Rural Versus Urban Hospitalizations for Firearm Injuries in Children and Adolescents

Abstract

Hospitalizations for firearm assaults among urban 15- to 19-year-olds represent the highest injury rate. Notably, hospitalizations are lower for urban versus rural 5- to 9-year-olds and 10- to 14-year-olds, and unintentional firearm injuries are most common among these groups. Preventative public health approaches should address these differences in injury epidemiology.

A Multicenter Evaluation of a Firearm Safety Intervention in the Pediatric Outpatient Setting

“…There were study sites at trauma centers in Oklahoma and Kansas, but they did not receive study approval from their IRB until after enrollment for the pilot had been completed. Having adequate geographic sampling is important because the firearm injury epidemiology differs between rural and urban communities in the United States, and these differences and how they influence preventive public health approaches need to be evaluated [16].…”

The Impact of State Firearm Laws on Homicide Rates in Suburban and Rural Areas Compared to Large Cities in the United States, 1991‐2016

“…both the rates and trends in firearm homicide differ between urban and nonurban counties, [5][6][7][8][9] yet no study has specifically tested the effect of state firearm laws in urban compared to nonurban spaces. This article aims to examine whether state firearm laws impact homicide rates differently in large cities versus smaller localities in the United States.…”

“…Most of the public health literature on homicide classifies urbanicity at the county level using coding schemes developed by CDC or US Department of Agriculture (USDA) ( Table A1; available online only). [5][6][7][8][9][10][11][12] Isserman highlights a problem (which he terms the "county trap") of classifying urbanicity based on counties because these designations capture integration rather than separation. 24 Research that uses CDC or USDA distinctions are classifying many counties as urban because they are tied to metropolitan areas even if the qualities of the areas making up the county being classified are decidedly nonurban on their own.…”

“…In response to the problem of firearm violence, many states have passed laws regulating the sale, purchase, and possession of firearms . Several studies have demonstrated that both the rates and trends in firearm homicide differ between urban and nonurban counties, yet no study has specifically tested the effect of state firearm laws in urban compared to nonurban spaces. This article aims to examine whether state firearm laws impact homicide rates differently in large cities versus smaller localities in the United States.…”

“…An important contribution of the present study is the use of cities, rather than counties, as the basis for disaggregation of homicide rates. Most of the public health literature on homicide classifies urbanicity at the county level using coding schemes developed by CDC or US Department of Agriculture (USDA) (; available online only) . Isserman highlights a problem (which he terms the “county trap”) of classifying urbanicity based on counties because these designations capture integration rather than separation .…”