Relationships between socioeconomic deprivation and pediatric firearm-related injury at the neighborhood level. Issue 3 (12th September 2022)

• Record Type: Journal Article
• Authors: Trinidad, Stephen; Vancil, Andrew; Brokamp, Cole; Moody, Suzanne; Gardner, Dawne; Parsons, Allison A.; Riley, Carley; Sahay, Rashmi; Sofer, Nicole; Beck, Andrew F.; Falcone, Richard A.; Kotagal, Meera
• Is Part Of: Journal of trauma and acute care surgery. Volume 93:Issue 3(2022)
• Page Start: 283
• Page End: 290
• Publication Date: 2022-09-12
• Subjects: Pediatric -- firearm -- injury -- neighborhood -- social determinants of health; Surgical intensive care -- Periodicals; Surgical emergencies -- Periodicals; Wounds and injuries -- Surgery -- Periodicals; 617.026
• DOI: 10.1097/TA.0000000000003679
• Languages: English
• ISSNs: 2163-0755

Abstract

Abstract : Significant inequities exist in the rates of pediatric firearm-related injuries. This study shows that a child's neighborhood context profoundly impacts their risk of firearm injury, with black children and children from disadvantaged neighborhoods bearing the greatest burden. Abstract : BACKGROUND: Disparities in pediatric injury are widely documented and partly driven by differential exposures to social determinants of health (SDH). Here, we examine associations between neighborhood-level SDH and pediatric firearm-related injury admissions as a step to defining specific targets for interventions to prevent injury. METHODS: We conducted a retrospective review of patients 16 years or younger admitted to our Level I pediatric trauma center (2010–2019) after a firearm-related injury. We extracted patients' demographic characteristics and intent of injury. We geocoded home addresses to enable quantification of injury-related admissions at the neighborhood (census tract) level. Our population-level exposure variable was a socioeconomic deprivation index for each census tract. RESULTS: Of 15, 686 injury-related admissions, 140 were for firearm-related injuries (median age, 14 years; interquartile range, 11–15 years). Patients with firearm-related injuries were 75% male and 64% Black; 66% had public insurance. Nearly half (47%) of firearm-related injuries were a result of assault, 32% were unintentional, and 6% were self-inflicted; 9% died. At the neighborhood level, the distribution of firearm-related injuries significantly differed by deprivation quintile ( p < 0.05). Children from the highest deprivation quintile experienced 25% of injuries of all types, 57% of firearm-related injuries, and 70% of all firearm-related injuries from assault. They had an overall risk of firearm-related injury 30 times that of children from the lowest deprivation quintile. CONCLUSION: Increased neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization, at rates far higher than injury-related admissions overall. Addressing neighborhood-level SDH may help prevent pediatric firearm-related injury. LEVEL OF EVIDENCE: Prognostic and epidemiological, Level III. Abstract :