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Beard JH, Raissian R, Roberts L, Partain L, Midberry J, Walker T, Trombley S, MacMillan J, Morrison CN. Systematic disparities in reporting on community firearm violence on local television news in Philadelphia, PA, USA. Prev Med Rep 2024; 42:102739. [PMID: 38699078 PMCID: PMC11063638 DOI: 10.1016/j.pmedr.2024.102739] [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: 01/15/2024] [Revised: 04/01/2024] [Accepted: 04/20/2024] [Indexed: 05/05/2024] Open
Abstract
Objective To better understand how community firearm violence (CFV) is communicated to the public, we aimed to identify systematic differences between the characteristics of shooting victims and events covered on television news and all shootings in Philadelphia, PA, a city with escalating CFV incidence. Methods We compiled a stratified sample of local television news clips covering shootings that occurred in Philadelphia aired on two randomly selected days per month from January-June 2021 (n = 154 clips). We coded the clips to determine demographic and geographic information about the shooting victims and events and then matched coded shootings with corresponding shootings in the Philadelphia police database. We compared characteristics of shooting victims and shooting event locations depicted in television clips (n = 62) with overall characteristics of shootings in Philadelphia during the study period (n = 1082). Results Compared to all individuals shot, victims whose shootings were covered on local television news more likely to be children and more likely to be shot in a mass shooting. The average median household income of shooting locations featured on television was significantly higher than the median household income across all shooting locations ($60,302 for television shootings vs. $41,233 for all shootings; p = 0.002). Shootings featured on television occurred in areas with lower rates of income inequality and racialized economic segregation compared to all shooting locations. Conclusions Television news outlets in Philadelphia systematically over-reported shootings of children, mass shootings, and shootings that occurred in neighborhoods with higher median household income, less socioeconomic inequality, and lower rates of racialized economic segregation.
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Affiliation(s)
- Jessica H. Beard
- Department of Surgery, Division of Trauma Surgery and Surgical Critical Care, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Raha Raissian
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Leah Roberts
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Laura Partain
- School of Communication, Ohio State University, Columbus, OH, USA
| | - Jennifer Midberry
- Department of Journalism and Communication, Lehigh University, Bethlehem, PA, USA
| | - Tia Walker
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Shannon Trombley
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Jim MacMillan
- The Philadelphia Center for Gun Violence Reporting, Philadelphia, PA, USA
| | - Christopher N. Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Gause EL, McLone SG, Cunningham M, Jay J. Community-Academic Partnership to Assess the Role of Physical Disinvestment on Firearm Violence in Toledo, OH. J Urban Health 2024:10.1007/s11524-024-00870-y. [PMID: 38771432 DOI: 10.1007/s11524-024-00870-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/22/2024]
Abstract
Reversing physical disinvestment, e.g., by remediating abandoned buildings and vacant lots, is an evidence-based strategy to reduce urban firearm violence. However, adoption of this strategy has been inconsistent across US cities. Our community-academic partnership sought to support adoption in Toledo, OH, USA, by generating locally relevant analyses on physical disinvestment and firearm violence. We used a spatial case-control design with matching. Physical disinvestment measures were derived from a citywide parcel foot audit conducted by the Lucas County Land Bank in summer 2021. Firearm violence outcomes were incident-level shootings data from the Toledo Police Department from October 2021 through February 2023. Shooting locations were matched to controls 1:4 on poverty rate, roadway characteristics, and zoning type. Exposures were calculated by aggregating parcels within 5-min walking buffers of each case and control point. We tested multiple disinvestment measures, including a composite index. Models were logistic regressions that adjusted for the matching variables and for potential spatial autocorrelation. Our sample included N = 281 shooting locations and N = 1124 matched controls. A 1-unit increase in the disinvestment score, equal to approximately 1 additional disrepair condition for the average parcel within the walking buffer, was associated with 1.68 times (95% CI: 1.36, 2.07) higher odds of shooting incidence. Across all other measures, greater disinvestment was associated with higher odds of shooting incidence. Our finding of a strong association between physical disinvestment and firearm violence in Toledo can inform local action. Community-academic partnership could help increase adoption of violence prevention strategies focused on reversing physical disinvestment.
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Affiliation(s)
- Emma L Gause
- Center for Climate and Health, Boston University School of Public Health, Boston, MA, USA.
- Firearm Injury and Policy Research Program, University of Washington, Seattle, WA, USA.
| | - Suzanne G McLone
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Malcolm Cunningham
- Mayor's Office of Neighborhood Safety and Engagement, City of Toledo, OH, USA
- Bloomberg American Health Initiative, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jonathan Jay
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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3
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Jacoby SF, South EC. "Redlining" Maps and Contemporary Firearm Violence Research: Is It Time to Ask New Questions? Ann Intern Med 2024; 177:678-679. [PMID: 38648641 DOI: 10.7326/m24-0870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Sara F Jacoby
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Eugenia C South
- Penn Medicine Center for Health Justice and Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Dholakia A, Burdick KJ, Kreatsoulas C, Monuteaux MC, Tsai J, Subramanian SV, Fleegler EW. Historical Redlining and Present-Day Nonsuicide Firearm Fatalities. Ann Intern Med 2024; 177:592-597. [PMID: 38648643 DOI: 10.7326/m23-2496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Redlining began in the 1930s with the Home Owners' Loan Corporation (HOLC); this discriminatory practice limited mortgage availability and reinforced concentrated poverty that still exists today. It is important to understand the potential health implications of this federally sanctioned segregation. OBJECTIVE To examine the relationship between historical redlining policies and present-day nonsuicide firearm fatalities. DESIGN Maps from the HOLC were overlaid with incidence of nonsuicide firearm fatalities from 2014 to 2022. A multilevel negative binomial regression model tested the association between modern-day firearm fatalities and HOLC historical grading (A ["best"] to D ["hazardous"]), controlling for year, HOLC area-level demographics, and state-level factors as fixed effects and a random intercept for city. Incidence rates (IRs) per 100 000 persons, incidence rate ratios (IRRs), and adjusted IRRs (aIRRs) for each HOLC grade were estimated using A-rated areas as the reference. SETTING 202 cities with areas graded by the HOLC in the 1930s. PARTICIPANTS Population of the 8597 areas assessed by the HOLC. MEASUREMENTS Nonsuicide firearm fatalities. RESULTS From 2014 to 2022, a total of 41 428 nonsuicide firearm fatalities occurred in HOLC-graded areas. The firearm fatality rate increased as the HOLC grade progressed from A to D. In A-graded areas, the IR was 3.78 (95% CI, 3.52 to 4.05) per 100 000 persons per year. In B-graded areas, the IR, IRR, and aIRR relative to A areas were 7.43 (CI, 7.24 to 7.62) per 100 000 persons per year, 2.12 (CI, 1.94 to 2.32), and 1.42 (CI, 1.30 to 1.54), respectively. In C-graded areas, these values were 11.24 (CI, 11.08 to 11.40) per 100 000 persons per year, 3.78 (CI, 3.47 to 4.12), and 1.90 (CI, 1.75 to 2.07), respectively. In D-graded areas, these values were 16.26 (CI, 16.01 to 16.52) per 100 000 persons per year, 5.51 (CI, 5.05 to 6.02), and 2.07 (CI, 1.90 to 2.25), respectively. LIMITATION The Gun Violence Archive relies on media coverage and police reports. CONCLUSION Discriminatory redlining policies from 80 years ago are associated with nonsuicide firearm fatalities today. PRIMARY FUNDING SOURCE Fred Lovejoy Housestaff Research and Education Fund.
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Affiliation(s)
- Ayesha Dholakia
- Department of Pediatrics, Boston Children's Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts (A.D., K.J.B.)
| | - Kendall J Burdick
- Department of Pediatrics, Boston Children's Hospital, and Department of Pediatrics, Boston Medical Center, Boston, Massachusetts (A.D., K.J.B.)
| | | | - Michael C Monuteaux
- Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts (M.C.M.)
| | - Jennifer Tsai
- Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, and St. Joseph's Medical Center in Stockton, Stockton, California (J.T.)
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, Massachusetts, and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.V.S.)
| | - Eric W Fleegler
- Department of Emergency Medicine, Massachusetts General Hospital, and Departments of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts (E.W.F.)
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Randolph SD, Gonzalez-Guarda RM, Pearson J. Addressing Systemic Racism and Racialized Violence to Reduce Firearm Injury and Mortality Inequities. JAMA HEALTH FORUM 2024; 5:e241044. [PMID: 38573649 DOI: 10.1001/jamahealthforum.2024.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
This JAMA Forum discusses systemic racism and racialized violence, promising approaches to address inequities in firearm violence, and ways to treat the trauma of gun violence.
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Affiliation(s)
| | | | - Jay Pearson
- Sanford School, Duke University, Durham, North Carolina
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Ziminski D. A social problem analysis of the 1993 Brady Act and the 2022 Bipartisan Safer Communities Act. Front Public Health 2024; 12:1338722. [PMID: 38601502 PMCID: PMC11004240 DOI: 10.3389/fpubh.2024.1338722] [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: 11/15/2023] [Accepted: 03/13/2024] [Indexed: 04/12/2024] Open
Abstract
In June 2022, the U.S. federal government passed its first major firearm policy since the Brady Handgun Violence Prevention Act of 1993, the Bipartisan Safer Communities Act (BSCA). Summative content analysis was used to explore how the social problem of firearm violence was outlined in both policies, with the goal of extracting the social issue's definition from the policies' approaches to solving it. Both policies do not outline the various types of firearm violence, nor the disproportionate effect of firearm violence on certain populations. This work informs the role of federal policy in defining and monitoring firearm violence as a public health issue, identifying both individual and structural risk and protective factors from an asset-based lens, and allocating preventative efforts in communities that are most affected.
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Affiliation(s)
- Devon Ziminski
- School of Social Work, Rutgers University, New Brunswick, NJ, United States
- New Jersey Gun Violence Research Center, School of Public Health, Rutgers University, Piscataway, NJ, United States
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Kraus NT, Connor S, Shoda K, Moore SE, Irani E. Historic redlining and health outcomes: A systematic review. Public Health Nurs 2024; 41:287-296. [PMID: 38148621 DOI: 10.1111/phn.13276] [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: 05/31/2023] [Revised: 11/06/2023] [Accepted: 12/06/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to synthesize the existing literature on the associations between historic redlining and modern-day health outcomes across the lifespan. METHOD This review searched PubMed and CINAHL for peer-reviewed, data-based articles examining the relationship between historic redlining and any health outcome. Articles were appraised using the JBI critical appraisal checklist. The results were synthesized using a narrative summary approach. RESULTS Thirty-six articles were included and focused on various health outcomes, including cardiovascular outcomes, breast cancer incidence and mortality, firearm injury or death, birth-related outcomes, and asthma outcomes. Most of the included articles (n = 31; 86%) found significant associations between historic redlining and adverse health outcomes such as increased cardiovascular disease, higher rates of preterm births, increased cancer incidence, reduced survival time after breast cancer diagnosis, and increased firearm injury incidence. DISCUSSION This review demonstrates the persistent effect of historic redlining on individuals' health. Public health nurses should recognize redlining as a form of structural racism when caring for affected communities and should advocate for policies and programs that advance health equity. Nurse researchers should develop and test multilevel interventions to address systemic racism and improve health outcomes in communities affected by redlining.
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Affiliation(s)
- Noa T Kraus
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Sarah Connor
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Krista Shoda
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Dirago C, Poulson M, Hatchimonji J, Byrne J, Scantling D. Geospatial Analysis of Social Vulnerability, Race, and Firearm Violence in Chicago. J Surg Res 2024; 294:66-72. [PMID: 37866068 DOI: 10.1016/j.jss.2023.08.058] [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: 05/03/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION Urban firearm violence (UFV) is associated with inequities rooted in structural racism and socioeconomic disparities. Social vulnerability index (SVI) is a composite measure that encompasses both. We sought to understand the relationship between SVI and the incidence of UFV in Chicago using geospatial analysis for the first time. MATERIALS AND METHODS Firearm assaults in Chicago 2001-2019 were obtained from the Trace. Locations of incidents were geocoded using ArcGIS and overlaid with census tract vector files. These data were linked to 2018 SVI measures obtained from the Center for Disease Control and Prevention. Shooting rates were calculated by tabulating the total number of shootings per capita in each census tract. We used Poisson regression with robust error variance to estimate the incident rate of UFV in different levels of social vulnerability and Local Moran's I to evaluate spatial autocorrelation. RESULTS In total, 642 census tracts were analyzed. The median shooting rate was 2.6 per 1000 people (interquartile 0.77, 7.0). When compared to those census tracts with very low SVI, census tracts with low SVI had a 1.7-time increased incident rate of shootings (incidence rate ratio [IRR] 1.74, 95% CI 1.08, 2.81), tracts with moderate SVI had a 3.1-time increased incident rate (IRR 3.07, 95% CI 2.31, 4.10), and tracts with high SVI had a 7-time increased incident rate (IRR 7.03, 95% CI 5.45, 9.07). CONCLUSIONS In Chicago, social vulnerability has a significant association with rates of firearm violence, providing a focus point for policy intervention to address high rates of interpersonal violence in similar cities.
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Affiliation(s)
- Camille Dirago
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
| | - Michael Poulson
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts
| | | | - James Byrne
- Department of Surgery, Johns Hopkins Hospital, Baltimore, Maryland
| | - Dane Scantling
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; Department of Surgery, Boston Medical Center, Boston, Massachusetts.
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Marineau LA, Uzzi M, Buggs SA, Ihenacho N, Campbell JC. Risk and Protective Factors for Firearm Assault Injuries Among Black Men: A Scoping Review of Research. TRAUMA, VIOLENCE & ABUSE 2023:15248380231217042. [PMID: 38153002 DOI: 10.1177/15248380231217042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.
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Affiliation(s)
| | - Mudia Uzzi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shani A Buggs
- Department of Emergency Medicine, University of California, Davis, USA
- California Firearm Violence Research Center, Davis, USA
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10
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Polcari AM, Slidell MB, Hoefer LE, Henry MC, Zakrison TL, Rogers SO, Benjamin AJ. Social Vulnerability and Firearm Violence: Geospatial Analysis of 5 US Cities. J Am Coll Surg 2023; 237:845-854. [PMID: 37966089 DOI: 10.1097/xcs.0000000000000845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Firearm violence is now endemic to certain US neighborhoods. Understanding factors that impact a neighborhood's susceptibility to firearm violence is crucial for prevention. Using a nationally standardized measure to characterize community-level firearm violence risk has not been broadly studied but could enhance prevention efforts. Thus, we sought to examine the association between firearm violence and the social, structural, and geospatial determinants of health, as defined by the Social Vulnerability Index (SVI). STUDY DESIGN In this cross-sectional study, we merged 2018 SVI data on census tract with shooting incidents between 2015 and 2021 from Baltimore, Chicago, Los Angeles, New York City, and Philadelphia. We used negative binomial regression to associate the SVI with shooting incidents per 1,000 people in a census tract. Moran's I statistics and spatial lag models were used for geospatial analysis. RESULTS We evaluated 71,296 shooting incidents across 4,415 census tracts. Fifty-five percent of shootings occurred in 9.4% of census tracts. In all cities combined, a decile rise in SVI resulted in a 37% increase in shooting incidents (p < 0.001). A similar relationship existed in each city: 30% increase in Baltimore (p < 0.001), 50% in Chicago (p < 0.001), 28% in Los Angeles (p < 0.001), 34% in New York City (p < 0.001), and 41% in Philadelphia (p < 0.001). Shootings were highly clustered within the most vulnerable neighborhoods. CONCLUSIONS In 5 major US cities, firearm violence was concentrated in neighborhoods with high social vulnerability. A tool such as the SVI could be used to inform prevention efforts by directing resources to communities most in need and identifying factors on which to focus these programs and policies.
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Affiliation(s)
- Ann M Polcari
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Mark B Slidell
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Lea E Hoefer
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Marion Cw Henry
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Tanya L Zakrison
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Selwyn O Rogers
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
| | - Andrew J Benjamin
- From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer)
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11
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Boateng ACO, Webster J, Richmond TS. Spiritual coping behaviors among injured urban black men in Philadelphia. Arch Psychiatr Nurs 2023; 46:91-97. [PMID: 37813511 PMCID: PMC10562640 DOI: 10.1016/j.apnu.2023.08.004] [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: 05/01/2023] [Accepted: 08/16/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE High rates of firearm injury among urban Black men in the US can lead to long physical and psychological recovery times, worsened by limited access to mental health services. Spirituality can propel positive thoughts, actions, perceptions and behaviors about self and others yet how it is used among Black men recovering from firearm injury is underexplored. This study examined the role of spirituality in the recovery of Black male survivors of firearm injury. METHOD Ten injured urban Black men in Philadelphia were interviewed using descriptive phenomenology. A subset of participants from the Emotional Responses and Recovery from Injury in Urban Black Men study who agreed to be recontacted for future studies were enrolled. Informed consent was obtained, semi-structured interviews were conducted via phone and were audiotaped, transcribed, and de-identified. Thematic content analysis was used to understand perceptions of spirituality and to identify spiritual coping behavior themes. RESULTS Findings suggest that injured urban Black men engaged in theistic and non-theistic spiritual activities that resulted in positive character development, reduced risk of re-injury, hope, improved mental health and social bonds. CONCLUSION Spirituality may serve as a protective factor against firearm re-injury or retaliation by promoting desired behaviors and mental health among injured urban Black men. Combining culturally sensitive spiritual resources and psychotherapy may lead to effective trauma-informed care in addressing spiritual and existential challenges of injured urban Black men who may find spirituality important.
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Affiliation(s)
- Augustine C O Boateng
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America; Penn Injury Science Center, United States of America.
| | - Jessica Webster
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America; Penn Injury Science Center, United States of America
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12
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Pino EC, Jacoby SF, Dugan E, Jay J. Exposure to Neighborhood Racialized Economic Segregation and Reinjury and Violence Perpetration Among Survivors of Violent Injuries. JAMA Netw Open 2023; 6:e238404. [PMID: 37099300 PMCID: PMC10134006 DOI: 10.1001/jamanetworkopen.2023.8404] [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: 11/21/2022] [Accepted: 03/02/2023] [Indexed: 04/27/2023] Open
Abstract
Importance Much is unknown about how individual and neighborhood factors converge in the association with risk for violent reinjury and violence perpetration. Objectives To investigate the association of exposure to neighborhood racialized economic segregation with reinjury and use of violence against others among survivors of violent penetrating injury. Design, Setting, and Participants This retrospective cohort study was performed using data obtained from hospital, police, and state vital records. The study was performed at Boston Medical Center, an urban, level I trauma center that is the largest safety-net hospital and busiest trauma center in New England. The cohort included all patients treated for a nonfatal violent penetrating injury from 2013 to 2018. Patients with no Boston metropolitan area home address were excluded. Individuals were followed up through 2021. Data were analyzed from February to August 2022. Exposure American Community Survey data were used to measure neighborhood deprivation using the racialized economic Index of Concentration at the Extremes (ICE) for patient residential address upon hospital discharge. ICE was measured on a scale from -1 (most deprived) to 1 (most privileged). Main Outcomes and Measures Primary outcomes were violent reinjury and police-reported perpetration of violence within 3 years of an index injury. Results Of 1843 survivors of violence (median [IQR] age, 27 [22-37] years; 1557 men [84.5%]; 351 Hispanic [19.5%], 1271 non-Hispanic Black [70.5%], and 149 non-Hispanic White [8.3%] among 1804 patients with race and ethnicity data), the cohort was skewed toward residing in neighborhoods with higher racialized economic segregation (median [IQR] ICE = -0.15 [-0.22 to 0.07]) compared with the state overall (ICE = 0.27). There were police encounters for violence perpetration among 161 individuals (8.7%) and violent reinjuries among 214 individuals (11.6%) within 3 years after surviving a violent penetrating injury. For each 0.1-unit increase in neighborhood deprivation, there was a 13% (hazard ratio [HR], 1.13; 95% CI, 1.03 to 1.25; P = .01) increase in risk of violence perpetration but no difference in risk for violent reinjury (HR, 1.03; 95% CI, 0.96 to 1.11; P = .38). The greatest occurrence for each outcome was within the first year after index injury; for example, incidents of violence perpetration occurred among 48 of 614 patients (7.8%) at year 1 vs 10 of 542 patients (1.8%) at year 3 in tertile 3 of neighborhood deprivation. Conclusions and Relevance This study found that living in a more economically deprived and socially marginalized area was associated with increased risk of using violence against others. The finding suggests that interventions may need to include investments in neighborhoods with the highest levels of violence to help reduce downstream transmission of violence.
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Affiliation(s)
- Elizabeth C. Pino
- Department of Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Sara F. Jacoby
- Penn Injury Science Center, University of Pennsylvania, Philadelphia
| | - Elizabeth Dugan
- Boston Violence Intervention Advocacy Program, Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts
| | - Jonathan Jay
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
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13
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South EC, Hemenway D, Webster DW. Gun violence research is surging to inform solutions to a devastating public health crisis. Prev Med 2022; 165:107325. [PMID: 36374716 PMCID: PMC9642971 DOI: 10.1016/j.ypmed.2022.107325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Eugenia C South
- Urban Health Lab, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - David Hemenway
- Harvard Injury Control Research Center, Boston, MA, United States of America
| | - Daniel W Webster
- Johns Hopkins Center for Gun Violence Prevention and Policy, Baltimore, MD, United States of America
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