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Merrill-Francis M, Chen MS, Dunphy C, Lennon NH, Grady C, Miller GF, McCourt AD. The Association Between State Minimum Wage and Firearm Homicides, 2000-2020. Am J Prev Med 2024; 66:963-970. [PMID: 38309671 PMCID: PMC11103548 DOI: 10.1016/j.amepre.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/05/2024]
Abstract
INTRODUCTION Recent research has indicated an association between both poverty and income inequality and firearm homicides. Increased minimum wages may serve as a strategy for reducing firearm violence by increasing economic security among workers earning low wages and reducing the number of families living in poverty. This study aimed to examine the association between state minimum wage and firearm homicides in the U.S. between 2000 and 2020. METHODS State minimum wage, obtained from Temple's Law Atlas and augmented by legal research, was conceptualized using the Kaitz Index. State-level homicide counts were obtained from 2000 to 2020 multiple-cause-of death mortality data from the National Vital Statistics System. Log-linear regressions were conducted to model the associations between state minimum wage and firearm homicides, stratifying by demographic groups. Analyses were conducted in 2023. RESULTS A 1% point increase in a state's Kaitz Index was associated with a 1.3% (95% CI: -2.1% to -0.5%) decrease in a state's firearm homicide rate. When interacted with quartile of firearm ownership, the Kaitz Index was associated with decreases in firearm homicide in all except the lowest quartile. These findings were largely consistent across stratifications. CONCLUSIONS Changing a state's minimum wage, whereby a full-time minimum wage worker's salary is closer to a state's median income, may be an option for reducing firearm homicides.
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Affiliation(s)
- Molly Merrill-Francis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia.
| | - May S Chen
- Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Christopher Dunphy
- Division of Injury Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Natalie H Lennon
- Division of Injury Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Catherine Grady
- Division of Violence Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Gabrielle F Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Alexander D McCourt
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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2
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Beard JH, Trombley S, Walker T, Roberts L, Partain L, MacMillan J, Midberry J. Public health framing of firearm violence on local television news in Philadelphia, PA, USA: a quantitative content analysis. BMC Public Health 2024; 24:1221. [PMID: 38698393 PMCID: PMC11067069 DOI: 10.1186/s12889-024-18718-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Firearm violence is an intensifying public health problem in the United States. News reports shape the way the public and policy makers understand and respond to health threats, including firearm violence. To better understand how firearm violence is communicated to the public, we aimed to determine the extent to which firearm violence is framed as a public health problem on television news and to measure harmful news content as identified by firearm-injured people. METHODS This is a quantitative content analysis of Philadelphia local television news stories about firearm violence using a database of 7,497 clips. We compiled a stratified sample of clips aired on two randomly selected days/month from January-June 2021 from the database (n = 192 clips). We created a codebook to measure public health frame elements and to assign a harmful content score for each story and then coded the clips. Characteristics of stories containing episodic frames that focus on single shooting events were compared to clips with thematic frames that include broader social context for violence. RESULTS Most clips employed episodic frames (79.2%), presented law enforcement officials as primary narrators (50.5%), and included police imagery (79.2%). A total of 433 firearm-injured people were mentioned, with a mean of 2.8 individuals shot included in each story. Most of the firearm-injured people featured in the clips (67.4%) had no personal information presented apart from age and/or gender. The majority of clips (84.4%) contained at least one harmful content element. The mean harmful content score/clip was 2.6. Public health frame elements, including epidemiologic context, root causes, public health narrators and visuals, and solutions were missing from most clips. Thematic stories contained significantly more public health frame elements and less harmful content compared to episodic stories. CONCLUSIONS Local television news produces limited public health coverage of firearm violence, and harmful content is common. This reporting likely compounds trauma experienced by firearm-injured people and could impede support for effective public health responses to firearm violence. Journalists should work to minimize harmful news content and adopt a public health approach to reporting on firearm violence.
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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, 3401 N. Broad St, 4th Floor, Zone C, Philadelphia, PA, 19140, USA.
| | - Shannon Trombley
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Tia Walker
- 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
| | - Jim MacMillan
- Philadelphia Center for Gun Violence Reporting, Philadelphia, PA, USA
| | - Jennifer Midberry
- Department of Journalism and Communication, Lehigh University, Bethlehem, PA, USA
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Kottke TE, Pronk NP, Woodard C, Arena R. The Potential Influence of Firearm Violence on Physical Inactivity in the United States. Am J Med 2024; 137:426-432. [PMID: 38336085 DOI: 10.1016/j.amjmed.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Despite broad recognition of the physical inactivity pandemic, little to no progress has been made in the past decade in mitigating the problem. The current analysis builds upon previous research into the drivers of physical inactivity to assess the potential interactions with firearm violence in the United States. METHODS We merged county-level data on firearm fatality rates, physical inactivity prevalence, the Social Vulnerability Index, and the American nations regional cultures schematic. RESULTS Counties with a physical inactivity prevalence currently above the federal government's 2030 goal (ie, ≥21.8%) had a significantly higher firearm fatality rate per 100,000 population. This finding was consistent for both the overall rate and race-based subgroups. The overall White, Hispanic, and Black firearm fatality rates were also significantly higher in the American nations group comprising Greater Appalachia, Deep South, El Norte, New France, and First Nation. Stepwise linear regression analysis revealed that the Social Vulnerability Index, American nations dichotomous grouping, and firearm fatality rate were all retained (P < .001) in predicting physical inactivity prevalence as a continuous variable. CONCLUSION In conclusion, the United States faces myriad health and societal challenges. Unhealthy lifestyles and gun violence are two of the leaders. The current analysis in conjunction with previous findings demonstrates that solving these challenges by interacting, create complexity to finding solutions that has not been thoroughly considered.
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Affiliation(s)
| | - Nicolaas P Pronk
- HealthPartners Institute, Minneapolis, Minn; Department of Health Policy and Management, University of Minnesota, Minneapolis; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Ill
| | - Colin Woodard
- Nationhood Lab, Pell Center for International Relations and Public Policy, Salve Regina University, Newport, RI
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Ill.
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Kim KV, Rehm J, Kaplan MS, Lange S. Relationship Between Alcohol Use and Firearm-Involved Suicide: Findings From the National Violent Death Reporting System, 2003-2020. Am J Prev Med 2024; 66:832-839. [PMID: 38000484 DOI: 10.1016/j.amepre.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Acute alcohol intoxication is a contributing factor in firearm-involved suicides. However, knowledge of the relationship between alcohol intoxication and firearm-involved suicide by age and sex (defined herein as the biological sex of the decedent) is limited. The purpose of the current study was to evaluate the sex- and age group-specific relationship between alcohol intoxication and firearm-involved suicide. METHODS Data from the National Violent Death Reporting System, 2003-2020, on suicide decedents (18+ years of age) were utilized. Age-group- and sex-specific multivariate binary logistic regression analyses were conducted. Statistical analyses were performed in 2023. RESULTS Alcohol intoxication (i.e., having a blood alcohol concentration of 0.08 g/dL or more) was significantly associated with using a firearm as the method of suicide for young (18-34 years; relative risk (RR)=1.31, 95% CI: 1.22-1.40) and middle-aged (35-64 years; RR=1.34, 95% CI: 1.27-1.39) females but not among older females (65+ years; RR=1.01, 95% CI: 0.87-1.17). Among males, the association was significant for all age-groups (young: RR=1.28, 95% CI: 1.25-1.30; middle-aged: RR=1.17, 95% CI: 1.15-1.19; and older: RR=1.04, 95% CI: 1.01-1.07). CONCLUSIONS Among males of all ages and young and middle-aged females, alcohol intoxication was associated with increased risk of suicide by firearm-an extremely lethal method that accounts for a majority of suicides in the U.S.-compared to their non-intoxicated counterparts. Interventions targeting excessive alcohol consumption may be effective in reducing suicide mortality rates.
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Affiliation(s)
- Kawon V Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Mark S Kaplan
- Luskin School of Public Affairs, University of California, Los Angeles, Los Angeles, California
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada.
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5
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Harris E. School Shootings in US Reach Highest Recorded Levels. JAMA 2024; 331:1354. [PMID: 38551574 DOI: 10.1001/jama.2024.3706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/24/2024]
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Hemenway D. Twenty-Five Years after Columbine - Firearms and Public Health in the United States. N Engl J Med 2024; 390:1352-1353. [PMID: 38624001 DOI: 10.1056/nejmp2401974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
- David Hemenway
- From the Harvard T.H. Chan School of Public Health, Boston
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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8
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Kim B, Thorpe LE, Spoer BR, Titus AR, Santaella-Tenorio J, Cerdá M, Gourevitch MN, Matthay EC. State-Level Firearm Laws and Firearm Homicide in US Cities: Heterogenous Associations by City Characteristics. J Urban Health 2024; 101:280-288. [PMID: 38536598 PMCID: PMC11052935 DOI: 10.1007/s11524-024-00851-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/28/2024]
Abstract
Despite well-studied associations of state firearm laws with lower state- and county-level firearm homicide, there is a shortage of studies investigating differences in the effects of distinct state firearm law categories on various cities within the same state using identical methods. We examined associations of 5 categories of state firearm laws-pertaining to buyers, dealers, domestic violence, gun type/trafficking, and possession-with city-level firearm homicide, and then tested differential associations by city characteristics. City-level panel data on firearm homicide cases of 78 major cities from 2010 to 2020 was assessed from the Centers for Disease Control and Prevention's National Vital Statistics System. We modeled log-transformed firearm homicide rates as a function of firearm law scores, city, state, and year fixed effects, along with time-varying city-level confounders. We considered effect measure modification by poverty, unemployment, vacant housing, and income inequality. A one z-score increase in state gun type/trafficking, possession, and dealer law scores was associated with 25% (95% confidence interval [CI]:-0.37,-0.1), 19% (95% CI:-0.29,-0.07), and 17% (95% CI:-0.28, -0.4) lower firearm homicide rates, respectively. Protective associations were less pronounced in cities with high unemployment and high housing vacancy, but more pronounced in cities with high income inequality. In large US cities, state-level gun type/trafficking, possession, and dealer laws were associated with lower firearm homicide rates, but buyers and domestic violence laws were not. State firearm laws may have differential effects on firearm homicides based on city characteristics, and city-wide policies to enhance socioeconomic drivers may add benefits of firearm laws.
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Affiliation(s)
- Byoungjun Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
- Department of Surgery, New York University Grossman School of Medicine, 1 Park Ave 6-815, New York, NY, USA.
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Ben R Spoer
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Andrea R Titus
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Julian Santaella-Tenorio
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Marc N Gourevitch
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Ellicott C Matthay
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
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Anestis MD. Firearm Access and Suicide Rates: An Unambiguously Robust Association. Arch Suicide Res 2024; 28:701-705. [PMID: 36987987 DOI: 10.1080/13811118.2023.2192753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Firearms account for approximately half of all suicide deaths within the United States each year. Recently, Lane and Kleck published pieces reporting conflicting results regarding the relationship between firearm access and suicide rates. In this commentary, I aim to contextualize the findings within the broader literature and to provide clarity for readers aiming to navigate the findings of the two studies. Ultimately, I conclude that the results of Lane more accurately represent the nature of the relationship and align with the extant literature on the topic.
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Morral AR, Smart R, Schell TL, Vegetabile B, Thomas E. Geographic and Demographic Differences in the Proportion of Individuals Living in Households With a Firearm, 1990-2018. JAMA Netw Open 2024; 7:e240562. [PMID: 38416496 PMCID: PMC10902733 DOI: 10.1001/jamanetworkopen.2024.0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/26/2023] [Indexed: 02/29/2024] Open
Abstract
Importance Measures of the proportion of individuals living in households with a firearm (HFR), over time, across states, and by demographic groups are needed to evaluate disparities in firearm violence and the effects of firearm policies. Objective To estimate HFR across states, years, and demographic groups in the US. Design, Setting, and Participants In this survey study, substate HFR totals from 1990 to 2018 were estimated using bayesian multilevel regression with poststratification to analyze survey data on HFR from the Behavioral Risk Factor Surveillance System and the General Social Survey. HFR was estimated for 16 substate demographic groups defined by gender, race, marital status, and urbanicity in each state and year. Exposures Survey responses indicating household firearm ownership were analyzed and compared with a common proxy for firearm ownership, the fraction of suicides completed with a firearm (FSS). Main Outcome and Measure HFR, FSS, and their correlations and differences. Results Among US adults in 2018, HFR was significantly higher among married, nonurban, non-Hispanic White and American Indian male individuals (65.0%; 95% credible interval [CI], 61.5%-68.7%) compared with their unmarried, urban, female counterparts from other racial and ethnic groups (7.3%; 95% CIs, 6.0%-9.2%). Marginal HFR rates for larger demographic groups also revealed important differences, with racial minority groups and urban dwellers having less than half the HFR of either White and American Indian (39.5%; 95% CI, 37.4%-42.9% vs 17.2%; 95% CI, 15.5%-19.9%) or nonurban populations (46.0%; 95% CI, 43.8%-49.5% vs 23.1%; 95% CI, 21.3%-26.2%). Population growth among groups less likely to own firearms, rather than changes in ownership within demographic groups, explains 30% of the 7 percentage point decline in HFR nationally from 1990 to 2018. Comparing HFR estimates with FSS revealed the expected high overall correlation across states (r = 0.84), but scaled FSS differed from HFR by as many as 20 percentage points for some states and demographic groups. Conclusions and Relevance This survey study of HFR providing detailed, publicly available HFR estimates highlights key disparities among individuals in households with firearms across states and demographic groups; it also identifies potential biases in the use of FSS as a proxy for firearm ownership rates. These findings are essential for researchers, policymakers, and public health experts looking to address geographic and demographic disparities in firearm violence.
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Affiliation(s)
| | | | | | | | - Emma Thomas
- Contributions completed while at RAND Corporation
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11
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Harris E. Most Firearm Deaths in US Children Happen While They Play. JAMA 2024; 331:281. [PMID: 38170565 DOI: 10.1001/jama.2023.26116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
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Muwanguzi M, Kule M, Nuwamanya S, Kaggwa MM. Firearm-related suicides, homicides, and homicide-suicides involving security officers in two East African Countries: a press media review. BMC Psychiatry 2023; 23:877. [PMID: 38001434 PMCID: PMC10675850 DOI: 10.1186/s12888-023-05368-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Firearm violence is a growing public health problem causing death globally. With easy accessibility to firearms, suicides, homicides, and homicide-suicides have increased among security officers, especially in developing countries affected by long-standing civil wars/political insurgencies. No study has explored firearm violence in East African countries. This study describes the press media reporting of suicides, homicides, and homicide-suicides among security officers in two East African countries (Uganda and Kenya). METHODS Due to the absence of suicide databases among East African countries, the present study reviewed press media reports. We utilized content analysis of suicides, homicides, and homicide-suicides reports among security forces. Relevant media reports between January-2020 and May-2023 were searched. Using ANOVA and chi-square tests, we tested for statistical differences in characteristics between victims and perpetrators. RESULTS Among the 56 perpetrated reports, most of them were homicides 44.64% (n = 25/56), 30.36% (n = 17/56) were homicide-suicides, and 25% (n = 14/56) were suicides. Perpetrators' age ranged from 21 to 47 years, majority being males [53/56 (94.64%)]. Victims were 58, mostly Ugandans [41/58 (73.21%)] with a mean age of 33.5 ± 8.81 years. Among the three main outcomes, statistically significant difference existed by country (χ2 = 23.88, p < 0.001), and perpetrators' age (F = 8.59, p = 0.005). There was a significant difference between perpetrators and the number of victims lost by age of victims (F = 10.37, p = 0.002). Among victims, type of security of perpetrator and citizenship of victims (χ2 = 24.18, p < 0.001) showed statistical difference with Ugandans having more victims to army officers while Kenyans to police officers. Brief incident descriptions pointed towards relationship dysfunctions, alcohol/substance abuse, intentional harm, and financial disagreements, as the potential causes. Only two perpetrators were reported to have mental health-related conditions. CONCLUSION This study shows that media reported firearms-related suicides, homicides, and homicide-suicides among security forces commonly involve males. Perpetrators in Uganda are mainly army officers while in Kenya the perpetrators are mostly police officers. Mental health conditions were not frequently reported among perpetrators. We recommend strengthening and enforcing gun regulation policies among security officers to curb this growing problem in these countries. Routine screening of mental health problems to enable early interventions is recommended among security officers.
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Affiliation(s)
- Moses Muwanguzi
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Moses Kule
- Department of Psychiatry, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Simpson Nuwamanya
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5Th, Hamilton, ON, L89 3K7, Canada
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Conrick KM, Adhia A, Ellyson A, Haviland MJ, Lyons VH, Mills B, Rowhani-Rahbar A. Race, structural racism and racial disparities in firearm homicide victimisation. Inj Prev 2023; 29:290-295. [PMID: 36564165 DOI: 10.1136/ip-2022-044788] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To identify an approach in measuring the association between structural racism and racial disparities in firearm homicide victimisation focusing on racism, rather than race. METHODS We examined associations of six measures of structural racism (Black/white disparity ratios in poverty, education, labour force participation, rental housing, single-parent households and index crime arrests) with state-level Black-white disparities in US age-adjusted firearm homicide victimisation rates 2010-2019. We regressed firearm homicide victimisation disparities on four specifications of independent variables: (1) absolute measure only; (2) absolute measure and per cent Black; (3) absolute measure and Black-white disparity ratio and (4) absolute measure, per cent Black and disparity ratio. RESULTS For all six measures of structural racism the optimal specification included the absolute measure and Black-white disparity ratio and did not include per cent Black. Coefficients for the Black-white disparity were statistically significant, while per cent Black was not. CONCLUSIONS In the presence of structural racism measures, the inclusion of per cent Black did not contribute to the explanation of firearm homicide disparities in this study. Findings provide empiric evidence for the preferred use of structural racism measures instead of race.
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Affiliation(s)
- Kelsey M Conrick
- School of Social Work, University of Washington, Seattle, Washington, USA
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
| | - Avanti Adhia
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Alice Ellyson
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Miriam Joan Haviland
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
| | - Vivian H Lyons
- Social Development Research Group, School of Social Work, Department of Psychiatry, University of Washington Allies in Healthier Systems for Health & Abundance in Youth, Seattle, Washington, USA
| | - Brianna Mills
- Firearm Injury & Policy Research Program, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
| | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA
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15
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QuickStats: Age-Adjusted Rates* of Firearm-Related Homicide,(†) by Race,(§) Hispanic Origin, and Sex - National Vital Statistics System, United States, 2021. MMWR Morb Mortal Wkly Rep 2023; 72:737. [PMID: 37384572 DOI: 10.15585/mmwr.mm7226a9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
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16
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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. J Law Med 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] [What about the content of this article? (0)] [Affiliation(s)] [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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17
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Kaufman EJ, Delgado MK. Tracking All Injuries From Firearms in the US-Reply. JAMA 2023; 329:514-515. [PMID: 36786792 DOI: 10.1001/jama.2022.22000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- Elinore J Kaufman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - M Kit Delgado
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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19
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Abstract
This study assesses racial and ethnic differences in overall burden of firearm-related mortality and in change in firearm-related mortality among youths from 1999 to 2020.
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Affiliation(s)
- Leonardo Mariño-Ramírez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - I. King Jordan
- School of Biological Sciences, Georgia Institute of Technology, Atlanta
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
| | - Eliseo J. Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities, Bethesda, Maryland
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20
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Wintemute GJ, Müller D, Bolstad K. Gun Violence in the United States. N Engl J Med 2022; 387:e32. [PMID: 36198178 DOI: 10.1056/nejmp2209472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Garen J Wintemute
- From the Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis Medical Center, Sacramento
| | - Daniel Müller
- From the Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis Medical Center, Sacramento
| | - Kyle Bolstad
- From the Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis Medical Center, Sacramento
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21
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Garbarino J. The War-Zone Mentality - Mental Health Effects of Gun Violence in U.S. Children and Adolescents. N Engl J Med 2022; 387:1149-1151. [PMID: 36155630 DOI: 10.1056/nejmp2209422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- James Garbarino
- From Cornell University, Ithaca, NY, and Loyola University, Chicago
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22
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Galea S, Abdalla SM. State Firearm Laws and Firearm-Related Mortality and Morbidity. JAMA 2022; 328:1189-1190. [PMID: 36166016 DOI: 10.1001/jama.2022.16648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint highlights the challenges to passing federal legislation that limits gun ownership and accessibility and summarizes some of the state laws used to successfully lower rates of firearm-related death and injury.
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Affiliation(s)
- Sandro Galea
- Boston University School of Public Health, Boston, Massachusetts
| | - Salma M Abdalla
- Boston University School of Public Health, Boston, Massachusetts
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23
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Abstract
This Viewpoint discusses the expansion of firearm injury research that involves diverse disciplinary perspectives that could potentially lead to lifesaving policy innovation.
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24
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Fontanarosa PB, Bibbins-Domingo K. The Unrelenting Epidemic of Firearm Violence. JAMA 2022; 328:1201-1203. [PMID: 36166046 DOI: 10.1001/jama.2022.17293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Phil B Fontanarosa
- Dr Fontanarosa is Executive Editor and Dr Bibbins-Domingo is Editor in Chief, JAMA
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25
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Abstract
This Viewpoint summarizes current data on firearm injuries in the US, discusses the limitations of available data sources, and proposes measures for a comprehensive system to track firearm injury and death
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Affiliation(s)
- Elinore J Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, Penn Injury Science Center, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
| | - M Kit Delgado
- Departments of Emergency Medicine and Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, Penn Injury Science Center, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
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26
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Webster DW, Gostin LO. The Supreme Court Expands Second Amendment Rights as the Nation Experiences Historic Levels of Firearms Violence. JAMA 2022; 328:1187-1188. [PMID: 36166019 DOI: 10.1001/jama.2022.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint discusses the recent Supreme Court decision declaring a broad right to carry firearms in public and offers a public health strategy for firearms safety laws.
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Affiliation(s)
- Daniel W Webster
- Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lawrence O Gostin
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC
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27
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Abstract
This JAMA Patient Page discusses the types of firearm injury and describes firearm violence statistics in the US.
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28
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Cunningham RM, Lee D, Carter PM. The Role of Academic Medical Centers in the Prevention of Violence and Firearm-Related Morbidity and Mortality. JAMA 2022; 328:1195-1196. [PMID: 36166011 DOI: 10.1001/jama.2022.16897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This Viewpoint argues that academic medical centers should address firearm violence through clinical care, education of health care professionals, research, and public policy discussions.
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Affiliation(s)
- Rebecca M Cunningham
- UM Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor
| | - Daniel Lee
- UM Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor
| | - Patrick M Carter
- UM Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor
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29
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Abstract
This Viewpoint argues for US businesses to get involved in the battle against gun violence to ensure employees’ health and wellness and reduce employers’ health insurance costs.
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Affiliation(s)
- Zirui Song
- Department of Health Care Policy and Center for Primary Care, Harvard Medical School, Boston, Massachusetts
- Department of Medicine, Massachusetts General Hospital, Boston
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30
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31
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Kuehn BM. Rising US Firearm Deaths During Pandemic Linked to Poverty. JAMA 2022; 327:2183. [PMID: 35699699 DOI: 10.1001/jama.2022.9111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abstract
IMPORTANCE Most US states have amended self-defense laws to enhance legal immunities for individuals using deadly force in public. Despite concerns that "stand your ground" (SYG) laws unnecessarily encourage the use of deadly violence, their impact on violent deaths and how this varies across states and demographic groups remains unclear. OBJECTIVE To evaluate the association of SYG laws with homicide and firearm homicide, nationally and by state, while considering variation by the race, age, and sex of individuals who died by homicide. DESIGN, SETTING, AND PARTICIPANTS This cohort study used a controlled, multiple-baseline and -location interrupted time series design, using natural variation in the timings and locations of SYG laws to assess associations. Changes in homicide and firearm homicide were modeled using Poisson regression analyses within a generalized additive model framework. Analyses included all US states that enacted SYG laws between 2000 and 2016 and states that did not have SYG laws enacted during the full study period, 1999 to 2017. Data were analyzed from November 2019 to December 2020. EXPOSURES SYG self-defense laws enacted by statute between January 1, 2000, to December 31, 2016. MAIN OUTCOMES AND MEASURES The main outcomes were statewide monthly rates of homicide and firearm-related homicide (per 100 000 persons) from January 1, 1999, to December 31, 2017, grouped by characteristics (ie, race, age, sex) of individuals who died by homicide. RESULTS Forty-one states were analyzed, including 23 states that enacted SYG laws during the study period and 18 states that did not have SYG laws, with 248 358 homicides (43.7% individuals aged 20-34 years; 77.9% men and 22.1% women), including 170 659 firearm homicides. SYG laws were associated with a mean national increase of 7.8% in monthly homicide rates (incidence rate ratio [IRR],1.08; 95% CI, 1.04-1.12; P < .001) and 8.0% in monthly firearm homicide rates (IRR, 1.08; 95% CI, 1.03-1.13; P = .002). SYG laws were not associated with changes in the negative controls of suicide (IRR, 0.99; 95% CI, 0.98-1.01) or firearm suicide (IRR, 1.00; 95% CI, 0.98-1.02). Increases in violent deaths varied across states, with the largest increases (16.2% to 33.5%) clustering in the South (eg, Alabama, Florida, Georgia, Louisiana). There were no differential associations of SYG laws by demographic group. CONCLUSIONS AND RELEVANCE These findings suggest that adoption of SYG laws across the US was associated with increases in violent deaths, deaths that could potentially have been avoided.
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Affiliation(s)
- Michelle Degli Esposti
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
| | - Douglas J. Wiebe
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - David K. Humphreys
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Abstract
This survey study uses responses from the 2021 National Firearms Survey to analyze firearm storage practices in US households with children.
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Affiliation(s)
- Matthew Miller
- Bouvé College of Health Sciences, Department of Health Sciences, Northeastern University, Boston, Massachusetts
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Deborah Azrael
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Richards JE, Boggs JM, Rowhani-Rahbar A, Kuo E, Betz ME, Bobb JF, Simon GE. Patient-Reported Firearm Access Prior to Suicide Death. JAMA Netw Open 2022; 5:e2142204. [PMID: 35006250 PMCID: PMC8749466 DOI: 10.1001/jamanetworkopen.2021.42204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Julie E. Richards
- Kaiser Permanente Washington Heath Research Institute, Seattle, Washington
- Department of Health Services, University of Washington, Seattle
| | | | - Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle
- Firearm Injury and Policy Research Program, Harborview Injury Prevention & Research Center, Seattle, Washington
| | - Elena Kuo
- Kaiser Permanente Washington Heath Research Institute, Seattle, Washington
| | - Marian E. Betz
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora
| | - Jennifer F. Bobb
- Kaiser Permanente Washington Heath Research Institute, Seattle, Washington
| | - Gregory E. Simon
- Kaiser Permanente Washington Heath Research Institute, Seattle, Washington
- Psychiatry and Behavioral Sciences, University of Washington, Seattle
- Kaiser Permanente Washington Department of Mental Health & Wellness, Seattle, Washington
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Brantingham PJ, Tita GE, Jung S, Ahern J. Assessment of Case Fatality Rates and Overall Prevalence of Firearm Violence in California, 2005-2019. JAMA Netw Open 2022; 5:e2145442. [PMID: 35089356 PMCID: PMC8800075 DOI: 10.1001/jamanetworkopen.2021.45442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This case series uses state hospitalization and death records to examine trends in rates of gun homicides and other rates of firearm violence in California between 2005 and 2019.
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Affiliation(s)
| | - George E. Tita
- Department of Criminology, Law and Society, University of California, Irvine
| | - Shelley Jung
- School of Public Health, University of California, Berkeley
| | - Jennifer Ahern
- School of Public Health, University of California, Berkeley
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36
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Hureau D, Wilson T. The Co-Occurrence of Illegal Gun Carrying and Gun Violence Exposure: Evidence for Practitioners From Young People Adjudicated for Serious Involvement in Crime. Am J Epidemiol 2021; 190:2544-2551. [PMID: 34189585 DOI: 10.1093/aje/kwab188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/09/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
We depicted the episodic nature of illegal gun carrying and tested its co-occurrence with gun violence victimization and exposure. We tested differences in differences using data from the Pathways to Desistance Study, originally collected between 2000 and 2010 (Phoenix, Arizona, and Philadelphia, Pennsylvania), on young people adjudicated for serious involvement in crime. We then tested the changes in gun victimization experiences attending gun-carrying changes for this sample. We found gun victimization to be highest during periods of gun carrying, and this correspondence held regardless of future or past gun-carrying behavior. This manifests both in direct victimization and witnessing gun violence. Even among gun carriers, episodes of noncarrying are common, with 76.4% of gun carriers in a 1-year period also reporting a pause in their carrying behavior of at least 6 months. Gun carrying and gun violence exposure co-occur at a high rate. During any period of gun carrying, the carrier has at least a 2% chance of getting shot versus near 0% for periods of noncarrying. Our results suggest that illegal gun carrying is malleable, and public health efforts to reduce the incidence of gun carrying could yield meaningful reductions in violence.
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Rowhani-Rahbar A, Haviland MJ, Azrael D, Miller M. Knowledge of State Gun Laws Among US Adults in Gun-Owning Households. JAMA Netw Open 2021; 4:e2135141. [PMID: 34792594 PMCID: PMC8603069 DOI: 10.1001/jamanetworkopen.2021.35141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This survey study assesses US gun owners’ knowledge of their state’s gun laws.
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Affiliation(s)
- Ali Rowhani-Rahbar
- Department of Epidemiology, School of Public Health, University of Washington, Seattle
- Firearm Injury and Policy Research Program, University of Washington, Seattle
| | - Miriam J. Haviland
- Firearm Injury and Policy Research Program, University of Washington, Seattle
| | - Deborah Azrael
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Matthew Miller
- Harvard Injury Control Research Center, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
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Spark TL, Wright-Kelly E, Ma M, James KA, Reid CE, Brooks-Russell A. Assessment of Rural-Urban and Geospatial Differences in Perceived Handgun Access and Reported Suicidality Among Youth in Colorado. JAMA Netw Open 2021; 4:e2127816. [PMID: 34623407 PMCID: PMC8501400 DOI: 10.1001/jamanetworkopen.2021.27816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Suicide is the second leading cause of death in adolescents, with firearms the most common method, especially in rural communities. Identifying where to target lethal means safety interventions could better leverage limited resources. OBJECTIVES To understand the associations of rurality, school-level prevalence of easy handgun access, and suicidality measures in Colorado youth, to explore spatial distribution of school-level measures, and to identify communities with high prevalence of both easy handgun access and suicidality. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the 2019 Healthy Kids Colorado Survey, an anonymous cross-sectional school-based survey conducted at 256 participating Colorado high schools. Participants included students from schools recruited for statewide population-based estimates and additional schools opting in. Data were analyzed from November 9, 2020, to March 13, 2021. EXPOSURES Urban-centric locale according to a 7-level continuum. Geocoded location of schools was used for spatial analysis. MAIN OUTCOMES AND MEASURES The main outcomes were weighted prevalence for easy handgun access and 4 measures of mental health and suicidality in the previous year (ie, feeling sad for 2 weeks and considering suicide, planning suicide attempt, or attempting suicide in the past year). RESULTS A total of 59 556 students (49.7% [95% CI, 49.3%-50.1%] male and 50.3% [95% CI, 49.9%-50.7%] female; 53.9% [95% CI, 53.5%-54.3%] in 9th and 10th grade; 36.4% [95% CI, 36.0%-36.8%] Hispanic and 50.8% [95% CI, 50.4%-51.2%] non-Hispanic White) from 256 schools participated. Most schools were rural or in small towns (56.8% [95% CI, 50.7%-62.9%]), while more students participated from urban and suburban schools (57.8% [95% CI, 57.6%-58.0%]). Prevalence of perceived easy access to handguns increased with increasing rurality, with 36.2% (95% CI, 35.2%-37.1%) of students in rural (remote) schools reporting easy access, compared with 18.2% (95% CI, 17.3%-19.1%) for city (large) schools. The spatial distribution of easy handgun access and suicidality measures had minimal overlap, but there was correlation at school-level between easy handgun access and considering suicide (ρ = 0.203 [95% CI, 0.0748-0.331]), planning suicide (ρ = 0.300 [95% CI, 0.173-0.427]), and attempting suicide (ρ = 0.218 [95% CI, 0.0869-0.350) in the previous year. The highest quartile for prevalence of both perceived easy access to handguns and planning suicide in the previous year included 21 schools (81.0% [95% CI, 64.0%-97.9%] rural [remote] or rural [distant]). CONCLUSIONS AND RELEVANCE These findings suggest that rural-remote communities in Colorado may benefit most from interventions focused on limiting youth access to handguns when youth are in crisis, with some communities at especially high risk. Spatially referenced data may improve targeting interventions to where they are needed most.
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Affiliation(s)
- Talia L. Spark
- Rocky Mountain Mental Illness Research, Education, and Clinical Care, Department of Veteran Affairs, Aurora, Colorado
- Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora
| | - Erin Wright-Kelly
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Ming Ma
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Katherine A. James
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Ashley Brooks-Russell
- Injury and Violence Prevention Center, University of Colorado Anschutz Medical Campus, Aurora
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
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Bossarte RM, Ziobrowski HN, Benedek DM, Dempsey CL, King AJ, Nock MK, Sampson NA, Stein MB, Ursano RJ, Kessler RC. Mental Disorders, Gun Ownership, and Gun Carrying Among Soldiers After Leaving the Army, 2016-2019. Am J Public Health 2021; 111:1855-1864. [PMID: 34623878 PMCID: PMC8561191 DOI: 10.2105/ajph.2021.306420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 11/04/2022]
Abstract
Objectives. To examine associations of current mental and substance use disorders with self-reported gun ownership and carrying among recently separated US Army soldiers. Veterans have high rates of both gun ownership and mental disorders, the conjunction of which might contribute to the high suicide rate in this group. Methods. Cross-sectional survey data were collected in 2018-2019 from 5682 recently separated personnel who took part in the Army Study to Assess Risk and Resilience in Servicemembers. Validated measures assessed recent mood, anxiety, substance use, and externalizing disorders. Logistic regression models examined associations of sociodemographic characteristics, service characteristics, and mental disorders with gun ownership and carrying. Results. Of the participants, 50% reported gun ownership. About half of owners reported carrying some or most of the time. Mental disorders were not associated significantly with gun ownership. However, among gun owners, major depressive disorder, panic disorder, posttraumatic stress disorder, and intermittent explosive disorder were associated with significantly elevated odds of carrying at least some of the time. Conclusions. Mental disorders are not associated with gun ownership among recently separated Army personnel, but some mental disorders are associated with carrying among gun owners. (Am J Public Health. 2021;111(10):1855-1864. https://doi.org/10.2105/AJPH.2021.306420).
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Affiliation(s)
- Robert M Bossarte
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Hannah N Ziobrowski
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - David M Benedek
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Catherine L Dempsey
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Andrew J King
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Matthew K Nock
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Nancy A Sampson
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Murray B Stein
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Robert J Ursano
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
| | - Ronald C Kessler
- Robert M. Bossarte is with the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown. Hannah N. Ziobrowski, Andrew J. King, Nancy A. Sampson, and Ronald C. Kessler are with the Department of Health Care Policy, Harvard Medical School, Boston, MA. David M. Benedek, Catherine L. Dempsey, and Robert J. Ursano are with the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, Bethesda, MD. Matthew K. Nock is with the Department of Psychology, Harvard University, Cambridge, MA. Murray B. Stein is with the Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla
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Abstract
OBJECTIVES To test the associations of childhood domestic gun access with adult criminality and suicidality. METHODS Analyses were based on a 20+ year prospective, community-representative study of 1420 children, who were assessed up to 8 times during childhood (ages 9-16; 6674 observations) about access to guns in their home. Participants were then followed-up 4 additional times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1336 participants) about criminality and suicidality. RESULTS During childhood, the 3-month prevalence of having a gun in the home was 55.1% (95% confidence interval [CI]: 52.1%-58.7%). Of the children in homes with guns, 63.3% (95% CI: 59.7%-66.9%) had access to a gun, and 25.0% (95% CI: 21.2%-28.8%) owned a gun themselves. Having gun access as a child was associated with higher levels of adult criminality (odds ratios = 1.1-3.5) and suicidality (odds ratios = 2.9-4.4), even after adjusting for childhood correlates of gun access. Risk of adult criminality and suicidality among those with childhood gun access was greatest in male individuals, those living in urban areas, and children with a history of behavior problems. Even in these groups, however, most children did not display adult criminality or suicidality. CONCLUSIONS Childhood gun access is prospectively associated with later adult criminality and suicidality in specific groups of children.
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Affiliation(s)
- William E Copeland
- Department of Psychiatry, University of Vermont, Burlington, Vermont;
- Department of Psychiatry and Behavioral Sciences, Medical Center, Duke University, Durham, North Carolina
| | - Guangyu Tong
- Yale Center for Analytical Sciences, Yale University, New Haven, Connecticut
| | - Elizabeth J Gifford
- Center for Child and Family Policy and the Children's Health and Discovery Initiative, Duke University, Durham, North Carolina; and
| | - Michele M Easter
- Department of Psychiatry and Behavioral Sciences, Medical Center, Duke University, Durham, North Carolina
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development and Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marvin S Swartz
- Department of Psychiatry and Behavioral Sciences, Medical Center, Duke University, Durham, North Carolina
| | - Jeffrey W Swanson
- Department of Psychiatry and Behavioral Sciences, Medical Center, Duke University, Durham, North Carolina
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Hsu YT, Chen YW, Chang DC, Perez NP, Westfal ML, Hung YC, Kelleher CM, Masiakos PT, Sacks CA. Annual Incidence of Hospitalization for Nonfatal Firearm-Related Injuries in New York From 2005 to 2016. JAMA Netw Open 2021; 4:e2115713. [PMID: 34319357 PMCID: PMC8319760 DOI: 10.1001/jamanetworkopen.2021.15713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE In the US, approximately 40 000 people die due to firearm-related injuries annually. However, nonfatal firearm-related injuries are less precisely tracked. OBJECTIVES To assess the annual incidence of hospitalization for nonfatal firearm-related injuries in New York and to compare the annual incidence by sex, race/ethnicity, county of residence, and calendar years. DESIGN, SETTING, AND PARTICIPANTS This retrospective cross-sectional study used data from the New York Statewide Planning and Research Cooperative System for patients aged 15 years or older who presented to an emergency department in New York with nonfatal firearm-related injuries from January 1, 2005, to December 31, 2016. Data were analyzed from January 15, 2019, to April 21, 2021. EXPOSURE A nonfatal firearm-related injury, defined by International Classification of Diseases, Ninth Revision, Clinical Modification and International Statistical Classification of Diseases, Tenth Revision, Clinical Modification codes. MAIN OUTCOMES AND MEASURES The annual incidence of nonfatal firearm-related injuries was calculated by determining the number of patients with a nonfatal firearm-related injury each year divided by the total population of New York. RESULTS The study included 31 060 unique patients with 35 059 hospital encounters for nonfatal firearm-related injuries. The mean (SD) age at admission was 28.5 (11.9) years; most patients were male (90.6%) and non-Hispanic Black individuals (62.0%). The overall annual incidence was 18.4 per 100 000 population. Although decreasing trends of annual incidence were observed across the state during the study period, this trend was not present in all 62 counties, with 32 counties (51.6%) having an increase in the incidence of injuries between 2005 and 2010 and 29 (46.8%) having an increase in the incidence of injuries between 2010 and 2015. In 19 of the 30 counties (63.3%) that had a decrease in incidence in earlier years, the incidence increased in later years. CONCLUSIONS AND RELEVANCE The annual incidence of hospitalization for nonfatal firearm-related injuries in New York during the study period was 18.4 per 100 000 population. Reliable tracking of nonfatal firearm-related injury data may be useful for policy makers, hospital systems, community organizers, and public health officials as they consider resource allocation for trauma systems and injury prevention programs.
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Affiliation(s)
- Yu-Tien Hsu
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ya-Wen Chen
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - David C. Chang
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Numa P. Perez
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Maggie L. Westfal
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ya-Ching Hung
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Cassandra M. Kelleher
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Peter T. Masiakos
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Chana A. Sacks
- Division of General Internal Medicine and Mongan Institute, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
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Brandt CA, Workman TE, Farmer MM, Akgün KM, Abel EA, Skanderson M, Bean-Mayberry B, Zeng-Treitler Q, Mason M, Bastian LA, Goulet JL, Post LA. Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study. West J Emerg Med 2021; 22:525-532. [PMID: 34125022 PMCID: PMC8203018 DOI: 10.5811/westjem.2021.4.51203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Presence of a firearm is associated with increased risk of violence and suicide. United States military veterans are at disproportionate risk of suicide. Routine healthcare provider screening of firearm access may prompt counseling on safe storage and handling of firearms. The objective of this study was to determine the frequency with which Veterans Health Administration (VHA) healthcare providers document firearm access in electronic health record (EHR) clinical notes, and whether this varied by patient characteristics. METHODS The study sample is a post-9-11 cohort of veterans in their first year of VHA care, with at least one outpatient care visit between 2012-2017 (N = 762,953). Demographic data, veteran military service characteristics, and clinical comorbidities were obtained from VHA EHR. We extracted clinical notes for outpatient visits to primary, urgent, or emergency clinics (total 105,316,004). Natural language processing and machine learning (ML) approaches were used to identify documentation of firearm access. A taxonomy of firearm terms was identified and manually annotated with text anchored by these terms, and then trained the ML algorithm. The random-forest algorithm achieved 81.9% accuracy in identifying documentation of firearm access. RESULTS The proportion of patients with EHR-documented access to one or more firearms during their first year of care in the VHA was relatively low and varied by patient characteristics. Men had significantly higher documentation of firearms than women (9.8% vs 7.1%; P < .001) and veterans >50 years old had the lowest (6.5%). Among veterans with any firearm term present, only 24.4% were classified as positive for access to a firearm (24.7% of men and 20.9% of women). CONCLUSION Natural language processing can identify documentation of access to firearms in clinical notes with acceptable accuracy, but there is a need for investigation into facilitators and barriers for providers and veterans to improve a systemwide process of firearm access screening. Screening, regardless of race/ethnicity, gender, and age, provides additional opportunities to protect veterans from self-harm and violence.
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Affiliation(s)
- Cynthia A. Brandt
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - T. Elizabeth Workman
- The George Washington University, Biomedical Informatics Center, Washington, District of Columbia
- VA Medical Center, Washington, District of Columbia
| | - Melissa M. Farmer
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Kathleen M. Akgün
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut
| | - Erica A. Abel
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale School of Medicine, Department of Psychiatry, New Haven, Connecticut
| | | | - Bevanne Bean-Mayberry
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California
- UCLA David Geffen School of Medicine, Department of Medicine, Los Angeles, California
| | - Qing Zeng-Treitler
- The George Washington University, Biomedical Informatics Center, Washington, District of Columbia
- VA Medical Center, Washington, District of Columbia
| | - Maryann Mason
- Northwestern University, Department of Emergency Medicine, Chicago, Illinois
| | - Lori A. Bastian
- VA Connecticut Healthcare System, West Haven, Connecticut
- Yale School of Medicine, Department of Internal Medicine, New Haven, Connecticut
| | - Joseph L. Goulet
- Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Lori A. Post
- Northwestern University, Department of Emergency Medicine, Chicago, Illinois
- Northwestern University, Department of Geriatric Medicine, Chicago, Illinois
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Quenzer F, Givner A, Dirks R, Coyne CJ, Ercoli F, Townsend R. Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers. West J Emerg Med 2021; 22:518-524. [PMID: 34125021 PMCID: PMC8203010 DOI: 10.5811/westjem.2021.4.49315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 04/03/2021] [Accepted: 04/03/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Intentional self-harm (suicide) by firearms is a growing problem in the United States. Currently, there are no large studies that have identified risk factors for patients who die from self-inflicted gunshot wounds. Our objectives are to 1) identify risk factors for patients with the highest morbidity and mortality from self-inflicted gunshot wounds (SIGSWs) at trauma centers 2) present the outcomes of victims of SIGSW by handguns (HG) versus all other specified guns (AOG) and 3) compare the presentations and outcomes of victims with head or face (HF) injuries to other regions of the body. METHODS We performed a retrospective analysis from the National Trauma Database (NTDB) data between 2012 and 2013 of all SIGSW patients who presented to trauma centers. Categorical data included patient characteristics upon presentation and outcomes which were compared between patients with HG injury versus AOG injury using the Chi-Squared test, where AOG includes shotguns, hunting rifles, and military firearms. Additionally, analysis of head and face (HF) injuries versus other bodily injuries (OBI) were compared between the HG group versus AOG group using Chi-squared test. RESULTS There were 7,828 SIGSWs, of those, 78% (6,115) were white and 84.3% (6,600) were male. There were 5,139 HG injuries, 1,130 AOG injuries, and 1,405 unidentified gun injuries. The HG group was likely to be older (>55 years old), hypotensive (systolic blood pressure < 90), have a lower Glasgow Coma Score (GCS < 9), use illegal, or use prescription drugs. In comparing HF injuries (4,799) versus other bodily injuries (OBI) (3,028), HF group was more likely to use handguns, expire in ED, require ICU, and have a higher percent of overall mortality. Of the total OBI, the thorax, upper extremities, and abdomen were the most commonly injured. CONCLUSION In our retrospective study of SIGSWs, we were able to demonstrate that SIGSW by handguns are associated with higher rates of mortality versus all other types of firearms. SIGSWs in older white males with handguns are the most at-risk for severe complications. Future efforts should improve screening methods for handguns in suicidal patients and at developing prevention programs.
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Affiliation(s)
- Faith Quenzer
- University of California, San Diego, Department of Emergency Medicine, San Diego, California
| | - Andrew Givner
- Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California
| | - Rachel Dirks
- University of California, San Francisco-Fresno, Department of Emergency Medicine, Fresno, California
| | - Christopher J. Coyne
- University of California, San Diego, Department of Emergency Medicine, San Diego, California
| | - Frank Ercoli
- Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California
- Desert Regional Medical Center, Desert Trauma Surgeons, Palm Springs, California
| | - Ricard Townsend
- Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California
- Desert Regional Medical Center, Desert Trauma Surgeons, Palm Springs, California
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Abstract
BACKGROUND Higher availability of firearms has been connected to higher rates of interpersonal violence in previous studies. Yet, those studies have focused mainly on the United States, or used aggregated international data to study firearm violence. Whether those aggregated findings are applicable to understanding the phenomenon in continental Europe specifically remains unclear. The aim of this systematic review is to bring together all studies that exclusively use European data. METHODS Nine databases were searched, resulting in more than 1900 individual studies. These studies were assessed on relevance and eligibility for this study, based on their title, abstract and full text. Information on study characteristics, operationalizations of main concepts and study results were extracted from the six eligible studies. RESULTS Four studies assessed the impact of firearm restrictive regulations on the rate of firearm homicides. Two other studies correlated rates of firearm availability and -violence. Results vary: some studies show a clear decline once availability of firearms is restricted, while others indicate a limited effect on only a very specific subgroup, such as female victims, or national guards with weapons at home. Moreover, studies used various operationalizations for firearm availability, thereby decreasing the comparability of findings. CONCLUSION Empirical research exclusively using European data is still lacking. To increase comparability of future studies, methodological inconsistencies and regional gaps need to be overcome. Assessing how firearm availability can be measured with reliable and valid proxies across countries will be a crucial first step to improve future research on the link between firearms and firearm violence.
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Affiliation(s)
- Katharina Krüsselmann
- Institute of Security and Global Affairs, Leiden University, Leiden, The Netherlands
- * E-mail:
| | - Pauline Aarten
- Institute of Security and Global Affairs, Leiden University, Leiden, The Netherlands
| | - Marieke Liem
- Institute of Security and Global Affairs, Leiden University, Leiden, The Netherlands
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Abstract
This study uses police department registry data to describe trends in incidence of firearm shootings and deaths in January-November 2020, before and after the closure of nonessential businesses in March, the killing of George Floyd in May, and the partial lifting of containment policies in June.
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Affiliation(s)
- Jessica H. Beard
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Sara F. Jacoby
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia
| | - Zoë Maher
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Beidi Dong
- Department of Criminology, Law and Society, George Mason University, Fairfax, Virginia
| | - Elinore J. Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Amy J. Goldberg
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania
| | - Christopher N. Morrison
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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Manley NR, Huang DD, Lewis RH, Bee T, Fischer PE, Croce MA, Magnotti LJ. Caught in the crossfire: 37 Years of firearm violence afflicting America's youth. J Trauma Acute Care Surg 2021; 90:623-630. [PMID: 33405467 DOI: 10.1097/ta.0000000000003060] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Publicly available firearm data are difficult to access. Trauma registry data are excellent at documenting patterns of firearm-related injury. Law enforcement data excel at capturing national violence trends to include both circumstances and firearm involvement. The goal of this study was to use publicly available law enforcement data from all 50 states to better define patterns of firearm-related homicides in the young. METHODS All homicides in individuals 25 years or younger in the United States over a 37-year period ending in 2016 were analyzed: infant, 1 year or younger; child, 1 to 9 years old; adolescent, 10 to 19 years old; and young adult, 20 to 25 years old. Primary data files were obtained from the Federal Bureau of Investigation and comprised the database. Data analyzed included homicide type, situation, circumstance, month, firearm type, and demographics. Rates of all homicides and firearm-related homicides per 1 million population and the proportion of firearm-related homicides (out of all homicides) were stratified by year and compared over time using simple linear regression. RESULTS A total of 171,113 incidents of firearm-related homicide were analyzed (69% of 246,437 total homicides): 5,313 infants, 2,332 children, 59,777 adolescents, and 103,691 young adults. Most (88%) were male and Black (59%) with a median age of 20 years. Firearm-related homicides peaked during the summer months of June, July, and August (median, 1,156 per year; p = 0.0032). Rates of all homicides (89 to 53 per 1 million population) and firearm-related homicides (56 to 41 per 1 million population) decreased significantly from 1980 to 2016 (β = -1.12, p < 0.0001 and β = -0.57, p = 0.0039, respectively). However, linear regression analysis identified a significant increase in the proportion of firearm-related homicides (out of all homicides) from 63% in 1980 to 76% in 2016 (β = 0.33, p < 0.0001). CONCLUSION For those 25 years or younger, the proportion of firearm-related homicides has steadily and significantly increased over the past 37 years, with 3 of 4 homicides firearm related in the modern era. Despite focused efforts, reductions in the rate of firearm-related homicides still lag behind those for all other methods of homicide by nearly 50%. That is, while the young are less likely to die from homicide, for those unfortunate victims, it is more likely to be due to a firearm. This increasing role of firearms in youth homicides underscores the desperate need to better direct prevention efforts and firearm policy if we hope to further reduce firearm-related deaths in the young. LEVEL OF EVIDENCE Epidemiological study, level III.
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Affiliation(s)
- Nathan R Manley
- From the Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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Jamieson PE, Romer D. The association between the rise of gun violence in popular US primetime television dramas and homicides attributable to firearms, 2000-2018. PLoS One 2021; 16:e0247780. [PMID: 33730080 PMCID: PMC7968679 DOI: 10.1371/journal.pone.0247780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 02/12/2021] [Indexed: 11/18/2022] Open
Abstract
Injuries and fatalities due to firearms are a major burden on public health in the US. The rise in gun violence in popular movies has been suggested as a potential cultural influence on this behavior. Nevertheless, homicide rates have not increased over recent decades in the US, suggesting that media portrayals have had little influence on gun violence. Here we challenge this interpretation by examining trends in the proportion of violence that are attributable to firearms, a measure that should be more sensitive to media violence. In addition, we examine trends in the portrayal of guns in popular television (TV) dramas, which are viewed more frequently than movies. We ask (a) whether gun violence has increased in these TV shows not only on an absolute basis but also as a proportion of violent scenes and (b) whether trends in gun portrayal on these shows are associated with corresponding trends in the proportion of real-world violence attributable to firearms in the US from 2000 to 2018. To answer these questions, we coded annual instances of violence, gun violence, and proportion of violence involving guns for each 5-minute segment of 33 popular TV dramas in the police, medical, and legal genres from 2000 to 2018. Trends in annual rates of violence, gun violence and proportion of violence involving guns were determined over the study period and were compared to annual rates of homicide attributable to firearms in three age groups: 15–24, 25–34 and 35 and older. Although violence on TV dramas peaked in 2011, gun use steadily increased over the study period both in absolute terms and in relation to other violent methods. The latter metric paralleled trends in homicides attributable to firearms for all three age groups, with the strongest relationship for youth ages 15–24 (R2 = .40, P = .003). The positive relation between relative amount of TV violence involving guns and actual homicides due to firearms, especially among youth, is consistent with the hypothesis that entertainment media are contributing to the normative acceptance of guns for violent purposes. Future research is needed to study the influence of media violence on gun acquisition at the individual level.
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Affiliation(s)
- Patrick E. Jamieson
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, United States of America
- * E-mail:
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Carmichael H, Samuels JM, Jamison EC, Bol KA, Coleman JJ, Campion EM, Velopulos CG. Finding the elusive trauma denominator: Feasibility of combining data sets to quantify the true burden of firearm trauma. J Trauma Acute Care Surg 2021; 90:466-470. [PMID: 33105286 DOI: 10.1097/ta.0000000000003005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Evidence guiding firearm injury prevention is limited by current data collection infrastructure. Trauma registries (TR) omit prehospital deaths and underestimate the burden of injury. In contrast, the National Violent Death Reporting System (NVDRS) tracks all firearm deaths including prehospital fatalities, excluding survivors. This is a feasibility study to link these data sets through collaboration with our state public health department, aiming to better estimate the burden of firearm injury and assess comparability of data. METHODS We reviewed all firearm injuries in our Level I TR from 2011 to 2017. We provided the public health department with in-hospital deaths, which they linked to NVDRS using patient identifiers and time of injury/death. The NVDRS collates information about circumstances, incident type, and wounding patterns from multiple sources including death certificates, autopsy records, and legal proceedings. We considered only subjects with injury location in a single urban county to best estimate in-hospital and prehospital mortality. RESULTS Of 168 TR deaths, 166 (99%) matched to NVDRS records. Based on data linkages, we estimate 320 prehospital deaths, 184 in-hospital deaths, and 453 survivors for a total of 957 firearm injuries. For the matched patients, there was near-complete agreement regarding simple demographic variables (e.g., age and sex) and good concordance between incident types (suicide, homicide, etc.). However, agreement in wounding patterns between NVDRS and TR varied. CONCLUSION We demonstrate the feasibility of linking TR and NVDRS data with good concordance for many variables, allowing for good estimation of the trauma denominator. Standardized data collection methods in one data set could improve methods used by the other, for example, training NVDRS abstractors to utilize Abbreviated Injury Scale designations for injury patterns. Such data integration holds immediate promise for guiding prevention strategies. LEVEL OF EVIDENCE Epidemiological study, level IV.
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Affiliation(s)
- Heather Carmichael
- From the University of Colorado (H.C., J.M.S., C.G.V.), Aurora; Colorado Department of Public Health and Environment (E.C.J., K.A.B.), Health Statistics and Evaluation Branch; and Department of Surgery (J.J.C., E.M.C.), Denver Health Medical Center, Denver, Colorado
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Abstract
IMPORTANCE Adolescent access to firearms increases their risk of firearm injury. OBJECTIVE To examine adolescent firearm access in homes with guns, how storage may modify access, and discordance between parent and adolescent report of access. DESIGN, SETTING, AND PARTICIPANTS This survey study used data on parents and their adolescent children from a nationally representative online survey of adults in gun-owning households, conducted from June 30 to August 11, 2019. Individuals who owned firearms and parents of adolescents were oversampled. All parents living with a child aged 13 to 17 years were invited to have their child participate in a separate survey. Respondents with more than 1 adolescent living with them were asked to choose the child with the most recent birthday. Analyses were conducted from June 1, 2020, to January 4, 2021. MAIN OUTCOMES AND MEASURES Firearm access was assessed by asking adolescents how long it would take to access a loaded gun in their home. Parents were asked whether their child could independently access a household firearm. Individuals who owned guns reported firearm storage practices. Study-specific poststratification weights adjusted for survey nonresponse and undercoverage or overcoverage resulting from the study-specific sample design and for benchmark demographic distributions. RESULTS Of 6721 adults invited to participate, 4030 completed the survey. Of these, 280 had a firearm in their homes and had a child aged 13 to 17 years who participated in the survey. The mean (SD) age of parents was 45.2 (7.2) years; of children, 15.0 (1.4) years. The sample included 159 male adolescents (weighted percentage, 60.8%; 95% CI, 53.8%-67.8%) and 129 male adults (weighted percentage, 48.3%; 95% CI, 40.9%-55.6%). In 33.9% (95% CI, 26.7%-41.2%) of households, an adolescent reported that they could access a loaded firearm in less than 5 minutes. In homes where all guns were locked, 23.7% (95% CI, 12.3%-35.1%) of adolescents reported that they could access a loaded firearm in less than 5 minutes. Overall, 70.4% (95% CI, 63.7%-77.1%) of parents reported that their child could not access a household firearm. In households where parents said their child could not access a firearm, 21.8% (95% CI 13.8%-29.7%) of their children indicated that they could access a firearm within 5 minutes and 14.9% (95% CI, 8.9%-20.9%) indicated that they could access a firearm in more than 5 minutes but less than 1 hour. CONCLUSIONS AND RELEVANCE In this study, many adolescents reported having ready access to loaded guns in their homes, even when all household firearms were locked. Many adolescents who reported having access to household firearms lived with parents who knew their children had access, but others lived with parents who did not know. These finding should inform prevention efforts aimed at reducing adolescent access to household firearms.
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Affiliation(s)
- Carmel Salhi
- Bouvé College of Health Sciences, Department of Health Sciences, Northeastern University, Boston, Massachusetts
| | - Deborah Azrael
- Harvard Injury Control Research Center, Department of Health Policy and Management, T.H. Chan Harvard School of Public Health, Boston, Massachusetts
| | - Matthew Miller
- Bouvé College of Health Sciences, Department of Health Sciences, Northeastern University, Boston, Massachusetts
- Harvard Injury Control Research Center, Department of Health Policy and Management, T.H. Chan Harvard School of Public Health, Boston, Massachusetts
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Anestis MD, Bryan CJ, Capron DW, Bryan AO. Lethal Means Counseling, Distribution of Cable Locks, and Safe Firearm Storage Practices Among the Mississippi National Guard: A Factorial Randomized Controlled Trial, 2018-2020. Am J Public Health 2021; 111:309-317. [PMID: 33351652 PMCID: PMC7811068 DOI: 10.2105/ajph.2020.306019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To examine whether lethal means counseling and provision of cable locks prompt safe firearm storage relative to control among firearm-owning members of the Mississippi National Guard.Methods. This randomized controlled trial utilized a 2 × 2 factorial design (lethal means counseling vs control, provision of cable locks vs no cable locks). Follow-up assessments took place at 3 and 6 months after baseline. Data were collected (n = 232; 87.5% male; mean age = 35.01 years; 77.2% White) from February 2018 through July 2020.Results. Relative to control, lethal means counseling and provision of cable locks resulted in greater adoption of several safe storage methods over time. Lethal means counseling outperformed control (3 months: 55.0% vs 39.0%; odds ratio [OR] = 1.91). Cable locks outperformed control at 3 and 6 months on number of storage methods (1.41 vs 1.11; d = 0.29 and 1.34 vs 1.16; d = 0.15, respectively) and locking devices (59.8% vs 29.9%; OR = 3.49 and 58.4% vs 35.8%; OR = 2.52, respectively)Conclusions. Lethal means counseling and cable locks can result in sustained changes in firearm storage.Public Health Implications. The military may benefit from lethal means counseling, perhaps administering at point of entry.Trial Registration. Clinical Trials.gov identifier: NCT03375099.
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Affiliation(s)
- Michael D Anestis
- Michael D. Anestis is with the New Jersey Gun Violence Research Center and the Department of Urban-Global Public Health, School of Public Health, Rutgers, The State University of New Jersey, Piscataway. Craig J. Bryan and AnnaBelle O. Bryan are with the Department of Psychiatry and Behavioral Health, the Ohio State University Wexner Medical Center, Columbus. Daniel W. Capron is with the School of Psychology, University of Southern Mississippi, Hattiesburg
| | - Craig J Bryan
- Michael D. Anestis is with the New Jersey Gun Violence Research Center and the Department of Urban-Global Public Health, School of Public Health, Rutgers, The State University of New Jersey, Piscataway. Craig J. Bryan and AnnaBelle O. Bryan are with the Department of Psychiatry and Behavioral Health, the Ohio State University Wexner Medical Center, Columbus. Daniel W. Capron is with the School of Psychology, University of Southern Mississippi, Hattiesburg
| | - Daniel W Capron
- Michael D. Anestis is with the New Jersey Gun Violence Research Center and the Department of Urban-Global Public Health, School of Public Health, Rutgers, The State University of New Jersey, Piscataway. Craig J. Bryan and AnnaBelle O. Bryan are with the Department of Psychiatry and Behavioral Health, the Ohio State University Wexner Medical Center, Columbus. Daniel W. Capron is with the School of Psychology, University of Southern Mississippi, Hattiesburg
| | - AnnaBelle O Bryan
- Michael D. Anestis is with the New Jersey Gun Violence Research Center and the Department of Urban-Global Public Health, School of Public Health, Rutgers, The State University of New Jersey, Piscataway. Craig J. Bryan and AnnaBelle O. Bryan are with the Department of Psychiatry and Behavioral Health, the Ohio State University Wexner Medical Center, Columbus. Daniel W. Capron is with the School of Psychology, University of Southern Mississippi, Hattiesburg
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