Afif Iman N, Gobaud Ariana N, Morrison Christopher N, Jacoby Sara F, Maher Zoë, Dauer Elizabeth D, Kaufman Elinore J, Santora Thomas A, Anderson Jeffrey H, Pathak Abhijit, Sjoholm Lars Ola, Goldberg Amy J, Beard Jessica H
Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, PA, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Prev Med. 2022 May;158:107020. doi: 10.1016/j.ypmed.2022.107020. Epub 2022 Mar 14.
Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.
美国城市枪支暴力事件近期呈上升趋势，这已有充分记录，然而，新冠疫情期间，这种公共卫生威胁在人员、地点和强度方面的动态变化相对尚未得到充分研究。这项描述性流行病学研究涵盖2015年1月1日至2021年3月31日，利用了费城警察局的枪击受害者登记册，该数据库包含了费城所有因人际枪支暴力而被枪击和/或杀害的个人信息。我们将疫情前的受害者和事件特征与实施疫情防控措施后的情况进行了比较。在本研究中，防控措施于2020年3月16日开始，当时费城下令非必要企业关闭。防控措施实施前，每季度有331人（标准误=13.9）被枪击，实施后每季度有545人（标准误=66.4）被枪击（p=0.031）。防控措施实施后，被枪击女性的比例增加了39%（95%置信区间：1.21，1.59），被枪击儿童的比例增加了17%（95%置信区间：1.00，1.35）。黑人女性和儿童在防控措施实施后更有可能被枪击（相对危险度分别为1.11，95%置信区间：1.02，1.20和1.08，95%置信区间：1.03，1.
