Relationships Between Socioeconomic Deprivation And Pediatric Firearm-related Injury At The Neighborhood Level
*Meera Kotagal, Cole Brokamp, Andrew Vancil, Dawne Gardner, *Suzanne Moody, Carley Riley, Rashmi Sahay, Nicole Sofer, Andrew F. Beck, *Richard A. Falcone, Jr.
Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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 old admitted to our level 1 pediatric trauma center (2010-2019) after a firearm-related injury. We extracted patientsí 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:Out of 15,686 injury-related admissions, 140 were for firearm-related injuries (median age 14 years [IQR 11,15]). Patients with firearm-related injuries were 75% male and 64% Black; 66% had Medicaid. 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 (Figure 1; p<.05). Children from the highest deprivation quintile experienced 25% of injuries of all types, but 57% of firearm-related injuries.
Conclusions:Higher neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization, at rates far higher than injury-related admissions overall. Addressing neighborhood poverty, stress, and risk of violence may prevent pediatric firearm-related injury.
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