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Race disparities in firearm injuries and outcomes among Tennessee children
Colin A Martin1, Purnima Unni, Matthew P Landman
1Monroe Carell, Jr. Children's Hospital at Vanderbilt University, Department of Pediatric Surgery, Nashville, TN 37232-9780, USA. colin.a.martin@vanderbilt.edu
Insights
Black children in Tennessee are overrepresented and 4 times more likely to die from firearm injuries than white children. This highlights the need for targeted injury prevention programs for disparate populations.
Area of Science:
- Pediatric Trauma Research
- Public Health
- Epidemiology
Background:
- Firearm injuries pose a significant threat to child safety.
- Disparities in outcomes based on race and socioeconomic status are evident in pediatric trauma.
- Understanding these disparities is crucial for effective injury prevention.
Purpose of the Study:
- To identify racial and socioeconomic factors linked to adverse outcomes in Tennessee children with firearm injuries.
- To analyze the association between race, injury circumstances, and mortality rates.
- To inform the development of targeted firearm injury prevention strategies.
Main Methods:
- Analysis of a pediatric trauma registry and medical examiner data (1998-2010).
- Inclusion of children aged 15 years and younger with firearm injuries.
- Utilized descriptive statistics and logistic regression, including zip code socioeconomic data.
Main Results:
- 188 children sustained firearm injuries; 29% died.
- Black children were overrepresented (2.5x) and 4 times more likely to die from firearm injuries than white children.
- Assaults were more common among black children (67%) compared to white children (12%).
Conclusions:
- Black children in Tennessee experience disproportionately worse outcomes from firearm injuries.
- Zip code-level data can guide the creation of specific prevention programs for vulnerable populations.
- Interventions are needed to reduce both intentional and unintentional childhood firearm injuries.
Purpose:
The aim of this study was to identify race and socioeconomic factors associated with worse outcomes among Tennessee children who sustain firearm injuries.
Methods:
We queried our institutional pediatric trauma registry and the Davidson County Regional Medical Examiner database for children ages 15 years and younger who sustained firearm injuries between July 1998 and July 2010. Descriptive statistics and logistic regression modeling were used to analyze demographic data, circumstance of injury (unintentional or intentional), odds of death, and characteristics of zip codes (total population, race distribution, and median income) where injuries occurred.
Results:
One hundred eighty-eight children (median age, 13.2 years; range, 1.1-15.8 years) sustained a firearm injury and were either admitted to our institution or were referred directly to the medical examiner. More whites (n = 109, or 58%) sustained a firearm injury than blacks (n = 79, or 42%), but blacks were overrepresented 2.5-fold more compared with the general Tennessee population. Fifty-four children (29%) died, of whom 35 (65%) were black and 19 (35%) were white (P < .001). Ninety-three children sustained unintentional firearm injuries, and 84 were intentional (n = 67, assault; n = 17, suicide). When data were stratified by intent, 67% of blacks and 12% of whites were assaulted (P < .001). After controlling for age and intent, black children were 4 times more likely to die of firearm injuries than whites (P = .008; 95% confidence interval, 1.4-11.3).
Conclusion:
In a sample of firearm-injured Tennessee children, blacks were notably overrepresented and far more likely to die than whites. Using zip code data will help to establish firearm injury prevention programs specific to disparate populations and to reduce both violent and accidental childhood firearm injuries.
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