Your neighborhood matters: an ecological social determinant study of the relationship between residential racial segregation and the risk of firearm fatalities

Shour, Abdul R.; Anguzu, Ronald; Zhou, Yuhong; Muehlbauer, Alice; Joseph, Adedayo; Oladebo, Tinuola; Puthoff, David; Onitilo, Adedayo A.

doi:10.1186/s40621-023-00425-w

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…Poor neighborhoods may lack resources, educational opportunities, and social support systems, which can exacerbate cycles of violence and increase the likelihood of firearm injuries. 14…”

Section: Discussionmentioning

confidence: 99%

“…Poor neighborhoods may lack resources, educational opportunities, and social support systems, which can exacerbate cycles of violence and increase the likelihood of firearm injuries. 14 Uninsured status is another risk factor for firearm injuries, with an odds ratio (OR) of 1.57 (95% CI 1.81-2.00). This finding suggests a potential link between socioeconomic status and the likelihood of firearm injuries.…”

Section: Other Significant Risk Factors For Firearms Injuriesmentioning

confidence: 99%

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The Distressed Communities Index: A Measure of Community-Level Economic Deprivation and Rate of Firearm Injuries in Maryland

Akinyemi

Weldeslase

Hughes

et al. 2023

The American Surgeon™

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Background This study aimed to investigate the relationship between community-level economic deprivation, as measured by the Distressed Communities Index (DCI) and ED visits on account of firearm injuries (assaults and unintentional). Methods A retrospective analysis was conducted using the Maryland State Emergency Department Databases (SEDD) from January 2019 to December 2020 to explore the association between the DCI and ED visits because of firearm injuries (assaults and unintentional). The DCI utilizes 7 variables, based on zip codes, generating 5 levels of socioeconomic distress (prosperous, comfortable, mid-tier, at-risk, and distressed). In a multivariate analysis, we adjusted for age, sex, mental conditions, alcohol addiction, substance abuse, smoking, race/ethnicity, insurance type, and median income. Results Of the 2725 ED visits for firearm injuries, 84.5% were Black and 88.5% male. The median age was 27 (21-35) years, and the mortality rate was 17.7%. A statistically significant association was found between economic deprivation and ED visits for firearm injuries. Compared to prosperous communities, the odds ratios (ORs) were comfortable (OR = 1.33, 95% CI 1.04-1.71, P = .03), mid-tier (OR = 1.69, 95% CI 1.33-2.15, P < .001), at-risk (OR = 1.53, 95% CI 1.17-1.99, P < .001), and distressed (OR = 2.65, 95% CI 2.11-3.33, P < .001). Discussion The study highlights the significant association between community-level economic deprivation, as measured by the Distressed Communities Index, and the incidence of firearm injuries in Maryland. The findings underscore the importance of addressing socioeconomic disparities and implementing targeted interventions to reduce firearm-related injuries in economically distressed communities.

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“…Poor neighborhoods may lack resources, educational opportunities, and social support systems, which can exacerbate cycles of violence and increase the likelihood of firearm injuries. 14…”

Section: Discussionmentioning

confidence: 99%

Section: Other Significant Risk Factors For Firearms Injuriesmentioning

confidence: 99%

The Distressed Communities Index: A Measure of Community-Level Economic Deprivation and Rate of Firearm Injuries in Maryland

Akinyemi

Weldeslase

Hughes

et al. 2023

The American Surgeon™

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Association of pediatric firearm injury with neighborhood social deprivation in Philadelphia

Kauffman,

Nance,

Cannon

et al. 2024

Trauma Surg Acute Care Open

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BackgroundFirearm-related injury is the leading cause of death among children and adolescents. There is a need to clarify the association of neighborhood environment with gun violence affecting children. We evaluated the relative contribution of specific social determinants to observed rates of firearm-related injury in children of different ages.MethodsThis was a population-based study of firearm injury in children (age <18 years) that occurred in Philadelphia census tracts (2015–2021). The exposure was neighborhood Social Deprivation Index (SDI) quintile. The outcome was the rate of pediatric firearm injury due to interpersonal violence stratified by age, sex, race, and year. Hierarchical negative binomial regression measured the risk-adjusted association between SDI quintile and pediatric firearm injury rate. The relative contribution of specific components of the SDI to neighborhood risk of pediatric firearm injury was estimated. Effect modification and the role of specific social determinants were evaluated in younger (<15 years old) versus older children.Results927 children were injured due to gun violence during the study period. Firearm-injured children were predominantly male (87%), of black race (89%), with a median age of 16 (IQR 15–17). Nearly one-half of all pediatric shootings (47%) occurred in the quintile of highest SDI (Q5). Younger children represented a larger proportion of children shot in neighborhoods within the highest (Q5), compared with the lowest (Q1), SDI quintile (25% vs 5%; p<0.007). After risk adjustment, pediatric firearm-related injury was strongly associated with increasing SDI (Q5 vs Q1; aRR 14; 95% CI 6 to 32). Specific measures of social deprivation (poverty, incomplete schooling, single-parent homes, and rented housing) were associated with significantly greater increases in firearm injury risk for younger, compared with older, children. Component measures of the SDI explained 58% of observed differences between neighborhoods.ConclusionsNeighborhood measures of social deprivation are strongly associated with firearm-related injury in children. Younger children appear to be disproportionately affected by specific adverse social determinants compared with older children. Root cause evaluation is required to clarify the interaction with other factors such as the availability of firearms and interpersonal conflict that place children at risk in neighborhoods where gun violence is common.Level of evidenceLevel III - Observational Study

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A Scoping Review and Assessment of the Area-Level Composite Measures That Estimate Social Determinants of Health Across the United States

Hassett,

Stuhlsatz,

Snyder

2024

Public Health Rep

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Objectives: Evidence-informed population health initiatives often leverage data from various sources, such as epidemiologic surveillance data and administrative datasets. Recent interest has arisen in using area-level composite measures describing a community’s social risks to inform the development and implementation of health policies, including payment reform initiatives. Our objective was to capture the breadth of available area-level composite measures that describe social determinants of health (SDH) and have potential for application in population health and policy work. Methods: We conducted a scoping review of the scientific literature from 2010 to 2022 to identify multifactorial indices and rankings reflected in peer-reviewed literature that estimate SDH and that have publicly accessible data sources. We discovered several additional composite measures incidental to the scoping review process. Literature searches for each composite measure aimed to contextualize common applications in public health investigations. Results: From 491 studies, we identified 31 composite measures and categorized them into 8 domains: environmental conditions and pollution, opportunity and infrastructure, deprivation and well-being, COVID-19, rurality, food insecurity, emergency response and community resilience, and health. Composite measures are applied most often as an independent variable associated with disparities, risk factors, and/or outcomes affecting individuals, populations, communities, and health systems. Conclusions: Area-level composite measures describing SDH have been applied to wide-ranging population health work. Social risk indicators may enable policy makers, evaluators, and researchers to better assess community risks and needs, thereby facilitating the evidence-informed development, implementation, and study of initiatives that aim to improve population health.

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Your neighborhood matters: an ecological social determinant study of the relationship between residential racial segregation and the risk of firearm fatalities

Cited by 4 publications

References 34 publications

The Distressed Communities Index: A Measure of Community-Level Economic Deprivation and Rate of Firearm Injuries in Maryland

The Distressed Communities Index: A Measure of Community-Level Economic Deprivation and Rate of Firearm Injuries in Maryland

Association of pediatric firearm injury with neighborhood social deprivation in Philadelphia

A Scoping Review and Assessment of the Area-Level Composite Measures That Estimate Social Determinants of Health Across the United States

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