Bray-Aschenbrenner Amelia, Wang Jinli, Bernardin Mary E
Division of Pediatric Emergency Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University in St. Louis School of Medicine, Box 8116, Children's Place Campus, MO, 63110, St. Louis, USA.
Center for Biostatistics and Data Science, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8067, St. Louis, MO, USA.
BMC Pediatr. 2025 Jul 2;25(1):486. doi: 10.1186/s12887-025-05835-x.
Firearm injuries are the leading cause of death among children in the United States. Research indicates that increased green spaces can reduce violent crime, but the incident locations of pediatric firearm injuries have not been studied in relation to environmental hazards like air pollution, which disproportionately affects underresourced communities.
This retrospective, observational cohort study reviewed patients aged 0-18 who presented with firearm injuries at St. Louis Children's Hospital Emergency Department between 2015 and 2021. Groups of city blocks most vulnerable to air pollution ["vulnerable block groups" (VBGs)] were obtained from the St. Louis EcoUrban Assessment Tool and sociodemographic information from each zip code was obtained from the 2021 American Community Survey. Statistical analyses, including Wilcoxon rank-sum tests, Spearman correlation coefficients, and negative binomial regression, were used to examine the relationships between pediatric firearm injuries, VBGs, and sociodemographic factors across 76 zip codes.
429 pediatric firearm injury victims were identified from 42 incident zip codes, with over 50% occurring in just 6 zip codes. VGB data was available for 76 zip codes. The high firearm incidence zip codes had significantly higher percentages of residents living below the poverty level (22.9% vs. 5%), more Black occupants (90.8% vs. 7%), fewer White occupants (6.4% vs. 81.4%), fewer married households (21.5% vs. 44.1%), and more female-headed households (30.9% vs. 9.3%) compared to the other 70 zip codes. There was a significant positive correlation between the number of firearm injuries and the number of VBGs per zip code (CC 0.80, p < 0.0001). When adjusted for confounders, the correlation remained significant (Spearman partial correlation coefficient = 0.28, p = 0.02), though the rate of firearm injuries per VBG did not (1.02, p = 0.91).
Children in St. Louis living in areas with high levels of poverty and air pollution are at increased risk of firearm injuries, with Black children disproportionately affected. This suggests that environmental racism impacts childhood health and highlights the need for further research into how ecological policies and urban planning can improve the health and safety of minoritized children.
在美国，枪支伤害是儿童死亡的主要原因。研究表明，增加绿地面积可以减少暴力犯罪，但儿科枪支伤害的事发地点尚未与空气污染等环境危害相关联进行研究，而空气污染对资源匮乏社区的影响尤为严重。
这项回顾性观察队列研究对2015年至2021年间在圣路易斯儿童医院急诊科因枪支伤害就诊的0至18岁患者进行了回顾。从圣路易斯生态城市评估工具中获取最易受空气污染影响的城市街区组["脆弱街区组"（VBGs）]，并从2021年美国社区调查中获取每个邮政编码区域的社会人口信息。使用包括威尔科克森秩和检验、斯皮尔曼相关系数和负二项回归在内的统计分析方法，来研究76个邮政编码区域内儿科枪支伤害、VBGs和社会人口因素之间的关系。
从42个事发邮政编码区域中识别出429名儿科枪支伤害受害者，其中超过50%的事件仅发生在6个邮政编码区域。76个邮政编码区域可获取VBG数据。与其他70个邮政编码区域相比，枪支伤害发生率高的邮政编码区域中，生活在贫困线以下的居民比例显著更高（22.9%对5%），黑人居住者更多（90.8%对7%），白人居住者更少（6.4%对81.4%），已婚家庭更少（21.5%对44.1%），女性户主家庭更多（30.9%对9.3%）。每个邮政编码区域的枪支伤害数量与VBG数量之间存在显著正相关（CC 0.80，p < 0.0001）。在对混杂因素进行调整后，这种相关性仍然显著（斯皮尔曼偏相关系数 = 0.28，p = 0.02），尽管每个VBG的枪支伤害发生率没有显著差异（1.02，p = 0.91）。
生活在贫困和空气污染程度高的地区的圣路易斯儿童遭受枪支伤害的风险增加，黑人儿童受到的影响尤为严重。这表明环境种族主义影响儿童健康，并凸显了进一步研究生态政策和城市规划如何能够改善少数族裔儿童健康和安全状况的必要性。
