Karbakhsh Mojgan, Rajabali Fahra, Zheng Alex, Pike Ian
BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
Department of Pediatrics, The University of British Columbia, Vancouver, British Columbia, Canada.
Health Promot Chronic Dis Prev Can. 2025 Jun;45(6):286-298. doi: 10.24095/hpcdp.45.6.03.
Firearm-related injuries (FRI) are an important public health issue in Canada. This study aims to determine the incidence of FRI in British Columbia (BC) and examine the distribution according to demographics, intent, urban-rural residence and neighbourhood deprivation.
De-identified data on deaths and hospitalizations (2010-2019) were retrieved from the BC Vital Statistics and the Discharge Abstract Database obtained from the BC Ministry of Health. We implemented the Canadian Index of Multiple Deprivation for the dissemination area-level marginalization.
A total of 1868 fatal and nonfatal FRI were included in our study, of which 46.4% were due to self-harm. The annual injury rate was 3.93 per 100 000, with the highest rates among men aged 15 to 34 years. Rates were highest in rural and remote areas, in neighbourhoods with the least diverse ethno-cultural composition, and the greatest level of situational vulnerability and economic dependency. We did not observe significantly different rates across residential instability quintiles. The marginalization pattern for intentional self-harm was similar to the aggregated deprivation profile. While assaults were more common in neighbourhoods with higher levels of situational vulnerability and more diverse populations, unintentional injuries were more prevalent in neighbourhoods with higher levels of situational vulnerability.
This study revealed that the burden of FRI was not evenly distributed across demographic determinants, neighbourhood deprivation or urban-rural areas of residence throughout BC. We also observed different deprivation profiles across the various intents of injury and death. Findings highlight the need for addressing FRI at its root causes, by implementing system-level interventions focussed on suicide prevention, poverty reduction, and promoting employment and education.
在加拿大，与枪支相关的伤害（FRI）是一个重要的公共卫生问题。本研究旨在确定不列颠哥伦比亚省（BC）FRI的发生率，并根据人口统计学、意图、城乡居住情况和社区贫困程度对其分布进行研究。
从BC省生命统计数据以及BC省卫生部提供的出院摘要数据库中检索了去识别化的死亡和住院数据（2010 - 2019年）。我们采用了加拿大多重剥夺指数来衡量地区层面的边缘化程度。
我们的研究共纳入了1868例致命和非致命的FRI病例，其中46.4%是由于自残。年伤害率为每10万人3.93例，在15至34岁的男性中发生率最高。在农村和偏远地区、民族文化构成最单一、情境脆弱性和经济依赖性最高的社区，发生率最高。我们未观察到不同居住不稳定五分位数之间的发生率有显著差异。故意自残的边缘化模式与总体剥夺情况相似。虽然袭击在情境脆弱性较高且人口更加多样化的社区更为常见，但意外伤害在情境脆弱性较高的社区更为普遍。
本研究表明，FRI的负担在BC省的人口统计学决定因素、社区贫困程度或城乡居住区域之间分布不均。我们还观察到不同伤害和死亡意图的剥夺情况各不相同。研究结果强调需要通过实施侧重于预防自杀、减少贫困以及促进就业和教育的系统层面干预措施，从根本上解决FRI问题。
