Network exposure and homicide victimization in an African American community

Risk and Protective Factors for Firearm Assault Injuries Among Black Men: A Scoping Review of Research

Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.

PROTOCOL: Street outreach conflict mediation programs for reducing violence

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: This systematic review will synthesize the available evaluation research on the effectiveness of street outreach conflict mediation programs. The review seeks to answer the following primary question: Are street outreach worker strategies that use conflict mediation and/or violence interruption strategies effective at reducing violence? Assuming a sufficient number of eligible studies, this review will also address two additional questions: Are there certain program elements that render these strategies more or less effective? Are there certain conditions under which these strategies are more or less effective? As policymakers struggle to understand the policy options available to them for preventing and reducing violence, having clear answers to these three questions will help them make more informed decisions. The primary focus of this review is the effect of these strategies on violence. Nonetheless, when data are available we will collect information on secondary outcomes such as the cost-effectiveness of these strategies and their impacts on perceptual or attitudinal measures such as fear, perceived safety, and violence-related norms.

Using the Socio-Ecological Model to Understand Increased Risk of Gun Violence in the African American Community

Gun violence is a major public health issue of growing concern in the United States (U.S.) with 48,830 lives lost to gun related violence in 2021, documenting the highest number of gun related homicides and suicides ever recorded. The African American community is disproportionately impacted by gun violence and members of this community are almost 14x more likely to die by gun homicide than their white counterparts. The Centers for Disease Control and Prevention (CDC) has identified a socio-ecological framework as a lens through which to better understand violence and inform potential prevention strategies to address it. This model identifies four levels (individual, relationship, community, societal) which help to enhance our understanding of the complex interplay between individuals and their environments. Here, we use this model to understand why the African American community experiences elevated risk of gun violence in the U.S. and propose strategies for prevention. Understanding the issue of gun violence beyond individual level risk, this analysis highlights the interplay between multiple levels including the ways in which societal level factors influence violence. While this paper provides a lens through which to understand the multi-leveled factors that contribute to gun violence in the African American community, it also serves as a call to action for policymakers, scholars, and agencies to develop culturally informed policy and programming efforts specific to those who are most impacted.

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

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Upward Mobility Context and Health Outcomes and Behaviors during Transition to Adulthood: The Intersectionality of Race and Sex

This study investigates how upward mobility context affects health during transition to adulthood and its variations by race and sex. Using county-level upward mobility measures and data from the Panel Study of Income Dynamics, we apply propensity score weighting techniques to examine these relationships. Results show that low upward mobility context increases the likelihood of poor self-rated health, obesity, and cigarette use but decreases alcohol consumption probability. Conversely, high upward mobility context raises the likelihood of distress, chronic conditions, and alcohol use but reduces cigarette use likelihood. In low-opportunity settings, Black individuals have lower risks of chronic conditions and cigarette use than White men. In high-opportunity settings, Black women are more likely to experience depression and chronic conditions, and Black men are likelier to smoke than White men. Our findings emphasize the complex link between upward mobility context and health for different racial and sex groups.

Evaluating the impact of a street outreach intervention on participant involvement in gun violence

The past several years have witnessed increased calls for community violence interventions (CVIs) that address firearm violence while centering local expertise and avoiding the criminal legal system. Currently, little evidence exists on CVI effectiveness at the individual level. This study presents an evaluation of the impact of a street outreach-based CVI [Chicago CRED (Create Real Economic Destiny)] on participant involvement in violence. We used a quasiexperimental design with a treatment sample of 324 men recruited by outreach staff from 2016 to 2021 and a balanced comparison sample of 2,500 men from a network of individuals arrested in CRED's service areas. We conducted a Bayesian survival analysis to evaluate CRED's effect on individual violence-related outcomes on three levels of treatment: All enrolled participants, a subsample that made it through the initial phase, and those who completed programming. The intervention had a strong favorable effect on the probability of arrest for a violent crime for those completing the program: After 24 mo, CRED alumni experienced an 11.3 percentage point increase in survival rates of arrest for a violent crime relative to their comparisons (or, stated differently, a 73.4% reduction in violent crime arrests). The other two treatment levels experienced nontrivial declines in arrests but did not reach statistical significance. No statistically significant reduction in victimization risk was detected for any of the treatment levels. Results demonstrate that completion of violence intervention programming reduces the likelihood of criminal legal involvement for participants, despite the numerous systemic and environmental factors that impede personal success.

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

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

The cumulative effect of gun homicide-related loss on neighborhood perceptions among street-identified black women and girls: A mixed-methods study

Racial disparities in death indicate that Black women and girls are disproportionately bereaved by violent loss across their lifetime. Yet the context and consequences of this loss remain largely understudied. This study examines the effect of gun homicide-related loss of relative/friends on subjective neighborhood perceptions among street-identified Black women and girls (ages 16 to 54). The study used a convergent mixed-methods design, with simultaneous quantitative and qualitative components. Data were collected from two low-income, high-crime neighborhoods in Wilmington, Delaware. Quantitative data (n = 277) included a community-based survey on health, opportunity and violence. Qualitative data (n = 50) included semi-structured interviews primarily from a sub-group of the survey population. This study used a street participatory action research (Street PAR) methodology, which included members of the target population onto the research project. OLS regression analyses predicted the effect of exposure to gun homicide on perceptions of neighborhood social environment (i.e., safety, aesthetic quality, walkability, social cohesion, and availability of healthy foods). Interviews were analyzed using grounded theory. Approximately 87% of those surveyed were exposed to a relative/friend gun homicide. All interviewees were exposed to a relative/friend gun homicide. Exposure to the gun homicide of either a relative or friend alone was nonsignificant. But the combination of exposure to gun homicides of both a relative and friend was significantly related to poorer neighborhood perceptions, even when controlling for co-occurring factors. Mixed-method findings indicate that the cumulative impact of gun homicide-related loss matters most in shaping negative neighborhood perceptions. Qualitative data suggest that losing multiple members of one's familial and peer networks to homicide is a powerful form of co-victimization that alters how participants conceptualize and navigate public space. Interventions to decrease gun violence should consider how traumatic loss has unintended consequences on the quality of life of co-victims and those in close proximity to street life.

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

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

How Americans encounter guns: Mixed methods content analysis of YouTube and internet search data

Firearm-related injury and death is a serious public health issue in the U.S. As more Americans consume news and media online, there is growing interest in using these channels to prevent firearm-related harms. Understanding the firearm-related narratives to which consumers are exposed is foundational to this work. This research used the browsing behavior of a representative sample of American adults to identify seven firearm-related content "ecosystems" (defined as naturally occurring networks of channels watched by the same users) on YouTube; we then described the demographics and internet search patterns of users affiliated with each ecosystem. Over the 9-month study period, 72,205 panelists had 16,803,075 person-video encounters with 7,274,093 videos. Among these, 282,419 were related to firearms. Using fast greedy clustering, we partitioned users and channel interactions into seven distinct channel-based content ecosystems that reached more than 1/1000 YouTube users per day. These ecosystems were diverse in reach, users, and content (e.g., guns for self-protection, guns for fun). On average, 0.5% of panelists performed a firearm-related internet search on a given day. The vast majority of searches were related to mass shootings or police-involved shootings (e.g., "active shooter"), and virtually none were about more common firearm harm such as suicide. Searches for firearm safety information were most common among panelists affiliated with the "Hunting & Fishing" and "Guns & Gear" ecosystems, which were watched primarily by older, white men. These findings identify an opportunity for analyzing firearm-related narratives and tailoring firearm safety messaging for users affiliated with specific online content ecosystems.

Using social network analysis to examine gun violence

Research has found gun violence is a social contagion that spreads from one individual to another. To understand the social networks of violence, previous research has used social network analysis, a tool that explores the relationships between social actors. Most of the prior research uses coarrest data and incident reports to produce social networks. The current study incorporates the use of an underused data source, ballistic evidence, to better understand gun violence. The aim was to identify drivers of gun violence and to examine network concentration. Specifically, National Integrated Ballistic Information Network (NIBIN) leads and associated criminal incidents in combination with all incident reports were collected from a large urban county in the Pacific Northwest between 2015 and 2017. Social network analysis was conducted to produce a NIBIN network to demonstrate the connections between incidents where the same firearm was used. Social network analysis was also conducted to identify individuals who were the most involved in gun violence. Results reveal gun violence is very interconnected as many of the same firearms were discharged in multiple different incidents with several other individuals involved, indicating a connection between these individuals. This demonstrates the utility of using ballistic evidence beyond using only incident and coarrest data because it provides more information that directly relates to gun violence and the transfer of guns. Additionally, this can be very useful for law enforcement agencies to identify who is integral in the gun violence networks that can be helpful for prevention and intervention strategies.

Racial and Social Determinants of Civilian Gunshot Wounds to the Head

OBJECTIVE

To assess the clinical, racial, and social characteristics of victims of Gunshot wounds (GSWs) to the head and assess for associations between these factors and outcomes.

SUMMARY BACKGROUND DATA

Previous literature has not focused on the association of race and socioeconomic factors with these specific injuries.

METHODS

We identified patients with GSWs to the head who presented to 2 urban academic medical centers between 1998 and 2020, and extracted patient-level demographic data, information about the clinical and surgical course, and outcomes at discharge and follow-up.

RESULTS

The cohort included 250 patients, 90% (n = 226) of whom were male, with a mean age of 28 years. Forty-five percent were white (n = 112), 19% Black (n = 48), 18% Latinx (n = 45), with 6% "other" (n = 16), and 12% "unknown" (n = 29). The majority of patients presented with assault-related trauma (n = 153, 61%) as compared to self-inflicted injuries (n = 97, 39%). Across the entire cohort, sex, age, race, and median income by ZIP code were not significant predictors of outcome. Victims of assault by GSW to the head were more likely to be age 18 or younger (OR 5.26, P = 0.01), between the ages of 19 and 33 years (OR 4.7, P = 0.001), Black (OR 6.66, P < .001), and Latinx (OR 2.65, P = 0.03). Most patients (n = 155, 63%) had a poor functional outcome (modified Rankin Score 3-6) at discharge.

CONCLUSION

Age, race, and income status were not independent predictors of mortality or functional outcome at discharge in our population. Assault-related GSWs to the head mostly involved young Black or Latinx men of lower socioeconomic status, while self-inflicted injuries were largely seen in older white men.

The Art and Science of Urban Gun Violence Reduction: Evidence from the Advance Peace Program in Sacramento, California

Urban gun violence is a critical human health and social justice issue. Strategies to reduce urban gun violence are increasingly being taken out of the domain of police and into community-based programs. One such community-driven gun violence reduction program analyzed here is called Advance Peace. Advance Peace (AP) uses street outreach workers as violence interrupters and adult mentors to support the decision making and life chances of those at the center of urban gun violence. We reported on the impact Advance Peace had on gun violence and program participants in the City of Sacramento, California, from 2018–2019. Using an interrupted time series model, we attributed a gun violence reduction of 18% city wide and up to 29% in one of the AP target neighborhoods from the intervention. We also found that of the 50 participants in the Advance Peace Sacramento program 98% were alive, 90% did not have a new gun charge or arrest, 84% reported an improved outlook on life, all received cognitive behavioral therapy, and 98% reported that their AP outreach worker was one of the most important adults in their life. Advance Peace is a viable community-driven, urban gun violence, and healing-focused program.

A national analysis of trauma care proximity and firearm assault survival among U.S. police

Past research on factors influencing firearm assault (FA) mortality have not focused on police officers who, compared to other U.S. workers and the general public, experience especially high rates of firearm victimization. This study focuses on this unique population of FA victims and examines the relationship between travel time to the nearest trauma care facility and the probability of survival among officers shot on duty. Combining data on trauma care center location and 7 years of data on U.S. police officers fatally or non-fatally assaulted with a firearm, we use logistic regression to model the probability of FA fatality among police by proximity of the FA to the nearest trauma care facility. We find that travel time to trauma care was not associated with reduced FA mortality among police from 2014 to 2020. FA mortality was significantly lower in 2020 than the six years prior.

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

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

Predicting Violent Victimization Using Social Network Analysis From Police Data

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

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

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

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

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

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

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

Neighborhood Perceptions of Gun Violence and Safety: Findings from a Public Health-Social Work Intervention

Efforts to reduce gun violence have moved away from models that rely solely on law enforcement approaches, toward public health-focused models of intervention. This paper discusses urban gun violence from a public health and social work perspective, examining a method to interrupt, reduce and prevent gun violence at the community level. A qualitative research design was utilized to evaluate perceptions held by thirty-seven community members regarding the impact of a gun and related violence prevention program, Albany SNUG. Five key findings emerged from the data analysis: 1) Violence was viewed as significant, widespread and a source of despair and hopelessness; 2) Residents perceived a lack of resources and opportunities within the community; 3) There was general consensus regarding the program's importance to the community; 4) There were several obstacles and challenges to program implementation as identified by participants; and 5) Community involvement and shared responsibility were viewed as central to the reduction of gun and related violence. Recommendations for practice and policy changes and the potential role for social work in future collective efficacy and social change initiatives are also discussed.

Forecasting homicide in the red stick: Risk terrain modeling and the spatial influence of urban blight on lethal violence in Baton Rouge, Louisiana

Incorporating features of the built environment, risk terrain modeling (RTM), is used to predict future criminal events in micro-units (i.e., city blocks). The current study examines the application of RTM to forecast homicide in the capital city of Baton Rouge, Louisiana while including a novel environmental risk factor, blighted properties. Based upon the extant literature and knowledge of the city, eighteen environmental risk factors are expected to spatially influence homicide. Results indicate that places most at risk of experiencing a homicide are located in areas where blighted properties are concentrated and in close proximity to convenience stores. RTM successfully identities and evaluates environmental risk factors that spatially influence lethal violence. Additionally, RTM is able to accurately forecast future acts of homicide. The results underscore how crime prevention through environmental design (CPTED) and blight remediation could be utilized as straightforward and prudent strategies to reduce lethal violence.

Firearm Violence in Wilmington

Firearm related assault injuries disproportionately affect young men of color related to a variety of social & ecological vulnerabilities. Delaware, and particularly the city of Wilmington, has experienced a disproportionately high number of these injuries, and this article follows the public health approach in defining the scope of the problem, establishing what is known about the pathophysiology and transmission of injury, describing the effectiveness of newer prevention programs in both public safety and public health, and highlighting important constraints and considerations for program evaluation and research.

Strain and Opportunity: A Theory of Repeat Victimization

General strain theory is often applied to explain the origin of deviant behavior, while the risky lifestyles and opportunities perspective is often used to examine the ongoing risk for victimization. However, given evidence that the delinquent coping mechanisms operationalized by the general strain tests and the risky behaviors measured in the risky lifestyles models are often the same behaviors, the current study argues that these two models can be constructed as a uniform framework to explain the onset and continuity of victimization, including involvement in delinquency, from childhood through adolescence. Experiences of child maltreatment are posited to trigger feelings of negative emotions more likely managed with forms of coping that can foster opportunities for suffering further victimization. Using data from the first three waves of the National Longitudinal Study of Adolescent Health (Add Health), the results show that youth who adopt maladaptive forms of coping with childhood abuse and neglect, including engaging in substance abuse, running away from home, and drug selling, are at further risk for subsequent experiences of victimization in adolescence. However, the model provides only one pathway linking child maltreatment to adolescent victimization, and the strength of support varies based on the measures of negative emotions and coping strategies.

Preventing Violence: A Public Health Participatory Approach to Homicide Reviews

Death review teams are a common method for assessing preventable deaths, yet they rarely review adult homicides and do not typically include community members. Academic-community partnerships can enhance public health research by encouraging translation of research into practice and support a data-driven approach to improve community health and well-being. We describe the Pittsburgh Homicide Review Group, a community-partnered initiative to prevent future homicides through data review and community dialogue. Group members reviewed all 42 Pittsburgh 2012 homicides informed by three primary data sources: publicly available data, local service databases, and community outreach resources. Thirty-two individuals representing relevant county agencies and community groups participated in eight reviews. Data sharing among partners resulted in a comprehensive understanding of the context of homicides. Review meetings supported a collective discussion around potential contributing factors to homicides, intervention implications, and recommendations. Academic-community homicide review partnerships are a productive approach to inform homicide prevention and interventions that are relevant to communities and should be implemented widely.

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

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

The Contagious Spread of Violence Among US Adolescents Through Social Networks

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Gun violence in Americans' social network during their lifetime

INTRODUCTION

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Modeling the Role of Networks and Individual Differences in Inter-Group Violence

There is significant heterogeneity within and between populations in their propensity to engage in conflict. Most research has neglected the role of within-group effects in social networks in contributing to between-group violence and focused instead on the precursors and consequences of violence, or on the role of between-group ties. Here, we explore the role of individual variation and of network structure within a population in promoting and inhibiting group violence towards other populations. Motivated by ethnographic observations of collective behavior in a small-scale society, we describe a model with differentiated roles for individuals embedded within friendship networks. Using a simple model based on voting-like dynamics, we explore several strategies for influencing group-level behavior. When we consider changing population level attitude changes and introducing control nodes separately, we find that a particularly effective control strategy relies on exploiting network degree. We also suggest refinements to our model such as tracking fine-grained information spread dynamics that can lead to further enrichment in using evolutionary game theory models for sociological phenomena.

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

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

Long-term mortality of patients surviving firearm violence

OBJECTIVE

We aim to calculate the 5-year mortality after surviving to hospital discharge after a firearm injury and estimate the association of firearm injury with later mortality.

METHODS

We performed a retrospective cohort study of patients from an urban emergency department (ED) and trauma centre in Oakland, California, USA, in 2007. We created three cohorts of patients presenting for (1) gunshot wound (GSW), (2) MVC and (3) assault without a firearm. Demographic and clinical information was obtained from the clinical chart, and the California Department of Public Health Vital Statistics and Social Security Death Master File (2007-2012) were queried to identify patients who died.

RESULTS

We analysed 516 GSW patients, 992 MVC patients and 695 non-GSW assault patients. Of the GSW patients, 86.4% were alive at 5 years. All-cause 5-year mortality among GSW victims surviving to discharge after injury was 5.1%. Compared with MVC patients, both GSW and non-GSW assault patients have higher risk of death at 5 years (HR 2.54 (95% CI 1.41 to 4.59) and HR 1.64 (95% CI 1.01 to 2.68), respectively), adjusting for age, sex and race. Risk of death was higher in the first year for the GSW cohort (HR 6.14 (95% CI 2.35 to 16.08) and HR 5.06 (95% CI 1.88 to 13.63) as compared with MVC and non-GSW assault cohorts, respectively). Homicide was the cause of death in 79.2% of GSW patients who died after surviving the index injury.

CONCLUSION

Among individuals presenting to the ED after injury or assault and surviving to discharge, firearm injury exposure is an important predictor of death within 5 years and most pronounced in the first year after injury.

Firearm injuries in the United States

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSION

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

Sources of guns to dangerous people: what we learn by asking them

Gun violence exacts a lethal toll on public health. This paper focuses on reducing access to firearms by dangerous offenders, contributing original empirical data on the gun transactions that arm offenders in Chicago. Conducted in the fall of 2013, analysis of an open-ended survey of 99 inmates of Cook County Jail focuses on a subset of violence-prone individuals with the goal of improving law enforcement actions. Among our principal findings: *Our respondents (adult offenders living in Chicago or nearby) obtain most of their guns from their social network of personal connections. Rarely is the proximate source either direct purchase from a gun store, or theft. *Only about 60% of guns in the possession of respondents were obtained by purchase or trade. Other common arrangements include sharing guns and holding guns for others. *About one in seven respondents report selling guns, but in only a few cases as a regular source of income. *Gangs continue to play some role in Chicago in organizing gun buys and in distributing guns to members as needed. *The Chicago Police Department has a considerable effect on the workings of the underground gun market through deterrence. Transactions with strangers and less-trusted associates are limited by concerns over arrest risk (if the buyer should happen to be an undercover officer or a snitch), and about being caught with a "dirty" gun (one that has been fired in a crime).

Geographic association of liquor licenses and gunshot wounds in Chicago

BACKGROUND

The association between alcohol and interpersonal violence is well established. Up to 80% of homicide perpetrators and victims are known to have used alcohol before the incident. However, the association between proximity to a liquor-selling establishment and gun violence is more controversial.

METHODS

Scene address data from the Illinois State Trauma Registry from 1999 to 2009 were used to geocode all gunshot wounds (GSWs) presenting to trauma centers in Chicago during the study period. These data were linked to publicly available US Census Demographic Data and City of Chicago Liquor Board data. A combination of ordinary least squares and geographically weighted regression was performed to identify "risk regions" throughout the study area. Logistic regression analysis was then performed to assess the independent effect of proximity to an establishment with a liquor license (LL) on trauma center admissions for GSWs.

RESULTS

A total of 11,744 GSWs were geocoded. No association between LLs and GSWs was identified for the city overall (odds ratio [OR] .97, 95% confidence interval [CI] .96 to .99). However, 5 distinct regions of influence between LLs and GSWs were found. In regions with the highest association, likelihood of a GSW near a packaged LL was extraordinarily high (OR 518.08, 95% CI 10.23 to 1,000), and tavern LLs were also very significant (OR 21.51, 95% CI 1.81 to 255.53).

CONCLUSIONS

We found that proximity to an establishment with an LL was a strong independent predictor of GSW incidence for many areas of the city, even after controlling for neighborhood characteristics. However, this association was not demonstrable for the entire city, and, in fact, marked regional variation was apparent. These data may contribute to our understanding of the interplay between alcohol and violent injury disparities.

Gun possession among American youth: a discovery-based approach to understand gun violence

Objective

To apply discovery-based computational methods to nationally representative data from the Centers for Disease Control and Preventions’ Youth Risk Behavior Surveillance System to better understand and visualize the behavioral factors associated with gun possession among adolescent youth.

Results

Our study uncovered the multidimensional nature of gun possession across nearly five million unique data points over a ten year period (2001–2011). Specifically, we automated odds ratio calculations for 55 risk behaviors to assemble a comprehensive table of associations for every behavior combination. Downstream analyses included the hierarchical clustering of risk behaviors based on their association “fingerprint” to 1) visualize and assess which behaviors frequently co-occur and 2) evaluate which risk behaviors are consistently found to be associated with gun possession. From these analyses, we identified more than 40 behavioral factors, including heroin use, using snuff on school property, having been injured in a fight, and having been a victim of sexual violence, that have and continue to be strongly associated with gun possession. Additionally, we identified six behavioral clusters based on association similarities: 1) physical activity and nutrition; 2) disordered eating, suicide and sexual violence; 3) weapon carrying and physical safety; 4) alcohol, marijuana and cigarette use; 5) drug use on school property and 6) overall drug use.

Conclusions

Use of computational methodologies identified multiple risk behaviors, beyond more commonly discussed indicators of poor mental health, that are associated with gun possession among youth. Implications for prevention efforts and future interdisciplinary work applying computational methods to behavioral science data are described.