Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Violence involving firearms is a leading cause of death among US youth ages 14 to 24. The emergency department is the primary medical setting for care of assault-injured youth and an underused but important setting for violence-prevention programs.WHAT THIS STUDY ADDS: Among assault-injured youth seeking emergency department care, firearm possession rates are high, most obtained outside of legal channels. Higher rates of negative retaliatory attitudes and substance use among those youth with firearms increases risk of future lethal violence. abstract BACKGROUND AND OBJECTIVES: Firearm violence is a leading cause of death among youth. The objectives of this study were (1) determine firearm possession rates and associated correlates among youth seeking care for assault in an emergency department (ED); (2) understand differences in risk factors for youth with firearm possession; and (3) identify firearm possession characteristics in this population: type, reason for possession, and source of firearms. METHODS:Youth (14 to 24 years old) presenting to a Level 1 ED with assault were administered a computerized screening survey. Validated instruments were administered, measuring demographics, firearm rates and characteristics, attitudes toward aggression, substance use, and previous violence history.RESULTS: Among 689 assault-injured youth, 23% reported firearm possession in the past 6 months. Only 17% of those reporting firearm possession obtained the gun from a legal source; 22% reported ownership of highly lethal automatic/semiautomatic weapons and 37.1% reported having a firearm for protection. Logistic regression analysis identified significant correlates of firearm possession, including male gender, higher socioeconomic status, illicit drug use, recent serious fight, and retaliatory attitudes.CONCLUSIONS: ED assault-injured youth had high rates of firearm possession (23.1%), most of which were not obtained from legal sources. Youth with firearm possession were more likely to have been in a recent serious fight, and to endorse aggressive attitudes that increase their risk for retaliatory violence. Future prevention efforts should focus on minimizing illegal firearm access among high-risk youth, nonviolent alternatives to retaliatory violence, and substance use prevention. Dr Carter carried out the analyses, drafted the manuscript, and reviewed and revised the manuscript; Drs Walton and Zimmerman were responsible for the initial conceptualization and design of the study, design of data collection elements, and reviewed and revised the manuscript; Drs Newton and Whiteside assisted with the analysis, drafting of the manuscript, and critical review of the manuscript; Mr Clery assisted with the drafting of the manuscript and critical review of the manuscript; Dr Cunningham was responsible for the initial conceptualization and design of the study, design of data collection elements, aided in the analysis, and reviewed and revised the manuscript; and all authors approved the final manuscript...

Injury-related Pediatric Mortality in Shiraz, Iran: A Community-based Survey

“…This may be explained by higher rates of retaliatory attitudes (32) and easier access to firearms (33) in children of this age category. Therefore, educating the families regarding safe storage of the firearms is very important.…”

Firearm Violence Among High-Risk Emergency Department Youth After an Assault Injury

“…Direct literature comparisons are limited because this longitudinal study, to our knowledge, is the first to comprehensively characterize such a broad range of firearm violence outcomes among a systematically sampled cohort of assault-injured youth. Observed rates of firearm behaviors, however, are higher than those in national adolescent samples, 50,51 as well as in previous ED-and school-based studies that have focused on either violent injury recidivism 19,[52][53][54] or examined surrogate markers (eg, firearm possession/carriage; severe peer violence) 13,46,55,56 for firearm violence. Our results highlight that an ED assault-injury visit is an important indicator of future firearm violence risk and emphasize the substantial need for evidence-based interventions addressing this risk.…”

“…As in previous work, 13 past 6-month firearm possession was a composite of 5 measures from the Tulane Study 41,42 characterizing firearm ownership/carriage. Measures excluded hunting or sporting activities.…”

“…4 Among assault-injured youth seeking urban ED care, almost 25% report having a firearm, with recent violence, attitudes favoring retaliation, and illicit drug use cited as key risk factors for illicit firearm possession. 13 Substance use, which is as high as 55% among assault-injured ED youth, 14 has also been shown to be a key risk factor for a range of high-risk firearm behaviors, including weapon carriage, 15,16 unsafe weapon storage, 16 and firearm-related threats against others. 17 Furthermore, although almost 50% of assaultinjured ED youth have a recent mental health diagnosis (eg, major depressive episode, posttraumatic stress disorder [PTSD]), ,20% have received treatment for that illness, 18 and previous studies have not characterized how a preexisting mental health diagnosis may contribute to future firearm violence risk in this population.…”

Comparing Substance Use And Violence Among Adolescents Recruited From an Urban Emergency Department: Does Parenting Status Matter?

“…Cunningham et al [20] found that 1/5 of adolescents recruited through the urban ED reported carrying a weapon. Carter et al [21] found high rates of firearm possession among assault-injured youth, with nearly 1 in 4 reporting possession, and 42% of those with firearms carrying the weapon outside the home; additionally, 32% of these assault-injured youth with firearms were also parents, raising questions about safe firearm storage within the home. However, an examination substance use and violence among a general sample of adolescent parents who utilize emergency department (ED) services is understudied.…”