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Beyond the Index: Family Fragility as a Geographic Risk Factor for Pediatric Firearm Injuries.

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Pediatric firearm injuries are linked to family fragility and social determinants of health. Addressing family structure disruptions can help reduce disparities in child firearm hospitalizations.

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Area of Science:

  • Public Health
  • Epidemiology
  • Pediatric Trauma

Background:

  • Geographic social determinants of health (SDOH) influence pediatric firearm injuries.
  • Existing SDOH metrics may lack explanatory power and actionable insights.
  • Family fragility, defined by family structure disruption, is a potential underrecognized driver of firearm injury disparities.

Purpose of the Study:

  • To evaluate the impact of family fragility on pediatric firearm hospitalizations.
  • To assess family fragility in the context of other geographic SDOH.
  • To understand risk factors for pediatric firearm injury hospitalization.

Main Methods:

  • Analysis of pediatric firearm hospitalizations (ages 0-19) in Florida from 2012-2021.
  • Calculation of county-level incidence rates per 100k population.
  • Multivariable linear regression to identify risk factors, including social vulnerability index (SVI) components and family fragility (non-marital births, divorces involving minors).

Main Results:

  • 3887 pediatric firearm hospitalizations were recorded.
  • County-level incidence varied widely (0-24 per 100k).
  • Family fragility, rurality, and SVI components (socioeconomic, housing/transportation) were significant predictors of firearm hospitalizations. Risk factors differed for self-harm vs. non-self-harm injuries.

Conclusions:

  • Pediatric firearm hospitalizations are associated with family fragility, rurality, and established SDOH.
  • Self-harm firearm injuries exhibit a distinct risk factor profile.
  • Further research is needed to validate findings and explore interventions for strengthening families.