Analyzing Child Firearm Assault Injuries by Race and Ethnicity During the COVID-19 Pandemic in 4 Major US Cities.
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ABSTRACT:
SUBMITTER: Jay J
PROVIDER: S-EPMC9996392 | biostudies-literature | 2023 Mar
REPOSITORIES: biostudies-literature
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Analyzing Child Firearm Assault Injuries by Race and Ethnicity During the COVID-19 Pandemic in 4 Major US Cities.
Jay Jonathan J Martin Rachel R Patel Manish M Xie Kristal K Shareef Faizah F Simes Jessica T JT
JAMA network open 20230301 3
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Project description:Research on spatial injury patterns is limited by a lack of precise injury occurrence location data. Using linked hospital and death records, we examined residence and injury locations for firearm assaults and homicides in or among residents of King County, Washington, USA from 1 January 2010 to 31 December 2014. In total, 670 injuries were identified, 586 with geocoded residence and injury locations. Three-quarters of injuries occurred outside the census tract where the victim resided. Median distance between locations was 3.9 miles, with victims 18-34 having the greatest distances between residence and injury location. 40 of 398 tracts had a ratio of injury incidents to injured residents of >1. Routine collection of injury location data and homelessness status could decrease misclassification and bias. Researchers should consider whether residential address is an appropriate proxy for injury location, based on data quality and their specific research question.
| S-EPMC7526511 | biostudies-literature
Project description:Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.
| S-EPMC11295296 | biostudies-literature
Project description:Firearm deaths continue to be a major public health problem, but the number of non-fatal firearm injuries and the characteristics of patients and injuries is not well known. The American College of Surgeons Committee on Trauma, with support from the National Collaborative on Gun Violence Research, leveraged an existing data system to capture lethal and non-lethal injuries, including patients treated and discharged from the emergency department and collect additional data on firearm injuries that present to trauma centers. In 2020, Missouri had the 4th highest firearm mortality rate in the country at 23.75/100,000 population compared to 13.58/100,000 for the US overall. We examined the characteristics of patients from Missouri with firearm injuries in this cross-sectional study. Of the overall 17,395 patients, 1,336 (7.7%) were treated at one of the 11 participating trauma centers in Missouri during the 12-month study period. Patients were mostly male and much more likely to be Black and uninsured than residents in the state as a whole. Nearly three-fourths of the injuries were due to assaults, and overall 7.7% died. Few patients received post-discharge services.
| S-EPMC10664957 | biostudies-literature
Project description: Not available
| S-EPMC9832380 | biostudies-literature
Project description:BackgroundThe existence of socio-economic inequalities in child mortality is well documented. African cities grow faster than cities in most other regions of the world; and inequalities in African cities are thought to be particularly large. Revealing health-related inequalities is essential in order for governments to be able to act against them. This study aimed to systematically compare inequalities in child mortality across 10 major African cities (Cairo, Lagos, Kinshasa, Luanda, Abidjan, Dar es Salaam, Nairobi, Dakar, Addis Ababa, Accra), and to investigate trends in such inequalities over time.MethodsData from two rounds of demographic and health surveys (DHS) were used for this study (if available): one from around the year 2000 and one from between 2007 and 2011. Child mortality rates within cities were calculated by population wealth quintiles. Inequality in child mortality was assessed by computing two measures of relative inequality (the rate ratio and the concentration index) and two measures of absolute inequality (the difference and the Erreyger's index).ResultsMean child mortality rates ranged from about 39 deaths per 1,000 live births in Cairo (2008) to about 107 deaths per 1,000 live births in Dar es Salaam (2010). Significant inequalities were found in Kinshasa, Luanda, Abidjan, and Addis Ababa in the most recent survey. The difference between the poorest quintile and the richest quintile was as much as 108 deaths per 1,000 live births (95% confidence interval 55 to 166) in Abidjan in 2011-2012. When comparing inequalities across cities or over time, confidence intervals of all measures almost always overlap. Nevertheless, inequalities appear to have increased in Abidjan, while they appear to have decreased in Cairo, Lagos, Dar es Salaam, Nairobi and Dakar.ConclusionsConsiderable inequalities exist in almost all cities but the level of inequalities and their development over time appear to differ across cities. This implies that inequalities are amenable to policy interventions and that it is worth investigating why inequalities are higher in one city than in another. However, larger samples are needed in order to improve the certainty of our results. Currently available data samples from DHS are too small to reliably quantify the level of inequalities within cities.
| S-EPMC4066831 | biostudies-literature
Project description:ObjectiveThis study is the first to examine net worth poverty, and its intersection with income poverty, by race and ethnicity among child households in the United States.BackgroundScholarship on economic scarcity for children has largely concentrated on income deficits and thus leaves open important questions about wealth deficits.MethodData come from the 1989-2019 waves of the Survey of Consumer Finances, on households with at least one resident child under the age of 18. Net worth poverty is measured as household net worth, defined as total assets minus total debts, that is less than one-fourth of the federal poverty line.ResultsIn 2019, 57% of Black and 50% of Latino child households were net worth poor. The majority of these households were not income poor. Racial and ethnic differences in net worth poverty (unlike those for income poverty) persist even when sociodemographic variation predicting income poverty is controlled for.ConclusionNet worth poverty is so prevalent in the lives of non-White children that, after sociodemographic characteristics are controlled for, Black and Latino child households have about the same probability of not being poor as they do of being net worth poor.ImplicationsA focus on income deprivation alone will overlook the precarious economic conditions related to family net worth and ignore growing disparities by race and ethnicity.
| S-EPMC8653971 | biostudies-literature
Project description:BackgroundFirearm sales in the United States (U.S.) markedly increased during the COVID-19 pandemic. Our objective was to determine if firearm injuries in children were associated with stay-at-home orders (SHO) during the COVID-19 pandemic. We hypothesized there would be an increase in pediatric firearm injuries during SHO.MethodsThis was a multi institutional, retrospective study of institutional trauma registries. Patients <18 years with traumatic injuries meeting National Trauma Data Bank (NTDB) criteria were included. A "COVID" cohort, defined as time from initiation of state SHO through September 30, 2020 was compared to "Historical" controls from an averaged period of corresponding dates in 2016-2019. An interrupted time series analysis (ITSA) was utilized to evaluate the association of the U.S. declaration of a national state of emergency with pediatric firearm injuries.ResultsNine Level I pediatric trauma centers were included, contributing 48,111 pediatric trauma patients, of which 1,090 patients (2.3%) suffered firearm injuries. There was a significant increase in the proportion of firearm injuries in the COVID cohort (COVID 3.04% vs. Historical 1.83%; p < 0.001). There was an increased cumulative burden of firearm injuries in 2020 compared to a historical average. ITSA showed an 87% increase in the observed rate of firearm injuries above expected after the declaration of a nationwide emergency (p < 0.001).ConclusionThe proportion of firearm injuries affecting children increased during the COVID-19 pandemic. The pandemic was associated with an increase in pediatric firearm injuries above expected rates based on historical patterns.
| S-EPMC9001175 | biostudies-literature
Project description:BackgroundIdentifying community characteristics associated with firearm assault could facilitate prevention. We investigated the effect of community firearm dealer and alcohol outlet densities on individual risk of firearm assault injury.MethodsIn this density-sampled case-control study of Californians, January 2005-September 2015, cases comprised all residents with a fatal or nonfatal firearm assault injury. For each month, we sampled controls from the state population in a 4:1 ratio with cases. Exposures were monthly densities of county-level pawn and nonpawn firearm dealers and ZIP code-level off-premises alcohol outlets and bars and pubs ("bars/pubs"). We used case-control-weighted G-computation to estimate risk differences (RD) statewide and among younger Black men, comparing observed exposure densities to hypothetical interventions setting these densities to low. We estimated additive interactions between firearm and alcohol retailer density. Secondary analyses examined interventions targeted to high exposure density or outcome burden areas.ResultsThere were 67,850 cases and 268,122 controls. Observed (vs. low) densities of pawn firearm dealers and off-premises alcohol outlets were individually associated with elevated monthly risk of firearm assault per 100,000 people (RD pawn dealers : 0.06, 95% CI: 0.05, 0.08; RD off-premises outlets : 0.01, 95% CI: 0.01, 0.03), but nonpawn firearm dealer and bar/pub density were not; models targeting only areas with the highest outcome burden were similar. Among younger Black men, estimates were larger. There was no interaction between firearm and alcohol retailer density.ConclusionsOur results are consistent with the hypothesis that limiting pawn firearm dealers and off-premises alcohol outlet densities can reduce interpersonal firearm violence.
| S-EPMC10538383 | biostudies-literature
Project description:ImportanceThe COVID-19 pandemic has contributed to poorer mental health and a greater need for treatment. Nationally representative estimates of major depressive disorder (MDD) and mental health treatment among US adolescents during the pandemic are needed.ObjectiveTo estimate MDD prevalence among adolescents, evaluate mental health treatment use among adolescents with MDD, and assess differences by race and ethnicity.Design, setting, and participantsThis cross-sectional analysis of the nationally representative 2021 National Survey on Drug Use and Health included noninstitutionalized US adolescents between the ages of 12 and 17 years (n = 10 743). Analytic weights were applied to all rates and model estimates to be nationally representative and account for sample design and survey nonresponse. Data were collected from January 14 to December 20, 2021, and analyzed from February 11 to April 3, 2023.ExposuresSelf-reported race and ethnicity.Main outcomes and measuresDichotomous outcomes of MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), MDD-specific mental health treatment, any type of mental health treatment, telehealth visits, and delays in mental health treatment.ResultsThe sample included 10 743 adolescents (51.1% male). Self-reported race and ethnicity included 5.1% Asian, 14.1% Black, 23.3% Latinx, 51.2% White, and 6.3% more than 1 race. Ages were evenly distributed: 34.0% aged 12 to 13 years; 33.3% aged 14 to 15 years; and 32.7% aged 16 to 17 years. Adolescents of more than 1 race or ethnicity had the highest MDD rate (26.5%). Compared with White adolescents, the lowest rates of any MDD treatment overall were found among Latinx adolescents (29.2% [95% CI, 22.2%-36.2%]) and those of more than 1 race or ethnicity (21.1% [95% CI, 11.6%-30.7%]). Similar results were found for treatment by any clinician (Latinx, 25.6% [95% CI, 18.8%-32.4%]; >1 race or ethnicity, 19.1% [95% CI, 9.7%-28.6%]), treatment by a mental health specialist (Latinx, 22.9% [95% CI, 16.9%-28.9%]; >1 race or ethnicity, 16.7% [95% CI, 7.1%-26.3%]), treatment by a nonspecialist clinician (Latinx, 7.3% [95% CI, 3.3%-11.3%]; >1 race or ethnicity, 4.8% [95% CI, 1.9%-7.7%]), and use of any psychotropic medication prescription (Latinx, 11.6% [95% CI, 7.3%-15.9%]; >1 race or ethnicity, 8.3% [95% CI, 2.8%-13.7]). Compared with White adolescents, Black adolescents had lower rates of MDD treatment by any clinician (31.7% [95% CI, 23.7%-39.8%]) and by nonspecialist clinicians (8.4% [95% CI, 3.8%-13.2%]) and experienced lower prescription rates for any psychotropic medication (12.6 [95% CI, 4.6%-20.6%]). Asian (16.0% [95% CI, 5.0%-27.2%]) and Latinx (17.8% [95% CI, 12.6%-23.0%]) adolescents had lower rates of virtual mental health treatment compared with White adolescents. Black (19.1% [95% CI, 14.1%-24.2%]) and Latinx (17.9% [95% CI, 15.0%-21.1%]) adolescents had lower rates of appointments transition to telehealth, while Black adolescents (14.1% [95% CI, 10.7%-17.4%]) experienced delays getting their prescriptions.Conclusions and relevanceDuring the first full calendar year of the pandemic, approximately 1 in 5 adolescents had MDD, and less than half of adolescents who needed treatment had any mental health treatment. Adolescents in racial and ethnic minority groups, particularly Latinx, experienced the lowest treatment rates. Federal policy should target adolescents as a whole, and minority populations in particular, to ensure equitable treatment access. Efforts should consider the social, racial, ethnic, and cultural determinants of health.
| S-EPMC10562990 | biostudies-literature
Project description:BackgroundRace- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.PurposeTo determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.Study designSystematic review; Level of evidence, 4.MethodsUsing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered for inclusion. Original sports medicine research studies that focused on athletes were included. Outcome measures included reporting and analysis of patient demographics (age, sex, race, ethnicity). Studies that included demographic variables in a multivariate analysis or that performed a race-/ethnicity-based stratified analyses were considered to have analyzed that variable. Studies that reported and/or analyzed patient demographics were examined. Chi-square tests were performed to determine statistical significance.ResultsA total of 5140 publications were screened, and 842 met the inclusion criteria. Age and sex were well reported (84.1% and 87.0%, respectively), while race (3.8%) and ethnicity (2.0%) were poorly reported. There was no difference in rates of reporting age, sex, race, or ethnicity between the American Journal of Sports Medicine (AJSM), the Orthopaedic Journal of Sports Medicine (OJSM), or Sports Health: A Multidisciplinary Approach (Sports Health). The rate of analysis was also calculated as a percentage of the studies that reported that variable. Of the studies that reported age, 38.5% analyzed age. Using this method, 26.2% of studies analyzed sex, 40.6% analyzed race, and 17.6% analyzed ethnicity. Although there was no difference in the overall rate at which studies from the 3 journals analyzed ethnicity, Sports Health studies analyzed age (P = .044), sex (P = .001), and race (P = .027) more frequently than studies published in AJSM and OJSM. Of the studies that analyzed race, most of those studies (8/13, 61.5%) found significant race-based differences in reported outcomes.ConclusionThis systematic review demonstrated that race and ethnicity are poorly reported and analyzed in athlete-specific sports medicine literature, despite the fact that a majority of studies analyzing race found significant differences between racial groups. Improved reporting of race and ethnicity can determine whether race- and ethnicity-based differences exist in patient interventions to ameliorate disparities in patient outcomes.
| S-EPMC11490984 | biostudies-literature