Citation

Trinidad S, Vancil A, Brokamp C, Moody S, Gardner D, Parsons AA, Riley C, Sahay R, Sofer N, Beck AF, Falcone RAJ, Kotagal M. J. Trauma Acute Care Surg. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000003679

PMID

unavailable

Abstract

Background 
Disparities in pediatric injury are widely documented and partly driven by differential exposures to social determinants of health (SDH). Here, we examine associations between neighborhood-level SDH and pediatric firearm-related injury admissions as a step to defining specific targets for interventions to prevent injury.
Methods 
We conducted a retrospective review of patients ≤16 years old admitted to our level 1 pediatric trauma center (2010-2019) after a firearm-related injury. We extracted patients' demographic characteristics and intent of injury. We geocoded home addresses to enable quantification of injury-related admissions at the neighborhood (census tract) level. Our population-level exposure variable was a socioeconomic deprivation index for each census tract.
Results 
Out of 15,686 injury-related admissions, 140 were for firearm-related injuries (median age 14 years [IQR 11,15]). Patients with firearm-related injuries were 75% male and 64% Black; 66% had public insurance. Nearly half (47%) of firearm-related injuries were a result of assault, 32% were unintentional, and 6% were self-inflicted; 9% died. At the neighborhood level, the distribution of firearm-related injuries significantly differed by deprivation quintile (p <.05). Children from the highest deprivation quintile experienced 25% of injuries of all types, 57% of firearm-related injuries, and 70% of all firearm-related injuries from assault. They had an overall risk of firearm-related injury 30-times that of children from the lowest deprivation quintile.
Conclusions 
Increased neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization, at rates far higher than injury-related admissions overall. Addressing neighborhood-level social determinants of health may help prevent pediatric firearm-related injury.
Level of Evidence 
Prognostic and Epidemiological - Level III

Language: en