Factors Associated With Firearm Injury Among Pediatric Members of a Large Integrated Healthcare System.


Journal

Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145

Informations de publication

Date de publication:
04 2023
Historique:
received: 03 05 2022
revised: 07 09 2022
accepted: 10 09 2022
medline: 2 5 2023
pubmed: 20 9 2022
entrez: 19 9 2022
Statut: ppublish

Résumé

Few studies have tested multiple socio-ecological risk factors assocated with firearm injury among pediatric populations and distinguished self-inflicted from non-self-inflicted injury. To address this gap, the current study examined demographic, individual psychosocial, and neighborhood variables as risk factors for firearm injury among a large cohort of children and adolescents. Retrospective cohort study. Data were obtained from the electronic health records of a large integrated healthcare system. The cohort included children <18 years with at least one clinical encounter between January 1, 2010 and December 31, 2018. Poisson regression was used to examine demographic (age, gender, race and ethnicity, Medicaid status), psychosocial (depression, substance use disorder, medical comorbidities), and neighborhood education variables as potential risk factors for non-self-inflicted and self-inflicted firearm injuries. For non-self-inflicted injury, the highest relative risk was found for children age 12-17 years old compared to 0-5 year olds (RR = 37.57); other risk factors included male gender, Black and Hispanic race and ethnicity (compared to White race), being a Medicaid recipient, lower neighborhood education, and substance use disorder diagnosis. For self-inflicted injury, only age 12-17 years old and male gender were associated with increased risk. These results reinforce the established higher risk for firearm injury among adolescent males, highlight differences between self-inflicted and non-self-inflicted injuries, and the need to consider demographic, psychosocial, and neighborhood variables as risk factors to inform interventions aimed to reduce firearm injuries among children and adolescents.

Sections du résumé

BACKGROUND AND OBJECTIVES
Few studies have tested multiple socio-ecological risk factors assocated with firearm injury among pediatric populations and distinguished self-inflicted from non-self-inflicted injury. To address this gap, the current study examined demographic, individual psychosocial, and neighborhood variables as risk factors for firearm injury among a large cohort of children and adolescents.
METHODS
Retrospective cohort study. Data were obtained from the electronic health records of a large integrated healthcare system. The cohort included children <18 years with at least one clinical encounter between January 1, 2010 and December 31, 2018. Poisson regression was used to examine demographic (age, gender, race and ethnicity, Medicaid status), psychosocial (depression, substance use disorder, medical comorbidities), and neighborhood education variables as potential risk factors for non-self-inflicted and self-inflicted firearm injuries.
RESULTS
For non-self-inflicted injury, the highest relative risk was found for children age 12-17 years old compared to 0-5 year olds (RR = 37.57); other risk factors included male gender, Black and Hispanic race and ethnicity (compared to White race), being a Medicaid recipient, lower neighborhood education, and substance use disorder diagnosis. For self-inflicted injury, only age 12-17 years old and male gender were associated with increased risk.
CONCLUSIONS
These results reinforce the established higher risk for firearm injury among adolescent males, highlight differences between self-inflicted and non-self-inflicted injuries, and the need to consider demographic, psychosocial, and neighborhood variables as risk factors to inform interventions aimed to reduce firearm injuries among children and adolescents.

Identifiants

pubmed: 36122825
pii: S1876-2859(22)00431-4
doi: 10.1016/j.acap.2022.09.005
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

604-609

Informations de copyright

Copyright © 2022 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Auteurs

Sonya Negriff (S)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter); Kaiser Permanente Bernard J. Tyson School of Medicine Department of Health Systems Science, Pasadena, CA USA (S Negriff, C Nau, AL Sharp, and RC Hechter). Electronic address: sonya.x.negriff@kp.org.

Margo Sidell (M)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter).

Claudia Nau (C)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter); Kaiser Permanente Bernard J. Tyson School of Medicine Department of Health Systems Science, Pasadena, CA USA (S Negriff, C Nau, AL Sharp, and RC Hechter).

Adam L Sharp (AL)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter); Kaiser Permanente Bernard J. Tyson School of Medicine Department of Health Systems Science, Pasadena, CA USA (S Negriff, C Nau, AL Sharp, and RC Hechter); Kaiser Permanente Bernard J. Tyson School of Medicine Department of Clinical Science, Pasadena, CA USA (AL Sharp).

Corinna Koebnick (C)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter).

Richard Contreras (R)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter).

Deborah S Ling Grant (DSL)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter).

Johnathan K Kim (JK)

Kaiser Permanente Southern California Department of Psychiatry, Riverside, CA USA (JK Kim).

Rulin C Hechter (RC)

Kaiser Permanente Southern California Department of Research & Evaluation, Pasadena, CA USA (S Negriff, M Sidell, C Nau, AL Sharp, C Koebnick, R Contreras, DSL Grant, and RC Hechter); Kaiser Permanente Bernard J. Tyson School of Medicine Department of Health Systems Science, Pasadena, CA USA (S Negriff, C Nau, AL Sharp, and RC Hechter).

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