Prevalence and correlates of handgun access among adolescents seeking care in an urban emergency department.

OBJECTIVE

To determine prevalence and correlates of handgun access among adolescents seeking care in an urban Emergency Department (ED) in order to inform future injury prevention strategies.

METHODS

In this observational cross-sectional study performed in the ED of a large urban hospital, 14- to 18-year-old adolescents completed a computerized survey of risk behaviors. Adolescents seeking ED care (for injury or medical complaint) were approached seven days a week over a 22-month period. Validated measures included measures of demographics, sexual activity, substance use, injury, violent behavior, and handgun access. A logistic regression model predicting handgun access was performed.

RESULTS

A total of 3050 adolescents completed the survey (44% male, 58.9% African-American), with 417 (12%) refusing to participate. One-third of the sample (n=1003) reported access to a handgun, and of those 54% were males (n=542). Logistic regression results indicated that older age (AOR: 1.58; 95% CI: 1.30-1.94), African-American race (AOR: 1.34; 95% CI: 1.11-1.61), male gender (AOR: 1.99; 95% CI: 1.66-2.37), and being employed (AOR: 1.35; 95% CI: 1.11-1.65), as well as seeking ED care for a medical complaint as compared to intentional injury (AOR: 1.69; 95% CI 1.62-2.50) predicted handgun access. Binge drinking (AOR: 1.75; 95% CI: 1.37-2.27), marijuana use (AOR: 1.93; 95% CI: 1.58-2.36), sexual activity (AOR: 1.64; 95% CI: 1.32-2.02), prior injury by a gun (AOR: 1.80; 95% CI: 1.32-2.46), serious physical violence (AOR: 1.37; 95% CI: 1.13-1.66) and group fighting (AOR: 2.07; 95% CI: 1.68-2.56) also predicted access.

CONCLUSIONS

High rates of handgun access were evident among adolescents presenting in an inner city ED, including those seeking care for non-injury related reasons. Adolescents with access to handguns were more likely to report risk behaviors and past injury, providing clinicians with an opportunity for injury prevention initiatives.