Injury Epidemiology最新文献

{"title":"Repeat self-harm hospitalizations in Canada: a survival analysis.","authors":"Li Liu, Gisèle Contreras, Wendy Thompson","doi":"10.1186/s40621-025-00576-y","DOIUrl":"https://doi.org/10.1186/s40621-025-00576-y","url":null,"abstract":"<p><strong>Background: </strong>Repeat self-harm hospitalizations are associated with a greater risk of suicide and place a substantial burden on the healthcare system. In Canada, despite growing awareness of self-harm as a public heath issue, most existing research has focused on the prevalence of self-harm, with less attention given to repeat admissions. This study aims to assess the risk of repeat self-harm hospitalizations in Canada and identify population subgroups at higher risk.</p><p><strong>Methods: </strong>We included 74,055 patients discharged between April 2016 and March 2022, with self-harm hospitalizations recorded in the Canadian Institute for Health Information's Discharge Abstract Database and the Ontario Mental Health Reporting System. After an initial self-harm hospitalization, patients were followed for repeat admissions during the study period. The risk of readmission was estimated using Kaplan-Meier survival analysis, while hazard ratios for factors such as sex, age group, method of self-harm and the presence of a mental disorder diagnosis, were calculated using Cox regression models.</p><p><strong>Results: </strong>Among patients hospitalized for self-harm, the risk of readmission was 9.3% within one year and 13.0% within three years of the index hospitalization. Three-quarters of readmissions occurred within the first year, and 90% occurred within two years. Females had a higher risk of readmission than males (hazard ratio = 1.32), with the highest risk observed among females aged 10-14 years (19.2% within three years), while patients aged 65 years and older had the lowest risk for both males and females. Females who self-harmed by cutting and patients of both sexes who used substance-related poisoning methods, as well as patients with a mental disorder diagnosis, were also at greater risk of readmissions.</p><p><strong>Conclusion: </strong>In Canada, approximately one in ten patients hospitalized for self-harm were readmitted, with most readmissions occurring within the subsequent first year. Certain subgroups, including females, young girls, individuals who engaged in self-harm through cutting or substance use, and those with a mental disorder, face higher risks. This study provides insights to guide targeted interventions aimed at preventing recurrence, informing resource allocation, and emphasizing the need for comprehensive mental health support to improve outcomes for at-risk individuals.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"26"},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability.","authors":"Terry L Bunn, Jacqueline Seals, Dana Quesinberry, Alaina Murphy, Julia F Costich","doi":"10.1186/s40621-025-00580-2","DOIUrl":"https://doi.org/10.1186/s40621-025-00580-2","url":null,"abstract":"<p><strong>Background: </strong>Vulnerable populations at risk of injury include persons with intellectual and developmental disabilities (IDD), and persons who are deaf or hard of hearing (DHH). The purpose of this study was to describe and compare emergency department and inpatient hospitalization (ED + IP) injury rates and rate ratios by injury type among persons under age 65 with IDD or with DHH to those without IDD or DHH.</p><p><strong>Methods: </strong>This is a descriptive population-based retrospective cross-sectional study of injuries among patients under the age of 65 with an IDD disability or a DHH disability using Kentucky ED + IP discharge datasets from 2019 to 2023. Injury rates and injury rate ratios were calculated for those under the age of 65 with an IDD or a DHH disability and without an IDD or a DHH disability, using number of persons under age 65 with or without the related disability as the denominator.</p><p><strong>Results: </strong>The overall injury rate was lower for persons under age 65 with an IDD or DHH compared to those without those disabilities in 2023 (1 and 3 per 100,000 population, respectively). IDD or DHH disability types had significantly lower overall ED + IP injury rate ratios compared to those without those disabilities (IDD: 0.667 [95% CI: 0.640-0.694], DHH: 0.658 [95% CI: 0.633-0.683]). When ED + IP injury type rate ratios were compared, IDD or DHH persons had higher injury rate ratios for self-harm (IDD: 8.740 [95% CI: 7.783-9.815], DHH: 1.7846 [95% CI: 1.402-2.272]), assault (IDD: 1.386 [95% CI: 1.173-1.637], DHH: 1.310 [95% CI: 1.115-1.540]), unintentional falls (IDD: 1.540 [95% CI: 1.436-1.633], DHH: 1.283 [95% CI: 1.201-1.372]), and drug poisonings (IDD: 2.401 [95% CI: 2.103-2.740], DHH:1.620 [95% CI: 1.391-1.886]) compared to those without such disabilities. Those with IHH or DHH who were treated for injuries incurred triple the charges of patients without these conditions (~$17,086 IDD; $19,550 DHH; and $5,216 no IDD or DHH disabilities).</p><p><strong>Conclusions: </strong>These findings have implications for health policy at the state and federal level. Clinical care interventions to reduce assault, self-harm, drug poisonings and unintentional injuries and healthcare utilization in persons with IDD or DHH should be publicly funded or covered by health insurance.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"27"},"PeriodicalIF":2.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unintentional firearm deaths among children, 0-17 years of age, by race: Findings from the national violent death reporting system, 2015-2021.","authors":"Samuel Fischer, Matthew Miller, Eliot W Nelson, Christopher Chang, Deborah Azrael","doi":"10.1186/s40621-025-00573-1","DOIUrl":"https://doi.org/10.1186/s40621-025-00573-1","url":null,"abstract":"<p><strong>Background: </strong>Unintentional firearm death (UFD) rates are higher among Black children than among White and Hispanic children. Whether disparities in UFD rates among Black as compared to White and Hispanic children vary by other demographic characteristics or by circumstances is unknown.</p><p><strong>Methods: </strong>Data come from the 32 states contributing to the National Violent Death Reporting System (NVDRS), 2015-2021. Our sample comprises children 0-17 who died from unintentional firearm injuries. Race/ethnicity- and age-specific population data at the state and county level were used to calculate rates. UFD rates were compared within and across race-ethnicity groupings by age, sex, urbanization and across four NVDRS coded circumstances. Urbanization was assigned using a six-level urban-rural classification scheme from the National Center for Health Statistics (NCHS) based on the county in which the fatal injury occured.</p><p><strong>Findings: </strong>Of the 568 UFDs, four-fifths of victims were male (82%) and four-fifths died in a home (84%), usually the Victim's home (55%). Most deaths involved a child playing with a firearm (63%). Overall, UFD rates were 4.6-fold higher for Black children compared with White children. Black children's rates were more than 6-fold higher than those of White children for females and for children five to nine years of age, and nearly 8-fold higher for children living in large central metro counties.</p><p><strong>Conclusions: </strong>Black children die from unintentional firearm injury at disproportionately high rates, especially young children living in urban centers. The underlying reasons for these racial disparities are unclear and should be a priority for future research.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"25"},"PeriodicalIF":2.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing a hospital-based violence intervention program's referrals for children and families in a pediatric emergency department.","authors":"Narmeen I Khan, Sri S Chinta, Brooke M Cheaton, Mark Nimmer, Michael N Levas","doi":"10.1186/s40621-025-00578-w","DOIUrl":"https://doi.org/10.1186/s40621-025-00578-w","url":null,"abstract":"<p><strong>Background: </strong>Our pediatric tertiary care hospital sees a high rate of firearm injuries. Hospital-based violence intervention programs (HVIPs) reduce violent injury recidivism rates in victims. However, significant gaps exist in the delivery of trauma-informed services to families. Our specific aim was to increase our HVIP referral rate by 20% over a 12-month time frame for children seen for interpersonal violence in the emergency department (ED).</p><p><strong>Methods: </strong>Our quality improvement study was done at a pediatric tertiary care hospital and encompassed patients 0 to 18 years of age who presented to our ED for assault-related concerns from December 26, 2021 to June 23, 2024. The primary outcome measure was percentage of HVIP-eligible patients who received a referral from the ED. We conducted a root cause analysis by interviewing stakeholders including HVIP staff, ED providers, nurses, and social workers to understand gaps in the referral process. Key drivers included electronic medical record (EMR) trigger tools for referral placement, accessibility of HVIP staff, and staff knowledge of HVIP eligibility and services. We integrated three main EMR-based interventions on June 15, 2023 that triggered referrals to the HVIP.</p><p><strong>Results: </strong>Our ED HVIP referral rate during the pre-intervention period (December 26, 2021 to June 15, 2023) was 53.6%. During our post-intervention phase (June 15, 2023 to June 23, 2024), the referral rate reached and sustained at 93.5%, a 74.4% increase.</p><p><strong>Conclusions: </strong>We identified a large percentage of missed HVIP-eligible referrals and developed interventions that significantly increased our referral rate. However, this did not translate into increased enrollment, indicating the need for additional efforts.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"24"},"PeriodicalIF":2.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redlining, reinvestment, and racial segregation: a bayesian spatial analysis of mortgage lending trajectories and firearm-related violence.","authors":"Gia Barboza-Salerno, Brittany Liebhard, Sharefa Duhaney, Taylor Harrington","doi":"10.1186/s40621-025-00579-9","DOIUrl":"https://doi.org/10.1186/s40621-025-00579-9","url":null,"abstract":"<p><strong>Background: </strong>In the United States, firearm-related violence disproportionately impacts low-income, racially segregated communities more than affluent, predominantly White neighborhoods. This trend stems from historical disinvestment, discriminatory lending practices, and persistent structural inequalities. Housing policies have enforced racial segregation, limiting wealth accumulation in low-income communities. This study examines the relationship between historical and contemporary lending discrimination in mortgage originations and firearm-related violence in Chicago, Illinois. By analyzing investment and disinvestment patterns, we assess how housing discrimination continues to influence the risk of victimization in various social contexts.</p><p><strong>Methods: </strong>Redlining scores were derived from the 1930s Homeowners' Loan Corporation (HOLC) grades, while contemporary lending indicators were obtained from the 2019 Home Mortgage Disclosure Act (HMDA). We classified neighborhoods into four lending trajectories-sustained disinvestment, disinvestment, growing investment, and high investment-based on historical redlining and contemporary mortgage lending patterns. Sustained disinvestment reflects historical redlining and ongoing lending discrimination, while growing investment targets areas that were historically redlined but are now experiencing increased lending activity. Bayesian spatial models examined firearm-related homicide risk across lending trajectories, adjusting for area deprivation index (ADI) and racial segregation.</p><p><strong>Results: </strong>In unadjusted models, sustained disinvestment (Relative Risk [RR] = 2.230, 95% CrI: [1.352, 3.681]) was associated with increased firearm-related homicide risk, while growing investment (RR = 0.782, 95% CrI: [0.452, 1.359]) and high investment (RR = 0.146, 95% CrI: [0.054, 0.397]) were associated with lower risk. After adjusting for ADI and racial segregation, the effect of sustained disinvestment attenuated (RR = 1.714, 95% CrI: [1.054, 2.791]), suggesting partial mediation. However, growing investment increased by 155% (RR = 1.987, 95% CrI: [1.144, 3.458]), indicating suppression, indicating that ADI and segregation initially masked its association with firearm homicide risk.</p><p><strong>Conclusion: </strong>Findings highlight the need for policies that address the long-term effects of lending discrimination. Reverse redlining-where financial institutions target minority communities with high-cost loans-further exacerbates existing inequities. Additionally, neighborhood deprivation and segregation shape firearm-related violence risk, underscoring the broader consequences of systemic housing discrimination.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"23"},"PeriodicalIF":2.4,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring spatial dynamics of trauma and substance use among suicide deaths in the United States (2017-2021).","authors":"Bianca D Smith, Kechna Cadet, Terrinieka W Powell","doi":"10.1186/s40621-025-00574-0","DOIUrl":"https://doi.org/10.1186/s40621-025-00574-0","url":null,"abstract":"<p><strong>Background: </strong>Suicide remains a significant cause of death in the United States. Traumatic events, such as experiences of violence, financial loss, and mental illness, significantly increase an individual's risk of suicide. Substance use, often used as a coping mechanism for trauma, frequently occurs alongside these events. Geographic patterns of trauma and substance use may reveal underlying factors that contribute to suicide rates across the nation.</p><p><strong>Methods: </strong>Data from the National Violent Death Reporting System (NVDRS), collected between 2017 and 2021, was used to examine spatial relationships between traumatic events and substance use among suicides. Spatial autocorrelation was used to assess global spatial dependence of traumatic events among suicide deaths. Additionally, hot spot analyses were conducted to pinpoint regions with significantly elevated or reduced experiences of trauma. Colocation analyses were conducted to identify areas where traumatic events and substance use co-occur spatially.</p><p><strong>Results: </strong>Traumatic events among suicides exhibited geographic clustering. Spatial clusters of traumatic events were identified in specific regions across the U.S. and its territories. Hot spots were predominantly observed in Western and Midwestern areas, while more cold spots were found in Southern regions. Additionally, colocation analysis revealed that Midwestern counties had a higher likelihood of experiencing traumatic events in conjunction with substance use history among suicide decedents.</p><p><strong>Conclusion: </strong>Clustering patterns may provide insight on underlying mechanisms that have significant impacts on suicide outcomes. The colocation analysis helps reveal patterns of spatial clustering, shedding light on potential risk factors or shared characteristics in those areas. By examining both global and local spatial patterns, researchers gain insights into the distribution of trauma and substance use-related incidents and their association with suicide.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"22"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of child access prevention laws on adolescent suicide: a negative control approach.","authors":"Sean MacAllister, Matthew Miller, Sonja Swanson","doi":"10.1186/s40621-025-00577-x","DOIUrl":"https://doi.org/10.1186/s40621-025-00577-x","url":null,"abstract":"<p><strong>Background: </strong>Recent publications on Child Access Prevention (CAP) laws suggest substantial protective effects on adolescent firearm suicide. However, these studies have also found comparable protective effect estimates on adolescent non-firearm suicide and adult firearm suicide, which may indicate residual confounding. Here we apply bias analysis techniques to assess the effects of CAP laws while accounting for potential unmeasured sources of bias using a negative control approach.</p><p><strong>Method: </strong>Using established bias formulas, we bias-adjust previously published point estimates and their 95% confidence intervals (CI) assuming that an arbitrary confounder biases all suicide-related effect estimates and that adolescent non-firearm suicide and adult firearm suicide are negative controls. Negative controls are outcomes or populations that prior subject matter suggests should not be meaningfully affected by the exposure and can be used to better understand and sometimes account for bias in the primary exposure-outcome relationship.</p><p><strong>Results: </strong>After bias adjustments, effect estimates were attenuated, with many of the confidence intervals including the null. Assuming that adolescent non-firearm suicide is a negative control outcome and taking a published point estimate as the bias parameter, the bias-adjusted effect estimate for adolescent firearm suicide decreased from an incidence rate ratio of 0.87 (95% CI: 0.78, 0.97) to 0.95 (95% CI: 0.85, 1.07). When adult firearm suicide was used as the negative control, the bias-adjusted estimate was 0.92 (95% CI: 0.82, 1.03).</p><p><strong>Conclusion: </strong>Our findings suggest that CAP laws may have had a smaller public health impact on adolescent suicide than previously estimated. Given the strong evidence that reducing access to firearms can prevent suicide deaths, and that secure storage helps reduce access for many children, our findings underscore the need to continue to identify and promote effective ways to motivate adults to make household firearms inaccessible to children.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"21"},"PeriodicalIF":2.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding knowledge and approval for sociopolitical groups: results from the 2023 National Survey of Gun Policy.","authors":"Rebecca Valek, Julie A Ward, Vanya Jones, Tim Carey, Cassandra K Crifasi","doi":"10.1186/s40621-025-00575-z","DOIUrl":"https://doi.org/10.1186/s40621-025-00575-z","url":null,"abstract":"<p><strong>Background: </strong>Increased concerns of political violence in the US have drawn attention to sociopolitical movements across the political spectrum. The 2023 National Survey of Gun Policy sought to characterize approval of these movements and whether gun ownership was associated with this approval.</p><p><strong>Methods: </strong>The National Survey of Gun Policy was fielded from 1/4/23 - 2/6/23 among a nationally representative sample of US adults (N = 3,096), including gun owners (n = 1,002). Respondents rated their level of approval for the militia, antifascist (Antifa), white supremacy, Christian nationalist, boogaloo, and anarchist movements. Logistic regression was used to compare differences in movement approval by gun ownership.</p><p><strong>Results: </strong>Approval of each movement was relatively low, ranging from 4% for the boogaloo movement to 13% for the Christian nationalist movement. Proportions of respondents that reported lacking knowledge was highest for the boogaloo movement (64%) and lowest for the white supremacy movement (17%); these two movements had similar proportions of approval (4% and 5%, respectively). Significantly larger proportions of gun owners reported both knowledge and approval of any of the six movements compared to non-gun owners, but differences in approval by gun ownership were no longer significant when only comparing those with knowledge of the movements.</p><p><strong>Conclusions: </strong>Results indicate low probabilities of knowledge and approval. Moreover, greater knowledge was not accompanied by greater approval (e.g., white supremacy). Gun ownership was associated with movement knowledge, but not with movement approval among those with knowledge. These findings suggest opportunities for more proactive public health messaging to appeal to majority groups to resist movements that may sow division.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"20"},"PeriodicalIF":2.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and ethnic disparities in pediatric firearm deaths persist in 2022 and 2023.","authors":"Rafael Klein-Cloud, Bailey Roberts, Emma Cornell, Colleen Nofi, Chethan Sathya","doi":"10.1186/s40621-025-00571-3","DOIUrl":"10.1186/s40621-025-00571-3","url":null,"abstract":"<p><strong>Background: </strong>Firearms became the leading cause of death in the United States pediatric population in 2019 and have persisted as the leading cause through 2021, with widening racial and ethnic disparities. We aimed to examine recent trends in U.S pediatric firearm mortality, how they differ by intent, and identify which ages, and racial and ethnic groups have been most impacted over time.</p><p><strong>Methods: </strong>The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database was queried for mortalities in children aged 0-19 years from 2014-2023, and crude death rate was reported as number of deaths per 100,000 persons per year.</p><p><strong>Results: </strong>Firearms continued to be the leading cause of death in patients aged 0-19 years from 2021 to 2023, firearm crude death rate decreased from 5.8 to 5.5. In patients aged 14-19, firearms became the leading cause of death in 2016. In patients aged 0-13 years, firearms continue to be the fourth leading cause of death. Firearm death rates for Black children decreased from 18.6 in 2022 to 17.6 in 2023 yet remained far higher than other races, and highest in all census regions. Crude firearm death rates for American Indian and Alaskan Native (AIAN) children remained the second highest. The firearm suicide rate in Black children (1.8) surpassed that of White children (1.6) in 2022 and was the highest of any ethnicity in 2023. NonCore (rural) regions had the highest firearm crude death rates in 2018-19, and AIAN children were disproportionately affected in these areas, while Large Central Metro areas surpassed this in 2020-2021.</p><p><strong>Conclusions: </strong>Firearms remain the leading cause of death among children aged 14-19, and the fourth leading cause of death among children 13 and younger. Racial and ethnic disparities remain prominent, as Black and American Indian and Alaskan Native children continue to be disproportionately affected, particularly by firearm suicide. Prevention strategies should target these vulnerable populations and children at highest risk to prevent future firearm deaths.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"19"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial de-concentration of fatal and nonfatal firearm violence in Boston, MA, 2007-2021.","authors":"Faizah Shareef, Emma L Gause, Suzanne McLone, Erika Gebo, Jonathan Jay","doi":"10.1186/s40621-025-00572-2","DOIUrl":"10.1186/s40621-025-00572-2","url":null,"abstract":"<p><strong>Background: </strong>It is a \"law\" of criminology that urban crime chronically recurs at the same microplaces (i.e., street segments and intersections). An influential study found high concentrations of firearm violence at microplaces in Boston, MA, from 1980 to 2008. The current study assessed whether this strong spatial concentration has persisted.</p><p><strong>Approach: </strong>Fatal and nonfatal shooting incidents with one or more victims from January 2007 through September 2021 were included, obtained from the Boston Police Department. We matched shootings to the closest microplaces, i.e., intersections and street segments in Boston (n = 32,267). We operationalized spatial concentration as the probability of shootings occurring at the same microplace. We employed a case-only design, with shootings as the units of analysis; the outcome of interest was a binary indicator for whether another shooting in the dataset occurred at the same microplace in the past or future. We used log-linear regression to estimate this outcome as a function of study year.</p><p><strong>Results: </strong>Annual shootings decreased over the study period, except for a spike in 2020. Spatial concentration of shootings declined from 62% in 2007 to 55% in 2021. We estimated that spatial concentration declined by an average of 1.8% per year [95% CI (-1.1, -3.4), p < 0.001].</p><p><strong>Implications: </strong>This declining trend in the spatial concentration of firearm violence has important implications for place-based interventions and underscores the need to monitor this trend over time. Social media, which reshapes social interactions and is linked to community violence, warrants further study as a potential cause.</p>","PeriodicalId":37379,"journal":{"name":"Injury Epidemiology","volume":"12 1","pages":"18"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}