The epidemiology and deprivation profile of firearm-related injuries and deaths in British Columbia, Canada.

Abstract

Introduction: Firearm-related injuries (FRI) are an important public health issue in Canada. This study aims to determine the incidence of FRI in British Columbia (BC) and examine the distribution according to demographics, intent, urban-rural residence and neighbourhood deprivation.

Methods: De-identified data on deaths and hospitalizations (2010-2019) were retrieved from the BC Vital Statistics and the Discharge Abstract Database obtained from the BC Ministry of Health. We implemented the Canadian Index of Multiple Deprivation for the dissemination area-level marginalization.

Results: A total of 1868 fatal and nonfatal FRI were included in our study, of which 46.4% were due to self-harm. The annual injury rate was 3.93 per 100 000, with the highest rates among men aged 15 to 34 years. Rates were highest in rural and remote areas, in neighbourhoods with the least diverse ethno-cultural composition, and the greatest level of situational vulnerability and economic dependency. We did not observe significantly different rates across residential instability quintiles. The marginalization pattern for intentional self-harm was similar to the aggregated deprivation profile. While assaults were more common in neighbourhoods with higher levels of situational vulnerability and more diverse populations, unintentional injuries were more prevalent in neighbourhoods with higher levels of situational vulnerability.

Conclusion: This study revealed that the burden of FRI was not evenly distributed across demographic determinants, neighbourhood deprivation or urban-rural areas of residence throughout BC. We also observed different deprivation profiles across the various intents of injury and death. Findings highlight the need for addressing FRI at its root causes, by implementing system-level interventions focussed on suicide prevention, poverty reduction, and promoting employment and education.