Akinyemi Oluwasegun A, Weldeslase Terhas A, Hughes Kakra, Williams Mallory, Cornwell Edward E
Department of Surgery, Howard University College of Medicine, Washington, DC, USA.
Am Surg. 2023 Dec;89(12):6084-6090. doi: 10.1177/00031348231191243. Epub 2023 Jul 24.
This study aimed to investigate the relationship between community-level economic deprivation, as measured by the Distressed Communities Index (DCI) and ED visits on account of firearm injuries (assaults and unintentional).
A retrospective analysis was conducted using the Maryland State Emergency Department Databases (SEDD) from January 2019 to December 2020 to explore the association between the DCI and ED visits because of firearm injuries (assaults and unintentional). The DCI utilizes 7 variables, based on zip codes, generating 5 levels of socioeconomic distress (prosperous, comfortable, mid-tier, at-risk, and distressed). In a multivariate analysis, we adjusted for age, sex, mental conditions, alcohol addiction, substance abuse, smoking, race/ethnicity, insurance type, and median income.
Of the 2725 ED visits for firearm injuries, 84.5% were Black and 88.5% male. The median age was 27 (21-35) years, and the mortality rate was 17.7%. A statistically significant association was found between economic deprivation and ED visits for firearm injuries. Compared to prosperous communities, the odds ratios (ORs) were comfortable (OR = 1.33, 95% CI 1.04-1.71, = .03), mid-tier (OR = 1.69, 95% CI 1.33-2.15, < .001), at-risk (OR = 1.53, 95% CI 1.17-1.99, < .001), and distressed (OR = 2.65, 95% CI 2.11-3.33, < .001).
The study highlights the significant association between community-level economic deprivation, as measured by the Distressed Communities Index, and the incidence of firearm injuries in Maryland. The findings underscore the importance of addressing socioeconomic disparities and implementing targeted interventions to reduce firearm-related injuries in economically distressed communities.
本研究旨在调查以困境社区指数（DCI）衡量的社区层面经济匮乏与因枪支伤害（袭击和意外）而进行的急诊就诊之间的关系。
利用2019年1月至2020年12月的马里兰州急诊科数据库（SEDD）进行回顾性分析，以探讨DCI与因枪支伤害（袭击和意外）而进行的急诊就诊之间的关联。DCI基于邮政编码使用7个变量，生成5个社会经济困境水平（繁荣、舒适、中等、有风险和困境）。在多变量分析中，我们对年龄、性别、精神状况、酒精成瘾、药物滥用、吸烟、种族/族裔、保险类型和收入中位数进行了调整。
在2725次因枪支伤害而进行的急诊就诊中，84.5%为黑人，88.5%为男性。中位年龄为27（21 - 35）岁，死亡率为17.7%。发现经济匮乏与因枪支伤害而进行的急诊就诊之间存在统计学上的显著关联。与繁荣社区相比，优势比（OR）分别为：舒适社区（OR = 1.33，95%CI 1.04 - 1.71，P = 0.03）、中等社区（OR = 1.69，95%CI 1.33 - 2.15，P < 0.001）、有风险社区（OR = 1.53，95%CI 1.17 - 1.99，P < 0.001）和困境社区（OR = 2.65，95%CI 2.11 - 3.33，P < 0.001）。
该研究突出了以困境社区指数衡量的社区层面经济匮乏与马里兰州枪支伤害发生率之间的显著关联。研究结果强调了解决社会经济差距以及实施有针对性的干预措施以减少经济困境社区中与枪支相关伤害的重要性。
