Analyzing Child Firearm Assault Injuries by Race and Ethnicity During the COVID-19 Pandemic in 4 Major US Cities

Jay, Jonathan; Martin, Rachel; Patel, Manish R.; Xie, Kristal; Shareef, Faizah; Simes, Jessica T.

doi:10.1001/jamanetworkopen.2023.3125

Cited by 14 publications

(8 citation statements)

References 6 publications

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“…By the end of the study period, exposure was roughly comparable across age cohorts but exposure was consistently lowest among White youth. Other recent work, such as a 2023 study by Jay et al, reported that during the pandemic, Black children were 100 times, and Hispanic children 25 times, more likely than White children to be shot in Chicago and other major US cities.…”

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confidence: 96%

“…Young people’s exposure to firearm violence in US cities has surged during the COVID-19 pandemic . This study by Lanfear and colleagues examines how long-term changes in firearm violence have influenced exposure across multiple birth cohorts in Chicago, Illinois.…”

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confidence: 99%

“…Young people’s exposure to firearm violence in US cities has surged during the COVID-19 pandemic. 1 , 2 This study by Lanfear and colleagues 3 examines how long-term changes in firearm violence have influenced exposure across multiple birth cohorts in Chicago, Illinois. Comparing 4 cohorts from the Project on Human Development in Chicago Neighborhoods (PHDCN), Lanfear et al 3 find that any benefits younger cohorts might have from declines in citywide violence from 1994 to 2014 were erased by subsequent violence increases.…”

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Structural Racism and Long-term Disparities in Youth Exposure to Firearm Violence

Jay

2023

JAMA Netw Open

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Young people's exposure to firearm violence in US cities has surged during the COVID-19 pandemic. 1,2 This study by Lanfear and colleagues 3 examines how long-term changes in firearm violence have influenced exposure across multiple birth cohorts in Chicago, Illinois. Comparing 4 cohorts from the Project on Human Development in Chicago Neighborhoods (PHDCN), Lanfear et al 3 find that any benefits younger cohorts might have from declines in citywide violence from 1994 to 2014 were erased by subsequent violence increases. The results underscore how little progress we have made over several decades to address the root causes of community firearm violence and its disproportionate effects on Black and Hispanic youth.In the study by Lanfear and colleagues, 3 the youngest PHDCN cohort, born around 1996, entered adulthood after a sustained lull in firearm homicide rates in Chicago (ie, 2004-2014). This lull limited the cohort's exposure to neighborhood experiences of firearm violence, such as seeing someone get shot, during early life. However, these youth were in the highest-risk phase of adolescence (ages 18-24 years) when firearm violence spiked in 2016 and again in 2020. 3 Consequently, their cumulative risk of being shot was comparable to cohorts born earlier, including those who entered adolescence during the most violent years of the 1990s. 3 Exposure to firearm violence is associated with lasting consequences for youth and their loved ones. Indirect exposure (eg, witnessing violence) and direct exposure (eg, surviving an assault) can influence mental and physical health outcomes over the life course. In a subset of individuals, exposure is associated with the future enactment of firearm violence, feeding cycles of firearm violence at the community level. The increase in firearm violence during the COVID-19 pandemic is likely to have long-term outcomes because it substantially increased both indirect 1 and direct 2 exposure among US youth. Therefore, it is crucial to continue scaling up public health programs to halt the violence surge and deal with its aftermath, especially through community-based outreach programs and trauma-informed services.At the same time, efforts must directly target the systemic inequities that concentrate firearm violence exposure among Black and Hispanic youth. Racial and ethnic disparities in these outcomes are profound and longstanding. In the study by Lanfear et al, 3 differences in firearm violence exposure by race were more extreme than differences between birth cohorts. By the end of the study period, exposure was roughly comparable across age cohorts but exposure was consistently lowest among White youth. Other recent work, such as a 2023 study by Jay et al, 2 reported that during the pandemic, Black children were 100 times, and Hispanic children 25 times, more likely than White children to be shot in Chicago and other major US cities.These staggering disparities demand action against structural racism as a driver of firearm violence. Incremental violence reductions, such as those...

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Structural Racism and Long-term Disparities in Youth Exposure to Firearm Violence

Jay

2023

JAMA Netw Open

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“…Firearm injury is associated with increased severity of adverse health outcomes and mental health needs, further compounding existing health and racial inequities among survivors and communities . Adult and pediatric survivors experience high rates of posttraumatic stress disorder, anxiety, and depression .…”

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confidence: 99%

Engagement With Mental Health Services Among Survivors of Firearm Injury

Magee,

Ortiz,

Adams

et al. 2023

JAMA Netw Open

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ImportanceDespite the prevalence of posttraumatic stress symptoms after firearm injury, little is known about how firearm injury survivors connect with mental health services.ObjectiveTo determine facilitators and barriers to mental health care engagement among firearm injury survivors.Design, Setting, and ParticipantsA qualitative study of 1-on-1, semistructured interviews conducted within a community setting in Indianapolis, Indiana, between June 2021 and January 2022. Participants were recruited via community partners and snowball sampling. Participants who survived an intentional firearm injury, were shot within Indianapolis, were aged 13 years or older, and were English speaking were eligible. Participants were asked to discuss their lives after firearm injury, the emotional consequences of their injury, and their utilization patterns of mental health services. Data were analyzed from August 2022 to June 2023.Main Outcomes and MeasuresSurvivors’ lived experience after firearm injury, sources of emotional support, mental health utilization, and their desired engagement with mental health care after firearm injury.ResultsA total of 18 participants (17 were Black [94%], 16 were male [89%], and 14 were aged between 13 and 24 years [77%]) who survived a firearm injury were interviewed. Survivors described family members, friends, and informal networks as their main source of emotional support. Barriers to mental health care utilization were perceived as a lack of benefit to services, distrust in practitioners, and fear of stigma. Credible messengers served as facilitators to mental health care. Survivors also described the emotional impact their shooting had on their families, particularly mothers, partners, and children.Conclusions and RelevanceIn this study of survivors of firearm injury, findings illustrated the consequences of stigma and fear when seeking mental health care, inadequate trusted resources, and the need for awareness of and access to mental health resources for family members and communities most impacted by firearm injury. Future studies should evaluate whether community capacity building, digital health delivery, and trauma-informed public health campaigns could overcome these barriers to mitigate the emotional trauma of firearm injuries to reduce health disparities and prevent future firearm violence.

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“…Inequities in firearm injuries in major US cities increased during the COVID-19 pandemic. Black children were 100 times more likely and Hispanic or Latino children were 25 times more likely to sustain firearm injuries than non-Hispanic White children . Urban communities with concentrated poverty experience disproportionately more firearm homicides, crime, and associated trauma than less disadvantaged neighborhoods .…”

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Addressing Systemic Racism and Racialized Violence to Reduce Firearm Injury and Mortality Inequities

Randolph,

Gonzalez-Guarda,

Pearson

2024

JAMA Health Forum

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Analyzing Child Firearm Assault Injuries by Race and Ethnicity During the COVID-19 Pandemic in 4 Major US Cities

Abstract: This cross-sectional study examines changes in rates and disparities of fatal and nonfatal firearm assaults among children in New York, Los Angeles, Chicago, and Philadelphia before and during the COVID-19 pandemic.

Cited by 14 publications

References 6 publications

Structural Racism and Long-term Disparities in Youth Exposure to Firearm Violence

Structural Racism and Long-term Disparities in Youth Exposure to Firearm Violence

Engagement With Mental Health Services Among Survivors of Firearm Injury

Addressing Systemic Racism and Racialized Violence to Reduce Firearm Injury and Mortality Inequities

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