Citation

Polcari AM, Hoefer LE, Callier K, Zakrison TL, Rogers SO, Henry M, Slidell MB, Benjamin AJ. J. Trauma Acute Care Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000003896

PMID

36850025

Abstract

BACKGROUND: Firearm-related injury in children is a public health crisis. The Social Vulnerability Index (SVI) identifies communities at-risk for adverse effects due to natural or human-caused crises. We sought to determine if SVI was associated with pediatric firearm-related injury and thus could assist in targeted prevention planning.

METHODS: The CDC's 2018 SVI data was merged on census tract with 2015-2022 open-access shooting incident data in children 19 or younger from Baltimore, Chicago, Los Angeles, New York City, and Philadelphia. Regression analyses were performed to uncover associations between firearm violence, SVI, SVI themes and social factors at the census tract level.

RESULTS: Of 11,654 shooting incidents involving children, 52% occurred in just 6.7% of census tracts, which were on average in the highest quartile of SVI. A decile increase in SVI was associated with a 45% increase in pediatric firearm-related injury in all cities combined (Incident Rate Ratio 1.45, 95% Confidence Interval 1.41-1.49, p < 0.001). A similar relationship was found in each city: 30% in Baltimore, 51% in Chicago, 29% in Los Angeles, 37% in New York City, and 35% in Philadelphia (all p < 0.001). Socioeconomic status and household composition were SVI themes positively associated with shootings in children, as well as the social factors below poverty, lacking a high school diploma, civilian with a disability, single-parent household, minority, and no vehicle access. Living in areas with multi-unit structures, populations aged 17 or younger, and speaking English less-than-well were negatively associated.

CONCLUSIONS: Geospatial disparities exist in pediatric firearm-related injury and are significantly associated with neighborhood vulnerability. We demonstrate a strong association between SVI and pediatric shooting incidents in multiple major U.S. cities. SVI can help identify social and structural factors, as well as geographic areas, to assist in developing meaningful and targeted intervention and prevention efforts. LEVEL OF EVIDENCE: Level III, Prognostic/Epidemiological.

Language: en