Chung Samantha H, Biely Christopher, Dudovitz Rebecca
Marlborough School, USA.
Department of Pediatrics, David Geffen School of Medicine at UCLA, USA.
SSM Popul Health. 2020 Mar 18;11:100568. doi: 10.1016/j.ssmph.2020.100568. eCollection 2020 Aug.
Access to firearms and perceived unsafe school environments are associated with negative adolescent health outcomes. Whether widespread acceptance of firearms alters these associations, however, is unknown. To address this literature gap, we examined whether peer acceptance of firearms moderates associations between personal firearm access and health outcomes. In 2018-2019, we analyzed Wave I of the National Longitudinal Study of Adolescent to Adult Health (collected 1994-1995) to assess personal firearm access and school-level percentage of firearm access, using weighted multilevel analyses with interactions to determine associations among personal access, school-level percentage of access, and adolescent depression, suicidality, general health, and perceived school safety. Models controlled for age, sex, race, region, urbanicity, family structure, parental income and education level, school type, school size, and school quality. Results showed that personal firearm access was associated with depression (OR 1.20 p = 0.03), suicidal ideation (OR 1.73, p < 0.001), and perceiving school as unsafe (OR 1.59, p < 0.001). A higher school-level percentage of access, however, was associated with lower rather than higher odds of perceiving school as unsafe (OR 0.83, p = 0.003). With interaction terms included, the association between personal access and suicidal ideation was weaker when school-level access was more common. Similarly, the association between school-level access and poor general health was negative among students with personal access but positive among students with no access. These findings suggest firearm access is a complex social phenomenon. In a low-access environment, personal firearm access may signify a high-risk physical and mental state. In schools where access is common, however, personal access may signify social belonging, possibly mitigating some potential negative health effects. Although evidence that firearm access is harmful remains clear, local norms may have a substantial moderating impact.
获取枪支和感知到的不安全学校环境与青少年不良健康结果相关。然而，枪支的广泛接受是否会改变这些关联尚不清楚。为了填补这一文献空白，我们研究了同伴对枪支的接受程度是否会调节个人枪支获取与健康结果之间的关联。在2018 - 2019年，我们分析了青少年到成人健康纵向研究的第一波数据（收集于1994 - 1995年），以评估个人枪支获取情况和学校层面的枪支获取百分比，使用加权多层次分析及交互作用来确定个人获取、学校层面获取百分比与青少年抑郁、自杀倾向、总体健康以及感知到的学校安全性之间的关联。模型控制了年龄、性别、种族、地区、城市化程度、家庭结构、父母收入和教育水平、学校类型、学校规模以及学校质量。结果显示，个人枪支获取与抑郁（比值比1.20，p = 0.03）、自杀意念（比值比1.73，p < 0.001）以及认为学校不安全（比值比1.59，p < 0.001）相关。然而，学校层面获取百分比越高，认为学校不安全的几率越低而非越高（比值比0.83，p = 0.003）。纳入交互项后，当学校层面的获取更为普遍时，个人获取与自杀意念之间的关联较弱。同样，在有个人获取的学生中，学校层面获取与总体健康不佳之间的关联为负，而在没有获取的学生中为正。这些发现表明枪支获取是一个复杂的社会现象。在获取率低的环境中，个人枪支获取可能意味着高风险的身心状态。然而，在获取普遍的学校中，个人获取可能意味着社会归属感，可能减轻一些潜在的负面健康影响。尽管枪支获取有害的证据仍然明确，但当地规范可能有重大的调节作用。
