for Suicide. J Clin Psychol 2017; 73:1343-1359. [PMID: 28170095 DOI: 10.1002/jclp.22425] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 10/09/2016] [Accepted: 10/31/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The importance of cultural meanings via motives for suicide - what is considered acceptable to motivate suicide - has been advocated as a key step in understanding and preventing development of suicidal behaviors. There have been limited systematic empirical attempts to establish different cultural motives ascribed to suicide across ethnic groups. METHOD We used a mixed methods approach and grounded theory methodology to guide the analysis of qualitative data querying for meanings via motives for suicide among 232 Caucasians, Asian Americans, and Latino/a Americans with a history of suicide attempts, ideation, intent, or plan. We used subsequent logistic regression analyses to examine ethnic differences in suicide motive themes. RESULTS This inductive approach of generating theory from data yielded an empirical model of 6 cultural meanings via motives for suicide themes: intrapersonal perceptions, intrapersonal emotions, intrapersonal behavior, interpersonal, mental health/medical, and external environment. Logistic regressions showed ethnic differences in intrapersonal perceptions (low endorsement by Latino/a Americans) and external environment (high endorsement by Latino/a Americans) categories. CONCLUSION Results advance suicide research and practice by establishing 6 empirically based cultural motives for suicide themes that may represent a key intermediary step in the pathway toward suicidal behaviors. Clinicians can use these suicide meanings via motives to guide their assessment and determination of suicide risk. Emphasis on environmental stressors rather than negative perceptions like hopelessness should be considered with Latino/a clients.
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Kposowa A, Hamilton D, Wang K. Impact of Firearm Availability and Gun Regulation on State Suicide Rates. Suicide Life Threat Behav 2016; 46:678-696. [PMID: 26999372 DOI: 10.1111/sltb.12243] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 01/03/2016] [Indexed: 11/30/2022]
Abstract
Past studies on suicide have investigated the association of firearm ownership and suicide risk in the United States. The aim of the present study was to build on previous work by examining the impact of firearm storage practices and the strictness of firearm regulation on suicide rates at the state level. Data were compiled from primarily three sources. Suicide and firearm ownership information was obtained from the Centers for Disease Control and Prevention. Strictness of handgun regulation was derived from figures available at the Law Center to Prevent Violence, and controls were taken from the US Bureau of the Census. Mixed models were fitted to the data. Household firearm ownership was strongly associated with both suicide by all mechanisms, and firearm suicide. Storage practices had especially elevated consequences on suicide rates. Percent with loaded guns and gun readiness increased suicide rates, and strictness of gun regulation reduced suicide rates. Ready access to firearms can make a difference between life and death. Loaded and unlocked firearms within reach become risk factors for fatal outcomes from suicidal behavior. Future research might want to examine ways of obtaining more recent data on individual firearm ownership. This study proposes several policy recommendations for suicide prevention.
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Affiliation(s)
- Augustine Kposowa
- Department of Sociology, University of California Riverside, Riverside, CA, USA
| | | | - Katy Wang
- Department of Statistics, University of California Riverside, Riverside, CA, USA
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Payton E, Thompson A, Price JH, Sheu JJ, Dake JA. African American legislators' perceptions of firearm violence prevention legislation. J Community Health 2016; 40:439-47. [PMID: 25301589 DOI: 10.1007/s10900-014-9954-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Firearm mortality is the leading cause of death for young African American males, however, few studies have focused on racial/ethnic minority populations and firearm violence. The National Black Caucus of State Legislators advocates for legislation that promotes the health of African Americans. Thus, the purpose of this study was to collect baseline data on African American legislators' perceptions regarding firearm violence in the African American community. A cross-sectional study of African American legislators (n = 612) was conducted to investigate the research questions. Of the 612 questionnaires mailed, 12 were not deliverable, and 170 were returned (28%). Utilizing a three wave mailing process, African American legislators were invited to participate in the study. The majority (88%) of respondents perceived firearm violence to be very serious among African Americans. Few (10%) legislators perceived that addressing legislative issues would be an effective strategy in reducing firearm violence among African Americans. The majority (72%) of legislators perceived the most effective strategy to reducing firearm violence in the African American community should focus on addressing societal issues (e.g. crime and poverty). After adjusting for the number of perceived barriers, the number of perceived benefits was a significant predictor of legislators' perceived effectiveness of firearm violence prevention legislation for 8 of the 24 potential firearm violence prevention legislative bills.
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Affiliation(s)
- Erica Payton
- Department of Physiology and Health Science, Ball State University, Cooper Science Building, CL 325, Muncie, IN, 47306, USA,
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Mekawi Y, Bresin K. Is the evidence from racial bias shooting task studies a smoking gun? Results from a meta-analysis. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2015. [DOI: 10.1016/j.jesp.2015.08.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Martin-Storey A, Prickett KC, Crosnoe R. Family process correlates of firearm ownership and firearm storage among families with young children. Matern Child Health J 2015; 19:17-24. [PMID: 24740723 DOI: 10.1007/s10995-014-1490-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To understand how family relations and dynamics were associated with firearm ownership among US families with 4-year-olds and with firearm storage among those families with firearms, controlling for sociodemographic characteristics of families and states. With representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8,100), logistic regression models employed a set of family process variables (e.g., parenting practices, parental stress, maternal depression, and safety behaviors) as (1) predictors of firearm ownership among all families and, (2) as predictors of safe firearm storage among firearm owning families. An estimated 22 % of families with pre-kindergarten age children reported having firearms in their households. Among firearm owning families, 69 % of families kept firearms in a locked cabinet. Comparing families who did and did not report owning firearms, those who did were more likely to report spanking their children. Firearm owning parents who reported higher levels of parenting stress and lower likelihood that their child always wore a helmet when bicycling were also more likely to report unsafe firearm storage practices. Family processes differentiated both firearm owners from non-firearm owners and firearms owners who locked up their firearms from firearm owners who did not. These findings suggest that firearm ownership and firearm safety behaviors likely arise from a more general family context related to child health and safety.
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Affiliation(s)
- Alexa Martin-Storey
- Département de Psychoéducation, Université de Sherbrooke, Pavillon A7, 2500 Boul. De l'Université, Sherbrooke, QC, J1K 2R1, Canada,
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Siegel M, Negussie Y, Vanture S, Pleskunas J, Ross CS, King C. The relationship between gun ownership and stranger and nonstranger firearm homicide rates in the United States, 1981-2010. Am J Public Health 2014; 104:1912-9. [PMID: 25121817 DOI: 10.2105/ajph.2014.302042] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the relationship between gun ownership and stranger versus nonstranger homicide rates. METHODS Using data from the Supplemental Homicide Reports of the Federal Bureau of Investigation's Uniform Crime Reports for all 50 states for 1981 to 2010, we modeled stranger and nonstranger homicide rates as a function of state-level gun ownership, measured by a proxy, controlling for potential confounders. We used a negative binomial regression model with fixed effects for year, accounting for clustering of observations among states by using generalized estimating equations. RESULTS We found no robust, statistically significant correlation between gun ownership and stranger firearm homicide rates. However, we found a positive and significant association between gun ownership and nonstranger firearm homicide rates. The incidence rate ratio for nonstranger firearm homicide rate associated with gun ownership was 1.014 (95% confidence interval=1.009, 1.019). CONCLUSIONS Our findings challenge the argument that gun ownership deters violent crime, in particular, homicides.
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Affiliation(s)
- Michael Siegel
- Michael Siegel, Yamrot Negussie, Sarah Vanture, and Jane Pleskunas are with the Department of Community Health Sciences, Boston University School of Public Health, Boston, MA. Craig S. Ross is with Virtual Media Resources, Natick, MA. Charles King III is with Greylock McKinnon Associates, Cambridge, MA, and Pleiades Consulting Group, Lincoln, MA
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Siegel M, Ross CS, King C. Examining the relationship between the prevalence of guns and homicide rates in the USA using a new and improved state-level gun ownership proxy. Inj Prev 2014; 20:424-6. [DOI: 10.1136/injuryprev-2014-041187] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Price JH, Thompson A, Khubchandani J, Dake J, Payton E, Teeple K. University presidents' perceptions and practice regarding the carrying of concealed handguns on college campuses. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2014; 62:461-469. [PMID: 24810834 DOI: 10.1080/07448481.2014.920336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess the perceptions and practices of a national sample of college and university presidents regarding their support for concealed handguns being carried on college campuses. PARTICIPANTS The sample for this study consisted of a national random sample of 900 college or university presidents. METHODS In the spring of 2013, a 3-wave mailing procedure was used to ensure an adequate response rate to a valid and reliable questionnaire. RESULTS The response rate was 46%, more than what was needed based on the power analysis. The vast majority (95%) of respondents were not supportive of carrying concealed handguns on campuses. They perceived there to be more disadvantages than advantages to handguns on campus. However, college administrators were not focused enough on the primary prevention of campus firearm trauma. CONCLUSIONS The findings of this study suggest a number of activities that could be implemented to enhance safety on college and university campuses.
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Affiliation(s)
- James H Price
- a Department of Health and Recreation Professions , University of Toledo , Toledo , Ohio
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Siegel M, Ross CS, King C. The relationship between gun ownership and firearm homicide rates in the United States, 1981-2010. Am J Public Health 2013; 103:2098-105. [PMID: 24028252 DOI: 10.2105/ajph.2013.301409] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES We examined the relationship between levels of household firearm ownership, as measured directly and by a proxy-the percentage of suicides committed with a firearm-and age-adjusted firearm homicide rates at the state level. METHODS We conducted a negative binomial regression analysis of panel data from the Centers for Disease Control and Prevention's Web-Based Injury Statistics Query and Reporting Systems database on gun ownership and firearm homicide rates across all 50 states during 1981 to 2010. We determined fixed effects for year, accounted for clustering within states with generalized estimating equations, and controlled for potential state-level confounders. RESULTS Gun ownership was a significant predictor of firearm homicide rates (incidence rate ratio = 1.009; 95% confidence interval = 1.004, 1.014). This model indicated that for each percentage point increase in gun ownership, the firearm homicide rate increased by 0.9%. CONCLUSIONS We observed a robust correlation between higher levels of gun ownership and higher firearm homicide rates. Although we could not determine causation, we found that states with higher rates of gun ownership had disproportionately large numbers of deaths from firearm-related homicides.
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Affiliation(s)
- Michael Siegel
- Michael Siegel is with the Department of Community Health Sciences, Boston University School of Public Health, Boston, MA. Craig S. Ross is with Virtual Media Resources, Natick, MA. Charles King III is with Greylock McKinnon Associates, Cambridge, and Pleiades Consulting Group, Lincoln, MA
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Price JH, Thompson A, Khubchandani J, Wiblishauser M, Dowling J, Teeple K. Perceived Roles of Emergency Department Physicians Regarding Anticipatory Guidance on Firearm Safety. J Emerg Med 2013; 44:1007-16. [DOI: 10.1016/j.jemermed.2012.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 06/28/2012] [Accepted: 11/05/2012] [Indexed: 10/27/2022]
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Thompson A, Price JH, Dake JA, Teeple K, Bassler S, Khubchandani J, Kerr D, Brookins Fisher J, Rickard M, Oden L, Aduroja A, Lyde A, Philips K, Adeyanju M, Eggleston B, Ferng-Kuo SF, Duquette D, Bartholomew K, Stratton C. Student perceptions and practices regarding carrying concealed handguns on university campuses. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2013; 61:243-253. [PMID: 23768222 DOI: 10.1080/07448481.2013.799478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE This multisite study assessed college student's perceptions and practices regarding carrying concealed handguns on campus. PARTICIPANTS Undergraduate students from 15 public midwestern universities were surveyed (N = 1,800). METHODS Faculty members distributed the questionnaire to students in general education classes or classes broadly representative of undergraduate students. RESULTS Useable questionnaires were returned by 1,649 students (92%). The majority (78%) of students was not supportive of concealed handguns on campuses, and 78% claimed that they would not obtain a permit to carry a handgun on campus, if it were legal. Those who perceived more disadvantages to carrying handguns on campus were females, who did not own firearms, did not have a firearm in the home growing up, and were not concerned with becoming a victim of crime. CONCLUSIONS The majority of students was not supportive of concealed handguns on campus and claimed that they would not feel safer if students and faculty carried concealed handguns.
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Affiliation(s)
- Amy Thompson
- Department of Health Professions, University of Toledo, Toledo, Ohio 43606, USA.
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Thompson A, Price JH, Dake J, Teeple K. Faculty perceptions and practices regarding carrying concealed handguns on university campuses. J Community Health 2012; 38:366-73. [PMID: 23089903 DOI: 10.1007/s10900-012-9626-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The presence of firearms in an environment significantly increases firearm trauma. So far, four states have passed legislation permitting the carrying of concealed handguns on university campuses and several other states are considering such legislation. The purpose of this study to assess the perceptions and practices of college faculty regarding support for carrying concealed handguns on their campuses. A valid and reliable questionnaire was sent to a random sample of 1,125 faculty at 15 randomly selected state universities in five Great Lakes states. A two wave postal mailing in the Spring of 2012 was conducted to help ensure an adequate response rate. A total of 791 (70 %) of the faculty responded. The vast majority felt safe on their campuses (98 %) and were not supportive of people carrying concealed handguns on their campuses (94 %). Seven of the eight potential disadvantages of carrying concealed handguns on campus were supported by the majority of faculty members. Those who were significantly more likely to perceive there to be disadvantages to carrying concealed handguns on campus were: those who did not own a firearm (OR = 4.89), Democrats (OR = 4.52) or Independents (OR = 2.25), Asians (OR = 2.49), and females (OR = 1.51). The vast majority of faculty felt safe on their campuses and perceived that carrying concealed handguns on campuses create more risks than benefits to the campus environment. Aggressive efforts are needed to help maintain the uniquely safe environment of college campuses.
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Gun control and suicide: The impact of state firearm regulations in the United States, 1995–2004. Health Policy 2011; 101:95-103. [DOI: 10.1016/j.healthpol.2010.10.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 10/04/2010] [Accepted: 10/10/2010] [Indexed: 11/24/2022]
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Abstract
This article summarizes the scientific literature on the health risks and benefits of having a gun in the home for the gun owner and his/her family. For most contemporary Americans, scientific studies indicate that the health risk of a gun in the home is greater than the benefit. The evidence is overwhelming for the fact that a gun in the home is a risk factor for completed suicide and that gun accidents are most likely to occur in homes with guns. There is compelling evidence that a gun in the home is a risk factor for intimidation and for killing women in their homes. On the benefit side, there are fewer studies, and there is no credible evidence of a deterrent effect of firearms or that a gun in the home reduces the likelihood or severity of injury during an altercation or break-in. Thus, groups such as the American Academy of Pediatrics urge parents not to have guns in the home.
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Affiliation(s)
- David Hemenway
- Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts
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Traylor A, Price JH, Telljohann SK, King K, Thompson A. Clinical psychologists' firearm risk management perceptions and practices. J Community Health 2010; 35:60-7. [PMID: 20094905 PMCID: PMC2816245 DOI: 10.1007/s10900-009-9200-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to investigate the current perceptions and practices of discussing firearm risk management with patients diagnosed with selected mental health problems. A three-wave survey was mailed to a national random sample of clinical psychologists and 339 responded (62%). The majority (78.5%) believed firearm safety issues were greater among those with mental health problems. However, the majority of clinical psychologists did not have a routine system for identifying patients with access to firearms (78.2%). Additionally, the majority (78.8%) reported they did not routinely chart or keep a record of whether patients owned or had access to firearms. About one-half (51.6%) of the clinical psychologists reported they would initiate firearm safety counseling if the patients were assessed as at risk for self-harm or harm to others. Almost half (46%) of clinical psychologists reported not receiving any information on firearm safety issues. Thus, the findings of this study suggest that a more formal role regarding anticipatory guidance on firearms is needed in the professional training of clinical psychologists.
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Affiliation(s)
- Andrea Traylor
- Family Studies & Social Work, Miami University, McGuffey Hall 110 H, Oxford, OH 45056 USA
| | - James H. Price
- Department of Health and Rehabilitative Services, The University of Toledo, 2801 W. Bancroft Mail Stop 119, Toledo, OH 43606 USA
| | - Susan K. Telljohann
- Department of Health and Rehabilitative Services, The University of Toledo, 2801 W. Bancroft Mail Stop 119, Toledo, OH 43606 USA
| | - Keith King
- Health Promotion & Education, University of Cincinnati, TEACHERS 526E, PO Box 210068, Cincinnati, OH 45221 USA
| | - Amy Thompson
- Department of Health and Rehabilitative Services, The University of Toledo, 2801 W. Bancroft Mail Stop 119, Toledo, OH 43606 USA
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Thompson A, Price JH, Mrdjenovich AJ, Khubchandani J. Reducing firearm-related violence on college campuses-police chiefs' perceptions and practices. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2009; 58:247-254. [PMID: 19959439 DOI: 10.1080/07448480903295367] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
CONTEXT Firearms are used in the majority of college aged suicides and homicides. With recent efforts by various gun lobbying groups to have firearms more accessible to college students on campuses, there is the potential for more firearm-related morbidity and mortality. OBJECTIVE This study assessed university police chiefs' perceptions and practices concerning selected issues of firearm violence and its reduction on college campuses. PARTICIPANTS The Directory of the International Association for College Law Enforcement Administrators was used to identify a national random sample of campus police chiefs (n = 600). The respondents were predominantly males (89%), 40 to 59 years of age (71%), Caucasian (85%), and worked for 21or more years in law enforcement (75%). METHODS In the fall of 2008, a 2-wave mailing procedure was used to ensure an adequate response rate to a valid and reliable questionnaire. RESULTS A total of 417 (70%) questionnaires were returned. A firearm incident had occurred in the past year on 25% of campuses and on 35% of campuses within the past 5 years. The majority of campuses (57%) had a plan in place for longer than a year to deal with an "active shooter" on campus. Virtually all (97%) of the campuses had a policy in place that prohibited firearms on campus. The primary barrier (46%) to a highly visible campus plan for preventing firearms violence was the perception that firearms violence was not a problem on their campus. CONCLUSIONS A greater awareness of the importance of a highly visible campus firearm policy and its potential for reducing firearm trauma on college campuses is needed.
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Affiliation(s)
- Amy Thompson
- Department of Health and Rehabilitation Services, The University of Toledo, Toledo, Ohio, USA.
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Price J, Mrdjenovich AJ, Thompson A, Dake JA. College counselors' perceptions and practices regarding anticipatory guidance on firearms. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2009; 58:133-139. [PMID: 19892650 DOI: 10.1080/07448480903221350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES This study assessed college counselors' anticipatory guidance on firearms for student clients. PARTICIPANTS The membership of the Association for University and College Counseling Center Directors was used to identify a national random sample of counseling centers (n = 361). One counselor from each center was selected to survey. METHODS In the winter of 2008, a 3-wave mailing procedure was used to maximize the response rate. Completed surveys served as consent (as approved by the University Human Subjects Committee). RESULTS A total of 213 counselors (59%) responded. They were unlikely to provide anticipatory guidance (6%), chart/keep records on client ownership/access to firearms (17%), or to counsel the majority of clients from various diagnostic categories on firearms. CONCLUSIONS University personnel are likely to refer students with suspected mental health problems to university counseling centers. The findings indicate that few counseling centers will address firearm issues with students.
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Affiliation(s)
- James Price
- The University of Toledo, Toledo, Ohio 43606, USA.
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Stansfield T, Rushforth G. UK Armed Forces Unintentional Firearm Injuries. J ROY ARMY MED CORPS 2009; 155:20-3. [DOI: 10.1136/jramc-155-01-06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Joe S, Baser RS, Neighbors HW, Caldwell CH, Jackson JS. 12-month and lifetime prevalence of suicide attempts among black adolescents in the National Survey of American Life. J Am Acad Child Adolesc Psychiatry 2009; 48:271-282. [PMID: 19182692 PMCID: PMC2760075 DOI: 10.1097/chi.0b013e318195bccf] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Provide nationally representative data on the prevalence and psychiatric correlates of suicidal ideation and attempts among African American and Caribbean black adolescents in the United States. METHOD Data on nonfatal suicidal behavior among 1,170 African American and Caribbean black adolescents aged 13 to 17 years are from the National Survey of American Life-Adolescent, a nationally representative household survey of adults with an attached adolescent sample conducted between February 2001 and June 2003. RESULTS Nationwide black adolescents reported having a lifetime prevalence of 7.5% for suicidal ideation and 2.7% for attempts. The 12-month prevalence of suicidal ideation and attempt was 3.2% and 1.4%, respectively. Among all respondents, 4% of black American adolescents and 7% of female subjects were projected to attempt suicide by age 17 years. African American adolescents were approximately five times more likely than Caribbean black adolescents to attempt suicide. Almost half of the National Survey of American Life-Adolescent respondents who reported a suicide attempt had never met criteria for any of the DSM-IV disorders by the time of their attempts. CONCLUSIONS Clinicians should be trained to screen for suicidal behavior, even among those without DSM-IV disorders, when treating black adolescents, particularly female subjects. In addition, preventive efforts should consider ethnic differences in suicide risk and targeting nonclinical settings.
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Affiliation(s)
- Sean Joe
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan.
| | - Raymond S Baser
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Harold W Neighbors
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - Cleopatra H Caldwell
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
| | - James S Jackson
- Dr. Joe is with the School of Social Work, University of Michigan, Dr. Baser is with the Institute for Social Research, and Drs. Neighbors, Caldwell, and Jackson are with the Department of Health Behavior and Health Education, School of Public Health, University of Michigan
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Macpherson AK, Schull MJ. Penetrating trauma in Ontario emergency departments: a population-based study. CAN J EMERG MED 2007; 9:16-20. [PMID: 17391595 DOI: 10.1017/s1481803500014688] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is a paucity of population-based research on health service utilization related to penetrating trauma in Canada, even though such trauma can result in serious injury or death, and gunshot wounds have been labelled the "the new public health issue." Complete epidemiologic data, including emergency department (ED) visits and hospitalizations, for penetrating trauma is not available. The objective of this paper is to describe the epidemiology of ED visits for firearm-related and knife-related penetrating trauma in one Canadian province. METHODS All EDs in the province of Ontario (pop. approx. 12 400 000 at the time of the study) submit data on ED visits to the National Ambulatory Care Reporting System. This database includes patients' demographic information (i.e., age, sex and geographic area of residence), the reason for the visit, disposition (i.e., admitted to hospital or sent home), and other diagnostic information. For visits related to injuries, the cause of injury is also reported (e-codes according to the Canadian Enhancement to the International Statistical Classification of Diseases and Related Health Problems, 10th rev [ICD-10-CA]). All patients seen in Ontario EDs for an injury related to a firearm, knife, or sharp object, were included in our study. RESULTS Of the 1.2 million ED visits in 2002-03 for trauma in Ontario, 40 240 (3.4%) patients were treated for injuries relating to penetrating trauma. Most patients were male, and most were 15-24 years of age. Penetrating trauma was frequently a result of knives or sharp objects (39 654 visits or 98.5%); only 1.5% (n = 586) of these injuries were caused by firearms. Of those hospitalized, 151 were related to firearms and 1455 were related to knives/ sharp objects. CONCLUSIONS Analyzing administrative data provides an estimate of the impact of penetrating trauma on a population, thereby providing prevention programs with data upon which to design their strategies. Evidence-based prevention strategies are needed to reduce the burden of penetrating trauma. Monitoring ED and hospitalization data over time will help to assess trends and provide evidence for the effectiveness of such strategies.
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Affiliation(s)
- Alison K Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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Giancola PR, Godlaski AJ, Parrott DJ. Perceptions of one's attacker's intentions following an aggressive interaction involving alcohol. The Journal of General Psychology 2007; 133:389-400. [PMID: 17128958 DOI: 10.3200/genp.133.4.389-400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The authors investigated and assessed the perceptions of one's attacker's intentions following an aggressive interaction involving alcohol. Participants were 328 (163 men and 165 women) healthy social drinkers between 21 and 35 years of age. After participants had consumed a beverage containing either alcohol or a placebo, the authors tested them on a modified version of the Taylor Aggression Paradigm (TAP; S. Taylor, 1967) in which participants received mild electric shocks from, and administered shocks to, a fictitious opponent (the attacker) under the guise of a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent. The authors queried participants about their perceptions of their opponents' intentions toward them on the task. Overall, participants who were least aggressive on the TAP perceived their opponent to have the most aggressive intentions and those who were the most aggressive perceived their opponent to have the least aggressive intentions. Alcohol only seemed to play a role for women. It appeared to decrease aggressive perceptions for the least aggressive women and to increase such perceptions for the most aggressive women. The authors discuss results according to L. Huesmann's (1988) cognitive script model of aggression.
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Affiliation(s)
- Peter R Giancola
- Department of Psychology University of Kentucky, Lexington 40506-0044, USA.
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