Abstract
BackgroundWe evaluated correlates of gunshot wound (GSW) injuries in Miami-Dade County, Florida. Firearm-related injury has previously been linked to socio- and geo-demographic indicators such as occupation, income, neighborhood and race in other metropolitan areas, but remains understudied in Miami.MethodsWe reviewed 4,547 cases from a Level I trauma center’s patient registry involving an intentional firearm-related injury occurring from 2002 to 2012. During this eleven-year study period, this trauma center was the only one in Miami-Dade County, and thus representative of countywide injuries.ResultsThe crude morbidity rate of GSW injury over the 11-year period was 15 per 100,000 persons with a crude mortality rate of 0.27 per 100,000 persons. The case fatality rate of injured patients was 15.4%. Both morbidity and mortality increased modestly over the 11-year study period. The total number of GSW patients rose annually during the study period and patients were disproportionately young, black males, though we observed higher severity of injury in white populations. Geo-demographic analysis revealed that both GSW incident locations and patient home addresses are spatially clustered in predominantly poor, black neighborhoods near downtown Miami, and that these patterns persisted throughout the study period. Using spatial regression, we observed that census tract-level GSW incidence rates (coded by home address) were associated with a census tract’s proportion of black residents (P < .001), single-parent households (P < .001), and median age (P < .001) (R2 = .42).ConclusionsThese findings represent the first representative geo-demographic analysis of GSW injuries in Miami-Dade County, and offer evidence to support urgent, targeted community engagement and prevention strategies to reduce local firearm violence.
Highlights
We evaluated correlates of gunshot wound (GSW) injuries in Miami-Dade County, Florida
In 2011, 478,400 fatal and nonfatal firearm violence incidents were reported within the United States, where firearm violence accounts for over 11,000 deaths annually [1, 2]
This is important for identifying so-called violence “hot spots” that can be targeted for injury and violence prevention in different cities across the United States
Summary
Data We reviewed the trauma registry at Jackson Memorial Hospital’s Ryder Trauma Center in Miami, FL, for all patients treated for a GSW from January 1, 2002 to December 31st, 2012 using International Classification of Disease coding (ICD-9) This medical center was the only Level I Trauma Center within MDC during the study period, and 5,412 patients sustained a firearmrelated injury. Data collected during treatment included date, age, sex, race, home address, incident address, occupation, admitting diagnosis, intensive care unit (ICU) length of stay, injury location, and mortality. Black patients include those of African-American and African-Caribbean descent. The Institutional Review Board at the University of Miami approved this study
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