Food Insecurity Predicts Urban Gun Violence

Smith, Randi N.; Williams, Keneeshia N; Roach, Robert Allen; Tracy, Brett M.

doi:10.1177/0003134820942194

Cited by 9 publications

(11 citation statements)

References 17 publications

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“…Food insecurity was found to be independently associated with rates of violent firearm injury, which has been reported in prior studies. Using the United States Department of Agriculture’s Food Access Research Atlas, Smith et al 18 showed that FI was associated with urban gun violence in Atlanta, Georgia. Other studies have shown a similar finding.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Smith et al found that FI was independently associated with an increased risk of firearm related injury for Atlanta's urban population. 18 Despite these findings, the link between FI and gun-related trauma is still understudied, with limited studies in most U. S. cities and data generally obtained from an aggregate level. The aim of this study was to investigate the association between area-level FI and gun violence in New Orleans, Louisiana, a region with high levels of FI and significant rates of gun violence.…”

mentioning

confidence: 99%

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The association between food insecurity and gun violence in a major metropolitan city

Ali¹,

Broome²,

Tatum³

et al. 2022

J Trauma Acute Care Surg

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BACKGROUND:Food insecurity (FI) is an important social determinant of health that is associated with many forms of violence. We hypothesized that FI would be associated with gun violence. METHODS:Firearm injury data was collected from 2016 to 2020 (n = 3115) at a single institution that serves as the only Level I trauma center in a major southern US city. The data were linked with Map the Meal Gap data, a publicly available data set, which estimates rates of county-level FI based on state-level FI and social determinants, including unemployment, poverty, disability, and other factors.Regression analysis was utilized to examine the relationship between FI with rates of overall gun trauma and odds of gun-related violence. Food insecurity by county of patient residence was categorized by rates less than the national average of 11.5% (low), between the national and state average (16.5%) (moderate), and greater than the state average (high). Out of state residents were excluded from the analyses. RESULTS:Of the 3,115 patients with firearm injuries identified, 138 (4.4%) resided in counties with low FI rates, 1048 (33.6%) in moderate FI, and 1929 (62.0%) in counties with high FI. Patients in regions of high FI were more likely to be a Level I trauma activation, a victim of assault, and have Medicaid or be self-pay. There was no significant difference in mortality by levels of FI. Food insecurity was significantly associated with firearm injury, with each percent increase in FI being related to approximately 56 additional gunrelated injuries per 100,000 people (95% confidence interval, 54-59) and increased odds of the injury classified as assault (odds ratio, 1.13; 95% confidence interval, 1.07-1.19). CONCLUSION:Violence prevention initiatives targeting food insecure communities may help alleviate the US gun violence epidemic. Further, trauma center screening for household FI and in-hospital interventions addressing FI may help reduce gun violence recidivism.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The association between food insecurity and gun violence in a major metropolitan city

Ali¹,

Broome²,

Tatum³

et al. 2022

J Trauma Acute Care Surg

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“…Additionally, prior work by our investigative team employed similar methods. 4 Hence, community-level FI statistics were used as the gold standard and were subsequently compared to results of the screening questionnaire for each participant. Contingency tables were utilized to determine sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the survey.…”

Section: Methodsmentioning

confidence: 99%

“…3 Additionally, Smith and colleagues determined FI is an independent correlate of firearm injury incidence. 4…”

Section: Introductionmentioning

confidence: 99%

“…3 Additionally, Smith and colleagues determined FI is an independent correlate of firearm injury incidence. 4 FI screening programs have been applied in a variety of clinical settings utilizing several iterations from a popular 18-item screening tool developed by the United States Department of Agriculture Food Security Model. 5 Recently, the 18-item survey has been simplified to a twoitem screening tool that was deemed clinically appropriate and able to determine FI in the outpatient clinical setting with high accuracy, sensitivity, and specificity.…”

Section: Introductionmentioning

confidence: 99%

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The Potential Impact of Food Insecurity in an Urban Trauma Population

Crichton

Manhan

Wang

et al. 2022

The American Surgeon

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Background Food insecurity (FI) has been defined as a lack of consistent access to enough food for a healthy active lifestyle. As of 12.7% of the United States are suffering from FI, which has been correlated with increased hospital costs and poorer health outcomes. Currently, limited data exists examining the relationship between trauma populations and FI despite both having similar root causes. We sought to determine this and validate a screening tool for FI in this population. Methods A cross-sectional survey study of trauma patients was conducted at a level 1 trauma center in Atlanta, Georgia. Survey questions included the first two items of the Core Food Security Module. Zip codes were used to determine FI, defined by the USDA Food Access Research and compared to individual participant survey responses. Binary classification test metrics were calculated to validate the two items as a screening tool in this population. Results The cohort included 136 patients, of which the majority were black (60.3%) and male (60.3%). Thirty-one respondents affirmed food security (22.8%) despite over half (51.5%) living in a food insecure community. The sensitivity and specificity for this screening to predict FI were 25 and 80%, respectively. Conclusion Although the specificity is high, this screening tool has a low sensitivity, accuracy, NPV, and PPV to determine food insecurity in this population. Community-level statistics suggests that food insecurity is a significant public problem amongst trauma patients. Prevention efforts should, therefore, aim to address both issues simultaneously.

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