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Association Between Geospatial Access to Care and Firearm Injury Mortality in Philadelphia.

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Firearm violence deaths in cities are rising. Longer travel times to trauma centers increase mortality risk, with 23% of shooting fatalities linked to access disparities.

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Area of Science:

  • Public Health
  • Trauma Surgery
  • Urban Violence Research

Background:

  • Firearm violence poses a significant and growing public health challenge in U.S. urban centers.
  • The impact of trauma center accessibility on firearm injury mortality requires comprehensive evaluation within trauma systems.

Purpose of the Study:

  • To investigate the relationship between geospatial access to trauma care and firearm injury mortality.
  • To assess the role of travel time to trauma centers as a determinant of survival in urban shooting incidents.

Main Methods:

  • Retrospective cohort study analyzing firearm injuries in Philadelphia (2015-2021).
  • Geospatial network analysis calculated predicted ground transport time to the nearest trauma center.
  • Hierarchical logistic regression and population attributable fraction estimated mortality risk and disparities.

Main Results:

  • Over 10,000 individuals were shot, with a 20% mortality rate (1,999 deaths).
  • Each additional minute of transport time to a trauma center increased mortality odds by 3% (OR, 1.03).
  • An estimated 23% of shooting fatalities (455 deaths) were attributable to disparities in geospatial access to care.

Conclusions:

  • Geospatial access to trauma care is a critical trauma system metric.
  • Improving access to trauma centers may significantly reduce firearm injury mortality in urban environments.
  • Addressing access disparities is crucial for mitigating deaths from gun violence.