Gun Violence Research Articles

Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK

ObjectiveRecent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors. MethodsStaff approached age 18–24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021–5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats). ResultsAcross sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %–16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault. ConclusionsViolence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.

Addressing global gun violence: a Lancet Commission on Global Gun Violence and Health

Addressing global gun violence: a Lancet Commission on Global Gun Violence and Health

Socioeconomic disparities based on shooting intent in pediatric firearm injury.

Pediatric firearm injury is often associated with socioeconomically disadvantaged neighborhoods. Most studies only include fatal injuries and do not differentiate by shooting intent. We hypothesized that differences in neighborhood socioeconomic disadvantage would be observed among shooting intents of fatal and nonfatal cases. A linked integrated database of pediatric fatal and nonfatal firearm injuries was developed from trauma center and medical examiner records in Harris County, Texas (2018-2020). Geospatial analysis was utilized to map victim residence locations, stratified by shooting intent. Area Deprivation Index (ADI), a composite measure of neighborhood socioeconomic disadvantage at the census tract level was linked to shooting intent. Differences in high ADI (more deprived) versus low ADI among the shooting intents were assessed. Unadjusted and adjusted regression models assessed differences in ADI scores across shooting intent, adjusted models controlled for age, gender, and race/ethnicity. Of 324 pediatric firearm injuries, 28% were fatal; 77% were classified as interpersonal violence, 15% unintentional, and 8% self-harm. Differences were noted among shooting intent across the ADI quartiles; with increases in ADI score, the odds of interpersonal violence injuries compared with self-harm injuries significantly increased by 5%; however, when adjusting for individual-level variables of age, gender, and race and ethnicity, no significant differences in ADI were noted. Our results suggest that children living in disadvantaged neighborhoods are more likely to be affected by interpersonal firearm violence compared with self-harm; however, when differences in race/ethnicity are considered, the differences attributable to neighborhood-level disadvantage disappeared. Resources should be dedicated to improving structural aspects of neighborhood disadvantage, which disproportionately impact racial/ethnic minoritized populations. Furthermore, firearm self-harm injuries occurred among children living in the less disadvantaged neighborhoods. Understanding the associations among individual and neighborhood-level factors are important for developing streamlined injury prevention interventions by shooting intent. Prognostic and Epidemiological; Level IV.

Federal Firearm Licensee Rates and Suicide in Maryland, 2014 to 2019.

Federal firearm licensee density is associated with interpersonal firearm violence. Yet the role of Federal firearm licensees in firearm suicide remains understudied, even though firearms are the method used in more than half of suicides. This study tested associations between the spatial distribution of federal firearm licensees and firearm suicides in Maryland. Kernel density estimation measured federal firearm licensee and suicide rates at the census tract level (n=1,397), and SaTScan detected clusters of licensees and suicides. Choropleth maps compared visual associations between federal firearm licensee, firearm, and non-firearm suicide rates and clusters. Generalized estimating equations tested associations between Federal firearm licensee rates and clusters and the odds of using a firearm as the lethal means overall and after stratifying by biological sex. Data were obtained in 2020 and analyzed in 2020-2024. The federal firearm licensee rate was associated with greater odds of firearm suicide overall (aOR=1.29, 95% CI=1.21, 1.38, p<0.001), for men (aOR=1.29, 95% CI=1.20, 1.39, p<0.001), and for women (aOR=1.26, 95% CI=1.07, 1.49, p=0.007). Suicide decedents in a census tract located in a federal firearm licensee cluster (vs not) had higher odds of firearm use overall (aOR=1.70, 95% CI=1.28, 2.27, p<0.001) and for men (aOR=1.67, 95% CI=1.22, 2.27, p=0.001), but not for women (aOR=1.65, 95% CI=0.81, 3.34, p=0.168). The federal firearm licensee rate and clusters were associated with firearm suicides and unrelated to the spatial distribution of non-firearm suicides. Prevention approaches that limit the number of these federal firearm licensees or alter their sales practices, such as federal firearm licensee zoning and land use provisions, advertising restrictions, or gun shop projects, may prevent firearm suicides.

Assessing the national and subnational firearm violence trends in Mexico from 1990 to 2019: secondary data analysis from the Global Burden of Disease study

BackgroundMexico is among the countries with the highest mortality rates by firearms worldwide. We aimed to analyse the trend in the burden of firearm violence (FV) by age and sex...

Respect and anxiety: Guns as ambiguous symbols for criminally involved youth in Sweden

Youth gun violence has surged in Sweden recently. Quantitative studies have described the prevalence and geographical locations of gun violence, but little research has examined how perpetrators and victims themselves experience and make sense of guns. This article draws on ethnographic interviews with young men who have firsthand experience of gun violence in a criminal context. Drawing on narrative analysis, it shows that guns are given multifaceted significance by the research participants and featured both implicitly and explicitly in their stories of their everyday lives. Guns were portrayed ambiguously, as a drastic means of self-protection that could also be used to remedy strained relations. Moreover, guns were presented as a means to build a reputation and gain respect. Gun violence was also charged with a range of emotions, notably hate, fear, and numbness. Even though young men considered that obtaining and using a gun could be justified, they also lamented the shootings, especially those committed by younger, putatively naive individuals.

Cross-State Relationship of Firearm Violence Between Police and Civilians: Gun Ownership as a Common Denominator.

Cross-State Relationship of Firearm Violence Between Police and Civilians: Gun Ownership as a Common Denominator.

Outcomes and implications of pediatric spinal gun shot wounds: A cross-sectional analysis using 2017-2021 TQIP data

BackgroundPediatric morbidity and mortality due to gun violence has steadily risen in recent years, becoming the leading cause of death among children and teens as of 2022 per the Center for Disease Control (CDC). For patients under the age of 17 in the United States, gunshot wounds (GSWs) are the underlying cause of traumatic spinal cord injury (tSCI) in 8.3% of patients. Although prior studies have examined the broader trends of firearm-related deaths in children, investigation specifically focusing on gunshot wounds to the spine has not addressed the pediatric population. MethodsThe TQIP database from 2017 to 2021 was queried for patients under the age of 18 with gunshot traumas, and ICD-10 diagnosis codes were used to identify associated spinal injuries. The incidence across time and risk factors for adverse hospital outcomes were analyzed using multivariate logistic regression. Factors of interest included demographic characteristics, insurance provider, and comorbidities. ResultsA total of 3,155 gunshot injuries to the spine (GSIS) in the pediatric population were reported to TQIP between 2017 and 2021. Average patient age was 16 ± 2.8 years old and the majority of patients (n=1819, 57.6%) were uninsured. Assault was the intent of firearm discharge in 2,582 (81.8%) patients and unintentional injury occurred in 322 (10.2%) cases. Mortality occurred in 11.7% of GSIS, twice that of the 5.8% seen in all pediatric GSW. Those with psychiatric disorders were more likely to result in extended LOS (OR, 2.538; 95% CI, 1.638-3.932; P < 0.001) and in-hospital complications (OR, 1.841; 95% CI, 1.139-2.891; P = 0.012) when analyzed with multivariate binomial logistic regression. ConclusionIn this large-scale retrospective study using TQIP data, we identified trends in spine injuries sustained from gun trauma in the pediatric population. Consideration of demographics, hospital course, and outcomes as examined in this study can provide valuable insights to clinicians, public health organizations, and policy makers.

Firearm injury hospitalizations and handgun purchaser licensing laws: longitudinal evaluation of state-level purchaser licensure requirements on firearm violence, 2000–2016

BackgroundHandgun purchaser licensing (HPL) laws mandate individuals to obtain a license from law enforcement before buying a firearm. Research indicates these laws effectively reduce various forms of fatal firearm violence, including homicides, suicides, and mass shootings. Our study sought to assess the impact of HPL laws on non-fatal firearm violence.MethodsUtilizing the augmented synthetic control method (ASCM), we estimated the average treatment effect on the treated (ATT) resulting from a full repeal of an HPL law in Missouri (2007), a partial repeal in Michigan (2012), and an adoption on HPL law in Maryland (2013) on firearm injury hospitalizations. We utilized RAND's healthcare cost and utilization project-based dataset from 2000 to 2016 for our outcome variable. We conducted in-time placebo testing and leave-one-out donor pool testing as sensitivity analyses.ResultsMaryland’s adoption was associated with a statistically significant 32.3% reduction in firearm-related injury hospitalization (FIH) rates (ATT = − 0.497, standard error (SE) = 0.123); Missouri’s repeal was associated with a statistically significant 35.7% increase in FIH rates (ASCM = 0.456, SE = 0.155); and Michigan’s partial repeal showed no statistically significant associations with FIH rates (ATT = − 0.074, SE = 0.129). Sensitivity analyses confirm the robustness of the estimated HPL effects.DiscussionHPL laws appear to be protective against hospitalizations for nonfatal firearm injuries. These findings align with prior research indicating that HPL laws are effective in reducing fatal firearm violence. States without such licensing systems ought to consider these robust policies as a means to address firearm violence.

State assault weapons bans are associated with fewer fatalities: analysis of US county mass shooting incidents (2014–2022)

BackgroundThe need for evidence to inform interventions to prevent mass shootings (MS) in the USA has never been greater.MethodsData were abstracted from the Gun Violence Archive, an independent online database...

Firearm Violence and Off-Premises Alcohol Outlets: The Role of Outlet Characteristics and Distance

Firearm Violence and Off-Premises Alcohol Outlets: The Role of Outlet Characteristics and Distance

Psychopathy, gun carrying, and firearm violence.

Psychopathy, gun carrying, and firearm violence.

Integrating firearm storage and safety devices into health care.

Millions of US children and adolescents live in homes with loaded firearms, with only half of these homes securing their guns. Firearm-related deaths among youth have doubled over the past decade, making firearms the leading cause of death for children and adolescents in the United States. The recent advisory by the US Surgeon General, identifying firearm violence as a public health crisis, underscores the urgent need for responsible firearm ownership, including safe firearm storage. However, the healthcare community currently lacks durable medical equipment (DME) codes for firearm storage devices, limiting the ability of healthcare providers to support responsible gun ownership. We propose the establishment of DME codes for firearm storage and safety devices, which would facilitate insurance coverage of these vital prevention measures. Durable medical equipment codes would empower physicians and other healthcare providers to integrate anticipatory guidance and lethal means counseling of firearm safety into routine care and support hospital- and community-based efforts to prevent firearm-related injuries and deaths among children and adolescents.

Racial capitalism and firearm violence: Developing a theoretical framework for firearm violence research examining structural racism

Despite the early promise of centering structural racism in explanatory models of firearm violence, there are noticeable gaps in what's been produced thus far; in particular, a deeper and more serious engagement with long-standing theories of racism is needed to further enrich our understanding of how structural inequalities produce unequal burdens of firearm-related harms. Thus, building on theories and concepts from a range of academic fields and Black philosophical perspectives, we developed a theoretical framework to help explain the role of place-based structural racism on firearm violence disparities. A central component of our framework is the concept racial capitalism, which contends that racial exploitation and the accumulation of assets depend on and reinforce one another. In this article, we present our framework and highlight how two processes related to racial capitalism—racialized dispossession and racialized spatial stigma—are connected with geographic disparities in firearm violence. We also present the results of an ecological cross-sectional study that reveals a potential key association between racial capitalism and firearm violence disparities on the neighborhood-level. We used a structural intersectionality approach and descriptive epidemiological methods to highlight and quantitatively describe spatial firearm violence disparities that could potentially be linked to the varying exposure of two dimensions of racial capitalism—historical redlining and contemporary racialized subprime mortgage lending. We found that sustained disadvantaged census tracts (tracts that were historically redlined and experienced higher contemporary subprime lending) experienced the highest burden of firearm violence in Baltimore City between 2015 and 2019. Our research suggests that racial capitalism could potentially be a root cause of firearm violence disparities. A theoretical framework based on racial capitalism can inform the development and usage of indicators and analytic methods for racism-related firearm violence research. Moreover, this framework can identify factors to prioritize in equity-based violence prevention policies and programs.

Deer Hunting Season and Firearm Violence in US Rural Counties

Firearm violence is a major public health problem in the US. However, relatively little research has focused particular attention on firearm violence in rural areas, and few studies have used research designs that draw on exogenous variation in the prevalence of firearms to estimate the association between firearm presence and shootings. To investigate the association between the start of deer hunting season and shootings in rural counties in the US. In this cohort study, data from all rural US counties in states with available data on the timing of deer hunting season were matched with data on shootings from the Gun Violence Archive from January 1, 2014, to December 31, 2021. Shootings in the first 3 weeks of deer hunting season were compared with the week prior to the start of deer hunting season. The main outcome was daily total shootings. The association between the start of deer hunting season and shootings was estimated using Poisson regression models to analyze change within counties while controlling for relevant calendar year, month of year, and seasonal effects. The sample included 854 rural counties with a mean (SD) population of 16 416 (18 329) per county and 5.4 (13.3) annual shootings per 100 000 people. The county fixed-effects specification analyzing the association between deer hunting season and shootings showed that relative to the week prior to deer hunting season, the incidence rate ratio for total shootings was 1.49 (95% CI, 1.13-1.95) for the first week of deer hunting season and 1.41 (95% CI, 1.02-1.94) for the second week of deer hunting season. Estimates remained consistent when excluding hunting accidents and were most pronounced in states with more hunting licenses per capita. In this cohort study of the association between the start of deer hunting season and firearm violence, results showed that the start of deer hunting season was associated with a substantial increase in shootings. The findings highlight the role of firearm prevalence in gun violence and suggest the need for focused policies designed to reduce firearm violence in areas with substantial hunting activity during the first weeks of deer hunting season.

Risky Weapon Carrying Behaviors, Youth Violence, and Substance Use Among Young Black Males in Chicago: A Cross-sectional Analysis.

. The study evaluates the prevalence of risky weapon-carrying behaviors (WCB) among YBM in Chicago and examines their associations with various forms of direct and vicarious violence-youth violence, community violence, and partner abuse-as well as substance use and substance-related aggression. . We performed Pearson Chi-square tests and multivariable negative binomial regression analysis on cross-sectional data from 266 violence-involved young Black males (YBM) in Chicago. This data was collected using a modified version of the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. Our dependent variable, weapon-carrying behavior, was measured by the frequency of weapon carrying, including items such as guns, knives, and clubs, over the past year. . In a sample of 266 YBM (ages 15-24, 99% African American), the mean age was 18.32 ±3.10 years, and 42.7% had some high school education. The 30-day weapon-carrying incidence was 17.3%, with 19.1% threatening someone with a weapon ≥ 2-3 times in the past year. About one-third engaged in partner violence (30.4%), primarily psychological (36.7%) and physical (28.3%) abuse. Approximately 64.8% experienced some form of violence or aggression in the past year, and 76.4% witnessed community violence. Over 20.8% reported binge drinking, and 43.6% engaged in illicit drug use, with 37.2% participating in or initiating violent acts following alcohol or drug consumption. Negative binomial regression results revealed that exposure to direct and vicarious violence, along with substance use, significantly increased the likelihood of carrying weapons. Specific risk factors such as recent threats or injuries, witnessing violence, involvement in physical altercations, and substance-related aggression significantly predict WCB. Age and relationship dynamics also critically influence these behaviors. Additionally, for each year of age, the risk for WCB increased by 22%. This study identified significant associations between different types of violence, substance use, and risky WCB among YBM in Chicago. The results underscore the need for comprehensive, culturally sensitive, multifaceted interventions addressing both individual and psychosocial factors behind risky WCB. These interventions are crucial for reducing gun violence and improving urban community safety, offering vital data to inform policies and interventions for youth protection in similar environments.

Faculty Behaviors and Beliefs About Teaching Gun Violence Prevention in Undergraduate Nursing Programs.

Gun violence is a public health crisis, but nurses report receiving little education related to gun violence prevention (GVP). This study aimed to describe undergraduate nursing faculty teaching behaviors and perceptions related to GVP and explore factors associated with teaching it. A cross-sectional survey design was used. Less than one-third of faculty taught GVP. Knowledge, confidence, and beliefs were significantly associated with teaching GVP. Most were favorable to include GVP in curricula and agreed assessing for gun access, counseling about safe gun storage, and counseling about lethal means restriction should be taught. Key barriers included content saturation, political atmosphere, lack of educational materials, and lack of topic expertise. Faculty agree that GVP should be taught, but most do not teach it in undergraduate nursing programs. Faculty development programs focused on GVP and support from national nursing organizations may decrease barriers in incorporating GVP into curricula.

Legislative Advocacy in Illinois for Firearm Injury Prevention.

The leading cause of death in children in the United States is injury caused by firearm violence. States that enact stricter laws related to firearm injury prevention have lower rates of mortality in children. In Illinois, we formed a coalition with medical professionals, medical organizations, community partners, and legislators to craft legislation to reduce the burden of firearm violence on children. These laws can be politically charged. Therefore, we decided to focus on a safe storage education law. We met regularly as a group to draft the bill and an information sheet to support it. Pediatricians and pediatric providers worked with the government relations teams in children’s hospitals throughout the state to garner supporting organizations. We also worked to garner cosponsors, provided written and oral testimony to the legislative body, and wrote op-eds to support the bill. Shortly after the bill was passed and signed into law in June of 2022, there was a mass shooting at Highland Park in Illinois. After the shooting, there was a mandate from the Illinois governor to work on passing an assault weapons ban. Pediatricians again provided input into the bill about how the weapons affect children, testified before the House Judiciary Committee, and wrote op-eds. Governor Pritzker signed the Protect Illinois Communities Act into law in January of 2023. Pediatricians actively worked in the passage of both bills, which highlights the importance of medical professionals as experts who can combine powerful stories and evidence based medicine to influence policy.

Demographic differences in perceived effectiveness for policies to prevent school shootings: results from a representative survey in New Jersey

ObjectiveTo determine what firearm policies New Jersey residents believe will prevent school shootings and the extent to which this varies by sex, firearm ownership status, and political affiliation.MethodsA representative sample of New Jersey residents (N = 1,018) was collected via the Eagleton Center on Public Interest Polling (ECPIP). Data were weighted to reflect the state's population. Participants were asked to rate how helpful they perceived different firearm-related policies to be for preventing school shootings.ResultsFindings indicate that participants perceived universal and expanded background checks, increased mental health funding, and requiring a license for firearm purchases as most effective for preventing school shootings. Arming school personnel, prayer in schools, decreasing the number of entrances at schools, and secure storage requirements were viewed as less effective. Firearm ownership, sex, and political affiliation significantly influenced perceptions of the effectiveness of these policies.ConclusionThe study examined the perceived effectiveness of policies to prevent school shootings. The study highlights disparities and commonalities in policy support among different groups, emphasizing the importance of collective efforts to address gun violence in schools.

Characterizing Pediatric Patients at Risk for Violence-Related Injuries at a Trauma Center in the Midwest United States

Introduction Hospital-based violence intervention programs (HVIPs) have emerged nationwide to help address the societal and economic costs of violence. Little literature exists regarding selecting those patients most likely to benefit from intensive case management. The study aims to describe the pediatric patient population presenting at a Level 1 ACS trauma center with a chief complaint of violent trauma and identify the characteristics of patients most at risk. Methods This retrospective study examined patients between the ages of eight- and nineteen-years old presenting with traumatic injury during the year 2019. Child abuse and non-accidental trauma patients were excluded. Results A total of 333 patients were included in the analysis. They were predominantly African American and male. The three-group design included those 8–11, 12–13, and 14–19 years. Most patients were over 14 years old (60.2%). “Classmates” was the most common relationship between assailant and victim overall (33.9%) and most prevalent in the youngest age group (8–11 year). The middle age group (12–13 year) were two times more likely to suffer from ADHD, and ADHD was a risk factor for self-harm in this age category. The oldest age group (14–19 year) suffered higher rates of gun violence and were attacked more often by unknown assailants. Conclusions There was a difference in the needs of the older and younger pediatric patients cared for. HVIPs should tailor their interventions to address the different age groups’ needs. HVIPs could also benefit from the integration of targeted mental health services and collaboration with local educational institutions.