Race and ethnicity, neighborhood poverty and pediatric firearm hospitalizations in the United States

Abstract

PurposeTo better understand the effects of race and/or ethnicity and neighborhood poverty on pediatric firearm injuries in the United States, we compared overall and intent-specific firearm hospitalizations (FH) with those of pedestrian motor vehicle crash hospitalizations (PMVH). MethodsWe used Nationwide Inpatient Sample data (1998–2011) among 0–15 year-olds in a 1:1 case-case study; 4725 FH and 4725 PMVH matched by age, year, and region. ResultsRisk of FH versus PMVH was 64% higher among black children, Odds ratio (OR) = 1.64, 95% confidence interval (95% CI) = 1.44–1.87, as compared to white children (P < .0001); this risk did not vary by neighborhood poverty (P interaction = .52). Risk of homicide FH versus PMVH was 842% higher among black (OR = 8.42, 95% CI = 6.27–11.3), 452% higher among Hispanics (OR = 4.52, 95% CI = 3.33–6.13) and 233% higher among other race (OR = 2.33, 95% CI = 1.52–3.59) compared to white children. There was a lower risk for unintentional FH among black OR = 0.73, 95% CI = 0.62–0.87, Hispanics (OR = 0.60, 95% CI = 0.49–0.74), and other (OR = 0.63, 95% CI = 0.47–0.83) compared to whites. These intent-specific risks attributed to race did not vary by neighborhood affluence. ConclusionsBlack children were at greater likelihood of FH compared to white children regardless of neighborhood economic status. Minority children had an increased likelihood of intentional FH and a decreased likelihood of unintentional FH as compared to white children irrespective of neighborhood income.