Polcari Ann M, Slidell Mark B, Hoefer Lea E, Henry Marion Cw, Zakrison Tanya L, Rogers Selwyn O, Benjamin Andrew J
From the Department of Surgery, The University of Chicago Medicine, Chicago, IL (Polcari, Hoefer).
J Am Coll Surg. 2023 Dec 1;237(6):845-854. doi: 10.1097/XCS.0000000000000845. Epub 2023 Sep 13.
Firearm violence is now endemic to certain US neighborhoods. Understanding factors that impact a neighborhood's susceptibility to firearm violence is crucial for prevention. Using a nationally standardized measure to characterize community-level firearm violence risk has not been broadly studied but could enhance prevention efforts. Thus, we sought to examine the association between firearm violence and the social, structural, and geospatial determinants of health, as defined by the Social Vulnerability Index (SVI).
In this cross-sectional study, we merged 2018 SVI data on census tract with shooting incidents between 2015 and 2021 from Baltimore, Chicago, Los Angeles, New York City, and Philadelphia. We used negative binomial regression to associate the SVI with shooting incidents per 1,000 people in a census tract. Moran's I statistics and spatial lag models were used for geospatial analysis.
We evaluated 71,296 shooting incidents across 4,415 census tracts. Fifty-five percent of shootings occurred in 9.4% of census tracts. In all cities combined, a decile rise in SVI resulted in a 37% increase in shooting incidents (p < 0.001). A similar relationship existed in each city: 30% increase in Baltimore (p < 0.001), 50% in Chicago (p < 0.001), 28% in Los Angeles (p < 0.001), 34% in New York City (p < 0.001), and 41% in Philadelphia (p < 0.001). Shootings were highly clustered within the most vulnerable neighborhoods.
In 5 major US cities, firearm violence was concentrated in neighborhoods with high social vulnerability. A tool such as the SVI could be used to inform prevention efforts by directing resources to communities most in need and identifying factors on which to focus these programs and policies.
枪支暴力如今在美国某些社区泛滥成灾。了解影响社区枪支暴力易感性的因素对预防工作至关重要。使用全国标准化的指标来描述社区层面的枪支暴力风险尚未得到广泛研究，但可能会加强预防工作。因此，我们试图研究枪支暴力与社会脆弱性指数（SVI）所定义的健康的社会、结构和地理空间决定因素之间的关联。
在这项横断面研究中，我们将2018年人口普查区的SVI数据与2015年至2021年来自巴尔的摩、芝加哥、洛杉矶、纽约市和费城的枪击事件进行了合并。我们使用负二项回归将SVI与每1000人中的枪击事件关联起来。莫兰指数（Moran's I）统计和空间滞后模型用于地理空间分析。
我们评估了4415个人口普查区的71296起枪击事件。55%的枪击事件发生在9.4%的人口普查区。在所有城市中，SVI每上升十分位数，枪击事件就增加37%（p<0.001）。每个城市都存在类似的关系：巴尔的摩增加30%（p<0.001），芝加哥增加50%（p<0.001），洛杉矶增加28%（p<0.001），纽约市增加34%（p<0.001），费城增加41%（p<0.001）。枪击事件在最脆弱的社区中高度聚集。
在美国5个主要城市，枪支暴力集中在社会脆弱性高的社区。像SVI这样的工具可用于指导预防工作，将资源导向最需要的社区，并确定这些项目和政策应关注的因素。
