Strong laws aren't enough: Historic redlining, state firearm laws, and urban firearm violence in the United States.

Concentrated Affluence and Deprivation and Spatial Distribution of Firearm Violence: Racial/Ethnic Disparities Across Urban Neighborhoods in the U.S.

Behavioral Responses to the Threat of Firearm Violence Among Colorado Adults.

Psychiatrists Are Uniquely Poised to Address Gun Violence

Frequency and Predictors of Adolescent Worry for School Gun Violence in the United States: Findings From a Nationally Representative Study.

Violent injuries contribute to significant death and disability in the United States every year. The number of hospitals who identify violence prevention as a priority is unknown. We sought to determine if hospitals in counties with high rates of firearm-related mortality identified violence prevention as a priority in their Community Health Needs Assessments (CHNAs) and if trauma center designation influenced this prioritization. This was a cross-sectional review of all publicly available CHNAs for hospitals within 27 Illinois counties from 2021 to 2023. Firearm to all-mechanism mortality ratios from 2017 to 2021 were identified using age-adjusted 5-year mortality rates obtained from the CDC's WISQARS' Health Equity Data for Illinois and stratified into quartiles. Descriptive statistics were used to compare the prioritization of violence prevention by firearm to all-mechanism mortality ratios (highest vs. lowest quartile) and trauma designation. Of 93 hospitals in 27 counties, 52 (55.9%) identified violence as a community issue. Hospitals in counties with the highest firearm to all-mechanism mortality ratios were more likely to identify violence as a priority than the lowest quartile counties (62.7% vs. 38.5%, p = 0.03). Trauma centers were not more likely than nontrauma centers to prioritize violence in both high ( p = 0.29) and low ( p = 0.77) firearm mortality counties. Among hospitals identifying violence as a community health issue in their CHNA, only 25 (48.1%) outlined a plan to address it. While hospitals within counties in the highest quartile of firearm mortality were more likely to identify violence as a community issue, few outlined a plan to address it. In addition, trauma centers were not more likely to identify violence as a community issue. Enhanced support for evidence-based programs, such as hospital-based violence intervention programs, may help bridge the gap between identification and intervention. Prognostic and Epidemiologic; Level IV.

ABSTRACT This study evaluates the process of implementation and the impact of a focused deterrence-based strategy on group member-involved gun violence in Malmö, Sweden. This is the first attempt to implement and evaluate a focused deterrence-based strategy to combat gun violence in a Swedish as well as a Nordic setting. The study presents an overview of the entire project, aiming to describe both the implementation and its impact, while also identifying specific areas for further investigation in more specialised studies. The planning of what would later be called Ceasefire Malmö began in 2017 after an upsurge of gun violence that peaked in 2016–2017. We followed the process of planning and implementation until December 2022. The process evaluation finds that it was possible to implement the strategy in a Swedish setting, but also identifies challenges that need to be addressed in future implementations. The results further show that, in line with much of previous, mainly American, implementation studies, gun violence decreased following implementation. Results from this evaluation are, however, not fully conclusive and should be interpreted with some care. The evidence base for interventions to counteract group-related violence is limited and without more knowledge authorities risk implementing strategies with no proven effect, risking lives and wasting resources. As such, this evaluation makes a valuable contribution to policy makers, providing them with guidance on how to implement focused deterrence-based strategies in a European context and the effect of such strategies.

Importance Firearm violence is concentrated in structurally marginalized communities. Collective efficacy—a community’s belief in their ability to achieve a shared goal—has been associated with lower rates of firearm violence. It remains unclear whether structural determinants, such as eviction, may be associated with lower collective efficacy and firearm violence. Objective To understand if eviction is independently associated with firearm violence and if eviction moderates established associations between collective efficacy and firearm violence. Design, Setting, and Participants This cross-sectional study used participant data from the Healthy Chicago Surveys (HCS) from 2021 to 2023, and neighborhood-level data from the City of Chicago. Participants included respondents to the HCS, and data were analyzed from July to December 2024. Exposures Primary exposures included personal experience of eviction (self-reported) and neighborhood-level exposure to eviction (census-tract eviction rate). Neighborhood collective efficacy and related neighborhood measures were also examined in moderation analyses, modeling an interaction term between eviction and neighborhood measures. Main Outcome and Measures The primary outcome was exposure to firearm violence, measured by shooting events within 1000 feet of a participant’s home. Mixed-effects linear regression models were used to examine firearm violence as a function of eviction measures and theoretically-relevant covariates. Results The sample included 13 916 participants. Most participants were White (5194 [37.7%]), Black (3915 [28.4%]), or Hispanic (3150 [22.9%]); women (8625 [62.5%]) were oversampled relative to men (4923 [35.7%]). Additionally, 3362 individuals (25.2%) lived below the federal poverty line and 7032 (50.8%) had at least a bachelor’s degree. Most participants were age 45 to 64 years (4416 [31.8%]) or 30 to 44 years (4169 [30.0%]). The median (IQR) number of shootings within 1000 feet of a participant’s home was 3 (1-9). Each percentage increase in census tract eviction rate (mean [range], 0.88% [0%-5.33%]) was associated with 2.66 (95% CI, 2.01-3.31) additional shootings within 1000 ft of the participant’s home. Individual experience of eviction was associated with 1.04 (95% CI, 0.46-1.61) additional shootings within 1000 ft. Eviction was a significant moderator of associations of low collective efficacy with firearm violence (0.89; 95% CI, 0.20 to 1.58; P = .01). Conclusions and Relevance In this cross-sectional study, eviction was associated with increased firearm violence exposure. Eviction augmented associations between low collective efficacy and firearm violence, highlighting the contextual role of structural disadvantage in galvanizing this association. Eviction may be a tangible intervention target for violence prevention in US cities.

The Impact of Historical and Modern-Day Redlining on Firearm Violence: A Decade-Long Multilevel Study of 38 States.

Social media platforms have become a key tool for politicians to signal their policy positions and communicate about issues that are salient to them and their constituency. One such issue is gun violence. Grounded in framing and issue-attention cycle theories, this paper analyzes the response of members of the United States (US) Congress to mass shootings on social media. We analyzed 785,881 gun-related tweets from members of the 117th US Congress on X (formerly Twitter) between January 2021 and January 2023. We used logistic regression to model the main effects, implemented the PCMCI+ algorithm for causal discovery, and applied latent Dirichlet allocation topic modeling to evaluate the substantive differences between gun-related tweets from the two parties. Higher fatality counts were positively correlated with the probability of gun-related tweets by Congress members (OR=1.13, 95% CI=[1.12, 1.15], p < 0.001). A causal link was detected between mass shootings and subsequent legislators’ activity on X (ρ=0.122, p=0.001). Democrats were more likely to tweet about guns following mass shootings than Republicans (OR=3.60, 95% CI=[3.03, 4.28], p < 0.001), with qualitative differences in tweet substance between parties (community, families, victims, and mass shootings themselves are recurrent topics for Democrats, while Second Amendment rights and crime are frequent for Republicans). The paper suggests that while mass shootings elevate the level of discussion on guns in Congress, they trigger different reactions depending on party affiliation. Congress members tend to focus on topics aligned with party issues, likely reducing the opportunity for policy-making alignment.

This study is the first qualitative analysis to center the experiences of Latino survivors of firearm violence in the United States. Despite disproportionate exposure, Latino perspectives remain largely absent from research, policy, and practice. Drawing on interviews with 25 survivors and 10 family members from a predominantly Mexican American neighborhood in Chicago, we examine how gender, criminalization, and structural barriers shape recovery and access to support. Thematic analysis, guided by LatCrit theory and sociocultural coping frameworks, revealed two central themes. Gender influenced exposure to violence and institutional engagement: Latina survivors, often balancing trauma with caregiving roles, were more likely to seek formal support, while Latino men reported being treated as suspects rather than victims and expressed deep mistrust of police and healthcare systems. Across narratives, immigration status and discrimination shaped interactions with institutions, leaving even citizens feeling excluded. Survivors sought safety through both police presence and community support, though skepticism toward law enforcement persisted. Findings underscore the need for trauma-informed, culturally responsive interventions that address caregiving burdens, criminalization, and barriers to institutional trust.

BackgroundSince 2019, firearm violence has remained the leading cause of death for US children and adolescents aged 1‐19 years. This crisis has spurred action from policymakers, health professionals, and advocates. However, political polarization has contributed to divergent views on the causes and appropriate responses to firearm violence. Communication by elected officials, especially on social media, plays a critical role in shaping public opinion and policy agendas. Understanding how state policymakers discuss firearm violence, including the use of causal blame, calls to action, and health-related narratives, can inform more effective public health strategies.ObjectiveThis study aimed to examine how Pennsylvania state legislators discuss firearms and firearm violence on social media and assess the extent to which their messaging aligns with public health perspectives.MethodsWe conducted a 2-phase mixed methods analysis of X (formerly known as Twitter; X Corp) posts by Pennsylvania state legislators from May 27, 2017, to July 26, 2022. Posts were grouped into 3 time periods surrounding the Tree of Life Synagogue mass shooting in Pittsburgh. Using a Boolean search strategy, we identified 4573 posts related to firearms and firearm violence. After removing reposts and non-English content, we randomly sampled 1491 (32.6%) original posts authored by 152 unique legislators. Posts were coded using a structured codebook based on the Multiple Streams Framework to capture rhetorical framing, causal blame, and policy content. Interrater reliability was high (Holsti coefficient >0.8). We used chi-square tests and multivariable logistic regression to assess associations between rhetorical elements and policy mentions, adjusting for time period.ResultsMass shootings were the most frequently referenced category of firearm violence, peaking after the Tree of Life shooting (22/43, 51% vs 91/118, 77.1% vs 140/220, 63.6%; P=.004), while firearm suicide was rarely discussed. Posts using advocacy frames were nearly 5 times more likely to mention policy (adjusted odds ratio [aOR] 4.67, 95% CI 3.55‐6.16), whereas those referencing mass shootings (aOR 0.54, 95% CI 0.37‐0.77) or emotional appeals (aOR 0.53, 95% CI 0.40‐0.69) were significantly less likely to do so. Most posts used general advocacy (aOR 2.97, 95% CI 2.13-4.13) and vague blame (aOR 8.26, 95% CI 6.02‐11.35), resulting in nonspecific policy suggestions. Posts that attributed blame to firearm access were strongly associated with specific policy proposals (aOR 6.37, 95% CI 4.29-9.47) and inversely associated with general policy mentions (aOR 0.26, 95% CI 0.17‐0.42). Only 9.4% (133/1422) of posts used health frames; when present, they more often referenced physical consequences (58/133, 43.6% vs 216/1358, 15.9%; P<.001).ConclusionsPennsylvania legislators primarily focused on mass shootings and relied on emotional or symbolic language without proposing specific policies. Health frames were rare and typically focused on consequences rather than prevention. Findings highlight an opportunity to support policymakers with health-informed messaging strategies to promote actionable firearm violence prevention policies, particularly those addressing prevention.

This article presents a flexible framework for integrating Language Justice (LJ) principles into trauma-informed, culturally responsive research methodologies within the context of intimate partner violence. We describe the implementation of LJ across the research lifecycle, including study design, data collection, analysis, and dissemination, using the Domestic Violence Restraining Order Study Assessing Firearm Restrictions as a case example. While grounded in the context of intimate partner firearm violence, this article does not focus on study findings themselves. Instead, it uses the Domestic Violence Restraining Order Study Assessing Firearm Restrictions as a case example to demonstrate how LJ principles can be embedded into the research process. This perspective demystifies LJ implementation, detailing strategies for community engagement, bilingual instrument development, and linguistically affirming data collection. We underscore the importance of reciprocal partnerships with community organizations, multilingual data verification processes, and trauma-informed practices to amplify survivor voices and improve data quality. This approach offers deeper insights into the intersections of trauma, cultural diversity, and social justice, contributing to advancing health equity and strengthening the validity and impact of intimate partner violence research. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Abdominal gunshot wounds (GSWs) represent a severe and high-mortality subset of penetrating trauma. The damage is complex, driven by ballistic principles like kinetic energy transfer and cavitation, and frequently involves multiple intra-abdominal organs. Rapid clinical deterioration from hemorrhage and contamination necessitates an urgent, systematic response. Aim: This review outlines the comprehensive management of abdominal GSWs, emphasizing the critical roles of prehospital care, emergency department evaluation, and the integrated, multidisciplinary approach required for optimal patient outcomes. Methods: A narrative synthesis of clinical protocols and evidence-based practices is presented, covering pathophysiology, epidemiology, diagnostic evaluation (including the Extended FAST exam and CT imaging), and definitive treatment strategies guided by the patient's hemodynamic status. Results: Management begins with prehospital ABCs (Airway, Breathing, Circulation) and hemorrhage control. In the emergency department, hemodynamic status dictates the pathway: unstable patients proceed directly to exploratory laparotomy, while stable patients undergo CT scanning for injury characterization. The EFAST exam is a vital bedside tool for detecting hemoperitoneum in unstable cases. Definitive treatment is overwhelmingly surgical for patients with peritonitis or instability. Non-operative management is reserved for a highly select, stable subset. Core management includes aggressive resuscitation, often with massive transfusion protocols, broad-spectrum antibiotics, and tetanus prophylaxis. Conclusion: Successful management of abdominal GSWs hinges on rapid recognition, immediate resuscitation, and timely surgical intervention coordinated by a multidisciplinary trauma team. Despite advances, mortality remains high, underscoring the need for efficient trauma systems and ongoing advocacy for primary prevention of firearm violence.

Head gunshot injuries in civilian settings are severe traumas associated with high morbidity and mortality. Most studies focus on populations from regions with high firearm violence, limiting their applicability to low-violence settings. This study investigates the characteristics, management, and outcomes of head gunshot injuries in the Czech Republic, a country with low firearm-related violence and a unique injury profile dominated by suicides. We analyzed a prospectively collected cohort of 100 patients treated for head gunshot injuries at a single center between 2000 and 2024. Inclusion criteria included civilian head gunshot injuries in patients aged ≥ 18 years, admitted with signs of life. Data collected included demographic characteristics, context of injury (suicide, assault, accident, law enforcement), firearm types (conventional, less-lethal, captive bolt guns), Glasgow Coma Scale (GCS) scores, imaging findings, surgical interventions, and outcomes. Statistical analyses included Chi-square, Mann-Whitney tests, Kaplan-Meier survival analysis, and Cox regression modeling. Of 100 patients (94% male, mean age 50.0 years), 81% sustained injuries from suicide attempts. Conventional firearms caused 74% of injuries, while less-lethal guns (21%) and captive bolt guns (15%) contributed significantly. The mean GCS on admission was 6.35, with 65% of patients presenting with a GCS of 3. Penetrating injuries occurred in 58% of cases. Surgical intervention was performed in 27 patients (27%) and was associated with lower mortality (25.9% vs. 75.3%, p < 0.001). Overall survival varied significantly by firearm type, with less-lethal gun injuries showing improved outcomes (30-day mortality: 19.0%; mean survival: 2634 days). Suicidal injuries had worse outcomes compared to other contexts (30-day mortality: 70.4% vs. 26.3%, p < 0.001). In this low-violence setting, firearm-related suicides dominate head gunshot injuries, with a notable prevalence of less-lethal guns and captive bolt guns. The study highlights the importance of regional variations in injury patterns and outcomes, underscoring the need for tailored clinical guidelines and public health interventions to address specific demographic and cultural contexts.

Firearm violence is a critical public health issue in the United States. Extreme Risk Protection Order (ERPO) laws have been enacted in many states to prevent firearm violence, including mass violence. Oregon's ERPO law allows family/household members or law enforcement officers to petition a civil court for an order to temporarily restrict a person's access to firearms when at imminent risk of harming themselves or others. This study examined the characteristics of ERPO petitions filed in Oregon that involved mass violence threats. ERPO court records for petitions filed from January 1, 2018 to December 31, 2023 were obtained through the Oregon Judicial Case Information Network and abstracted; double coding was completed to assess interrater reliability. Descriptive analyses were conducted to examine characteristics of ERPO petitions filed to prevent mass violence. These petitions were compared to those without mass violence threats using Fisher's exact tests and the Wilcoxon rank sum test. From 2018 to 2023, 835 ERPO petitions were filed, of which 92 (11.0%) cited a risk of mass violence. ERPO petitions citing threats of mass violence were more likely to be granted (90.2%) than those without such threats (76.3%; p = 0.002). Risks of mass violence to schools or college campuses, specifically, were cited in 27 petitions, all of which were granted. Law enforcement officers filed a larger proportion of the petitions citing threats of mass violence (88.0%) than petitions without such threats (57.9%; p < 0.001). Our findings suggest that Oregon's ERPO law is being used as intended to address firearm injury risk, including mass violence risk and risk to schools and college campuses. Petitions citing mass violence threats appeared to differ significantly in terms of some characteristics from those citing non-mass violence threat types, including a higher likelihood of being granted. Further research on the use of ERPOs is needed to fully understand the barriers and facilitators to effective implementation of these laws to prevent mass violence.

Gun violence is a global issue with substantial psychological, social, and health impacts requiring the integration of community voices, especially those with lived experience, into research, implementation, and evaluation. The objective of this paper is to describe how a community-based participatory research (CBPR) partnership used think tanks and the empowerment-theory based community forum to create dialogue between researchers and community members and form action plans to address gun violence. The Violence as a Health Disparity workgroup held two "think tanks" to gather academic and community members to discuss research, lived experiences, and community-based and driven solutions for gun violence impacting North Carolina. Think tanks were structured using the empowerment-theory based community forum method, which guided participants through Freire's three stages of listening, dialogue, and action; qualitative data were analyzed using constant comparison. Seventy-two total participants (68% community partners) attended the think tanks, generating twenty discussion themes, four proposed community-engaged research projects, and six submitted grants related to gun violence prevention, promotion, and response. This project shows how Freire's empowerment theory can be applied to gun violence prevention and response to further community voice and strengthen community-academic relationships. The think tanks facilitated academic and community exchange of information, created a space for dialogue among shareholders and constituents across many positionalities related to gun violence, and acted as a successful method to generate action. These think tanks showcase an important potential method for increasing dialogue with, research co-led by, and equity for communities impacted by gun violence.

In 2020, firearm violence became the leading cause of death for American children and teens, a critical datapoint informing the 2024 U.S. Surgeon General's advisory on firearm violence. However, firearm violence has been a leading cause of death for Black youth-particularly, Black males-for decades, disproportionately impacting their morbidity and mortality. As the rights of Black youth to experience safety from firearm violence converge with the interests of white youth now increasingly impacted by it, it is imperative that prevention scientists critically interrogate what contributes to the national willfulness to see Black youth as perpetrators of violence deserving of punishment and a national reluctance to see Black youth as victims of violence deserving of healing and prevention? Guided by the Cycle of Dehumanization framework, we contend this pattern is symptomatic of racial dehumanization, a root cause of structural racism and violence. We argue that to successfully prevent youth firearm violence using a structural approach, we must disrupt dehumanizing narratives about Black male criminality and offer a viable solution through our visual storytelling and narrative change campaign, In All Ways Human. Using an adapted community engaged participatory action research approach and qualitative interviewing, our multimodal narrative change project captured 50 strategically disseminated (mural, billboards, kiosks, exhibits, digital galleries) portraits and stories that construct a counter-narrative with the power to prevent youth violence by transforming the ways in which Black males are seen, see one another, and see themselves. The impact and future directions of our narrative change effort are discussed.

This study examined the long-term mental health outcomes associated with childhood gun violence exposure by race/ethnicity and gender. Data were drawn from the National Longitudinal Survey of Youth 1997 (1997–2021). Gun violence exposure was measured as any exposure before age 18. Mental health outcomes assessed included depressive symptoms, heavy episodic drinking, and daily cigarette smoking. Hierarchical generalized linear models were used. Findings indicate that about 16.15% of the respondents reported childhood exposure to gun violence before the age of 18. Gun violence exposure was significantly associated with depressive symptoms among white men, white women, and Hispanic women. Additionally, it was associated with higher odds of heavy episodic drinking among Black men, white women, and Hispanic women. Gun violence exposure was associated with higher odds of daily smoking for all groups. The study findings suggest that there is a high prevalence of childhood exposure to gun violence in the U.S. The relationship between childhood gun violence exposure and adult mental health outcomes varies by race/ethnicity and gender. These results highlight the need for gun violence preventions and interventions tailored to specific demographic groups to address the long-term mental health consequences of childhood gun violence exposure.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11524-025-01034-2.

During the COVID-19 pandemic, suicide rates among adolescents of color rose sharply, and firearm injuries became the leading cause of death among children and youth. At the same time, firearm sales soared, changing the profile of American gun owners, and the political landscape of firearms altered amid groundbreaking US Supreme Court decisions, the National Rifle Association's collapse, and the proliferation of firearm deregulation policies. This new period of gun politics has coincided with larger societal phenomena, including growing distrust of government, institutions, and one another. Together, these developments demonstrate an urgent need to rethink our messaging strategy around gun violence. Specifically, while trust in health institutions and experts remains low, invoking the language of public health may be not only insufficient but also counterproductive. Until public health engages proactively as a discipline with the social and political aspects of firearm ownership and understands guns as means of replacing fear and uncertainty with strength and self-sufficiency, the field may find little success in reducing firearm deaths. This article discusses changes to the US gun landscape before, during, and after the pandemic, the Trump administration's approach to the Second Amendment, and what it all means for the future of gun politics in America.