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Siegel M. Universal Background Checks, Permit Requirements, and Firearm Homicide Rates. JAMA Netw Open 2024; 7:e2425025. [PMID: 39088216 PMCID: PMC11294962 DOI: 10.1001/jamanetworkopen.2024.25025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/03/2024] [Indexed: 08/02/2024] Open
Abstract
Importance A loophole in US gun policy is that people can purchase guns from private sellers without going through any background check. Some states have addressed this loophole by requiring universal background checks for all gun sales, either at the point of sale or through a permit system; however, most studies on the effectiveness of universal background checks have not analyzed these 2 policy mechanisms separately. Objective To assess the association of point-of-sale background check law and gun permit law, separately, with firearm homicide rates from 1976 through 2022 using the same methods and model specification. Design, Setting, and Participants This cross-sectional study used a difference-in-differences, fixed-effects regression model to evaluate firearm laws and firearm homicide rates in 48 states from 1976 through 2022. Data were obtained for 48 states except New Hampshire and Vermont and were analyzed in January 2024. Exposures Implementation of either the law requiring a universal background check at point of sale for all firearms without a permit or the laws combining universal background checks and a state permit requirement for all gun purchasers. Main Outcomes and Measures Annual, state-specific rates of firearm homicide per 100 000 people. Results From 1976 through 2022, 12 states adopted the universal background check laws without permitting requirements and 7 states implemented gun permit laws covering all firearms. The mean (SD) firearm homicide rate was 4.3 (0.1) per 100 000 people. Universal background checks for all firearms alone (without a state permitting system) were not associated with overall homicide rates (percentage change, 1.3%; 95% CI, -6.9% to 10.4%) or firearm homicide rates (percentage change, 3.7%; 95% CI, -5.3% to 13.6%). A law requiring a permit for the purchase of all firearms was associated with significantly lower overall homicide rates (percentage change, -15.4%; 95% CI, -28.5% to -0.01%) and firearm homicide rates (percentage change, -18.3%; 95% CI, -32.0% to -1.9%). Conclusions and Relevance This cross-sectional study found that universal background checks alone were not associated with firearm homicide rates, but a permit requirement for the purchase and possession of firearms was associated with substantially reduced rates of firearm homicide. The findings suggest that combining universal background checks and permit-to-purchase requirements is an effective strategy for firearm-related fatality reduction.
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Affiliation(s)
- Michael Siegel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Shipley J, Grigorian A, Swentek L, Barrios C, Kuza C, Santos J, Nahmias J. Long gun violence in California versus Texas: How legislation can reduce firearm violence. Surg Open Sci 2024; 20:51-54. [PMID: 38911056 PMCID: PMC11190741 DOI: 10.1016/j.sopen.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/27/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Long guns (LGs) are uniquely implicated in firearm violence and mass shootings. On 1/1/2019 California (CA) raised the minimum age to purchase LGs from 18 to 21. This study aimed to evaluate the incidence of LG violence in CA vs. Texas (TX), a state with rising firearm usage and fewer LG regulations, hypothesizing decreased LG firearm incidents in CA vs increased rates in TX after CA LG legislation. Methods A retrospective analysis of the Gun Violence Archive (2015-2021) was performed. An additional analysis of all firearm incidents within TX and CA was performed. CA and TX census data were used to calculate incidents of LG violence per 10,000,000 people. The primary outcome was the number of LG-related firearm incidents. Median yearly rates of LG violence per 10,000,000 people were compared for pre (2015-2018) vs post (2019-2021) CA LG legislation (Senate Bill 1100 (SB1100). Results Median LG incidents decreased in CA post-SB1100 (4.21 vs 1.52, p < 0.001) by nearly 64 %, whereas any gun firearm violence was similar pre vs post-SB1100 (77.0 vs 74.5 median incidents, p = 0.89). In contrast, median LG incidents increased after SB1100 (4.34 vs 5.17 median incidents, p = 0.011) by nearly 35 % in TX, with any gun incidents increasing by nearly 53 % (83.48 vs 127.46, p < 0.001). Conclusion CA LG firearm incidents decreased following SB 1100 legislation whereas the incidence in TX increased during this same time. Meanwhile, the incidence of any firearm violence remained similar in CA but increased in TX. This suggests the sharp decline in CA LG incidents may be related to SB1100. Accordingly, increasing the age to purchase a LG from 18 to 21 at a federal level may help curtail LG violence nationally.
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Affiliation(s)
- Jonathan Shipley
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Areg Grigorian
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Lourdes Swentek
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Cristobal Barrios
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Catherine Kuza
- Keck School of Medicine of the University of Southern California, Department of Anesthesia, Los Angeles, CA, USA
| | - Jeffrey Santos
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
| | - Jeffry Nahmias
- University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA
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Rencken CA, Schleimer JP, Miller M, Swanson SA, Rowhani-Rahbar A. Reporting and Description of Research Methodology in Studies Estimating Effects of Firearm Policies. Epidemiology 2024; 35:458-468. [PMID: 38597728 DOI: 10.1097/ede.0000000000001741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Evidence about which firearm policies work, to what extent, and for whom is hotly debated, perhaps partly because variation in research methodology has produced mixed and inconclusive effect estimates. We conducted a scoping review of firearm policy research in the health sciences in the United States, focusing on methodological considerations for causal inference. METHODS We identified original, empirical articles indexed in PubMed from 1 January 2000 to 1 September 2021 that examined any of 18 prespecified firearm policies. We extracted key study components, including policy type(s) examined, policy operationalization, outcomes, study setting and population, study approach and design, causal language, and whether and how authors acknowledged potential sources of bias. RESULTS We screened 7733 articles and included 124. A plurality of studies used a legislative score as their primary exposure (n = 39; 32%) and did not examine change in policies over time (n = 47; 38%). Most examined firearm homicide (n = 51; 41%) or firearm suicide (n = 40; 32%) as outcomes. One-third adjusted for other firearm policies (n = 41; 33%). Three studies (2%) explicitly mentioned that their goal was to estimate causal effects, but over half used language implying causality (n = 72; 58%). Most acknowledged causal identification assumptions of temporality (n = 91; 73%) and exchangeability (n = 111; 90%); other assumptions were less often acknowledged. One-third of studies included bias analyses (n = 42; 34%). CONCLUSIONS We identified a range of methodologic approaches in firearm policy research in the health sciences. Acknowledging the imitations of data availability and quality, we identify opportunities to improve causal inferences about and reporting on the effects of firearm policies on population health.
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Affiliation(s)
- Camerin A Rencken
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
| | - Julia P Schleimer
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
| | - Matthew Miller
- Department of Health Sciences, Northeastern University Bouvé College of Health Sciences, Boston, MA
| | - Sonja A Swanson
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Ali Rowhani-Rahbar
- From the Department of Epidemiology, University of Washington School of Public Health, Seattle, WA
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA
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Laudon AD, Davis ES, Zhao X, Kenzik K, Torres C, Sanchez SE, Brahmbhatt TS, Scantling DR. Bullet holes: A novel model to identify the most impactful gaps in the firearm homicide prevention laws of each state. J Trauma Acute Care Surg 2024; 97:142-148. [PMID: 38497933 DOI: 10.1097/ta.0000000000004309] [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: 03/19/2024]
Abstract
BACKGROUND Firearm homicides (FH) are a major cause of mortality in the United States. Firearm law implementation is variable across states, and legislative gaps may represent opportunities for FH prevention. For each state, we sought to identify which firearm law category would have been most effective if implemented and how effective it would have been. METHODS We conducted a retrospective cohort study examining the effects of firearm laws on FH rates in the 48 contiguous US states 2010 to 2019. Data were obtained from the CDC WONDER and FBI UCR databases, State Firearm Law Database, and US Census. Firearm laws were grouped into 14 categories. We assessed the association between the presence of each law category and FH rate as an incidence rate ratio (IRR) using a Poisson regression accounting for state population characteristics and laws of surrounding states. We estimated the IRR for each state that did not have a given law category present and determined which of these missing law categories would have been associated with the greatest reduction in FH rate. RESULTS FH rates varied widely across states and increased from a mean of 3.2 (SD = 1.7) to 4.2 (SD = 2.9) FH per 100,000. All law categories were significantly associated with decreased FH rate ( p < 0.05), with IRR ranging from 0.25 to 0.85. The most effective missing law category differed between states but was most commonly child access prevention (34.09% of states), assault weapons and large-capacity magazines (15.91%), preemption (15.91%), and concealed carry permitting (13.64%). In total across 2010 to 2019, we estimated that 129,599 fewer FH would have occurred with enactment of the most effective missing law category in each state. CONCLUSION Modeling firearm law prevention of FH with regard to state legislative and population characteristics can identify the highest impact missing law categories in each state. These results can be used to inform efforts to reduce FH. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
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Affiliation(s)
- Aksel D Laudon
- From the Department of Surgery (A.D.L., E.S.D., X.Z., K.K., C.T., S.E.S., D.R.S.), Boston University Chobanian & Avedisian School of Medicine; Division of Trauma and Acute Care Surgery (C.T., S.E.S., D.R.S.), Boston Medical Center; and Division of Trauma and Acute Care Surgery (T.S.B.), Cedars-Sinai Medical Center, Boston, Massachusetts
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Roberts L, Hoofnagle MH, Bushover B, Gobaud AN, Mehranbod CA, Fish C, Morrison CN. Interstate Highway Connections and Traced Gun Transfers Between the 48 Contiguous United States. JAMA Netw Open 2024; 7:e245662. [PMID: 38592720 PMCID: PMC11004838 DOI: 10.1001/jamanetworkopen.2024.5662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/10/2024] [Indexed: 04/10/2024] Open
Abstract
Importance Interstate gun flow has critical implications for gun violence prevention, as gun transfers across state lines can undermine local gun control policies. Objective To identify possible gun trafficking routes along interstate highways in the US. Design, Setting, and Participants This repeated-measures, ecological, cross-sectional study used data from the Bureau of Alcohol, Tobacco, Firearms and Explosives from January 1, 2010, to December 31, 2019, to examine associations between interstate connections via 13 highways that each spanned at least 1000 miles and interstate traced gun transfer counts for the 48 contiguous United States. Analyses were completed in November 2023. Exposures Characteristics of the origin states and the transportation connections between the destination state and the origin states. Main Outcomes and Measures The main outcome was the total count of guns used in crimes in each destination state per year that were originally purchased in the origin state. Bayesian conditional autoregressive Poisson models were used to examine associations between the count of guns used in crime traced to interstate purchases and interstate highway connections between origin and destination states. Results Between 2010 and 2019, 526 801 guns used in crimes in the contiguous 48 states were traced to interstate purchases. Northbound gun transfers along the Interstate 95 corridor were greater than expected to New Jersey (incidence rate ratio [IRR], 2.80; 95% credible interval [CrI], 1.01-7.68) and Maryland (IRR, 3.07; 95% CrI, 1.09-8.61); transfers were similarly greater along Interstate 15 southbound, Interstate 25 southbound, Interstate 35 southbound, Interstate 75 northbound and southbound, Interstate 10 westbound, and Interstate 20 eastbound and westbound. Conclusions and Relevance This repeated-measures, ecological, cross-sectional study identified that guns used in crimes traced to interstate purchases moved routinely between states along multiple major transportation routes. Interstate gun transfers are a major contributor to gun crime, injury, and death in the US. National policies and interstate cooperation are needed to address this issue.
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Affiliation(s)
- Leah Roberts
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Mark H. Hoofnagle
- Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Brady Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Ariana N. Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Christina A. Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Carolyn Fish
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Kim B, Thorpe LE, Spoer BR, Titus AR, Santaella-Tenorio J, Cerdá M, Gourevitch MN, Matthay EC. State-Level Firearm Laws and Firearm Homicide in US Cities: Heterogenous Associations by City Characteristics. J Urban Health 2024; 101:280-288. [PMID: 38536598 PMCID: PMC11052935 DOI: 10.1007/s11524-024-00851-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/28/2024]
Abstract
Despite well-studied associations of state firearm laws with lower state- and county-level firearm homicide, there is a shortage of studies investigating differences in the effects of distinct state firearm law categories on various cities within the same state using identical methods. We examined associations of 5 categories of state firearm laws-pertaining to buyers, dealers, domestic violence, gun type/trafficking, and possession-with city-level firearm homicide, and then tested differential associations by city characteristics. City-level panel data on firearm homicide cases of 78 major cities from 2010 to 2020 was assessed from the Centers for Disease Control and Prevention's National Vital Statistics System. We modeled log-transformed firearm homicide rates as a function of firearm law scores, city, state, and year fixed effects, along with time-varying city-level confounders. We considered effect measure modification by poverty, unemployment, vacant housing, and income inequality. A one z-score increase in state gun type/trafficking, possession, and dealer law scores was associated with 25% (95% confidence interval [CI]:-0.37,-0.1), 19% (95% CI:-0.29,-0.07), and 17% (95% CI:-0.28, -0.4) lower firearm homicide rates, respectively. Protective associations were less pronounced in cities with high unemployment and high housing vacancy, but more pronounced in cities with high income inequality. In large US cities, state-level gun type/trafficking, possession, and dealer laws were associated with lower firearm homicide rates, but buyers and domestic violence laws were not. State firearm laws may have differential effects on firearm homicides based on city characteristics, and city-wide policies to enhance socioeconomic drivers may add benefits of firearm laws.
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Affiliation(s)
- Byoungjun Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Surgery, New York University Grossman School of Medicine, 1 Park Ave 6-815, New York, NY, USA.
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Ben R Spoer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Andrea R Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Julian Santaella-Tenorio
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Marc N Gourevitch
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Ellicott C Matthay
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Lind A, Mason SM, Brady SS. Investing in family-centered early childhood education: A conceptual model for preventing firearm homicide among Black male youth in the United States. Prev Med 2024; 181:107917. [PMID: 38408647 PMCID: PMC10947821 DOI: 10.1016/j.ypmed.2024.107917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Firearms are now the number one killer of children and adolescents in the United States. Firearm homicides among Black male youth are the driver of this increase. Prevention requires a multi-faceted life course approach. Academic achievement has been identified as a protective factor. Early childhood education, which is linked to later achievement, is thus an intervention area of interest. Conceptualizing the potential links between early childhood education and reduced risk for youth firearm homicide is important for guiding policy advocacy and informing future research. METHODS This paper presents a conceptual model linking early childhood education to reduced risk for firearm homicide. Each link in the model is discussed, and a corresponding review of the literature is presented. The need for anti-racist policies to strengthen the impact of early childhood education is highlighted. RESULTS Early education and firearm homicide research are each well-established but largely disconnected. There are clear immediate benefits of early childhood education; however, these effects wane with time, particularly for youth of color. At the same time, juvenile delinquency-a major risk factor for firearm homicide-is influenced by educational inequities. CONCLUSIONS Effective interventions to reduce firearm homicides among Black male youth in the United States are needed. Early childhood education shows promise as an intervention. However, to have an impact, this education needs to be accessible and affordable for all, particularly families of color and low income. Societal structures and policies must also better support the positive gains seen through early childhood education to avoid dissipation.
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Affiliation(s)
- Allison Lind
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
| | - Susan M Mason
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Sonya S Brady
- Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, MN, United States
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Liu T, Fang X, Bai Z, Liu L, Lu H, Qi X. Outcomes of selective non-operative management in adults with abdominal gunshot wounds: a systematic review and meta-analysis. Int J Surg 2024; 110:1183-1195. [PMID: 38051918 PMCID: PMC10871643 DOI: 10.1097/js9.0000000000000915] [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: 03/06/2023] [Accepted: 11/05/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND AND AIMS Abdominal gunshot wounds (GSWs), a clinically devastating injury, can result in a variety of severe and lethal complications. Traditionally, exploratory laparotomy is the first-line approach for the management of abdominal GSWs, but it is associated with a considerable amount of unnecessary surgeries. At present, selective non-operative management (SNOM) of abdominal GSWs is becoming an effective and well-recognized approach, but it remains widely disputed since many surgeons are skeptical about the validity of SNOM in clinical practice. This meta-analysis aims to estimate the outcomes of SNOM and immediate laparotomy in patients with GSWs by collecting the currently available evidence. METHODS The PubMed , EMBASE , and Cochrane Library databases were searched. A random-effects model was employed. A pooled proportion with 95% confidence intervals (CIs) was calculated. Heterogeneity was evaluated using Cochran's Q test and I2 statistics. RESULTS Overall, 53 studies involving 60 291 participants were included. The pooled proportions of SNOM and SNOM failure were 27.0% (95% CI=24.0-30.0%) and 10.0% (95% CI=7.0-13.0%), respectively. The pooled mortality after SNOM and SNOM failure were 0.0% (95% CI=0.0-1.0%) and 0.0% (95% CI=0.0-0.0%), respectively. The pooled proportions of immediate laparotomy and unnecessary immediate laparotomy were 73.0% (95% CI=70.0-76.0%) and 10.0% (95% CI=8.0-13.0%), respectively. The pooled mortality after immediate laparotomy and unnecessary immediate laparotomy was 10.0% (95% CI=8.0-13.0%) and 0.0% (95% CI=0.0-1.0%), respectively. Heterogeneity was statistically significant in nearly all meta-analyses. CONCLUSION Immediate laparotomy is still the mainstay approach for the management of abdominal GSWs. Approximately one-third of patients with abdominal GSWs undergo SNOM. SNOM failure is not frequent, and its related mortality is also rare.
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Affiliation(s)
- Tingwei Liu
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
- Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command
- Graduate School, Jinzhou Medical University, Jinzhou, People’s Republic of China
| | - Xiaohui Fang
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
- Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command
- Shenyang Pharmaceutical University, Shenyang
| | - Zhaohui Bai
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
- Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command
- Shenyang Pharmaceutical University, Shenyang
| | - Lu Liu
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
| | - Hui Lu
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
| | - Xingshun Qi
- Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province
- Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command
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Swilley-Martinez ME, Coles SA, Miller VE, Alam IZ, Fitch KV, Cruz TH, Hohl B, Murray R, Ranapurwala SI. "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021. Epidemiol Rev 2023; 45:15-31. [PMID: 37789703 DOI: 10.1093/epirev/mxad010] [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: 05/16/2022] [Revised: 07/31/2023] [Accepted: 09/28/2023] [Indexed: 10/05/2023] Open
Abstract
Race is a social construct, commonly used in epidemiologic research to adjust for confounding. However, adjustment of race may mask racial disparities, thereby perpetuating structural racism. We conducted a systematic review of articles published in Epidemiology and American Journal of Epidemiology between 2020 and 2021 to (1) understand how race, ethnicity, and similar social constructs were operationalized, used, and reported; and (2) characterize good and poor practices of utilization and reporting of race data on the basis of the extent to which they reveal or mask systemic racism. Original research articles were considered for full review and data extraction if race data were used in the study analysis. We extracted how race was categorized, used-as a descriptor, confounder, or for effect measure modification (EMM)-and reported if the authors discussed racial disparities and systemic bias-related mechanisms responsible for perpetuating the disparities. Of the 561 articles, 299 had race data available and 192 (34.2%) used race data in analyses. Among the 160 US-based studies, 81 different racial categorizations were used. Race was most often used as a confounder (52%), followed by effect measure modifier (33%), and descriptive variable (12%). Fewer than 1 in 4 articles (22.9%) exhibited good practices (EMM along with discussing disparities and mechanisms), 63.5% of the articles exhibited poor practices (confounding only or not discussing mechanisms), and 13.5% were considered neither poor nor good practices. We discuss implications and provide 13 recommendations for operationalization, utilization, and reporting of race in epidemiologic and public health research.
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Affiliation(s)
- Monica E Swilley-Martinez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Serita A Coles
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7440, United States
| | - Vanessa E Miller
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Ishrat Z Alam
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Kate Vinita Fitch
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
| | - Theresa H Cruz
- Prevention Research Center, Department of Pediatrics, Health Sciences Center, University of New Mexico, Albuquerque, NM 87131, United States
| | - Bernadette Hohl
- Penn Injury Science Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-6021, United States
| | - Regan Murray
- Center for Public Health and Technology, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, United States
| | - Shabbar I Ranapurwala
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7435, United States
- Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC 27599, United States
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Ghio M, Simpson JT, Ali A, Fleckman JM, Theall KP, Constans JI, Tatum D, McGrew PR, Duchesne J, Taghavi S. Association Between Markers of Structural Racism and Mass Shooting Events in Major US Cities. JAMA Surg 2023; 158:1032-1039. [PMID: 37466952 PMCID: PMC10357360 DOI: 10.1001/jamasurg.2023.2846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/22/2023] [Indexed: 07/20/2023]
Abstract
Importance The root cause of mass shooting events (MSEs) and the populations most affected by them are poorly understood. Objective To examine the association between structural racism and mass shootings in major metropolitan cities in the United States. Design, Setting, and Participants This cross-sectional study of MSEs in the 51 largest metropolitan statistical areas (MSAs) in the United States analyzes population-based data from 2015 to 2019 and the Gun Violence Archive. The data analysis was performed from February 2021 to January 2022. Exposure Shooting event where 4 or more people not including the shooter were injured or killed. Main Outcome and Measures MSE incidence and markers of structural racism from demographic data, Gini income coefficient, Black-White segregation index, and violent crime rate. Results There were 865 MSEs across all 51 MSAs from 2015 to 2019 with a total of 3968 injuries and 828 fatalities. Higher segregation index (ρ = 0.46, P = .003) was associated with MSE incidence (adjusted per 100 000 population) using Spearman ρ analysis. Percentage of the MSA population comprising Black individuals (ρ = 0.76, P < .001), children in a single-parent household (ρ = 0.44, P < .001), and violent crime rate (ρ = 0.34, P = .03) were other variables associated with MSEs. On linear regression, structural racism, as measured by percentage of the MSA population comprising Black individuals, was associated with MSEs (β = 0.10; 95% CI, 0.05 to 0.14; P < .001). Segregation index (β = 0.02, 95% CI, -0.03 to 0.06; P = .53), children in a single-parent household (β = -0.04, 95% CI, -0.11 to 0.04; P = .28), and Gini income coefficient (β = -1.02; 95% CI, -11.97 to 9.93; P = .93) were not associated with MSEs on linear regression. Conclusions and Relevance This study found that major US cities with higher populations of Black individuals are more likely to be affected by MSEs, suggesting that structural racism may have a role in their incidence. Public health initiatives aiming to prevent MSEs should target factors associated with structural racism to address gun violence.
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Affiliation(s)
- Michael Ghio
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - John Tyler Simpson
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Ayman Ali
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Julia M. Fleckman
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Katherine P. Theall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Joseph I. Constans
- Tulane University School of Science & Engineering, New Orleans, Louisiana
| | - Danielle Tatum
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Patrick R. McGrew
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
- University Medical Center, New Orleans, Louisiana
| | - Sharven Taghavi
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
- University Medical Center, New Orleans, Louisiana
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11
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Gobaud AN, Morrison CN, Mehranbod CA, Hoofnagle MH. Gun shows and universal background check laws across state lines. Prev Med 2022; 165:107094. [PMID: 35605878 PMCID: PMC10111879 DOI: 10.1016/j.ypmed.2022.107094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 04/15/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
States with more gun laws have fewer gun assaults, and associations are strongest for background check laws. However, sales between private buyers and sellers (i.e., gun shows) are exempt from some background check requirements according to federal and most state laws. The aim of this study was to determine whether gun shows are more likely to take place in counties that are near states with universal background check laws. This cross-sectional study used gun show data from a 2018 public online listing aggregated within 3107 counties in the contiguous 48 states. The main independent variable was the presence of a universal background check law in neighboring states. We controlled for potential drivers of demand for gun shows, including the total number of gun laws within-state and in neighboring states, local and in-flowing population size, and proportion of the local and in-flowing population who were gun owners. Bayesian conditional autoregressive Poisson models estimated associations between neighboring-state universal background check law and the presence of a gun show in each county while accounting for spatial dependencies and nesting of counties within states. Of the 1869 identified gun shows, nine of the states in which they occurred had a universal background check law. The presence of excess gun shows in counties near states with universal background check laws is consistent with the hypothesis that gun shows service demand from people seeking to circumvent prohibitions against gun purchases.
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Affiliation(s)
- Ariana N Gobaud
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America.
| | - Christopher N Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America; Department of Epidemiology and Preventive Medicine, Monash University School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Christina A Mehranbod
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States of America
| | - Mark H Hoofnagle
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, United States of America
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12
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Liu Y, Siegel M, Sen B. Association of State-Level Firearm-Related Deaths With Firearm Laws in Neighboring States. JAMA Netw Open 2022; 5:e2240750. [PMID: 36346633 PMCID: PMC9644258 DOI: 10.1001/jamanetworkopen.2022.40750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
IMPORTANCE Firearms are easily transported over state borders; hence permissive firearm laws in one state may have an interstate association with firearm-related deaths in nearby states. OBJECTIVES To examine whether certain firearm laws have an interstate association with firearm-related deaths in nearby states. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional observational study used data on state firearm-related deaths in the 48 contiguous states of the US between January 1, 2000, and December 31, 2019. A spatial autoregressive model with fixed effects for state and year was used to evaluate within-state, interstate, and overall associations between firearm laws and firearm-related deaths. Analyses were performed during January 2022. EXPOSURES The following 9 types of laws were evaluated: universal background checks for all firearms purchase, background checks for handgun sales at gun shows, license requirement to purchase all firearms, state dealer license requirement for handgun sales, requirement of retaining records of handgun sales, ban on purchasing a handgun on behalf of another, prohibition of firearm possession by persons who committed violent misdemeanors, required relinquishment of firearms for persons becoming prohibited from possessing them, and discretion in granting a concealed carry permit. MAIN OUTCOMES AND MEASURES State-level total firearm-related death rates, suicide rates, and homicide rates. RESULTS In sum, the study period included 662 883 firearm-related deaths of all intents. License requirement for firearm purchase had a within-state association (effect size, -1.79 [95% CI, -2.73 to -0.84]), interstate association (effect size, -10.60 [95% CI, -17.63 to -3.56]), and overall association (effect size, -12.38 [95% CI, -19.93 to -4.83]) per 100 000 population decrease in total firearm-related deaths. This law also had within-state association (effect size, -1.26 [95% CI, -1.72 to -0.80]), interstate association (effect size, -9.01 [95% CI, -15.00 to -3.02]), and overall association (effect size, -10.27 [95% CI, -16.53 to -4.01]) per 100 000 population decrease in firearm-related homicide. CONCLUSIONS AND RELEVANCE The findings of this pooled cross-sectional analysis suggest that certain firearm laws in one state were associated with other states' firearm-related deaths. Synergic legislative action in adjacent states, federal firearm legislation, and measures that reduce migration of firearms across state borders should be part of the overarching strategy to prevent firearm-related deaths.
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Affiliation(s)
- Ye Liu
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham
| | - Michael Siegel
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
| | - Bisakha Sen
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham
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13
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Barak-Ventura R, Marín MR, Porfiri M. A spatiotemporal model of firearm ownership in the United States. PATTERNS 2022; 3:100546. [PMID: 36033595 PMCID: PMC9403408 DOI: 10.1016/j.patter.2022.100546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/04/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022]
Abstract
Firearm injury is a major public health crisis in the United States, where more than 200 people sustain a nonfatal firearm injury and more than 100 people die from it every day. To formulate policy that minimizes firearm-related harms, legislators must have access to spatially resolved firearm possession rates. Here, we create a spatiotemporal econometric model that estimates monthly state-level firearm ownership from two cogent proxies (background checks per capita and fraction of suicides committed with a firearm). From calibration on yearly survey data that assess ownership, we find that both proxies have predictive value in estimation of firearm ownership and that interactions between states cannot be neglected. We demonstrate use of the model in the study of relationships between media coverage, mass shootings, and firearm ownership, uncovering causal associations that are masked by the use of the proxies individually. A spatiotemporal model of firearm prevalence in the United States is created The econometric model predicts firearm ownership in every state for every month Information theory is used to detail causal links related to firearm prevalence The media can influence firearm prevalence, which in turn moderates mass shootings
Firearm violence is a major public health crisis in the United States, where more than 200 people sustain a nonfatal firearm injury and more than 100 people die from it every day. Despite these unsettling figures, scientific research on firearm-related harm significantly lags behind because spatially and temporally resolved data on firearm ownership are unavailable. This paper presents a spatiotemporal model that predicts firearm prevalence at the resolutions of one state and one month from the numbers of background checks and suicides committed with a firearm. Drawing on principles from econometrics, the model also accounts for interactions between states. The model’s output is challenged in causal analysis, which uncovers unprecedented associations between firearm prevalence, media output on firearm regulations, and mass shootings.
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Affiliation(s)
- Roni Barak-Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Center for Urban Science and Progress, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
| | - Manuel Ruiz Marín
- Department of Quantitative Methods, Law and Modern Languages, Technical University of Cartagena, Cartagena, 30201 Murcia, Spain
- Murcia Bio-Health Institute (IMIB-Arrixaca), Health Science Campus, Cartagena, 30120 Murcia, Spain
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Center for Urban Science and Progress, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
- Corresponding author
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14
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Drake SA, Lemke MK, Yang Y. Exploring the complexity of firearm homicides in Harris County, Texas, from 2009 to 2021: Implications for theory and prevention. Soc Sci Med 2022; 305:115048. [PMID: 35617763 DOI: 10.1016/j.socscimed.2022.115048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/03/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
Abstract
Firearm violence is a major health problem in the United States that clusters asymmetrically across geographic and demographic lines, and the persistence and unequal distribution of firearm violence suggests that novel causal explanations and theoretical frameworks may be warranted to guide preventive strategies. Thus, this study explores the following three hypotheses that are grounded in complex systems theory: 1) trends in firearm homicides risks have shifted heterogeneously in Harris County across endemic degree of risk; 2) firearm homicides clusters have remained resilient in Harris County across the study time period; and 3), the associations between known contextual correlates of firearm homicides and the distribution of firearm homicides risks in Harris County have manifested as nonlinear. Using a retrospective study design (n = 4,397) from January 1, 2009-June 31, 2021, medicolegal death investigation data from the Harris County Institute of Forensic Sciences and estimates of community characteristics from the American Community Survey were analyzed using Joinpoint trend analysis, kernel density geospatial analysis, and proportion tests. Trend analyses revealed that firearm homicides risks shifted heterogeneously across endemic degree of risk, with geographical areas with lower initial firearm homicides risks experiencing more profound upward shifts across the time period of the study. Geospatial analyses identified the resiliency of firearm homicides clusters across the study period, particularly in central, southern, and south-western districts of the city. Finally, the relationships between known contextual correlates and the distribution of firearm homicides risks in Harris County appeared to be nonlinear, particularly regarding ethnicity. This study provides data-driven results that suggest the plausibility of complex systems theory in advancing the understanding of causality in firearm homicides. Further, these findings support the urgent need for complex systems-informed preventive efforts that account for spatiotemporal heterogeneity, key interactions that generate nonlinearity, and latent feedback loops that underlie resiliency in firearm homicides.
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Affiliation(s)
- Stacy A Drake
- College of Nursing, Texas A&M University, 2121 W. Holcombe Blvd #1011A, Houston, TX, 77030, USA.
| | - Michael K Lemke
- Department of Social Sciences, University of Houston-Downtown, USA
| | - Yijiong Yang
- Department of Research, The University of Texas Health Science Center Cizak School of Nursing at Houston, USA
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15
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Spitzer SA, Forrester JD, Tennakoon L, Spain DA, Weiser TG. A decade of hospital costs for firearm injuries in the United States by region, 2005-2015: government healthcare costs and firearm policies. Trauma Surg Acute Care Open 2022; 7:e000854. [PMID: 35497324 PMCID: PMC8995943 DOI: 10.1136/tsaco-2021-000854] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/07/2022] [Indexed: 11/19/2022] Open
Abstract
Background Firearm injuries are a costly, national public health emergency, and government-sponsored programs frequently pay these hospital costs. Understanding regional differences in firearm injury burden may be useful for crafting appropriate policies, especially with widely varying state gun laws. Objective To estimate the volume of, and hospital costs for, fatal and non-fatal firearm injuries from 2005 to 2015 for each region of the United States and analyze the proportionate cost by payer status. Methods We used the Healthcare Cost and Utilization Project Nationwide Inpatient Sample to identify patients admitted for firearm-related injuries from 2005 to 2015. We converted hospitalization charges to costs, which were inflation-adjusted to 2015 dollars. We used survey weights to create regional estimates. We used the Brady Gun Law to determine significance between firearm restrictiveness and firearm hospitalizations by region. Results There were a total of 317 479 firearm related admissions over the study period: 52 829 (16.66%), 66 671 (21.0%), 134 008 (42.2%), and 63 972 (20.2%) for the Northeast, Midwest, South, and West respectively, demonstrating high regional variability. In the Northeast, hospital costs were $1.98 billion (13.9% of total), of which 56.0% was covered by government payers; for the Midwest, costs were $1.53 billion (19.7% of total), 40.4% of which was covered by government payers; in the South costs were highest at $3.2 billion (41.4% of total), but government payers only covered 34.3%; and costs for the West were $1.94 billion (25.0% of total), with government programs covering 41.6% of the cost burden. Conclusions Hospital admissions and costs for firearm injuries demonstrated wide variation by region, suggesting opportunities for financial savings. As government insurance programs cover 41.5% of costs, tax dollars heavily subsidize the financial burden of firearm injuries and cost recovery options for treating residents injured by firearms should be considered. Injury control strategies have not been well applied to this national public health crisis. Level of evidence Level II, Economic and Value Based Evaluation
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Affiliation(s)
- Sarabeth A Spitzer
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Center for Surgery and Public Health, Boston, MA, USA
| | | | | | - David A Spain
- Department of Surgery, Stanford University, Stanford, California, USA
| | - Thomas G Weiser
- Department of Surgery, Stanford University, Stanford, California, USA
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16
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Saunders NR, Moore Hepburn C, Huang A, de Oliveira C, Strauss R, Fiksenbaum L, Pageau P, Liu N, Gomez D, Macpherson A. Firearm injury epidemiology in children and youth in Ontario, Canada: a population-based study. BMJ Open 2021; 11:e053859. [PMID: 34794997 PMCID: PMC8603258 DOI: 10.1136/bmjopen-2021-053859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Despite firearms contributing to significant morbidity and mortality globally, firearm injury epidemiology is seldom described outside of the USA. We examined firearm injuries among youth in Canada, including weapon type, and intent. DESIGN Population-based, pooled cross-sectional study using linked health administrative and demographic databases. SETTING Ontario, Canada. PARTICIPANTS All children and youth from birth to 24 years, residing in Ontario from 1 April 2003 to 31 March 2018. EXPOSURE Firearm injury intent and weapon type using the International Classification of Disease-10 CM codes with Canadian enhancements. Secondary exposures were sociodemographics including age, sex, rurality and income. MAIN OUTCOMES Any hospital or death record of a firearm injury with counts and rates of firearm injuries described overall and stratified by weapon type and injury intent. Multivariable Poisson regression stratified by injury intent was used to calculate rate ratios of firearm injuries by weapon type. RESULTS Of 5486 children and youth with a firearm injury (annual rate: 8.8/100 000 population), 90.7% survived. Most injuries occurred in males (90.1%, 15.5/100 000 population). 62.3% (3416) of injuries were unintentional (5.5/100 000 population) of which 1.9% were deaths, whereas 26.5% (1452) were assault related (2.3/100 00 population) of which 18.7% were deaths. Self-injury accounted for 3.7% (204) of cases of which 72.0% were deaths. Across all intents, adjusted regression models showed males were at an increased risk of injury. Non-powdered firearms accounted for half (48.6%, 3.9/100 000 population) of all injuries. Compared with handguns, non-powdered firearms had a higher risk of causing unintentional injuries (adjusted rate ratio (aRR) 14.75, 95% CI 12.01 to 18.12) but not assault (aRR 0.84, 95% CI 0.70 to 1.00). CONCLUSIONS Firearm injuries are a preventable public health problem among youth in Ontario, Canada. Unintentional injuries and those caused by non-powdered firearms were most common and assault and self-injury contributed to substantial firearm-related deaths and should be a focus of prevention efforts.
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Affiliation(s)
- Natasha Ruth Saunders
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | | | | | | | | | - Lisa Fiksenbaum
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Paul Pageau
- Department of Emergency Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | | | - David Gomez
- ICES, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Alison Macpherson
- ICES, Toronto, Ontario, Canada
- School of Kinesiology and Health Science, York University Faculty of Health, Toronto, Ontario, Canada
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Anderson DM, Sabia JJ, Tekin E. Child Access Prevention Laws and Juvenile Firearm-Related Homicides. JOURNAL OF URBAN ECONOMICS 2021; 126:103387. [PMID: 34898733 PMCID: PMC8664083 DOI: 10.1016/j.jue.2021.103387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Debate over safe-storage gun regulations has captured public attention in the aftermath of several high-profile shootings committed by minors. To date, the existing literature provides no evidence that these laws are effective at deterring gun crime, a conclusion that has prompted the National Rifle Association to assert that such regulations are "unnecessary" and "ineffective." Using data from the FBI's Supplementary Homicide Reports for the period 1985-2013, we find that child access prevention (CAP) laws are associated with a 17 percent reduction in firearm-related homicides committed by juveniles. The estimated effect is stronger among whites than nonwhites and is driven by states enforcing the strictest safe-storage standard. We find no evidence that CAP laws are associated with firearm-related homicides committed by adults or with non-firearm-related homicides committed by juveniles, suggesting that the observed relationship between CAP laws and juvenile firearm-related homicides is causal.
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Affiliation(s)
| | - Joseph J Sabia
- Director of the Center for Health Economics and Policy Studies, San Diego State University, and IZA
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