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Correction: Firearm Purchasing During the COVID-19 Pandemic. Ann Intern Med 2024. [PMID: 39008861 DOI: 10.7326/annals-24-00962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
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Ward JA, Valek RA, Jones VC, Crifasi CK. Reasons for Gun Ownership Among Demographically Diverse New and Prior Gun Owners. Am J Prev Med 2024:S0749-3797(24)00226-5. [PMID: 38971452 DOI: 10.1016/j.amepre.2024.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 06/27/2024] [Accepted: 06/30/2024] [Indexed: 07/08/2024]
Abstract
INTRODUCTION Pandemic-era social and political tensions may have accelerated pre-existing trends in gun owner diversification and shifts toward protection from people as a primary reason for gun ownership. Specific ownership motivations may shape storage behaviors, use patterns, policy support, and perceptions of safety. This study's objective was to assess the importance of specific reasons for owning guns, including protection from whom and in what circumstances, among demographic subgroups of new and prior gun owners. METHODS From January 4, 2023 to February 6, 2023, the National Survey of Gun Policy was fielded among a nationally representative sample of U.S. adults (N=3,096), including gun owners (n=1,002). Respondents rated the importance of 10 potential reasons for gun ownership, including at-home protection, out-of-home protection, protection in ideologic conflict, and hunting or recreation. In 2023-2024, respondents' self-report of important and highly important reasons for gun ownership were compared across political affiliation, race, ethnicity, age, sex, location, income, education, and recency of first purchase. RESULTS Majorities of gun owners from all demographic groups cited at-home protection, out-of-home protection, and hunting or recreation as very or extremely important. At least 10% of every demographic group endorsed at least 1 ideologic reason as extremely important. Newer gun owners more frequently endorsed multiple important reasons. CONCLUSIONS Concurrent, strongly held motivations may produce ambivalence or resistance to public health messaging that narrowly focuses on preventing violent firearm-related injury. Permissive firearm policies may compound behavioral ambivalence, exacerbating conditions that threaten collective safety and civic expression. These conditions call for more nuanced, multidimensional, societal efforts to assure collective safety.
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Affiliation(s)
- Julie A Ward
- Department of Medicine, Health, and Society, Vanderbilt College of Arts and Science, Nashville, Tennessee.
| | - Rebecca A Valek
- Oregon Health & Science University, Portland State University School of Public Health, Portland, Oregon; Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Vanya C Jones
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cassandra K Crifasi
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Sokol RL, Oliphant SJ, Bhatia S, Thulin EJ, Esposti MD, Hans Z. Associations Between Perceived Threats and Firearm Behaviors Among U.S. Adults. Am J Prev Med 2024:S0749-3797(24)00224-1. [PMID: 38960293 DOI: 10.1016/j.amepre.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
INTRODUCTION The number of U.S. adults who own and carry a firearm for self-defense is rising. Research has established that owning or carrying a firearm increases the risk of injury and death for firearm owners and the people in their lives. This study sought to better understand this paradox by estimating associations of perceived specific and diffuse threats with firearm behaviors among U.S. adults. METHODS The authors used data from the 2023 National Firearm Attitudes and Behaviors Study, a nationally representative cross-sectional survey of U.S. adults. Binary and ordinal logistic regression estimated associations of perceived specific (fear of attack in the community, fear of someone breaking into the home) and diffuse threats (belief in a dangerous world) with firearm ownership and carriage frequency, overall and stratified by gender. Adjusted models controlled for violence exposures and demographic characteristics. The authors conducted analyses in 2024. RESULTS Among all U.S. adults, the perceived specific threat of someone breaking into the home was associated with firearm ownership (AOR: 1.09 [0.98, 1.23]). Among firearm-owning adults, the diffuse threat of belief in a dangerous world was associated with firearm carriage frequency (1.11 [0.98, 1.25]). Both the associations persisted among men (AORs = 1.27 [1.05-1.52] and 1.15 [1.01-1.31], respectively), but analyses found no associations between perceived threats and firearm behaviors among women. CONCLUSIONS Perceived threats are associated with firearm behaviors among U.S. men, even after accounting for the actual violence they report experiencing or witnessing.
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Affiliation(s)
- Rebeccah L Sokol
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan; School of Social Work, University of Michigan, Ann Arbor, Michigan.
| | - Stephen J Oliphant
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan
| | - Shaun Bhatia
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan
| | - Elyse J Thulin
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan
| | | | - Zainab Hans
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan
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Haines KL, Gorenshtein L, Kaur K, Leraas H, Tripoli T, Freeman J, Fernandez-Moure J, Montgomery S, Feliz A, Agarwal S. Firearm Ownership: A Key Factor to Consider in Firearm Suicide Deaths in Children, Despite State Gun Laws. J Surg Res 2024; 301:191-197. [PMID: 38941715 DOI: 10.1016/j.jss.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/20/2024] [Accepted: 04/29/2024] [Indexed: 06/30/2024]
Abstract
INTRODUCTION Firearm-related suicides among children present a significant public health concern and a tragic loss of young lives. This study explores the relationship between firearm-related suicides, gun ownership, and state-specific gun laws. METHODS This retrospective cohort study collected data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research on children under 18 who died by firearm-related suicides between 2009 and 2016 in all 50 states and D.C. It also utilized data from the RAND State-Level Estimates of Household Firearm Ownership. The study focused on the rate of child firearm suicide deaths per 100,000 individuals. The key variable of interest was the percentage of guns owned per household in each state. Univariable analysis was conducted to examine the association between individual gun laws and child firearm suicide mortalities, while multivariable regression, adjusting for household gun ownership and significant firearm legislation, was employed to assess connection to child firearm suicide mortality. RESULTS From 2009 to 2016, 3903 children died from firearm-related suicides in the United States. In our analysis, 15 out of 44 firearm laws were found to be associated with reducing the rates of firearm suicides among children (P < 0.05). However, multivariable regression showed that higher state gun ownership rates were the primary predictor of increased child fatalities from firearms, with children in such states being 325% more likely to die when analyzing handgun laws and 337% more likely when analyzing long gun laws, as indicated by coefficients of 4.25 and 4.37, respectively. No state laws alone notably improved death rates. CONCLUSIONS Gun ownership has a stronger association with child suicide rates than state-specific gun laws. Given the weight of gun ownership, future research should prioritize comprehensive public health initiatives to prevent child firearm-related suicides.
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Affiliation(s)
- Krista L Haines
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
| | - Laura Gorenshtein
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina; Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kavneet Kaur
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Surgery Baylor Scott & White All Saints Medical Center, Fort Worth, Texas
| | - Harold Leraas
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Todd Tripoli
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Jennifer Freeman
- Department of Surgery Baylor Scott & White All Saints Medical Center, Fort Worth, Texas
| | - Joseph Fernandez-Moure
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Sean Montgomery
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Alexander Feliz
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Suresh Agarwal
- Division of Trauma and Critical Care and Acute Care Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Mukherjee S, Gordils J. Factors Associated With Gun Possession Among High-School Students in the U.S. Before and During the Pandemic. Psychol Rep 2024:332941241263750. [PMID: 38913602 DOI: 10.1177/00332941241263750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Background: Adolescents' possession of guns was a matter of concern even before the pandemic. It is pertinent to examine whether students continued possessing guns after schools reopened, and if so, identify factors that might have been associated with such behaviors. Towards this end, the present study examined the relationship between highschool students' experiences and their propensity to possess guns. Methods: This used responses from multiple nationally representative cross-sectional surveys of high school students from the 2019 and 2021 Youth Risk Behavior Survey (YRBS) and the 2021 Adolescent Behaviors and Experiences Survey (ABES). Gun possession within the past year was the main outcome of interest. Experiences of violence, assault, injury, and other adverse experiences were the independent variables. Bivariate and multivariate logistic regressions, adjusting for sample weights, were performed using SAS. Results: Out of a total of more than 25,000 and 38,000 valid responses, respectively in 2019 and 2021 to the question on gun possession, 4.7% and 4.2% reported carrying a gun at least once within the past year. Experiences of sexual violence, involvement in physical fight, perceived lack of safety, and being threatened/injured by weapons, were associated with higher adjusted odds of guns possession among males and females. Among ABES 2021 respondents (more than 7500), those who witnessed violence in the neighborhood were more likely to possess guns. This association was significant among males, whereas parents being informed about whereabouts was significant for females. Conclusion: This study shows that adverse experiences were associated with a higher odds of guns possession among female and male highschool students. Witnessing violent attack on someone in the neighborhood emerged as a risk factor for males. This suggests that social determinants of health as well as adverse experiences are associated with gun possession among high-school students.
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Affiliation(s)
- Soumyadeep Mukherjee
- Department of Health & Physical Education, Rhode Island College, Providence, RI, USA
| | - Jonathan Gordils
- Department of Psychology, University of Hartford, West Hartford, CT, USA
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Rowh A, Zwald M, Fowler K, Jack S, Siordia C, Walters J. Emergency Medical Services Encounters for Firearm Injuries - 858 Counties, United States, January 2019-September 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:551-557. [PMID: 38900705 PMCID: PMC11199023 DOI: 10.15585/mmwr.mm7324a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Firearm-related deaths and injuries have increased in recent years. Comprehensive and timely information on firearm injuries and the communities and geographic locations most affected by firearm violence is crucial for guiding prevention activities. However, traditional surveillance systems for firearm injury, which are mostly based on hospital encounters and mortality-related data, often lack information on the location where the shooting occurred. This study examined annual and monthly rates of emergency medical services (EMS) encounters for firearm injury per 100,000 total EMS encounters during January 2019-September 2023 in 858 counties in 27 states, by patient characteristics and characteristics of the counties where the injuries occurred. Overall, annual rates of firearm injury EMS encounters per 100,000 total EMS encounters ranged from 222.7 in 2019 to 294.9 in 2020; rates remained above prepandemic levels through 2023. Rates were consistently higher among males than females. Rates stratified by race and ethnicity were highest among non-Hispanic Black or African American persons; rates stratified by age group were highest among persons aged 15-24 years. The greatest percentage increases in annual rates occurred in urban counties and in counties with higher prevalence of severe housing problems, higher income inequality ratios, and higher rates of unemployment. States and communities can use the timely and location-specific data in EMS records to develop and implement comprehensive firearm injury prevention strategies to address the economic, social, and physical conditions that contribute to the risk for violence, including improvements to physical environments, secure firearm storage, and strengthened social and economic supports.
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Henson-Garcia M, Malthaner L, Beauchamp A, McKay S, Jetelina K. Epidemiological analysis of fatal and non-fatal firearm injuries occurring in gun establishments in the United States, 2015-2022. Inj Prev 2024:ip-2023-045127. [PMID: 38862213 DOI: 10.1136/ip-2023-045127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND Firearm-related injury represents a significant public health problem in the USA. Firearm purchasing has risen nationwide and there has been increased efforts to deploy injury prevention initiatives within gun establishments. However, firearm-related risks and harms that may occur inside these high-exposure settings are not well characterized. METHODS This secondary analysis leveraged Gun Violence Archive data to quantify firearm injury prevalence rates within different types of gun establishments from 1 January 2015 to 31 December 2022. Data were restricted to incidents that occurred in gun ranges, gun shops, and public and private ranges. The following incident characteristics were available in the individual-level data: date, location, injury count, fatality count, victim demographics (age, sex), shooting intent (suicide/self-inflicted, assault/homicide, unintentional, undetermined) and establishment type. RESULTS Over 7 years, 445 non-fatal and 183 fatal shooting events occurred across 576 unique establishments. Non-fatal, unintentional injuries predominated in stand-alone firing ranges whereas fatal, self-inflicted injuries concentrated in retail shops with accompanying firing ranges. Firearm-related assaults were prevalent among stand-alone retail shops. CONCLUSION Overall, this secondary analysis underscores that the prevalence of firearm injury in gun establishments across the USA is low, and these settings should continue to be studied as important contexts for intervention. Interweaving public health interventions into gun establishments presents an opportunity to potentially reduce associated harms to consumers interacting within these environments.
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Affiliation(s)
- Mike Henson-Garcia
- Department of Health Promotion and Behavioral Sciences, The University of Texas Houston Health Science Center School of Public Health, Dallas, Texas, USA
| | - Lauren Malthaner
- Department of Epidemiology, The University of Texas Houston Health Science Center School of Public Health, Dallas, Texas, USA
| | - Alaina Beauchamp
- Department of Epidemiology, The University of Texas Houston Health Science Center School of Public Health, Dallas, Texas, USA
- O'Donnell School of Public Health, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Sandra McKay
- Department of Pediatrics, University of Texas Houston Health Science Center McGovern Medical School, Houston, Texas, USA
| | - Katelyn Jetelina
- Department of Epidemiology, The University of Texas Houston Health Science Center School of Public Health, Dallas, Texas, USA
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Bandel SL, Moceri-Brooks J, Bond AE, Semenza D, Anestis MD. US Residents' Recognition of Proper Use of Firearm Cable Locks. JAMA Netw Open 2024; 7:e2415064. [PMID: 38837162 PMCID: PMC11154157 DOI: 10.1001/jamanetworkopen.2024.15064] [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: 01/23/2024] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
This survey study examines the ability of firearm owners and nonowners to determine correct and incorrect cable lock use across different types of firearms.
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Affiliation(s)
- Shelby L. Bandel
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, West Piscataway, New Jersey
- Department of Psychology, Rutgers, The State University of New Jersey, West Piscataway, New Jersey
| | - Jayna Moceri-Brooks
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, West Piscataway, New Jersey
| | - Allison E. Bond
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, West Piscataway, New Jersey
- Department of Psychology, Rutgers, The State University of New Jersey, West Piscataway, New Jersey
| | - Daniel Semenza
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, West Piscataway, New Jersey
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University–Camden, Camden, New Jersey
| | - Michael D. Anestis
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, West Piscataway, New Jersey
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Daraklis M, Pol M, Johnson L, Salvatora C, Kerns L. A Statistical Analysis of the Impact of Gun Ownership on Mass Shootings in the USA Between 2013 and 2022. J Urban Health 2024; 101:571-583. [PMID: 38831155 PMCID: PMC11189892 DOI: 10.1007/s11524-024-00881-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/05/2024]
Abstract
Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings-both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase-that is, for every 12.5% increase-in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.
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Affiliation(s)
- Madison Daraklis
- Department of Mathematics, Westminster College, New Wilmington, PA, USA
| | - Mehul Pol
- Department of Statistics, The University of Virginia, Charlottesville, VA, USA
| | - Lindsey Johnson
- Department of Mathematics, Westminster College, New Wilmington, PA, USA
| | - Cianna Salvatora
- Department of Mathematics, Wellesley College, Wellesley, MA, USA
| | - Lucy Kerns
- Department of Mathematics & Statistics, Youngstown State University, One University Plaza, Youngstown, OH, 44555, USA.
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Wolf ER, Rivara FP, Orr CJ, Sen A, Chapman DA, Woolf SH. Racial and Ethnic Disparities in All-Cause and Cause-Specific Mortality Among US Youth. JAMA 2024; 331:1732-1740. [PMID: 38703403 PMCID: PMC11070063 DOI: 10.1001/jama.2024.3908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/29/2024] [Indexed: 05/06/2024]
Abstract
Importance Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking. Objective To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race. Design, Setting, and Participants This cross-sectional study conducted temporal analysis (1999-2020) and comparison of aggregate mortality rates (2016-2020) for youth aged 1 to 19 years using US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Data were analyzed from June 30, 2023, to January 17, 2024. Main Outcomes and Measures Pooled, all-cause, and cause-specific mortality rates per 100 000 youth (hereinafter, per 100 000) for leading underlying causes of death were compared. Injuries were classified by mechanism and intent. Results Between 1999 and 2020, there were 491 680 deaths among US youth, including 8894 (1.8%) American Indian or Alaska Native, 14 507 (3.0%) Asian or Pacific Islander, 110 154 (22.4%) Black, 89 251 (18.2%) Hispanic, and 267 452 (54.4%) White youth. Between 2016 and 2020, pooled all-cause mortality rates were 48.79 per 100 000 (95% CI, 46.58-51.00) in American Indian or Alaska Native youth, 15.25 per 100 000 (95% CI, 14.75-15.76) in Asian or Pacific Islander youth, 42.33 per 100 000 (95% CI, 41.81-42.86) in Black youth, 21.48 per 100 000 (95% CI, 21.19-21.77) in Hispanic youth, and 24.07 per 100 000 (95% CI, 23.86-24.28) in White youth. All-cause mortality ratios compared with White youth were 2.03 (95% CI, 1.93-2.12) among American Indian or Alaska Native youth, 0.63 (95% CI, 0.61-0.66) among Asian or Pacific Islander youth, 1.76 (95% CI, 1.73-1.79) among Black youth, and 0.89 (95% CI, 0.88-0.91) among Hispanic youth. From 2016 to 2020, the homicide rate in Black youth was 12.81 (95% CI, 12.52-13.10) per 100 000, which was 10.20 (95% CI, 9.75-10.66) times that of White youth. The suicide rate for American Indian or Alaska Native youth was 11.37 (95% CI, 10.30-12.43) per 100 000, which was 2.60 (95% CI, 2.35-2.86) times that of White youth. The firearm mortality rate for Black youth was 12.88 (95% CI, 12.59-13.17) per 100 000, which was 4.14 (95% CI, 4.00-4.28) times that of White youth. American Indian or Alaska Native youth had a firearm mortality rate of 6.67 (95% CI, 5.85-7.49) per 100 000, which was 2.14 (95% CI, 1.88- 2.43) times that of White youth. Black youth had an asthma mortality rate of 1.10 (95% CI, 1.01-1.18) per 100 000, which was 7.80 (95% CI, 6.78-8.99) times that of White youth. Conclusions and Relevance In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.
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Affiliation(s)
- Elizabeth R. Wolf
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Richmond
- Children’s Hospital of Richmond at Virginia Commonwealth University, Richmond
| | - Frederick P. Rivara
- Department of Pediatrics, University of Washington, Seattle
- Seattle Children’s Research Institute, Seattle, Washington
- Editor, JAMA Network Open
| | - Colin J. Orr
- Department of Pediatrics, University of North Carolina at Chapel Hill
- Cecil G Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Anabeel Sen
- Department of Epidemiology, Virginia Commonwealth University School of Population Health, Richmond
| | - Derek A. Chapman
- Department of Epidemiology, Virginia Commonwealth University School of Population Health, Richmond
| | - Steven H. Woolf
- Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond
- Center on Society and Heath, Virginia Commonwealth University School of Population Health, Richmond
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Chaudhary S, Doh KF, Morris E, Chivily C, Washington DS, Gillespie SE, Jergel A, Lazarus S, Costa A, Call N, Rupp J, Simon HK. Reducing firearm access for youth at risk for suicide in a pediatric emergency department. Front Public Health 2024; 12:1352815. [PMID: 38859900 PMCID: PMC11163968 DOI: 10.3389/fpubh.2024.1352815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/25/2024] [Indexed: 06/12/2024] Open
Abstract
Background Firearm-related suicide is the second leading cause of pediatric firearm death. Lethal means counseling (LMC) can improve firearm safe-storage practices for families with youth at risk of suicide. Objectives This study aims to evaluate the feasibility of pediatric emergency department (ED) behavioral mental health (BMH) specialists providing LMC to caregivers of youth presenting with BMH complaints and to test for changes in firearm safety practices, pre-post ED LMC intervention, as measures of preliminary efficacy. Methods Prospective pilot feasibility study of caregivers of youth presenting to a pediatric ED with BMH complaints. Caregivers completed an electronic survey regarding demographics and firearm safe-storage knowledge/practices followed by BMH specialist LMC. Firearm owners were offered a free lockbox and/or trigger lock. One-week follow-up surveys gathered self-reported data on firearm safety practices and intervention acceptability. One-month interviews with randomly sampled firearm owners collected additional firearm safety data. Primary outcomes were feasibility measures, including participant accrual/attrition and LMC intervention acceptability. Secondary outcomes included self-reported firearm safety practice changes. Feasibility benchmarks were manually tabulated, and Likert-scale acceptability responses were dichotomized to strongly agree/agree vs. neutral/disagree/strongly disagree. Descriptive statistics were used for univariate and paired data responses. Results In total, 81 caregivers were approached; of which, 50 (81%) caregivers enrolled. A total of 44% reported having a firearm at home, 80% completed follow-up at one week. More than 80% affirmed that ED firearm safety education was useful and that the ED is an appropriate place for firearm safety discussions. In total, 58% of participants reported not having prior firearm safety education/counseling. Among firearm owners (n = 22), 18% reported rarely/never previously using a safe-storage device, and 59% of firearm owners requested safe storage devices.At 1-week follow-up (n = 40), a greater proportion of caregivers self-reported asking about firearms before their child visited other homes (+28%). Among firearm owners that completed follow-up (n = 19), 100% reported storing all firearms locked at one week (+23% post-intervention). In total, 10 caregivers reported temporarily/permanently removing firearms from the home. Conclusion It is feasible to provide LMC in the pediatric ED via BMH specialists to families of high-risk youth. Caregivers were receptive to LMC and reported finding this intervention useful, acceptable, and appropriate. Additionally, LMC and device distribution led to reported changes in safe storage practices.
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Affiliation(s)
- Sofia Chaudhary
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Kiesha Fraser Doh
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Emilie Morris
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | | | - Donnetta S. Washington
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
- School of Social Work, The University of GA, Athens, GA, United States
| | - Scott E. Gillespie
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrew Jergel
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Sarah Lazarus
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
- Pediatric Emergency Medicine Associates, Atlanta, GA, United States
- Morehouse School of Medicine, Atlanta, GA, United States
| | - Angela Costa
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
- Pediatric Emergency Medicine Associates, Atlanta, GA, United States
- Morehouse School of Medicine, Atlanta, GA, United States
| | - Nathan Call
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
| | - Jonathan Rupp
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Harold K. Simon
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Children’s Healthcare of Atlanta, Atlanta, GA, United States
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Wintemute GJ, Robinson SL, Crawford A, Tomsich EA, Reeping PM, Shev AB, Velasquez B, Tancredi D. Single-year change in views of democracy and society and support for political violence in the USA: findings from a 2023 nationally representative survey. Inj Epidemiol 2024; 11:20. [PMID: 38773542 PMCID: PMC11110245 DOI: 10.1186/s40621-024-00503-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/03/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND A 2022 survey in the USA found concerningly high prevalences of support for and personal willingness to engage in political violence, of beliefs associated with such violence, and of belief that civil war was likely in the near future. It is important to determine the durability of those findings. METHODS Wave 2 of a nationally representative cohort survey was conducted May 18-June 8, 2023; the sample comprised all respondents to 2022's Wave 1. Outcomes are expressed as weighted proportions; changes from 2022 to 2023 are for respondents who participated in both surveys, based on aggregated individual change scores. RESULTS The completion rate was 84.2%; there were 9385 respondents. After weighting, 50.7% (95% confidence interval (CI) 49.4%, 52.1%) were female; weighted mean (SD) age was 48.5 (25.9) years. About 1 in 20 respondents (5.7%, 95% CI 5.1%, 6.4%) agreed strongly/very strongly that "in the next few years, there will be civil war in the United States," a 7.7% decrease. In 2023, fewer respondents considered violence to be usually/always justified to advance at least 1 of 17 specific political objectives [25.3% (95% CI 24.7%, 26.5%), a 6.8% decrease]. However, more respondents thought it very/extremely likely that within the next few years, in a situation where they consider political violence justified, "I will be armed with a gun" [9.0% (95% CI 8.3%, 9.8%), a 2.2% increase] and "I will shoot someone with a gun" [1.8% (95% CI 1.4%, 2.2%), a 0.6% increase]. Among respondents who considered violence usually/always justified to advance at least 1 political objective, about 1 in 20 also thought it very/extremely likely that they would threaten someone with a gun (5.4%, 95% CI 4.0%, 7.0%) or shoot someone (5.7%, 95% CI 4.3%, 7.1%) to advance such an objective. CONCLUSIONS In this cohort, support for political violence declined from 2022 to 2023, but predictions of firearm use in political violence increased. These findings can help guide prevention efforts, which are urgently needed.
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Affiliation(s)
- Garen J Wintemute
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA.
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA.
- California Firearm Violence Research Center, Sacramento, CA, USA.
| | - Sonia L Robinson
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Andrew Crawford
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Elizabeth A Tomsich
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Paul M Reeping
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Aaron B Shev
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Bradley Velasquez
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Daniel Tancredi
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, School of Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
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Richards JA, Kuo E, Stewart C, Shulman L, Parrish R, Whiteside U, Boggs JM, Simon GE, Rowhani-Rahbar A, Betz ME. Reducing Firearm Access for Suicide Prevention: Implementation Evaluation of the Web-Based "Lock to Live" Decision Aid in Routine Health Care Encounters. JMIR Med Inform 2024; 12:e48007. [PMID: 38647319 PMCID: PMC11063417 DOI: 10.2196/48007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/12/2023] [Accepted: 02/27/2024] [Indexed: 04/25/2024] Open
Abstract
Background "Lock to Live" (L2L) is a novel web-based decision aid for helping people at risk of suicide reduce access to firearms. Researchers have demonstrated that L2L is feasible to use and acceptable to patients, but little is known about how to implement L2L during web-based mental health care and in-person contact with clinicians. Objective The goal of this project was to support the implementation and evaluation of L2L during routine primary care and mental health specialty web-based and in-person encounters. Methods The L2L implementation and evaluation took place at Kaiser Permanente Washington (KPWA)-a large, regional, nonprofit health care system. Three dimensions from the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) model-Reach, Adoption, and Implementation-were selected to inform and evaluate the implementation of L2L at KPWA (January 1, 2020, to December 31, 2021). Electronic health record (EHR) data were used to purposefully recruit adult patients, including firearm owners and patients reporting suicidality, to participate in semistructured interviews. Interview themes were used to facilitate L2L implementation and inform subsequent semistructured interviews with clinicians responsible for suicide risk mitigation. Audio-recorded interviews were conducted via the web, transcribed, and coded, using a rapid qualitative inquiry approach. A descriptive analysis of EHR data was performed to summarize L2L reach and adoption among patients identified at high risk of suicide. Results The initial implementation consisted of updates for clinicians to add a URL and QR code referencing L2L to the safety planning EHR templates. Recommendations about introducing L2L were subsequently derived from the thematic analysis of semistructured interviews with patients (n=36), which included (1) "have an open conversation," (2) "validate their situation," (3) "share what to expect," (4) "make it accessible and memorable," and (5) "walk through the tool." Clinicians' interviews (n=30) showed a strong preference to have L2L included by default in the EHR-based safety planning template (in contrast to adding it manually). During the 2-year observation period, 2739 patients reported prior-month suicide attempt planning or intent and had a documented safety plan during the study period, including 745 (27.2%) who also received L2L. Over four 6-month subperiods of the observation period, L2L adoption rates increased substantially from 2% to 29% among primary care clinicians and from <1% to 48% among mental health clinicians. Conclusions Understanding the value of L2L from users' perspectives was essential for facilitating implementation and increasing patient reach and clinician adoption. Incorporating L2L into the existing system-level, EHR-based safety plan template reduced the effort to use L2L and was likely the most impactful implementation strategy. As rising suicide rates galvanize the urgency of prevention, the findings from this project, including L2L implementation tools and strategies, will support efforts to promote safety for suicide prevention in health care nationwide.
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Affiliation(s)
- Julie Angerhofer Richards
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Elena Kuo
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Christine Stewart
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Lisa Shulman
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Rebecca Parrish
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle, WA, United States
| | - Ursula Whiteside
- NowMattersNow.org, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Jennifer M Boggs
- Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, United States
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
- Department of Mental Health & Wellness, Kaiser Permanente Washington, Seattle, WA, United States
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, United States
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA, United States
| | - Marian E Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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Tharp D, Goldstein EV, Medina RM, Brewer SC, Bakian AV, Coon H. Utah Latina/o/x suicide decedents less likely to die by firearm, even in rural areas: examining population-wide data from the Utah Office of the Medical Examiner. Front Public Health 2024; 12:1358043. [PMID: 38660351 PMCID: PMC11040675 DOI: 10.3389/fpubh.2024.1358043] [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: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Suicide death remains a significantly rarer event among Latina/o/x populations compared to non-Latina/o/x populations. However, the reasons why Latina/o/x communities experience relatively lower suicide rates are not fully understood. Critical gaps exist in the examination of Latina/o/x suicide death, especially in rural settings, where suicide death by firearm is historically more common within non-Latina/o/x populations. Method We tested whether the prevalence of Latina/o/x firearm suicide was meaningfully different in urban and rural environments and from non-Latino/a/x decedents when controlling for age, sex, and a social deprivation metric, the Area Deprivation Index. Suicide death data used in this analysis encompasses 2,989 suicide decedents ascertained in Utah from 2016 to 2019. This included death certificate data from the Utah Office of the Medical Examiner on all Utah suicide deaths linked to information by staff at the Utah Population Database. Results Compared to non-Latina/o/x suicide decedents, Latina/o/x suicide decedents had 34.7% lower adjusted odds of dying by firearm. Additionally, among the firearm suicide decedents living only in rural counties, Latina/o/x decedents had 40.5% lower adjusted odds of dying by firearm compared to non-Latina/o/x suicide decedents. Discussion The likelihood of firearm suicide death in Utah differed by ethnicity, even in rural populations. Our findings may suggest underlying factors contributing to lower firearm suicide rates within Latina/o/x populations, e.g., aversion to firearms or less access to firearms, especially in rural areas, though additional research on these phenomena is needed.
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Affiliation(s)
- Douglas Tharp
- Department of Geography, University of Utah, Salt Lake City, UT, United States
| | - Evan V. Goldstein
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Richard M. Medina
- Department of Geography, University of Utah, Salt Lake City, UT, United States
| | - Simon C. Brewer
- Department of Geography, University of Utah, Salt Lake City, UT, United States
| | - Amanda V. Bakian
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, United States
- Department of Family and Preventive Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Hilary Coon
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, United States
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Bond AE, Karnick AT, Capron DW, Anestis MD. Predicting potential underreporting of firearm ownership in a nationally representative sample. Soc Psychiatry Psychiatr Epidemiol 2024; 59:715-723. [PMID: 37351596 DOI: 10.1007/s00127-023-02515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE This study utilized demographic and intrapersonal variables to identify individuals who may have falsely denied firearm ownership and determined if individuals can be divided into meaningful subgroups. METHODS Participants were United States residents (N = 3500) recruited from January to June 2020. matched to the 2010 census data for age, race, sex, income, and education level. A Zero-Inflated Negative Binomial (ZINB) regression was utilized to determine potential underreporting of firearm ownership, and a latent class analysis was utilized to determine unique subgroups of those who were identified as underreporting firearm ownership in the ZINB. RESULTS Participants (N = 1306) were identified as underreporting firearm ownership (excess zeros) based on a model that included demographic and intrapersonal variables. A latent class analysis indicated that among excess zeros, three unique subgroups exist. CONCLUSIONS Determining who may be underreporting firearm ownership will allow for a more comprehensive understanding of firearm ownership in the US and more targeted safe storage messages that may reach those who own firearms and are at risk for firearm-related injury and death.
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Affiliation(s)
- Allison E Bond
- The New Jersey Gun Violence Research Center, Rutgers University, Newark, USA.
- The Department of Psychology, Rutgers University, Newark, USA.
| | - Aleksandr T Karnick
- The School of Psychology, The University of Southern Mississippi, Hattiesburg, USA
| | - Daniel W Capron
- The School of Psychology, The University of Southern Mississippi, Hattiesburg, USA
| | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Rutgers University, Newark, USA
- The School of Public Health, Rutgers University, Newark, USA
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16
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Hudgins J, Mannix C, Mannix R. Exposure to potentially lethal weapons and drugs among U.S. adolescents with recent depressive symptoms or suicidality in the Adolescent Behaviors and Experiences Survey. Psychiatry Res 2024; 334:115827. [PMID: 38442478 DOI: 10.1016/j.psychres.2024.115827] [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: 12/12/2023] [Revised: 02/19/2024] [Accepted: 02/24/2024] [Indexed: 03/07/2024]
Abstract
The scope of lethal means exposure (i.e. guns, intravenous drugs, prescription drugs) relative to depressive symptoms and suicidality in adolescents is not well described. Using the Adolescent Behaviors and Experiences Survey (ABES), we found lethal means exposure increased in a dose dependent manner with increasing depressive symptoms, adjusting for age, sex, race, and ethnicity. Adolescent males were more than 6 times more likely to have exposure to guns and intravenous drugs compared to adolescent females.
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Affiliation(s)
- Joel Hudgins
- Division of Emergency Medicine, Boston Children's Hospital, Boston Massachusetts 02115, USA; Harvard Medical School, Boston Massachusetts, USA
| | | | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston Massachusetts 02115, USA; Harvard Medical School, Boston Massachusetts, USA.
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17
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Wintemute GJ, Crawford A, Robinson SL, Tomsich EA, Reeping PM, Schleimer JP, Pear VA. Firearm Ownership and Support for Political Violence in the United States. JAMA Netw Open 2024; 7:e243623. [PMID: 38592725 PMCID: PMC11004826 DOI: 10.1001/jamanetworkopen.2024.3623] [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: 01/30/2024] [Indexed: 04/10/2024] Open
Abstract
Importance Little is known about support for and willingness to engage in political violence in the United States. Such violence would likely involve firearms. Objective To evaluate whether firearm owners' and nonowners' support for political violence differs and whether support among owners varies by type of firearms owned, recency of purchase, and frequency of carrying a loaded firearm in public. Design, Setting, and Participants This cross-sectional nationally representative survey study was conducted from May 13 to June 2, 2022, among US adult members of the Ipsos KnowledgePanel, including an oversample of firearm owners. Exposure Firearm ownership vs nonownership. Main Outcomes and Measures Main outcomes concern (1) support for political violence, in general and to advance specific political objectives; (2) personal willingness to engage in political violence, by severity of violence and target population; and (3) perceived likelihood of firearm use in political violence. Outcomes are expressed as weighted proportions and adjusted prevalence differences, with P values adjusted for the false-discovery rate and reported as q values. Results The analytic sample comprised 12 851 respondents: 5820 (45.3%) firearm owners, 6132 (47.7%) nonowners without firearms at home, and 899 (7.0%) nonowners with firearms at home. After weighting, 51.0% (95% CI, 49.9%-52.1%) were female, 8.5% (95% CI, 7.5%-9.5%) Hispanic, 9.1% (95% CI, 8.1%-10.2%) non-Hispanic Black, and 62.6% (95% CI, 61.5%-63.8%) non-Hispanic White; the mean (SD) age was 48.5 (18.0) years. Owners were more likely than nonowners without firearms at home to consider violence usually or always justified to advance at least 1 of 17 specific political objectives (owners: 38.8%; 95% CI, 37.3%-40.4%; nonowners: 29.8%; 95% CI, 28.5%-31.2%; adjusted difference, 6.5 percentage points; 95% CI, 4.5-9.3 percentage points; q < .001) but were not more willing to engage in political violence. Recent purchasers, owners who always or nearly always carry loaded firearms in public, and to a lesser extent, owners of assault-type rifles were more supportive of and willing to engage in political violence than other subgroups of firearm owners. Conclusions and Relevance In this study of support for political violence in the United States, differences between firearm owners and nonowners without firearms at home were small to moderate when present. Differences were greater among subsets of owners than between owners and nonowners. These findings can guide risk-based prevention efforts.
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Affiliation(s)
- Garen J. Wintemute
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Andrew Crawford
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Sonia L. Robinson
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Elizabeth A. Tomsich
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Paul M. Reeping
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Julia P. Schleimer
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
| | - Veronica A. Pear
- Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, California
- UC Davis Violence Prevention Research Program, Sacramento, California
- California Firearm Violence Research Center, Sacramento
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Bond AE, Stanley I, Bandel SL, Anestis M. Law enforcement and firearms: understanding firearm ownership and storage habits. Inj Prev 2024; 30:132-137. [PMID: 37875335 DOI: 10.1136/ip-2023-044919] [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: 04/06/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices. METHODS The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership. RESULTS Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation. CONCLUSION Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide.
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Affiliation(s)
- Allison E Bond
- Psychology, Rutgers University, Piscataway, New Jersey, USA
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
| | - Ian Stanley
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Shelby L Bandel
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
- Department of Psychology, The State University of NJ, Piscataway, New Jersey, USA
| | - Michael Anestis
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
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Mulugeta MG, Bailey G, Parsons K, Gillespie S, Johnson LM, Doh KF, Reisner A, Blackwell LS. Trends in pediatric firearm-related injuries and disparities in acute outcomes. Front Public Health 2024; 12:1339394. [PMID: 38566791 PMCID: PMC10985139 DOI: 10.3389/fpubh.2024.1339394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Background Firearm-related injuries (FRI) are an increasing cause of death and injury in children. The etiology for this rise is multifactorial and includes socioeconomic factors. Despite its prevalence and documented increase over COVID-19, there is a paucity of research on disparities and the influence of social determinants of health (SDH) in pediatric FRI. This study aims to explore the epidemiology of this vulnerable population in Atlanta, trends over time and relevant dates such as COVID-19 and a state firearm law, and disparities in clinical outcomes. Methods Retrospective cohort of patients with FRI (0-20 years-old, x̄=9.8, Median = 11) presenting to our hospital EDs from January 2014 to April 2023 (N = 701) and eligible for the Trauma Registry. This period includes two major events, namely the COVID-19 pandemic (March 2020), and passage of state law Constitutional Carry Act (SB 319) (April 2022), allowing for permit-less concealed firearm carry. Single series interrupted time series (ITS) models were run and clinical outcome differences between race and insurance groups were calculated unadjusted and adjusted for confounders using inverse propensity treatment weights (IPTW). The primary outcome was mortality; secondary are admission and discharge. Results Majority of FRI involved patients who were male (76.7%), Black (74.9%), publicly insured (82.6%), ≤12 years-old (61.8%), and injured by unintentional shootings (45.6%) or assault (43.7%). During COVID-19, there was a sustained increase in FRI rate by 0.42 patients per 1,000 trauma visits per month (95% CI 0.02-0.82, p = 0.042); post-SB 319 it was 2.3 patients per 1,000 trauma visits per month (95% CI 0.23-4.31, p = 0.029). Publicly insured patients had 58% lower odds of mortality than privately insured patients (OR 0.42, 95% CI 0.18-0.99, p = 0.047). When controlled for race and mechanism of injury, among other confounding factors, this association was not significant (p = 0.652). Conclusion Pediatric FRI are increasing over time, with disproportionate burdens on Black patients, at our hospitals. Disparities in mortality based on insurance necessitate further study. As social and economic repercussions of COVID-19 are still present, and state firearm law SB 319 is still in effect, assessment of ongoing trends is warranted to inform preventative strategies.
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Affiliation(s)
| | | | - Kendall Parsons
- Children's Healthcare of Atlanta, Atlanta, GA, United States
| | - Scott Gillespie
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Laura M. Johnson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Kiesha Fraser Doh
- Children's Healthcare of Atlanta, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Andrew Reisner
- Children's Healthcare of Atlanta, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, United States
| | - Laura S. Blackwell
- Children's Healthcare of Atlanta, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
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20
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Anestis MD, Moceri-Brooks J, Ziminski D, Barnes RT, Semenza D. Firearm Access and Gun Violence Exposure Among American Indian or Alaska Native and Black Adults. JAMA Netw Open 2024; 7:e240073. [PMID: 38436959 PMCID: PMC10912965 DOI: 10.1001/jamanetworkopen.2024.0073] [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: 10/19/2023] [Accepted: 12/18/2023] [Indexed: 03/05/2024] Open
Abstract
Importance American Indian or Alaska Native and Black adults experience elevated rates of firearm injury and death, but both groups are severely underrepresented in research on firearm exposure and behaviors. Objective To explore geodemographic differences in firearm behaviors and violence exposure among American Indian or Alaska Native and Black adults in the US. Design, Setting, and Participants In this survey study, nationally representative samples of American Indian or Alaska Native and/or Black adults recruited from KnowledgePanel were surveyed cross-sectionally. Surveys were administered online between April 12 and May 4, 2023. Main Outcomes and Measures Firearm access, storage, and carrying behaviors and lifetime firearm violence exposure were the primary outcomes. Demographic factors such as age, geographic location, and political affiliation were considered. Data were weighted to geodemographic distributions from the US Census Bureau's 2022 Current Population Survey. Results Of 3542 participants, 527 (14.9%) were American Indian or Alaska Native (280 [53.1%] female) and 3015 (85.1%) were Black (1646 [54.6%] female). Both groups exhibited high firearm access rates (American Indian or Alaska Native adults: 238 [45.4%; 95% CI, 39.4%-51.7%]; Black adults: 909 [30.4%; 95% CI, 28.0%-32.9%]), predominantly owning handguns for home protection. The groups demonstrated similar firearm storage patterns, and a substantial proportion endorsed always or almost always carrying firearms outside the home (American Indian or Alaska Native adults: 18.9%; Black adults: 15.2%). Self-protection was a common reason for carrying a firearm (American Indian or Alaska Native adults: 104 [84.9%; 95% CI, 74.1%-91.7%]; Black adults: 350 [88.3%; 95% CI, 82.3%-92.4%]), and a minority of participants cited lack of faith in the police (American Indian or Alaska Native adults: 19 [15.2%; 95% CI, 8.2%-26.7%]; Black adults: 61 [15.4%; 95% CI, 10.3%-21.2%]), indicating potential shifts in public safety dynamics. Conclusions and Relevance In this survey study of American Indian or Alaska Native and Black US adults, a substantial percentage of both groups reported living in homes with firearms, storing firearms loaded and unlocked, frequently carrying firearms outside the home, and having been exposed directly and indirectly to gun violence. These findings underscore the need for nuanced public health campaigns and policies and highlight challenges for law enforcement in contexts of racial disparities and changing legal frameworks.
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Affiliation(s)
- Michael D. Anestis
- New Jersey Gun Violence Research Center, Rutgers, The State University of New Jersey, Piscataway
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway
| | - Jayna Moceri-Brooks
- New Jersey Gun Violence Research Center, Rutgers, The State University of New Jersey, Piscataway
| | - Devon Ziminski
- New Jersey Gun Violence Research Center, Rutgers, The State University of New Jersey, Piscataway
- Senator Walter Rand Institute for Public Affairs, Rutgers University–Camden, Cinnaminson, New Jersey
| | - R. Thurman Barnes
- New Jersey Gun Violence Research Center, Rutgers, The State University of New Jersey, Piscataway
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway
| | - Daniel Semenza
- New Jersey Gun Violence Research Center, Rutgers, The State University of New Jersey, Piscataway
- School of Public Health, Rutgers, The State University of New Jersey, Piscataway
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University–Camden, Cinnaminson, New Jersey
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Ormiston CK, Lawrence WR, Sulley S, Shiels MS, Haozous EA, Pichardo CM, Stephens ES, Thomas AL, Adzrago D, Williams DR, Williams F. Trends in Adolescent Suicide by Method in the US, 1999-2020. JAMA Netw Open 2024; 7:e244427. [PMID: 38551558 PMCID: PMC10980967 DOI: 10.1001/jamanetworkopen.2024.4427] [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: 11/14/2023] [Accepted: 02/03/2024] [Indexed: 04/01/2024] Open
Abstract
Importance Adolescent suicide in the US is a major public health problem, yet temporal trends in suicide methods by demographics are understudied. Objective To examine national trends in suicide mortality by method (firearm, poisoning, hanging and asphyxiation, and all other means) from 1999 to 2020 by demographic characteristics. Design, Setting, and Participants This serial cross-sectional study used national death certificate data of adolescent (aged 10-19 years) suicide decedents compiled by the National Center for Health Statistics from January 1, 1999, to December 31, 2020. Data analysis was performed from April 1, 2023, to July 9, 2023. Exposures Age, sex, and race and ethnicity. Main Outcomes and Measures Trends in age-standardized mortality rates and average annual percent change (AAPC) in rates were estimated by age, sex, and race and ethnicity for each suicide method. Results This study assessed data from 47 217 adolescent suicide decedents. From 1999 to 2020, suicide by firearm (AAPC, 1.0; 95% CI, 0.1-1.9), poisoning (AAPC, 2.7; 95% CI, 1.0-4.4), hanging and asphyxiation (AAPC, 2.4; 95% CI, 0.2-4.6), and other means (AAPC, 2.9; 95% CI, 1.2-4.6) increased. Rapidly increasing rates were observed among female adolescents for poisoning (AAPC, 4.5; 95% CI, 2.3-6.7) and hanging and asphyxiation (AAPC, 5.9; 95% CI, 5.0-6.8) suicides. From 2007 to 2020, firearm suicides sharply increased among female (annual percent change [APC], 7.8; 95% CI, 6.0-9.5) and male (APC, 5.3; 95% CI, 4.3-6.3) adolescents. Firearm suicide rates increased among Black adolescents from 2012 to 2020 (APC, 14.5; 95% CI, 9.7-19.5), Asian and Pacific Islander adolescents from 2008 to 2020 (APC, 12.0; 95% CI, 9.7-14.5), American Indian and Alaska Native adolescents from 2014 to 2020 (APC, 10.6; 95% CI, 2.6-19.3), and Hispanic or Latino adolescents from 2011 to 2020 (APC, 10.2; 95% CI, 6.3-13.8). During the study period, Black adolescents had the highest average increase in hanging and asphyxiation suicides (AAPC, 4.2; 95% CI, 3.2-5.2). From 2011 to 2020, poisoning suicide deaths increased (APC, 12.6; 95% CI, 8.5-16.7) among female adolescents. Conclusions and Relevance Suicide rates increased across all methods from 1999 to 2020. Differences were noted by sex, age, and race and ethnicity. Increasing suicide rates among racial and ethnic minoritized youth are especially concerning, and effective prevention strategies are urgently needed.
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Affiliation(s)
- Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Wayne R. Lawrence
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | | | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Emily A. Haozous
- Pacific Institute for Research and Evaluation, Albuquerque, New Mexico
| | - Catherine M. Pichardo
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Erica S. Stephens
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Aleah L. Thomas
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
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Avila A, Lao OB, Neville HL, Yorkgitis BK, Chang HL, Thatch K, Plumley D, Larson SD, Fitzwater JW, Markley M, Pedroso F, Fischer A, Armstrong LB, Petroze RT, Snyder CW. Social determinants of health in pediatric trauma: Associations with injury mechanisms and outcomes in the context of the COVID-19 pandemic. Am J Surg 2024; 228:107-112. [PMID: 37661530 DOI: 10.1016/j.amjsurg.2023.08.019] [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: 05/13/2023] [Revised: 07/17/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19. METHODS Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in Florida were included. Patients were stratified by high vs. low Social Vulnerability Index (SVI). Injury mechanisms studied were child abuse, ATV/golf carts, and firearms. Mechanism incidence trends and mortality were evaluated by interrupted time series and multivariable logistic regression. RESULTS Of 19,319 children, 68% and 32% had high and low SVI, respectively. Child abuse increased across SVI strata and did not change with COVID. ATV/golf cart injuries increased after COVID among children with low SVI. Firearm injuries increased after COVID among children with high SVI. Mortality was predicted by injury mechanism, but was not independently associated with SVI, race, or COVID. CONCLUSION Social vulnerability influences pediatric trauma mechanisms and COVID effects. Child abuse and firearm injuries should be targeted for prevention.
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Affiliation(s)
- Azalia Avila
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Oliver B Lao
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Holly L Neville
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Brian K Yorkgitis
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - Henry L Chang
- Tampa General Hospital - Children's Hospital, Tampa, FL, 1 Tampa General Cir, Tampa, FL, 33606, USA; Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Keith Thatch
- Tampa General Hospital - Children's Hospital, Tampa, FL, 1 Tampa General Cir, Tampa, FL, 33606, USA; Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Donald Plumley
- Arnold Palmer Hospital for Children, Orlando Health, Orlando, FL, 92 W Miller St, Orlando, FL, 32806, USA.
| | - Shawn D Larson
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - John W Fitzwater
- Baylor Scott & White McLane Children's Medical Center, Temple, TX, 1901 SW H K Dodgen Loop, Temple, TX, 76502, USA.
| | - Michele Markley
- Salah Foundation Children's Hospital, Broward Health, Ft. Lauderdale, Florida, 1600 S Andrews Ave, Fort Lauderdale, FL, 33316, USA.
| | - Felipe Pedroso
- Nicklaus Children's Hospital, Miami, FL, 3100 SW 62nd Ave, Miami, FL, 33155, USA.
| | - Anne Fischer
- Palm Beach Children's Hospital, West Palm Beach, FL, 901 45th St, West Palm Beach, FL, 33407, USA.
| | - Lindsey B Armstrong
- Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Robin T Petroze
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - Christopher W Snyder
- Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
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23
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Allem JP, Biyani M, Bushman BJ. Surveillance of Gun-Related Conversations on Twitter. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:380-391. [PMID: 37962708 DOI: 10.1007/s11121-023-01599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/15/2023]
Abstract
Gun violence in the USA is a documented public health crisis. Publicly accessible data from Twitter posts can be used to rapidly capture and describe the public's recent conversations about guns. Because these gun-related conversations change rapidly, it is important to provide regularly updated information on them. Twitter posts containing gun-related terms were obtained from January 1, 2022 to June 30, 2022. To understand topics of gun-related tweets (N = 449,492), topic modeling was performed with Top2Vec. Gun ownership control, concern about gun safety and its impact on children and schools, and the Second Amendment were major areas of the gun-related discourse on Twitter. Several identified topics in this study were a consequence of the study period, including "Discourse on Capitol Riots," and "Wartime and Military Use of Guns," with the latter topic containing conversations about the Russia-Ukraine War. Conversations around the influence of the National Rifle Association (NRA) on gun policies and pro-gun ownership perspectives were also part of the public discourse. The intersection between alcohol, substance use, and gun use was infrequently observed. Findings suggest that gun-related conversations in social media such as Twitter can inform public health researchers.
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Affiliation(s)
- Jon-Patrick Allem
- Keck School of Medicine, University of Southern California, 1845 N Soto Street, 3rd Floor, SSB 312D, Los Angeles, CA, 90032, USA.
| | - Manan Biyani
- Keck School of Medicine, University of Southern California, 1845 N Soto Street, 3rd Floor, SSB 312D, Los Angeles, CA, 90032, USA
| | - Brad J Bushman
- School of Communication, The Ohio State University, Columbus, OH, USA
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Marchant A, Allyn S, Burke A, Gaal A, Dillon J. Have Incidence and Severity of Craniomaxillofacial Fractures Changed Since SARS-CoV-2? J Oral Maxillofac Surg 2024; 82:199-206. [PMID: 38040026 DOI: 10.1016/j.joms.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND An increase in severity and a decrease in incidence of craniomaxillofacial fractures (CMFs) were identified during the first several months of the SARS-CoV-2 pandemic. It is unclear if these changes have persisted in the current timeframe. PURPOSE The investigators hypothesize that the incidence and severity of CMF will not return to baseline prepandemic (control) levels as the pandemic stabilizes and becomes endemic. STUDY DESIGN, SETTING, SAMPLE This retrospective cohort study enrolled subjects who presented to Harborview Medical Center a Level 1 trauma center for the evaluation and management of CMF. Inclusion criteria were 1) Presentation timeline 2018 through 2022, 2) CMF identified by the 10th International Classification of Disease. Exclusion criteria were: 1) Undocumented etiology of facial fracture and 2) inadequate/unclear documentation otherwise. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE The predictor variable was year of injury relating to the start of the pandemic. The groups were the prepandemic (2018, 2019) and postpandemic (2020, 2021. 2022). MAIN OUTCOME VARIABLES The primary outcome variable was the CMF diagnosis identified using the corresponding International Classification of Disease, 10th Edition codes. The secondary outcome variables were mechanism of injury and injury severity. COVARIATES The covariates were age, sex, race/ethnicity, admission status, alcohol intoxication, toxicology screen, reimbursement source, abuse reported, and abuse investigated. ANALYSES Univariate and bivariate analyses were performed with statistical significance at P < .05. RESULTS The sample was composed of 5203 subjects. The annual volumes of subjects presenting with CMF were consistent over the study period (2018, 2019, 2020, 2021, 2022 n = 1018, 963, 1020, 1062, 1140, respectively). The incidence of Hispanics increased (2018, 2019, 2020, 2021, 2022: 11.1, 9.6, 12.2, 13.9, 13.2% (P < .05)) as did firearm CMF injuries (2018, 2019, 2020, 2021, 2022: 4.13, 4.98, 4.71, 7.16, 6.75% (P < .05)). The Injury Severity Score and Abbreviated Injury Scale were both lower postpandemic compared to prepandemic; mean Injury Severity Score post [18.27 ± 12.46] versus pre [19.25 ± 12.89] (P < .05), mean Abbreviated Injury Scale post [2.94 ± 1.15] versus pre [3.04 ± 1.14] (P < .05). CONCLUSIONS AND RELEVANCE While the severity of CMF decreased postpandemic, Hispanic and firearm CMF increased. The overall CMF incidence remained the same. The significant rise in firearm injuries warrants further study.
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Affiliation(s)
- Andrew Marchant
- Dental Student, University of Washington School of Dentistry, Seattle, WA
| | - Stuart Allyn
- Resident, University of Washington Oral and Maxillofacial Surgery, Seattle, WA
| | - Andrea Burke
- Assistant Professor, University of Washington Oral and Maxillofacial Surgery, Seattle, WA
| | - Austin Gaal
- Assistant Professor, University of Washington Oral and Maxillofacial Surgery, Seattle, WA
| | - Jasjit Dillon
- Professor, Program Director, Department of Oral & Maxillofacial Surgery, University of Washington, Chief of Service Harborview Medical Center, Seattle, WA.
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25
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Warner TD. Locked and loaded: correlates of in-home firearm storage beliefs and behaviours. Inj Prev 2024:ip-2023-045096. [PMID: 38302283 DOI: 10.1136/ip-2023-045096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To understand how crime and victimisation fears and risks operate alongside social status threats and motivations to shape unsafe in-home firearm storage practices and beliefs. METHODS Using data from firearm owners identified in a nationwide sample surveyed in 2023, this study examined how in-home loaded firearm accessibility, firearm storage practice and firearm safety beliefs are associated with: fear of crime and victimisation; perceived and personal victimisation; racial resentment; cultural and status threats; and masculinity threats. Regression models also accounted for the role of gender, race, marital status, political affiliation, geographic region and protective motivation for firearm ownership. RESULTS Over 40% of firearm owners reported having a loaded firearm 'always accessible' at home, and almost half think homes with firearms are safer than those without. About one-third of owners reported storing firearms locked but still loaded. Crime and victimisation fears and threats were unrelated to firearm storage behaviours and beliefs; however, firearm owners who experience higher levels of sociocultural anxiety are more likely to always have a loaded firearm accessible at home, store firearms locked and loaded, and believe that firearms make homes safer. CONCLUSIONS Identifying the barriers to safer storage beliefs and behaviours is essential for refining and enhancing effective firearm injury prevention strategies. Sociocultural anxieties may not reflect concrete threats to physical safety, but they can be experienced as feelings of insecurity, instability and distress that-for some Americans-may be managed by knowing they have a (loaded) firearm within reach.
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Affiliation(s)
- Tara D Warner
- Criminal Justice, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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26
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Roess AA, Henderson LF, Adams LM, Renshaw KD. Association Between Firearm Purchasing in Response to the COVID-19 Pandemic and Symptoms of Anxiety, Depression, and Stress, August 2021. AJPM FOCUS 2024; 3:100171. [PMID: 38293250 PMCID: PMC10825591 DOI: 10.1016/j.focus.2023.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Introduction Firearm sales and firearm-related injuries and deaths increased during the pandemic. Little is known about motivations for firearm purchasing in response to the COVID-19 pandemic and the mental health status of first-time purchasers. The purpose of this study was to estimate the association between firearm purchasing in response to the COVID-19 pandemic and anxiety symptoms, depressive symptoms, and stress. Methods The authors analyzed data from a survey that approximated a nationally representative sample of American adults (N=3,528) who either did not own firearms (n=2,327) or purchased firearms for the first time in response to the pandemic (n=240). Self-reported stress, depressive symptoms, and anxiety symptoms were determined using standardized self-assessment questionnaires (Perceived Stress Scale, Patient Health Questionnaire, and Depression Anxiety Stress Scale, respectively). Using multivariable logistic regression, the association between firearm purchasing and each mental health measure were assessed after controlling for demographics and other determinants. Results In each model, first-time firearm owners were more likely to be younger, live in urban areas, believe the government does too much for its citizens, stay home, stock up on items, and keep their children at home. First-time owners had significantly higher odds of anxiety and depressive symptoms than non-owners (AOR=1.05; 95% CI=1.04, 1.07 and AOR=1.15; 95% CI=1.04, 1.26, respectively). Conclusions First-time firearm purchasers report higher depressive and anxiety symptoms than non-owners, suggesting that there may be a risk of suicide and other related firearm violence.
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Affiliation(s)
- Amira A. Roess
- Department of Global and Community Health George Mason University, Fairfax, Virginia
| | - Laura F. Henderson
- Department of Global and Community Health George Mason University, Fairfax, Virginia
| | - Leah M. Adams
- Department of Psychology, George Mason University, Fairfax, Virginia
| | - Keith D. Renshaw
- Department of Psychology, George Mason University, Fairfax, Virginia
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27
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Anestis M, Bond AE, Baker N, Semenza DC. Regional differences in firearm ownership, storage and use: results from a representative survey of five US states. Inj Prev 2024; 30:53-59. [PMID: 37798091 DOI: 10.1136/ip-2023-044878] [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: 03/22/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Firearm access and storage practices influence risk for injury and death; however, prior research has considered only national and regional differences on these variables, overlooking state-level differences. OBJECTIVES To analyse and describe statewide differences in firearm ownership, storage and use in a representative sample of five US states. DESIGN Variables were assessed via an online self-report survey administered between 29 April 2022 and 15 May 2022. SETTING Surveys were completed online. PARTICIPANTS Participants (n=3510) were members of knowledge panel, a probability-based sample recruited to be representative of US adults. All participants were aged 18+ and resided in one of five states: Colorado, Minnesota, Mississippi, New Jersey or Texas. MEASUREMENTS We used χ2 tests to examine state differences in firearm ownership, childhood firearm experiences and purchasing. A series of analyses of covariance were then used to assess differences in firearm storage, firearms owned and carrying behaviours while adjusting for pertinent demographic characteristics. RESULTS We found significant differences in firearm ownership across states. There were significantly more first-time firearm purchasers during the firearm purchasing surge in New Jersey. Both Mississippi and Texas have elevated rates of unsecure storage practices and firearm carrying outside of the home. LIMITATIONS Results are cross-sectional and self-report. Findings may not generalise beyond the five states assessed in this survey. CONCLUSIONS Public health messaging around firearm safety should account for differences in key firearm behaviours related to ownership, storage and use to ensure effective communication and reduce the risk of gun injury and death across states.
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Affiliation(s)
- Michael Anestis
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Urban-Global Public Health, Rutgers The State University of New Jersey, Piscataway, New Jersey, USA
| | - Allison E Bond
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Nazsa Baker
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
| | - Daniel C Semenza
- New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Urban-Global Public Health, Rutgers The State University of New Jersey, Piscataway, New Jersey, USA
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Paladugu A, Shipley J, Grigorian A, Qazi A, Kong A, Kuza C, Donnelly M, Nahmias J. Trends in Legal Firearm Transactions: A Possible Protective Role of Gun Law Strength. Am Surg 2024:31348241230090. [PMID: 38266390 DOI: 10.1177/00031348241230090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
INTRODUCTION The United States (US) holds the highest personal firearm ownership among industrialized nations, with implications for firearm-related deaths tied to increased per capita gun ownership and varying gun laws. This study examines the influence of gun law strength on legal firearm transactions, positing a correlation between stronger laws and reduced transactions. The analysis, focused on the stress-laden COVID-19 pandemic, evaluates handgun, long gun, and multiple gun transactions in 2020 and 2021 compared to 2018-2019. METHODS The Giffords Gun Law scorecard categorized states into the top 25 "strong" and bottom 25 "weak" gun law groups. Multivariate linear regressions assessed the association between strong gun law states and monthly National Instant Criminal Background Check System (NICS) data from 2018 to 2021. The study queried NICS for handgun, long gun, and multiple gun transactions, comparing median monthly transactions in 2018 and 2019 to 2020 and 2018-2020 to 2021. RESULTS When evaluating gun law strength through multivariate linear regression models, stronger gun law states had fewer monthly NICS transactions for handguns, long guns, and multiple guns in 2020 and 2021 versus all comparison years (all P < .05). However, from 2018-2019 to 2020 and 2018-2020 to 2021, median monthly NICS transactions per 100,000 people for all gun types increased (all P < .05). CONCLUSION Stricter gun laws correlated with decreased firearm transactions in stronger law states, yet handgun, long gun, and multiple gun transactions increased during the pandemic years of 2020 and 2021. Therefore, strengthening firearm legislation may be protective against the proliferation of firearms, which warrants further research.
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Affiliation(s)
- Anushka Paladugu
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Jonathan Shipley
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Areg Grigorian
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Alliya Qazi
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Allen Kong
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Catherine Kuza
- Department of Anesthesiology, University of Southern California, Los Angeles, CA, USA
| | - Megan Donnelly
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
| | - Jeffry Nahmias
- Division of Trauma, Burns, Critical Care & Acute Care Surgery, University of California, Irvine, Orange, CA, USA
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Gaddis K, Woollen KC, Johnson LJ, Flaherty T, Byrnes JF. A structural vulnerability approach to older adult suicides: Trends and potential impacts of the COVID-19 pandemic in Clark County, NV (2017-2021). Forensic Sci Int Synerg 2024; 8:100454. [PMID: 38304716 PMCID: PMC10830507 DOI: 10.1016/j.fsisyn.2024.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 11/30/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
The ongoing SARS-CoV-2 (COVID-19) pandemic has affected all aspects of life in the United States and around the world. This is particularly true for marginalized and vulnerable groups who face disproportionate levels of violence and premature death within their communities. While general impacts of the pandemic have been well-studied overall, little has been done to examine the correlation between COVID-19 and the risk of suicide among older adults. Older adults are particularly at risk because they face challenges including ageism, inadequate support systems, unreliable transportation, and frequent social isolation. Medicolegal casework offers a unique vantage of these issues, as it aims to identify manner of death which may be influenced by underlying structural vulnerabilities. The current research draws upon data collected from the Clark County Office of the Coroner/Medical Examiner. A sample of 871 older adults (aged 50+), whose manner of death was deemed a suicide between the years 2017-2021, were included in this analysis. Statistical analyses investigated differences between adults aged 50-64, 65-84, and 85+ years. Results suggest statistically significant changes in mechanism of death between pre-pandemic and pandemic periods, indicating a shift in risk factors related to social isolation and the home environment. Understanding such changes in trends directly affects the interpretation of skeletal data in forensic anthropology and thus, should be taken into consideration when developing structural vulnerability profiles. Furthermore, the inclusion of a structural vulnerability approach in forensic case reports has the potential to provide additional context for deaths by suicide and may help develop policies and procedures for mitigating future risk.
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Affiliation(s)
- Katherine Gaddis
- University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, 89154, USA
| | - Katharine C. Woollen
- University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, 89154, USA
| | - Liam J. Johnson
- University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, 89154, USA
| | - Taylor Flaherty
- University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, 89154, USA
| | - Jennifer F. Byrnes
- University of Nevada, Las Vegas, 4505 S. Maryland Pkwy., Las Vegas, NV, 89154, USA
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Wintemute GJ, Robinson SL, Tomsich EA, Tancredi DJ. MAGA Republicans' views of American democracy and society and support for political violence in the United States: Findings from a nationwide population-representative survey. PLoS One 2024; 19:e0295747. [PMID: 38170700 PMCID: PMC10763974 DOI: 10.1371/journal.pone.0295747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Identifying groups at increased risk for political violence can support prevention efforts. We determine whether "Make America Great Again" (MAGA) Republicans, as defined, are potentially such a group. METHODS Nationwide survey conducted May 13-June 2, 2022 of adult members of the Ipsos KnowledgePanel. MAGA Republicans are defined as Republicans who voted for Donald Trump in the 2020 presidential election and deny the results of that election. Principal outcomes are weighted proportions of respondents who endorse political violence, are willing to engage in it, and consider it likely to occur. FINDINGS The analytic sample (n = 7,255) included 1,128 (15.0%) MAGA Republicans, 640 (8.3%) strong Republicans, 1,571 (21.3%) other Republicans, and 3,916 (55.3%) non-Republicans. MAGA Republicans were substantially more likely than others to agree strongly/very strongly that "in the next few years, there will be civil war in the United States" (MAGA Republicans, 30.3%, 95% CI 27.2%, 33.4%; strong Republicans, 7.5%, 95% CI 5.1%, 9.9%; other Republicans, 10.8%, 95% CI 9.0%, 12.6%; non-Republicans, 11.2%, 95% CI 10.0%, 12.3%; p < 0.001) and to consider violence usually/always justified to advance at least 1 of 17 specific political objectives (MAGA Republicans, 58.2%, 95% CI 55.0%, 61.4%; strong Republicans, 38.3%, 95% CI 34.2%, 42.4%; other Republicans, 31.5%, 95% CI 28.9%, 34.0%; non-Republicans, 25.1%, 95% CI 23.6%, 26.7%; p < 0.001). They were not more willing to engage personally in political violence. INTERPRETATION MAGA Republicans, as defined, are more likely than others to endorse political violence. They are not more willing to engage in such violence themselves; their endorsement may increase the risk that it will occur.
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Affiliation(s)
- Garen J. Wintemute
- Department of Emergency Medicine, Violence Prevention Research Program, and California Firearm Violence Research Center, University of California, Davis, Sacramento, California, United States of America
| | - Sonia L. Robinson
- Department of Emergency Medicine, Violence Prevention Research Program, and California Firearm Violence Research Center, University of California, Davis, Sacramento, California, United States of America
| | - Elizabeth A. Tomsich
- Department of Emergency Medicine, Violence Prevention Research Program, and California Firearm Violence Research Center, University of California, Davis, Sacramento, California, United States of America
| | - Daniel J. Tancredi
- Department of Pediatrics, University of California, Davis, Sacramento, California, United States of America
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Hoffmann JA, Carter CP, Olsen CS, Chaudhari PP, Chaudhary S, Duffy S, Glomb N, Goyal MK, Grupp-Phelan J, Haasz M, Ketabchi B, Kravitz-Wirtz N, Lerner EB, Shihabuddin B, Wendt W, Cook LJ, Alpern ER. Pediatric Firearm Injury Emergency Department Visits From 2017 to 2022: A Multicenter Study. Pediatrics 2023; 152:e2023063129. [PMID: 37927086 PMCID: PMC10842699 DOI: 10.1542/peds.2023-063129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Pediatric firearm injuries increased during the coronavirus disease 2019 pandemic, but recent trends in firearm injury emergency department (ED) visits are not well described. We aimed to assess how pediatric firearm injury ED visits during the pandemic differed from expected prepandemic trends. METHODS We retrospectively studied firearm injury ED visits by children <18 years old at 9 US hospitals participating in the Pediatric Emergency Care Applied Research Network Registry before (January 2017 to February 2020) and during (March 2020 to November 2022) the pandemic. Multivariable Poisson regression models estimated expected visit rates from prepandemic data. We calculated rate ratios (RRs) of observed to expected visits per 30 days, overall, and by sociodemographic characteristics. RESULTS We identified 1904 firearm injury ED visits (52.3% 15-17 years old, 80.0% male, 63.5% non-Hispanic Black), with 694 prepandemic visits and 1210 visits during the pandemic. Death in the ED/hospital increased from 3.1% prepandemic to 6.1% during the pandemic (P = .007). Firearm injury visits per 30 days increased from 18.0 prepandemic to 36.1 during the pandemic (RR 2.09, 95% CI 1.63-2.91). Increases beyond expected rates were seen for 10- to 14-year-olds (RR 2.61, 95% CI 1.69-5.71), females (RR 2.46, 95% CI 1.55-6.00), males (RR 2.00, 95% CI 1.53-2.86), Hispanic children (RR 2.30, 95% CI 1.30-9.91), and Black non-Hispanic children (RR 1.88, 95% CI 1.34-3.10). CONCLUSIONS Firearm injury ED visits for children increased beyond expected prepandemic trends, with greater increases among certain population subgroups. These findings may inform firearm injury prevention efforts.
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Affiliation(s)
- Jennifer A Hoffmann
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Camille P Carter
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Cody S Olsen
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Pradip P Chaudhari
- Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Sofia Chaudhary
- Division of Emergency Medicine, Department of Pediatrics and Department of Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Susan Duffy
- Departments of Emergency Medicine and Pediatrics, Brown University, Hasbro Children's Hospital, Providence, Rhode Island
| | - Nicolaus Glomb
- Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California
| | - Monika K Goyal
- Division of Emergency Medicine, Children's National Hospital, George Washington University, Washington, District of Columbia
| | - Jacqueline Grupp-Phelan
- Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California
| | - Maya Haasz
- Department of Pediatrics, Section of Emergency Medicine, Children's Hospital Colorado, University of Colorado, Aurora, Colorado
| | - Bijan Ketabchi
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California, Davis, Sacramento, California
| | - E Brooke Lerner
- Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York
| | - Bashar Shihabuddin
- Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Wendi Wendt
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Lawrence J Cook
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Elizabeth R Alpern
- Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
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Testa A, Tsai J. Loneliness and firearm acquisition among low-income U.S. veterans: Findings from the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) study. Soc Sci Med 2023; 338:116356. [PMID: 37939539 DOI: 10.1016/j.socscimed.2023.116356] [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: 08/14/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
RATIONALE There are theoretical reasons to expect loneliness related to firearm purchasing. For instance, loneliness might amplify social isolation and feelings of insecurity, anxiety, perceived danger, and need for self-reliance. Purchasing a firearm might be seen as a way to bolster one's security and gain a sense of control when faced with potential threats, yet there is a lack of research assessing this possibility. OBJECTIVE This study aimed to examine the relationship between loneliness and purchasing a firearm among a sample of low-income U.S. military veterans. METHODS Data are from a national survey of 1,004 low-income U.S. veterans collected in December 2022 and January 2023. Firth logistic regression-a rare event logistic regression model to address small-sample bias stemming from rare outcomes through a penalized likelihood approach-was used to estimate the adjusted association between loneliness and purchasing a firearm in the past year. RESULTS Approximately 5.4% reported the purchase of a new firearm in the past year, and respondents reported an average loneliness score of 1.82 (standard deviation = 1.96; range = 0-6). Results of Firth Logit regression analyses found that net of control variables for demographic, socioeconomic, and household characteristics, loneliness was positively associated with purchasing a firearm in the past year (OR = 1.167, 95% CI = 1.006, 1.352). CONCLUSION The findings indicate that loneliness among U.S. military veterans is associated with firearm purchasing. Considering the risks posed by both loneliness and firearm ownership for veteran suicide, the findings suggest the need for greater focus and synergistic strategies to address loneliness and safe firearm practices among U.S. veterans.
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Affiliation(s)
- Alexander Testa
- University of Texas Health Science Center at Houston, Department of Management, Policy and Community Health, United States.
| | - Jack Tsai
- University of Texas Health Science Center at Houston, Department of Management, Policy and Community Health, United States; U.S. Department of Veterans Affairs, National Center on Homelessness Among Veterans, United States
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Brewer K, Mantey DS, Thomas PB, Romm KF, Kong AY, Alexander AC. Identifying disparities in suicidal thoughts and behaviors among US adolescents during the COVID-19 pandemic. Prev Med 2023; 177:107791. [PMID: 38035944 PMCID: PMC10842713 DOI: 10.1016/j.ypmed.2023.107791] [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: 08/18/2023] [Revised: 11/24/2023] [Accepted: 11/26/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Suicidal thoughts and behaviors (STBs) became more common among racial and ethnic minorities and sexual and gender minorities (SGM) during the COVID-19 pandemic relative to White and non-SGM adolescents. This study examines associations between pandemic-related stressors and STBs among a nationally representative sample of adolescents to identify vulnerable subpopulations. METHODS We analyzed data from 6769 high school students using the 2021 Adolescent Behaviors and Experiences Survey. Pandemic-related stressors were assessed via seven items related to negative experiences (e.g., parent job loss; food insecurity) during the COVID-19 pandemic. Logistic regression analyses estimated the association between pandemic-related stressors and four outcomes: (1) sadness/hopelessness; (2) suicidal ideation; (3) suicide planning; and (4) recent suicide attempt (i.e., past 12 months). Interactions were modeled by sex, race/ethnicity, and sexual identity. RESULTS A greater number of pandemic-related stressors was associated with higher odds for sadness and hopelessness (aOR: 1.55; 95% CI:1.44-1.67), suicidal ideation (aOR: 1.48; 95% CI:1.39-1.57), suicide planning (aOR:1.47; 95% CI: 1.36-1.59), and recent suicide attempt (aOR: 1.64; 95% CI:1.42-1.88). Pandemic-related stressors were also more strongly associated with some types of STBs in males (relative to females) and SGM females (relative to heterosexual females). CONCLUSION Study findings indicate that pandemic-related stressors are associated with STBs within the US adolescent population, particularly among male and SGM female adolescents. Researchers are encouraged to use this knowledge to ensure nationwide suicide prevention efforts adequately address inequities in suicide risk.
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Affiliation(s)
- Khandis Brewer
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA
| | - Dale S Mantey
- Department of Health Promotion & Behavioral Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA; Department of Epidemiology, Human Genetics, & Environmental Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, TX, USA
| | - Priya B Thomas
- Department of Epidemiology, Human Genetics, & Environmental Sciences, the University of Texas Health Science Center, School of Public Health, Austin, TX, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Amanda Y Kong
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Adam C Alexander
- TSET Health Promotion Research Center, Stephenson Cancer Center, the University of Oklahoma Health Science Centers, Oklahoma City, OK, USA; Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Donnelly KA, Goyal MK. The Epidemiology of Violence Exposure in Children. Pediatr Clin North Am 2023; 70:1057-1068. [PMID: 37865430 DOI: 10.1016/j.pcl.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Exposure to violence remains a significant issue for children in the United States. The COVID-19 pandemic exacerbated many of these exposures. Violence unequally impacts children of color and lesbian, gay, bisexual, transgender, and questioning youth. Pediatricians can and must continue to advocate and intervene to decrease pediatric violence exposure and its effects.
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Affiliation(s)
- Katie A Donnelly
- Children's National Hospital, The George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA.
| | - Monika K Goyal
- Children's National Hospital, The George Washington University, 111 Michigan Avenue NW, Washington, DC 20010, USA
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Choi NG, Marti CN, Choi BY. Firearm use risk factors and access restriction among suicide decedents age 75 and older who disclosed their suicidal intent. Front Public Health 2023; 11:1255519. [PMID: 38026395 PMCID: PMC10654963 DOI: 10.3389/fpubh.2023.1255519] [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: 07/21/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background and aims A majority of older adult suicide decedents used firearms. In this study, we focused on suicide decedents age 75+ who disclosed their suicidal intent within a month of their injury/death to examine demographic and clinical characteristics associated with firearm use and firearm access restriction attempts by their family members. Methods The 2017-2019 U.S. National Violent Death Reporting System provided data (N = 1,734 suicidal intent disclosers; 1,476 males and 258 females; 21.4% of decedents age 75+). Generalized linear model (GLM) for a Poisson distribution with a log link was used to examine firearm use risk factors. Firearm access restriction attempts by decedents' family members were examined based on coroner/medical examiner and law enforcement (CME/LE) reports. Results Nearly three quarters of disclosers disclosed their intent to family members, and 82.9% of males and 27.5% of females used firearms. GLM results showed males, non-Hispanic white people, and residents in the South and West regions had higher likelihood of firearm use. CME/LE reports of 140 out of 1,294 firearm decedents included narratives related to firearm restriction attempts or lack thereof. Firearm access restrictions were not attempted in 65 cases because family members did not take suicidal intent disclosure seriously or because decedents promised no self-harm. Partial or complete removal of firearms in 75 cases were not effective as decedents had hidden a firearm or purchased a new one. Others used different lethal methods. Implications The findings indicate a need for: (a) training family members of older adults who are at risk of suicide in effective means safety/access restriction and strategies to prevent means substitution; (b) more comprehensive legislative reforms reducing access to firearms by those at risk of suicide; and (c) more comfort and palliative care and counseling for psychosocial risk factors.
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Affiliation(s)
- Namkee G. Choi
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - C. Nathan Marti
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, United States
| | - Bryan Y. Choi
- Department of Emergency Medicine, Philadelphia College of Osteopathic Medicine and BayHealth, Dover, DE, United States
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Song Z, Zubizarreta JR, Giuriato M, Koh KA, Sacks CA. Firearm Injuries In Children And Adolescents: Health And Economic Consequences Among Survivors And Family Members. Health Aff (Millwood) 2023; 42:1541-1550. [PMID: 37931194 DOI: 10.1377/hlthaff.2023.00587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
More US children and adolescents today die from firearms than any other cause, and many more sustain firearm injuries and survive. The clinical and economic impact of these firearm injuries on survivors and family members remains poorly understood. Using 2007-21 commercial health insurance claims data, we studied 2,052 child and adolescent survivors compared to 9,983 matched controls who did not incur firearm injuries, along with 6,209 family members of survivors compared to 29,877 matched controls, and 265 family members of decedents compared to 1,263 matched controls. Through one year after firearm injury, child and adolescent survivors experienced a 117 percent increase in pain disorders, a 68 percent increase in psychiatric disorders, and a 144 percent increase in substance use disorders relative to the controls. Survivors' health care spending increased by an average of $34,884-a 17.1-fold increase-with 95 percent paid by insurers or employers. Parents of survivors experienced a 30-31 percent increase in psychiatric disorders, with 75 percent more mental health visits by mothers, and 5-14 percent reductions in mothers' and siblings' routine medical care. Family members of decedents experienced substantially larger 2.3- to 5.3-fold increases in psychiatric disorders, with at least 15.3-fold more mental health visits among parents. Firearm injuries in youth have notable health implications for the whole family, along with large effects on societal spending.
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Affiliation(s)
- Zirui Song
- Zirui Song , Harvard University and Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Katherine A Koh
- Katherine A. Koh, Boston Health Care for the Homeless Program, Boston, Massachusetts, and Massachusetts General Hospital
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West SJ, Wood AM, Thomson ND, Aboutanos MB. Exploring changes in violence across two waves of the COVID-19 pandemic in Richmond, VA. Aggress Behav 2023; 49:559-567. [PMID: 37323082 PMCID: PMC10592552 DOI: 10.1002/ab.22094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/17/2023]
Abstract
The first wave of the COVID-19 pandemic carried with it an increase in violence in the United States and abroad. The proportion of violence cases involving firearms also increased during this time, yet little research has examined these effects using data from the second wave of COVID infections. Explanations for these documented increases in gun violence put forward by scholars include increased firearm purchases, alcohol consumption, unemployment, and organized crime activity. The current work examined these trends in Richmond, VA. We collected data on patients (N = 1744) presenting with violent injuries from 2018 to 2022 from the emergency department of a Level-1 Trauma Center in Richmond, VA. Data were coded on the basis of whether they presented before the pandemic, during the first wave, or during the second wave. Logistic binomial regressions revealed that the risk of gunshot wounds increased by 32% during the first wave and 44% during the second wave, relative to the pre-COVID period, but that the increase between the first and second wave was not significant. These findings held after controlling for victim age, race, sex, and injury severity. Further analyses revealed that these effects were specific to violent injury, as we found no increase in firearm use among self-injury cases. The heightened violence reported during the COVID-19 pandemic was also observed in Richmond, VA. Gun violence in particular increased over time as other forms of violence (i.e., assaults, stabbings, and self-harm) decreased.
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Affiliation(s)
- Samuel J. West
- Department of Surgery, Virginia Commonwealth University, USA
- Department of Psychology, Virginia State University, USA
| | - Ariel M. Wood
- Department of Surgery, Virginia Commonwealth University, USA
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Caves Sivaraman J, Tong G, Easter M, Swanson J, Copeland W. Violent Experiences and Patterns of Firearm Ownership From Childhood to Young Adulthood. JAMA Netw Open 2023; 6:e2336907. [PMID: 37851447 PMCID: PMC10585415 DOI: 10.1001/jamanetworkopen.2023.36907] [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: 05/17/2023] [Accepted: 08/23/2023] [Indexed: 10/19/2023] Open
Abstract
Importance Young adults in their 20s are at high relative risk for self- and other-directed firearm injury, but little is known about gun access patterns for this group. Objective To describe the longitudinal patterns of firearm access from childhood to young adulthood and to estimate whether violence experienced as a child or as an adult is associated with gun ownership in young adulthood. Design, Setting, and Participants The Great Smoky Mountains Study included participants from 11 contiguous, mostly rural counties in the Southeastern US. The first wave was completed in 1993 and the most recent in 2019. Periodic survey data were gathered in adolescence through participants' late 20s. In 2023, adjusted Poisson regression with incident rate ratios (IRRs) and 95% CIs were used to estimate associations between violence and gun ownership in young adulthood in 3 age cohorts from the original sample. Exposures Violent experiences in childhood (bullying, sexual and physical abuse, violent events, witnessing trauma, physical violence between parents, and school/neighborhood dangerousness) or adulthood (physical and sexual assault). Main Outcomes and Measures Initiating gun ownership was defined as no gun access or ownership in childhood followed by gun ownership at age 25 or 30 years. Maintaining gun ownership was defined as reporting gun access or ownership in at least 1 survey in childhood and ownership at age 25 or 30 years. Results Among 1260 participants (679 [54%] male; ages 9, 11, and 13 years), gun access or ownership was more common in childhood (women: 366 [63%]; men: 517 [76%]) than in adulthood (women: 207 [36%]; men: 370 [54%]). The most common longitudinal pattern was consistent access or ownership from childhood to adulthood (373 [35%]) followed by having access or ownership in childhood only (408 [32%]). Most of the violent exposures evaluated were not significantly associated with the outcomes. Being bullied at school was common and was associated with reduced ownership initiation (IRR, 0.76; 95% CI, 0.61-0.94). Witnessing a violent event was significantly associated with increased probability of becoming a gun owner in adulthood (IRR, 1.24; 95% CI, 1.03-1.49). Conclusions and Relevance In this cohort study, gun ownership and access were transitory, even in a geographic area where gun culture is strong. Early adulthood-when the prevalence of gun ownership was relatively low-may represent an opportune time for clinicians and communities to provide education on the risks associated with firearm access, as well as strategies for risk mitigation.
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Affiliation(s)
- Josie Caves Sivaraman
- RTI International, Research Triangle Park, North Carolina
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - Guangyu Tong
- Department of Biostatistics, Yale School of Medicine, New Haven, Connecticut
| | - Michele Easter
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - Jeffrey Swanson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
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Bryan CJ, Daruwala SE, Tabares JV, Butner JE, Coccaro EF, Gorka SM. Heightened threat perceptions and reduced stability in anxiety and fear among U.S. adults who carry handguns. J Anxiety Disord 2023; 99:102764. [PMID: 37597342 PMCID: PMC10543589 DOI: 10.1016/j.janxdis.2023.102764] [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: 04/05/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/21/2023]
Abstract
Firearm carrying is often motivated to provide safety and is correlated with increased anxiety related to elevated perceptions of the world as a dangerous place. No studies have investigated affective states among firearm owners as they occur in their natural environments. This study used ecological momentary assessment (EMA) to examine cognitive-affective states among firearm owners who carry handguns outside their home (n = 35), firearm owners who do not carry (n = 47), and non-firearm owners (n = 62). Participants completed a self-report questionnaire at baseline followed by EMA surveys of mood state with the Positive and Negative Affect Scale (PANAS) 6 times per day for 28 consecutive days. Carry handgun owners reported significantly higher threat perceptions, measured with the negative cognitions about the world subscale of the shortened Posttraumatic Cognitions Inventory (PTCI), than no-carry handgun owners (Mdiff=2.0, 95% CI=0.8-2.0, d=0.45, p = .001) and non-owners (Mdiff=1.8, 95% CI=0.6-2.9, d=0.42, p = .003). Groups did not significantly differ in mean momentary mood ratings assessed via EMA but stability in high-arousal negative arousal was significantly reduced among carry handgun owners (F(2, 150)= 3.7, p = .026). Results suggest firearm owners who carry handguns view the world as especially dangerous, are more likely to experience shifts in anxiety and fear, and take longer to recover from periods of elevated anxiety and fear.
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Affiliation(s)
- Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 3650 Olentangy River Rd, Suite 330, Columbus, OH 43214, United States.
| | - Samantha E Daruwala
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 3650 Olentangy River Rd, Suite 330, Columbus, OH 43214, United States
| | - Jeffrey V Tabares
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 3650 Olentangy River Rd, Suite 330, Columbus, OH 43214, United States
| | - Jonathan E Butner
- Department of Psychology, The University of Utah, 380 1530 E, Salt Lake City, UT 84112, United States
| | - Emil F Coccaro
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 3650 Olentangy River Rd, Suite 330, Columbus, OH 43214, United States
| | - Stephanie M Gorka
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 3650 Olentangy River Rd, Suite 330, Columbus, OH 43214, United States
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Wintemute GJ, Robinson SL, Crawford A, Tancredi D, Schleimer JP, Tomsich EA, Reeping PM, Shev AB, Pear VA. Views of democracy and society and support for political violence in the USA: findings from a nationally representative survey. Inj Epidemiol 2023; 10:45. [PMID: 37770994 PMCID: PMC10540371 DOI: 10.1186/s40621-023-00456-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/31/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Current conditions in the USA suggest an increasing risk for political violence. Little is known about the prevalence of beliefs that might lead to political violence, about support for and personal willingness to engage in political violence, and about how those measures vary with individual characteristics, lethality of violence, political objectives that violence might advance, or specific populations as targets. METHODS This cross-sectional US nationally representative survey was conducted on May 13 to June 2, 2022, of adult members of the Ipsos KnowledgePanel. Outcomes are weighted, population-representative proportions of respondents endorsing selected beliefs about American democracy and society and violence to advance political objectives. RESULTS The analytic sample included 8620 respondents; 50.5% (95% confidence interval (CI) 49.3%, 51.7%) were female; and weighted mean (± standard deviation) age was 48.4 (± 18.0) years. Nearly 1 in 5 (18.9%, 95% CI 18.0%, 19.9%) agreed strongly or very strongly that "having a strong leader for America is more important than having a democracy"; 16.2% (95% CI 15.3%, 17.1%) agreed strongly or very strongly that "in America, native-born white people are being replaced by immigrants," and 13.7% (95% CI 12.9%, 14.6%) agreed strongly or very strongly that "in the next few years, there will be civil war in the United States." One-third of respondents (32.8%, 95% CI 31.7%, 33.9%) considered violence to be usually or always justified to advance at least 1 of 17 specific political objectives. Among all respondents, 7.7% (95% CI 7.0%, 8.4%) thought it very or extremely likely that within the next few years, in a situation where they believe political violence is justified, "I will be armed with a gun"; 1.1% (95% CI 0.9%, 1.4%) thought it very or extremely likely that "I will shoot someone with a gun." Support for political violence and for the use of firearms in such violence frequently declined with increasing age, education, and income. CONCLUSIONS Small but concerning proportions of the population consider violence, including lethal violence, to be usually or always justified to advance political objectives. Prevention efforts should proceed urgently based on the best evidence available.
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Affiliation(s)
- Garen J Wintemute
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA.
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA.
- California Firearm Violence Research Center, Sacramento, CA, USA.
| | - Sonia L Robinson
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Andrew Crawford
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Daniel Tancredi
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
- Department of Pediatrics, UC Davis, Sacramento, CA, USA
| | - Julia P Schleimer
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Elizabeth A Tomsich
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Paul M Reeping
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Aaron B Shev
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Veronica A Pear
- UC Davis Violence Prevention Research Program, Sacramento, CA, USA
- Department of Emergency Medicine, UC Davis, Sacramento, CA, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
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O'Guinn ML, Siddiqui S, Ourshalimian S, Chaudhari PP, Spurrier R. Firearm Injuries in Lower Opportunity Neighborhoods During the COVID Pandemic. Pediatrics 2023; 152:e2023062530. [PMID: 37599643 DOI: 10.1542/peds.2023-062530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2023] [Indexed: 08/22/2023] Open
Abstract
OBJECTIVES We aimed to describe changes in pediatric firearm injury rates, severity, and outcomes after the coronavirus disease 2019 stay-at-home order in Los Angeles (LA) County. METHODS A multicenter, retrospective, cross-sectional study was conducted on firearm injuries involving children aged <18-years in LA County before and after the pandemic. Trauma activation data of 15 trauma centers in LA County from the Trauma and Emergency Medicine Information System Registry were abstracted from January 1, 2018, to December 31, 2021. The beginning of the pandemic was set as March 19, 2020, the date the county stay-at-home order was issued, separating the prepandemic and during-pandemic periods. Rates of firearm injuries, severity, discharge capacity, and Child Opportunity Index (COI) were compared between the groups. Analysis was performed with χ2 tests and segmented regression. RESULTS Of the 7693 trauma activations, 530 (6.9%) were from firearm injuries, including 260 (49.1%) in the prepandemic group and 270 (50.9%) in the during-pandemic group. No increase was observed in overall rate of firearm injuries after the stay-at-home order was issued (P = .13). However, firearm injury rates increased in very low COI neighborhoods (P = .01). Mechanism of injury, mortality rates, discharge capacity, and injury severity score did not differ between prepandemic and during-pandemic periods (all P values ≥.05). CONCLUSIONS Although there was no overall increase in pediatric firearm injuries during the pandemic, there was a disproportionate increase in areas of very low neighborhood COI. Further examination of community disparity should be a focus for education, intervention, and development.
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Affiliation(s)
- MaKayla L O'Guinn
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Sami Siddiqui
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Shadassa Ourshalimian
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Pradip P Chaudhari
- Department of Pedicatrics, Keck School of Medicine of University of Southern California, Los Angeles, California
- Division of Emergency Medicine & Transport Medicine, Children's Hospital Los Angeles, 4650 W Sunset Blvd, Los Angeles, California
| | - Ryan Spurrier
- Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
- Department of Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California
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Hicks BM, Vitro C, Johnson E, Sherman C, Heitzeg MM, Durbin CE, Verona E. Who bought a gun during the COVID-19 pandemic in the United States?: Associations with QAnon beliefs, right-wing political attitudes, intimate partner violence, antisocial behavior, suicidality, and mental health and substance use problems. PLoS One 2023; 18:e0290770. [PMID: 37643192 PMCID: PMC10464976 DOI: 10.1371/journal.pone.0290770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
There was a large spike in gun purchases and gun violence during the first year of the COVID-19 pandemic in the United States. We used an online U.S. national survey (N = 1036) to examine the characteristics of people who purchased a gun between March 2020 and October 2021 (n = 103) and compared them to non-gun owners (n = 763) and people who own a gun but did not purchase a gun during the COVID-19 pandemic (n = 170). Compared to non-gun owners, pandemic gun buyers were younger and more likely to be male, White race, and to affiliate with the Republican party. Compared to non-gun owners and pre-pandemic gun owners, pandemic gun buyers exhibited extreme elevations on a constellation of political (QAnon beliefs, pro-gun attitudes, Christian Nationalism, approval of former President Donald Trump, anti-vax beliefs, COVID-19 skepticism; mean Cohen's d = 1.15), behavioral (intimate partner violence, antisocial behavior; mean d = 1.38), mental health (suicidality, depression, anxiety, substance use; mean d = 1.21), and personality (desire for power, belief in a dangerous world, low agreeableness, low conscientiousness; mean d = 0.95) characteristics. In contrast, pre-pandemic gun owners only endorsed more pro-gun attitudes (d = 0.67), lower approval of President Joe Biden (d = -0.41) and were more likely to be male and affiliate with the Republican party relative to non-gun owners. Pandemic gun buyers represent an extreme group in terms of political and psychological characteristics including several risk-factors for violence and self-harm.
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Affiliation(s)
- Brian M. Hicks
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Catherine Vitro
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Elizabeth Johnson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Carter Sherman
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States of America
| | - C. Emily Durbin
- Department of Psychology, Michigan State University, East Lansing, MI, United States of America
| | - Edelyn Verona
- Department of Psychology, University of South Florida, Tampa, Florida, United States of America
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Semenza DC, Magee LA, Anestis MD, Buggs SA. Identity, experience, and threat: Assessing key correlates of firearm ownership and related behaviors in a representative sample of five US States. Prev Med Rep 2023; 34:102269. [PMID: 37387726 PMCID: PMC10302110 DOI: 10.1016/j.pmedr.2023.102269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/02/2023] [Accepted: 05/30/2023] [Indexed: 07/01/2023] Open
Abstract
The purpose of this study was to examine psychosocial, experiential, and demographic correlates of firearm ownership, carrying, and storage methods. We used a representative survey of 3,510 people living in five US states (Colorado, Minnesota, Mississippi, New Jersey, and Texas) conducted in 2022. Individuals provided information on past experiences with firearms, perceptions of threat and neighborhood safety, discrimination, and tolerance of uncertainty alongside demographic items. The analysis was conducted in November 2022. Past experiences with firearms and prior victimization are associated with increased firearm ownership and carrying practices. Threat sensitivity is associated with owning more guns while poorer perceptions of neighborhood safety correspond with owning fewer guns but greater risk for unsafe storage practices like storing a loaded gun in a closet or drawer. Intolerance of uncertainty is associated with owning fewer guns and lower risk for carrying outside of the home but greater risk for unsafe storage. Prior experience of discrimination is associated with risk for carrying firearms outside of the home. Demographic characteristics related to sex, rurality, military service, and political conservatism predict risky firearm-related behaviors related to firearm ownership, carrying frequency, and unsecure storage. Taken together, we find firearm ownership and risky firearm behaviors (e.g. carrying, unsafe storage) are more prominent among groups such as politically conservative males living in rural areas while also being influenced by threatening experiences, uncertainty, and perceptions of safety.
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Affiliation(s)
- Daniel C. Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, USA
- Department of Urban-Global Health, School of Public Health, Rutgers University, New Brunswick, NJ, USA
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, NJ, USA
| | - Lauren A. Magee
- O’Neill School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Michael D. Anestis
- Department of Urban-Global Health, School of Public Health, Rutgers University, New Brunswick, NJ, USA
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, NJ, USA
| | - Shani A.L. Buggs
- Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA, USA
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Lawrence WR, Freedman ND, McGee-Avila JK, Berrington de González A, Chen Y, Emerson MA, Gee GC, Haozous EA, Haque AT, Inoue-Choi M, Jackson SS, Lord B, Nápoles AM, Pérez-Stable EJ, Vo JB, Williams F, Shiels MS. Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020. JAMA Intern Med 2023; 183:849-856. [PMID: 37399025 PMCID: PMC10318548 DOI: 10.1001/jamainternmed.2023.2509] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/30/2023] [Indexed: 07/04/2023]
Abstract
Importance Although deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood. Objective To examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined as poisonings (eg, drug overdose), firearms, and all other injuries, including motor vehicle injuries and falls. Given the repercussions of the COVID-19 pandemic, US death rates for 2019 and 2020 were also compared. Design, Setting, and Participants Serial cross-sectional study using national death certificate data obtained from the National Center for Health Statistics and including all external causes of 3 813 894 deaths among individuals aged 20 years or older from January 1, 1999, to December 31, 2020. Data analysis was conducted from January 20, 2022, to February 5, 2023. Exposures Age, sex, and race and ethnicity. Main Outcomes and Measures Trends in age-standardized mortality rates and average annual percentage change (AAPC) in rates calculated by intent (suicide, homicide, unintentional, and undetermined), age, sex, and race and ethnicity for each external cause. Results Between 1999 and 2020, there were 3 813 894 deaths due to external causes in the US. From 1999 to 2020, poisoning death rates increased annually (AAPC, 7.0%; 95% CI, 5.4%-8.7%). From 2014 to 2020, poisoning death rates increased the most among men (APC, 10.8%; 95% CI, 7.7%-14.0%). During the study period, poisoning death rates increased in all the racial and ethnic groups examined; the most rapid increase was among American Indian and Alaska Native individuals (AAPC, 9.2%; 95% CI, 7.4%-10.9%). During the study period, death rates for unintentional poisoning had the most rapid rate of increase (AAPC, 8.1%; 95% CI, 7.4%-8.9%). From 1999 to 2020, firearm death rates increased (AAPC, 1.1%; 95% CI, 0.7%-1.5%). From 2013 to 2020, firearm mortality increased by an average of 4.7% annually (95% CI, 2.9%-6.5%) among individuals aged 20 to 39 years. From 2014 to 2020, mortality from firearm homicides increased by an average of 6.9% annually (95% CI, 3.5%-10.4%). From 2019 to 2020, mortality rates from external causes accelerated further, largely from increases in unintentional poisoning, and homicide due to firearms and all other injuries. Conclusions and Relevance Results of this cross-sectional study suggest that from 1999 to 2020, death rates due to poisonings, firearms, and all other injuries increased substantially in the US. The rapid increase in deaths due to unintentional poisonings and firearm homicides is a national emergency that requires urgent public health interventions at the local and national levels.
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Affiliation(s)
- Wayne R. Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Jennifer K. McGee-Avila
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Amy Berrington de González
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, United Kingdom
| | - Yingxi Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Marc A. Emerson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Gilbert C. Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles
| | - Emily A. Haozous
- Pacific Institute for Research and Evaluation, Albuquerque, New Mexico
| | - Anika T. Haque
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Maki Inoue-Choi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Sarah S. Jackson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Brittany Lord
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Eliseo J. Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Jacqueline B. Vo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Goldstein EV, Brenes F, Wilson FA. Critical gaps in understanding firearm suicide in Hispanic communities: demographics, mental health, and access to care. HEALTH AFFAIRS SCHOLAR 2023; 1:qxad016. [PMID: 38770408 PMCID: PMC11103729 DOI: 10.1093/haschl/qxad016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 05/09/2023] [Indexed: 05/22/2024]
Abstract
Suicide rates increased by 26.7% among Hispanics from 2015 to 2020, driven at least in part by highly lethal firearm suicide deaths. However, there are critical gaps in characterizing firearm suicide risks and prevention opportunities in Hispanic communities. We examined Hispanic adult firearm suicide decedents reported through the National Violent Death Reporting System from 2013-2019, focusing on demographic characteristics, firearm choices, suicidal thoughts/behaviors, mental health, and mental health treatment, compared with non-Hispanic adult firearm suicide decedents. Only 13.8% of Hispanic firearm suicide decedents were known to be undergoing treatment for a mental health or substance use problem prior to death, compared to 18.8% of non-Hispanic firearm suicide decedents. On average, Hispanic firearm suicide decedents were significantly less likely than non-Hispanic firearm suicide decedents known to have been treated for a mental health or substance use problem. These results may underscore the critical need for public health agencies and policymakers to promote initiatives integrating mental health screening into medical care, reducing mental health stigma among Hispanics, and expanding mental health treatment capacity in Hispanic communities.
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Affiliation(s)
- Evan V Goldstein
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84108, United States
| | - Francisco Brenes
- Nicole Wertheim College of Nursing and Health Sciences, Florida International University, Miami, FL 33199, United States
| | - Fernando A Wilson
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84108, United States
- Department of Economics, University of Utah, Salt Lake City, UT 84112, United States
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, UT 84112, United States
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46
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Schleimer JP, Kagawa RMC, Laqueur HS. Association of medical conditions and firearm suicide among legal handgun purchasers in California: a case-control study. Inj Epidemiol 2023; 10:26. [PMID: 37328869 DOI: 10.1186/s40621-023-00437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Suicide is a pressing public health problem, and firearm owners are at especially elevated risk. Certain health conditions are markers of suicide risk, but more research is needed on clinical risk markers for suicide among firearm owners specifically. Our goal was to examine associations of emergency department and inpatient hospital visits for behavioral and physical health conditions with firearm suicide among handgun purchasers. METHODS This was a case-control study of 5415 legal handgun purchasers in California who died between January 1, 2008, and December 31, 2013. Cases were firearm suicide decedents; controls were motor vehicle crash decedents. Exposures were emergency department and hospital visits for six categories of health diagnoses in the 3 years prior to death. To account for selection bias due to deceased controls, we used probabilistic quantitative bias analysis to generate bias-adjusted estimates. RESULTS There were 3862 firearm suicide decedents and 1553 motor vehicle crash decedents. In multivariable models, suicidal ideation/attempt (OR 4.92; 95% CI 3.27-7.40), mental illness (OR 1.97; 95% CI 1.60-2.43), drug use disorder (OR 1.40; 95% CI 1.05-1.88), pain (OR 1.34; 95% CI 1.07-1.69), and alcohol use disorder (OR 1.29; 95% CI 1.01-1.65) were associated with higher odds of firearm suicide. When adjusting for all conditions simultaneously, only the associations for suicidal ideation/attempt and mental illness remained significant. Quantitative bias analysis indicated that observed associations were generally biased downward. For example, the bias-adjusted OR for suicidal ideation/attempt was 8.39 (95% simulation interval 5.46-13.04), almost twice that of the observed OR. CONCLUSIONS Diagnoses for behavioral health conditions were markers for firearm suicide risk among handgun purchasers, even for conservative estimates that did not adjust for selection bias. Encounters with the healthcare system may provide opportunities to identify firearm owners at high risk of suicide.
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Affiliation(s)
- Julia P Schleimer
- Violence Prevention Research Program, University of California, Davis, 2315 Stockton Blvd., Sacramento, CA, 95817, USA.
- California Firearm Violence Research Center, Sacramento, CA, USA.
| | - Rose M C Kagawa
- Violence Prevention Research Program, University of California, Davis, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
| | - Hannah S Laqueur
- Violence Prevention Research Program, University of California, Davis, 2315 Stockton Blvd., Sacramento, CA, 95817, USA
- California Firearm Violence Research Center, Sacramento, CA, USA
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47
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Knapp S. Lethal Means Counseling for Suicidal Firearm Owners. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2023:1-9. [PMID: 37363717 PMCID: PMC10251328 DOI: 10.1007/s10879-023-09588-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
The death of a patient by suicide is one of the professional events most feared by psychotherapists and firearms are the most commonly used means of suicide. However, as the number of firearm owners within the United States has increased in recent years, so has the risk of firearm-related suicides. Suicidal patients with easy access to their firearms may give in to the wish to die and end their life with little opportunity for reflection or forethought. Furthermore, because the topic of gun control has become so polarized, patients may not always be open to discussing barriers between themselves and their firearms. Nonetheless, psychotherapists using non-judgmental, respectful, and collaborative lethal means counseling can substantially reduce patient suicides.
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48
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Hullenaar KL, Rowhani-Rahbar A, Morgan ER, Hicks CD, Rivara FP. Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children. Pediatrics 2023; 151:e2022060610. [PMID: 37212029 PMCID: PMC10233734 DOI: 10.1542/peds.2022-060610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVES To examine how youth and their caregivers' mental health risk factors for suicide are associated with youth firearm access inside and outside the home. METHODS This study examines a cross-section of the Adolescent Brain and Cognitive Development Social Development study data collected from 2016 to 2021. The sample included 2277 children aged 10 to 15 years from 5 study sites across the United States. We estimated multilevel generalized linear models of household firearm ownership and the child's reported firearm access (hard access or easy access). The primary exposures were the child's and their caregivers' mental health risk factors for suicide. RESULTS In the Adolescent Brain and Cognitive Development Social Development study sample, approximately 20% of children lived in a firearm-owning household and 5% of all children reported easy firearm access. In non-firearm-owning households, children with diagnosed lifetime suicidality were 2.48 times more likely (95% confidence interval [CI], 1.50-4.10) than their counterparts to report easy firearm access. In firearm-owning households, children of caregivers who self-reported any mental health history or externalizing problems were 1.67 times (95% CI, 1.10-2.54) and 2.28 times (95% CI, 1.55-3.37) more likely than their counterparts to report easy firearm access. CONCLUSIONS Youths with mental health risk factors for suicide may be just as likely or more likely to report firearm access as those without such risk factors. Youth suicide prevention efforts should address youths' firearm access outside the home and caregiver mental health.
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Affiliation(s)
- Keith L. Hullenaar
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Ali Rowhani-Rahbar
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Erin R. Morgan
- Harborview Injury Prevention and Research Center
- Departments ofEpidemiology
| | - Chelsea D. Hicks
- Harborview Injury Prevention and Research Center
- Pediatrics, University of Washington, Seattle, Washington
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49
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Ward JA, Uzzi M, Hudson T, Webster DW, Crifasi CK. Differences in Perceptions of Gun-Related Safety by Race and Gun Ownership in the United States. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2023; 51:14-31. [PMID: 37226750 PMCID: PMC10209993 DOI: 10.1017/jme.2023.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Motivated by disparities in gun violence, sharp increases in gun ownership, and a changing gun policy landscape, we conducted a nationally representative survey of U.S. adults (n=2,778) in 2021 to compare safety-related views of white, Black, and Hispanic gun owners and non-owners. Black gun owners were most aware of homicide disparities and least expecting of personal safety improvements from gun ownership or more permissive gun carrying. Non-owner views differed. Health equity and policy opportunities are discussed.
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Affiliation(s)
- Julie A Ward
- CENTER FOR GUN VIOLENCE SOLUTIONS, JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH, BALTIMORE, MD, USA
| | - Mudia Uzzi
- CENTER FOR GUN VIOLENCE SOLUTIONS, JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH, BALTIMORE, MD, USA
| | | | - Daniel W Webster
- CENTER FOR GUN VIOLENCE SOLUTIONS, JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH, BALTIMORE, MD, USA
| | - Cassandra K Crifasi
- CENTER FOR GUN VIOLENCE SOLUTIONS, JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH, BALTIMORE, MD, USA
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50
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Bond AE, Brooks JR, Rodriguez TR, Bandel SL, Anestis MD. Examining characteristics and experiences of Black firearm owners. J Clin Psychol 2023. [PMID: 37190950 DOI: 10.1002/jclp.23532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 04/05/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk. METHODS Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample. RESULTS In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners. CONCLUSION The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies.
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Affiliation(s)
- Allison E Bond
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Jasmin R Brooks
- Department of Psychology, The University of Houston, Houston, Texas, USA
| | - Taylor R Rodriguez
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Shelby L Bandel
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Rutgers University, Piscataway, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
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