Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York.
J Adolesc Health. 2017 Dec;61(6):779-785. doi: 10.1016/j.jadohealth.2017.06.018. Epub 2017 Sep 22.
Although previous research has made progress in identifying individuals predicted to face an elevated risk of being shot, it is not clear how that risk varies within individuals based on the contexts they encounter as they navigate daily life. The current study examines how the convergence of individual risk activity and neighborhood disadvantage and disorder triggers the risk of being shot.
Using a novel geographic information system application, 123 male gunshot assault victims between 10 and 24 years old in Philadelphia, Pennsylvania, described their minute-by-minute movements over the course of the day of the gunshot assault. Through latent class analysis, the primary exposure was real-life circumstance where nine theoretically informed risk factors converged, compared with two other circumstances. Case-crossover analyses of subjects' 10-minute segments of full-day activities compared gunshot assault victims at the time of assault with themselves earlier in the day.
Compared to when individuals were exposed to minimal situational risk or were mainly exposed to neighborhood disadvantage and disorder, the concurrence of risk activity and neighborhood disadvantage and disorder was associated with a 9.90 (95% CI: 2.72-36.14) and 6.06 (95% CI: 2.78-13.22) times higher risk of being shot. Importantly, the likelihood of being in the high-risk circumstance increased systematically over the course of the day leading up to the time when young individuals were shot.
After controlled individual's propensity to be shot (e.g., inherent traits), the concurrence of situational risks emerged as significant triggers of gunshot assault. The findings suggest potential for community-based gunshot violence interventions.
尽管先前的研究在确定可能面临更高枪击风险的个体方面取得了进展,但尚不清楚个体在日常生活中遇到的环境下,其风险如何变化。本研究探讨了个体风险活动与邻里劣势和失序的交汇如何引发枪击风险。
使用一种新颖的地理信息系统应用程序,研究人员调查了宾夕法尼亚州费城的 123 名 10 至 24 岁的男性枪击受害者,这些受害者在枪击事件发生当天描述了他们每分钟的活动情况。通过潜在类别分析,主要暴露于真实生活环境,即九个理论上有意义的风险因素交汇,与另外两种情况相比。对研究对象全天 10 分钟活动片段的病例交叉分析比较了枪击受害者在受攻击时与当天早些时候自己的情况。
与个体暴露于最小情境风险或主要暴露于邻里劣势和失序时相比,风险活动与邻里劣势和失序的同时发生与枪击风险增加 9.90 倍(95% CI:2.72-36.14)和 6.06 倍(95% CI:2.78-13.22)有关。重要的是,在导致年轻人被枪击的时间之前,他们处于高风险环境中的可能性会随着时间的推移而系统地增加。
在控制了个体被枪击的可能性(例如,固有特征)后,情境风险的同时发生成为枪击事件的重要触发因素。这些发现表明,基于社区的枪击暴力干预具有潜力。