Noorbakhsh Soroosh, Dunne Will, Babatola Oluwadamilola, Himmler Amber, Hart Lucy, Cave Nkosi, Jackson Kenya, Nwanaji-Enwerem Jamaji, Castro Alejandro De Leon, Krishnan Preethi, Kamaleswaran Rishikesan, Castater Christine, Smith Randi N
Emory University School of Medicine, Atlanta, GA, USA; Grady Memorial Hospital, Atlanta, GA, USA.
Emory University School of Medicine, Atlanta, GA, USA.
Injury. 2025 May 9:112418. doi: 10.1016/j.injury.2025.112418.
For firearm-related injuries (FRI), understanding spatial injury patterns may inform intervention strategies. This study evaluates geographic FRI patterns, emphasizing (1) proximity of home address to injury location and (2) locational social determinants of health (SDOH).
We performed a retrospective analysis of FRI patients at a Level 1 trauma center between 01/2016-10/2022. Patient home and injury ZCTAs (ZCTA tabulation areas) were collected. SDOH indicators were calculated by ZIP codes using the Distressed Communities Index (DCI, ranges from 0-100 [most distressed]) and Social Deprivation Index (SDI, ranges from 1-100 [highest deprivation]). SDOH index variations and distances between ZCTAs were calculated.
Of 37,537 trauma activations, 6326 were due to FRI. ZCTAs were available in 3864 (63.12 %) patients. The cohort was 86.5 % male and 85.2 % Black. Median (IQR) age was 30 (23-39) years. Home and injury locations were the same in 37.8 % of patients, within 5 miles of each other in 57.1 %, and within 20 miles in 87.2 %. DCI and SDI were significantly higher in injury vs home addresses (average DCI: home 59.5, injury 65.7; average SDI: home 71.8, injury 79.6; p < 0.001). Twenty ZCTAs (among 182) made up 68.4 % of injury locations. On linear regression, SDI and DCI were significantly associated with FRI number within ZCTAs.
FRI often happens close to home, and when ZCTAs differ, injury location SDOH tend to be worse. "Hotspots" with higher-than-average distress/deprivation present opportunity to maximize the impact of violence reduction; efforts should target these regions to mitigate factors perpetuating violence.
对于与枪支相关的伤害（FRI），了解空间伤害模式可为干预策略提供参考。本研究评估了FRI的地理模式，重点关注（1）家庭住址与受伤地点的距离，以及（2）健康的位置性社会决定因素（SDOH）。
我们对2016年1月至2022年10月期间一家一级创伤中心的FRI患者进行了回顾性分析。收集了患者的家庭住址和受伤的邮政编码制表区域（ZCTA）。使用困境社区指数（DCI，范围为0至100[最困境]）和社会剥夺指数（SDI，范围为1至100[最高剥夺]）按邮政编码计算SDOH指标。计算了ZCTA之间的SDOH指数变化和距离。
在37537次创伤激活中，6326次是由FRI引起的。3864名（63.12%）患者有ZCTA信息。该队列中86.5%为男性，85.2%为黑人。年龄中位数（IQR）为30（23 - 39）岁。37.8%的患者家庭住址和受伤地点相同，57.1%在彼此5英里范围内，87.2%在彼此20英里范围内。受伤地址的DCI和SDI显著高于家庭住址（平均DCI：家庭住址59.5，受伤地址65.7；平均SDI：家庭住址71.8，受伤地址79.6；p < 0.001）。182个ZCTA中的20个占受伤地点的68.4%。在线性回归中，SDI和DCI与ZCTA内的FRI数量显著相关。
FRI通常发生在离家较近的地方，当ZCTA不同时，受伤地点的SDOH往往更差。困境/剥夺高于平均水平的“热点地区”为最大限度地减少暴力影响提供了机会；应针对这些地区努力减轻使暴力持续存在的因素。
