Geo-demographics of gunshot wound injuries in Miami-Dade county, 2002–2012

Abstract

BackgroundWe evaluated correlates of gunshot wound (GSW) injuries in Miami-Dade County, Florida. Firearm-related injury has previously been linked to socio- and geo-demographic indicators such as occupation, income, neighborhood and race in other metropolitan areas, but remains understudied in Miami.MethodsWe reviewed 4,547 cases from a Level I trauma center’s patient registry involving an intentional firearm-related injury occurring from 2002 to 2012. During this eleven-year study period, this trauma center was the only one in Miami-Dade County, and thus representative of countywide injuries.ResultsThe crude morbidity rate of GSW injury over the 11-year period was 15 per 100,000 persons with a crude mortality rate of 0.27 per 100,000 persons. The case fatality rate of injured patients was 15.4%. Both morbidity and mortality increased modestly over the 11-year study period. The total number of GSW patients rose annually during the study period and patients were disproportionately young, black males, though we observed higher severity of injury in white populations. Geo-demographic analysis revealed that both GSW incident locations and patient home addresses are spatially clustered in predominantly poor, black neighborhoods near downtown Miami, and that these patterns persisted throughout the study period. Using spatial regression, we observed that census tract-level GSW incidence rates (coded by home address) were associated with a census tract’s proportion of black residents (P < .001), single-parent households (P < .001), and median age (P < .001) (R 2 = .42).ConclusionsThese findings represent the first representative geo-demographic analysis of GSW injuries in Miami-Dade County, and offer evidence to support urgent, targeted community engagement and prevention strategies to reduce local firearm violence.

Race Impacts Outcomes of Patients With Firearm Injuries

“…Zebib et al found that in Miami, White patients were more likely to sustain a more severe injury and have higher rates of mortality than Blacks, which supports our findings that Black patients had a lower mortality. 15 It is also possible that Black patients may have died more frequently in the field prior to arrival or in the trauma bay, as patients captured in this analysis were required to be admitted to the hospital. In addition, Black patients are more likely than other ethnic groups to avoid medical care in dire situations or seek delayed medical treatment due to beliefs that medical care will not change their outcomes.…”

Geospatial mapping can be used to identify geographic areas and social factors associated with intentional injury as targets for prevention efforts distinct to a given community

“…4–12 GIS is a broad term used to describe programs that analyze, manipulate, and display geographic data in various ways. The capabilities of GIS are expansive, and its mastery is critical in the discipline of geoinformatics.…”

Analysis of the factors increasing the mortality in emergency department following firearm injuries

“…The mortality rate was found to be 15% for the body overall (12). Zebib et al have determined the injury localizations and their rates due to firearms to be as follows: abdomen 19.3%, chest 11.3%, head 5.5%, pelvis 5.4%, lower extremity 15.9%, upper extremity 3.3% (15) . Kelly et al In their study, the mortality rate due to FAI was 18.6% (n = 11), 13.5% (n = 8) in the chest, and 5% (n = 3) in the head and neck vascular spaces (16).…”