Social Vulnerability Index is strongly associated with urban pediatric firearm violence: An analysis of five major US cities.
Journal
The journal of trauma and acute care surgery
ISSN: 2163-0763
Titre abrégé: J Trauma Acute Care Surg
Pays: United States
ID NLM: 101570622
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
medline:
24
8
2023
pubmed:
1
3
2023
entrez:
28
2
2023
Statut:
ppublish
Résumé
Firearm-related injury in children is a public health crisis. The Social Vulnerability Index (SVI) identifies communities at risk for adverse effects due to natural or human-caused crises. We sought to determine if SVI was associated with pediatric firearm-related injury and thus could assist in prevention planning. The Centers for Disease Control and Prevention's 2018 SVI data were merged on census tract with 2015 to 2022 open-access shooting incident data in children 19 years or younger from Baltimore, Chicago, Los Angeles, New York City, and Philadelphia. Regression analyses were performed to uncover associations between firearm violence, SVI, SVI themes, and social factors at the census tract level. Of 11,654 shooting incidents involving children, 52% occurred in just 6.7% of census tracts, which were on average in the highest quartile of SVI. A decile increase in SVI was associated with a 45% increase in pediatric firearm-related injury in all cities combined (incidence rate ratio, 1.45; 95% confidence interval, 1.41-1.49; p < 0.001). A similar relationship was found in each city: 30% in Baltimore, 51% in Chicago, 29% in Los Angeles, 37% in New York City, and 35% in Philadelphia (all p < 0.001). Socioeconomic status and household composition were SVI themes positively associated with shootings in children, as well as the social factors below poverty, lacking a high school diploma, civilian with a disability, single-parent household, minority, and no vehicle access. Living in areas with multi-unit structures, populations 17 years or younger, and speaking English less than well were negatively associated. Geospatial disparities exist in pediatric firearm-related injury and are significantly associated with neighborhood vulnerability. We demonstrate a strong association between SVI and pediatric shooting incidents in multiple major US cities. Social Vulnerability Index can help identify social and structural factors, as well as geographic areas, to assist in developing meaningful and targeted intervention and prevention efforts. Prognostic and Epidemiological; Level III.
Sections du résumé
BACKGROUND
Firearm-related injury in children is a public health crisis. The Social Vulnerability Index (SVI) identifies communities at risk for adverse effects due to natural or human-caused crises. We sought to determine if SVI was associated with pediatric firearm-related injury and thus could assist in prevention planning.
METHODS
The Centers for Disease Control and Prevention's 2018 SVI data were merged on census tract with 2015 to 2022 open-access shooting incident data in children 19 years or younger from Baltimore, Chicago, Los Angeles, New York City, and Philadelphia. Regression analyses were performed to uncover associations between firearm violence, SVI, SVI themes, and social factors at the census tract level.
RESULTS
Of 11,654 shooting incidents involving children, 52% occurred in just 6.7% of census tracts, which were on average in the highest quartile of SVI. A decile increase in SVI was associated with a 45% increase in pediatric firearm-related injury in all cities combined (incidence rate ratio, 1.45; 95% confidence interval, 1.41-1.49; p < 0.001). A similar relationship was found in each city: 30% in Baltimore, 51% in Chicago, 29% in Los Angeles, 37% in New York City, and 35% in Philadelphia (all p < 0.001). Socioeconomic status and household composition were SVI themes positively associated with shootings in children, as well as the social factors below poverty, lacking a high school diploma, civilian with a disability, single-parent household, minority, and no vehicle access. Living in areas with multi-unit structures, populations 17 years or younger, and speaking English less than well were negatively associated.
CONCLUSION
Geospatial disparities exist in pediatric firearm-related injury and are significantly associated with neighborhood vulnerability. We demonstrate a strong association between SVI and pediatric shooting incidents in multiple major US cities. Social Vulnerability Index can help identify social and structural factors, as well as geographic areas, to assist in developing meaningful and targeted intervention and prevention efforts.
LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
Identifiants
pubmed: 36850025
doi: 10.1097/TA.0000000000003896
pii: 01586154-990000000-00284
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
411-418Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Grinshteyn E, Hemenway D. Violent death rates: the US compared with other high-income OECD countries, 2010. Am J Med . 2016;129(3):266–273.
Andrews AL, Killings X, Oddo ER, Gastineau KAB, Hink AB. Pediatric firearm injury mortality epidemiology. Pediatrics . 2022;149(3):e2021052739.
Gun Violence Archive. Past Summary Ledgers. Available at: https://www.gunviolencearchive.org/ . Accessed October 1, 2021.
Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. N Engl J Med . 2022;386(20):1955–1956.
Hughes BD, Cummins CB, Shan Y, Mehta HB, Radhakrishnan RS, Bowen-Jallow KA. Pediatric firearm injuries: racial disparities and predictors of healthcare outcomes. J Pediatr Surg . 2020;55(8):1596–1603.
Fowler KA, Dahlberg LL, Haileyesus T, Gutierrez C, Bacon S. Childhood firearm injuries in the United States. Pediatrics . 2017;140(1):e20163486.
Urrechaga EM, Stoler J, Quinn K, Cioci AC, Nunez V, Rodriguez Y, et al. Geodemographic analysis of pediatric firearm injuries in Miami, FL. J Pediatr Surg . 2021;56(1):159–164.
Patel SJ, Badolato GM, Parikh K, Iqbal SF, Goyal MK. Sociodemographic factors and outcomes by intent of firearm injury. Pediatrics . 2021;147(4):e2020011957.
Rosenbaum K, Grigorian A, Yeates E, Kuza C, Kim D, Inaba K, et al. A national analysis of pediatric firearm violence and the effects of race and insurance status on risk of mortality. Am J Surg . 2021;222(3):654–658.
Trinidad S, Vancil A, Brokamp C, Moody S, Gardner D, Parsons AA, et al. Relationships between socioeconomic deprivation and pediatric firearm-related injury at the neighborhood level. J Trauma Acute Care Surg . 2022;93(3):283–290.
Trinidad S, Brokamp C, Sahay R, Moody S, Gardner D, Parsons AA, et al. Children from disadvantaged neighborhoods experience disproportionate injury from interpersonal violence. J Pediatr Surg . 2023;58(3):545–551.
Bayouth L, Lukens-Bull K, Gurien L, Tepas JJ 3rd, Crandall M. Twenty years of pediatric gunshot wounds in our community: have we made a difference? J Pediatr Surg . 2019;54(1):160–164.
Zebib L, Stoler J, Zakrison TL. Geo-demographics of gunshot wound injuries in Miami-Dade county, 2002–2012. BMC Public Health . 2017;17(1):174.
Kalesan B, Vyliparambil MA, Bogue E, Villarreal MD, Vasan S, Fagan J, et al. Race and ethnicity, neighborhood poverty and pediatric firearm hospitalizations in the United States. Ann Epidemiol . 2016;26(1):1–6 e1–2.
Carter PM, Cook LJ, Macy ML, Zonfrillo MR, Stanley RM, Chamberlain JM, et al. Individual and neighborhood characteristics of children seeking emergency department care for firearm injuries within the PECARN network. Acad Emerg Med . 2017;24(7):803–813.
Tracy BM, Smith RN, Miller K, Clayton E, Bailey K, Gerrin C, et al. Community distress predicts youth gun violence. J Pediatr Surg . 2019;54(11):2375–2381.
Krieger N, Waterman P, Chen JT, Soobader MJ, Subramanian SV, Carson R. Zip code caveat: bias due to spatiotemporal mismatches between zip codes and US census–defined geographic areas—the Public Health Disparities Geocoding Project. Am J Public Health . 2002;92(7):1100–1102.
Monuteaux MC, Mannix R, Fleegler EW, Lee LK. Predictors and outcomes of pediatric firearm injuries treated in the emergency department: differences by mechanism of intent. Acad Emerg Med . 2016;23(7):790–795.
Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry/Geospatial Research, Analysis, and Services Program. CDC/ASTDR Social Vulnerability Index 2018 Database. Available at: https://www.atsdr.cdc.gov/placeandhealth/svi/data_documentation_download.html . Accessed October 1, 2021.
Baltimore City. Part 1 Crime Data. Open Baltimore. Available at: https://data.baltimorecity.gov/datasets/baltimore::part-1-crime-data-/about . Accessed April 26, 2022.
City of Chicago. Violence Reduction — Victims of Homicides and Non-Fatal Shootings. Chicago Data Portal. Available at: https://data.cityofchicago.org/Public-Safety/Violence-Reduction-Victims-of-Homicides-and-Non-Fa/gumc-mgzr . Accessed April 26, 2022.
LA County Chief Information Officer. LA Shootings 2010–Present. Open Data Portal County of Los Angeles. Available at: https://data.lacounty.gov/Criminal/All-Shooting-Incidents-for-Deputy-Involved-Shootin/xutq-azb6 . Accessed April 26, 2022.
Police Department (NYPD). NYPD Shooting Incident Data (Historic). NYC Open Data. Available at: https://data.cityofnewyork.us/Public-Safety/NYPD-Shooting-Incident-Data-Historic-/833y-fsy8 . Accessed April 26, 2022.
Mapping Philadelphia's Gun Violence Crisis. 2015, 2016, 2017, 2018, 2019, 2021 Shooting Victims Data. Philadelphia Office of the Controller. Available at: https://controller.phila.gov/philadelphia-audits/mapping-gun-violence/#/?year=2022&map=11.13%2F39.99051%2F-75.14426 . Accessed April 26, 2022.
American Community Survey 5-year Data Profiles. United States Census Bureau. Washington, DC. Available at: https://data.census.gov/table?d=ACS+5-Year+Estimates+Data+Profiles . Accessed October 1, 2021.
Karmakar M, Lantz PM, Tipirneni R. Association of social and demographic factors with COVID-19 incidence and death rates in the US. JAMA Netw Open . 2021;4(1):e2036462.
Collings AT, Farazi M, Van Arendonk KJ, Fallat ME, Minneci PC, Sato TT, et al. The COVID-19 pandemic and associated rise in pediatric firearm injuries: a multi-institutional study. J Pediatr Surg . 2022;57(7):1370–1376.
Flynn-O'Brien KT, Collings AT, Farazi M, Fallat ME, Minneci PC, Speck KE, et al. Pediatric injury trends and relationships with social vulnerability during the COVID-19 pandemic: a multi-institutional analysis. J Trauma Acute Care Surg . 2023;94(1):133–140.
Ishizawa H, Stevens G. Non-English language neighborhoods in Chicago, Illinois: 2000. Soc Sci Res . 2007;36(3):1042–1064.
Alliance EL. Languages of New York City (digital version). In: DK Ross Perlin R, Kaufman D, Lampel J, Daurio M, Turin M, Craig S, eds., Languages of New York City (digital version), map. New York: Endangered Language Alliance. Available at: http://languagemap.nyc . Accessed September 15, 2022
Ruckert A, Huynh C, Labonte R. Reducing health inequities: is universal basic income the way forward? J Public Health (Oxf) . 2018;40(1):3–7.
Gibson M, Hearty W, Craig P. The public health effects of interventions similar to basic income: a scoping review. Lancet Public Health . 2020;5(3):e165–e176.
Qu S, Chattopadhyay SK, Hahn RA; Community Preventive Services Task Force. High school completion programs: a community guide systematic economic review. J Public Health Manag Pract . 2016;22(3):E47–E56.
Houghton A, Jackson-Weaver O, Toraih E, Burley N, Byrne T, McGrew P, et al. Firearm homicide mortality is influenced by structural racism in US metropolitan areas. J Trauma Acute Care Surg . 2021;91(1):64–71.
Mehranbod CA, Gobaud AN, Jacoby SF, Uzzi M, Bushover BR, Morrison CN. Historical redlining and the epidemiology of present-day firearm violence in the United States: a multi-city analysis. Prev Med . 2022;165(Pt A):107207.
Benns M, Ruther M, Nash N, Bozeman M, Harbrecht B, Miller K. The impact of historical racism on modern gun violence: redlining in the city of Louisville, KY. Injury . 2020;51(10):2192–2198.
Lipton R, Yang X, Braga AA, Goldstick J, Newton M, Rura M. The geography of violence, alcohol outlets, and drug arrests in Boston. Am J Public Health . 2013;103(4):657–664.
MacDonald J. Community design and crime: the impact of housing and the built environment. Crime Justice . 2015;44:333–383.
Chalfin A, Hansen B, Lerner J, Parker L. Reducing crime through environmental design: evidence from a randomized experiment of street lighting in New York City. J Quant Criminol . 2022;38:127–257.