Tang Yuni, Taylor Nandi L, Neuroth Lucas M, Higgins Kathleen A, Waller Anna E, Marshall Stephen W, Harmon Katherine J
Highway Safety Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Inj Epidemiol. 2024 Oct 25;11(1):58. doi: 10.1186/s40621-024-00539-9.
Firearm violence is a significant public health issue. However, it is unclear if there is an association between the Social Vulnerability Index (SVI) and the intent of both fatal and nonfatal firearm injuries, and if these associations are modified by community race and ethnic composition. This study examines the association between community-level social vulnerability and firearm injury incidence in North Carolina (NC) using 2021-2022 emergency medical services (EMS) data. Additionally, it investigates how these associations vary by the intent of injury (assault, self-inflicted, and unintentional), and whether they are modified by community racial/ethnic composition.
This cross-sectional study utilized NC EMS data, capturing firearm incidents from January 1, 2021, to December 31, 2022. The SVI from the Centers for Disease Control and Prevention (CDC) was used to assess community-level vulnerability. The SVI's racial/ethnic minority status component was removed for stratification analysis. Firearm injury rates were calculated per 100,000 population, and negative binomial regression models were used to estimate Incidence Rate Ratios (IRRs) for different SVI levels and intents of firearm injuries.
During the study period, we identified 7,250 EMS encounters at non-healthcare locations related to firearm injuries, encompassing 2,648 NC census tracts. Assault was the leading cause of firearm injuries (n = 3,799), followed by self-inflicted (n = 1,498), and unintentional injuries (n = 722). High-SVI communities had significantly higher rates of firearm injuries compared to low-SVI communities, particularly for assault-related injuries. When the minority status component was excluded from SVI, racial/ethnic minority status emerged as a significant modifier, with higher rates of firearm injuries being observed in communities with larger racial/ethnic minority populations.
Community-level social vulnerability is significantly associated with firearm injury incidence, with the effect being more pronounced in racial/ethnic minority communities. These findings underscore the need for targeted public health interventions that address underlying social determinants of health (e.g., access to education) to reduce firearm violence. Future research should further explore the intersection of social vulnerability and racial/ethnic composition to develop effective prevention strategies.
枪支暴力是一个重大的公共卫生问题。然而，尚不清楚社会脆弱性指数（SVI）与致命和非致命枪支伤害的意图之间是否存在关联，以及这些关联是否会因社区的种族和族裔构成而有所改变。本研究使用2021 - 2022年紧急医疗服务（EMS）数据，考察北卡罗来纳州（NC）社区层面的社会脆弱性与枪支伤害发生率之间的关联。此外，研究还调查了这些关联如何因伤害意图（袭击、自我伤害和意外）而有所不同，以及它们是否会因社区种族/族裔构成而改变。
这项横断面研究利用了北卡罗来纳州紧急医疗服务数据，收集了2021年1月1日至2022年12月31日期间的枪支事件。使用疾病控制与预防中心（CDC）的社会脆弱性指数来评估社区层面的脆弱性。在分层分析中去除了社会脆弱性指数中的种族/族裔少数群体地位成分。计算每10万人口的枪支伤害率，并使用负二项回归模型来估计不同社会脆弱性指数水平和枪支伤害意图下的发病率比（IRR）。
在研究期间，我们在非医疗场所识别出7250次与枪支伤害相关的紧急医疗服务接触事件，涉及2648个北卡罗来纳州人口普查区。袭击是枪支伤害的主要原因（n = 3799），其次是自我伤害（n = 1498）和意外伤害（n = 722）。与低社会脆弱性指数社区相比，高社会脆弱性指数社区的枪支伤害率显著更高，尤其是与袭击相关的伤害。当从社会脆弱性指数中排除少数群体地位成分时，种族/族裔少数群体地位成为一个显著的调节因素，在种族/族裔少数群体人口较多的社区中观察到更高的枪支伤害率。
社区层面的社会脆弱性与枪支伤害发生率显著相关，这种影响在种族/族裔少数群体社区中更为明显。这些发现强调了有针对性的公共卫生干预措施的必要性，这些措施应解决健康的潜在社会决定因素（如受教育机会）以减少枪支暴力。未来的研究应进一步探索社会脆弱性与种族/族裔构成的交叉点，以制定有效的预防策略。
