Changing epidemiology of firearm injury: a cohort study of non-fatal firearm victimisation before and during the COVID-19 pandemic, Indianapolis, Indiana

Abstract

ObjectiveTo examine victimisation rates, geographic patterns and neighbourhood characteristics associated with non-fatal firearm injury rates before and during the COVID-19 pandemic.DesignA retrospective cohort study.SettingCity of Indianapolis, Indiana, USA, 1 January 2017–30 June 2021.ParticipantsIntentional non-fatal firearm injury victims from Indianapolis Metropolitan Police Department records. The study included information on 2578 non-fatal firearm injury victims between ages 0 and 77 years. Of these victims, 82.5% were male and 77.4% were black.Primary and secondary outcome measuresRates of non-fatal firearm injuries per 100 000 population by victim age, race, sex and incident motive. Prepandemic and peripandemic non-fatal firearm injury rates.ResultsNon-fatal shooting rates increased 8.60%, from 57.0 per 100 000 person-years in prepandemic years to 65.6 per 100 000 person-years during the pandemic (p<0.001). Rates of female victims (15.2 vs 23.8 per 100,000; p<0.001) and older victims (91.3 vs 120.4 per 100,000; p<0.001) increased significantly during the pandemic compared with the prepandemic period. Neighbourhoods with higher levels of structural disadvantage (IRR: 1.157, 95% CI 1.012 to 1.324) and prepandemic firearm injury rates (IRR: 1.001, 95% CI 1.001 to 1.002) was positively associated with higher rates of non-fatal firearm injuries during the pandemic, adjusting for neighbourhood characteristics.ConclusionsNon-fatal firearm injuries increased significantly during the COVID-19 pandemic, particularly among female and older victims. Efforts are needed to expand and rethink current firearm prevention efforts that both address the diversification of victimisation and the larger societal trauma of firearm violence.

COVID-19 Pandemic Effects on the Epidemiology and Mortality of Pediatric Firearm Injuries; A Single Center Study

“…Our study brings to light multiple significant findings related to the effects of the COVID-19 pandemic on pediatric firearm injuries. Consistent with multiple previous studies [ 8 , [11] , [12] , [13] , [14] , [15] , [16] ], pediatric firearm injury rates were found to have significantly increased during the pandemic compared to the five preceding years. While most previous studies on the topic do not include information on the intent or circumstances surrounding the shootings [ 8 , 11 , 12 , 14 , 16 ], we found that the escalation in pediatric firearm injuries was driven by a significant increase in pediatric firearm assaults/homicides.…”

“…The relative decrease in unintentional pediatric firearm injuries that we discovered during the pandemic contradicts this theory, though the risks for firearm injury they point out are likely still accurate and significant. Our finding that pediatric firearm assaults/homicides significantly increased is likely still related in part to increased gun purchasing [ 8 , 11 , 13 , [23] , [24] , [25] ] and decreased youth supervision [ 8 , 14 , 16 ] associated with the COVID-19 pandemic. However, other factors such as COVID-19-induced economic crisis and subsequently increased neighborhood violence/crime rates may have played a more significant role in elevating pediatric firearm assaults/homicides.…”

“…Cohen et al reported a significant increase in pediatric firearm injuries during the COVID-19 pandemic, but was limited to victims under the age of 12 years [8] , missing adolescents who historically suffer the largest burden of firearm violence [ 9 , 10 ]. Several other studies are limited by lack of victim demographic information including victim ages [11] , sex and race/ethnicity [11] , [12] , [13] . Many do not include analysis of injury severity or hospital disposition [ 8 , [12] , [13] , [14] ].…”

“…Several other studies are limited by lack of victim demographic information including victim ages [11] , sex and race/ethnicity [11] , [12] , [13] . Many do not include analysis of injury severity or hospital disposition [ 8 , [12] , [13] , [14] ]. Most studies are limited by timeframe, including only the first several months of the COVID-19 pandemic [ 8 , 11 , 13 , 15 , 16 ], lacking potential impacts of the extensive Delta and Omicron variant surges [17] .…”

“…Many do not include analysis of injury severity or hospital disposition [ 8 , [12] , [13] , [14] ]. Most studies are limited by timeframe, including only the first several months of the COVID-19 pandemic [ 8 , 11 , 13 , 15 , 16 ], lacking potential impacts of the extensive Delta and Omicron variant surges [17] . Furthermore, while all such studies discuss speculations regarding the underlying causes of increased firearm injuries during the COVID-19 pandemic, the majority do not include the intent or circumstances surrounding the shootings [ 8 , 11 , 12 , 14 , 16 ].…”