Illinois community health needs assessments: Disparities in prioritizing firearm violence prevention

Violent injuries contribute to significant death and disability in the United States every year. The number of hospitals who identify violence prevention as a priority is unknown. We sought to determine if hospitals in counties with high rates of firearm-related mortality identified violence prevention as a priority in their Community Health Needs Assessments (CHNAs) and if trauma center designation influenced this prioritization.

This was a cross-sectional review of all publicly available CHNAs for hospitals within 27 Illinois counties from 2021 to 2023. Firearm to all-mechanism mortality ratios from 2017 to 2021 were identified using age-adjusted 5-year mortality rates obtained from the CDC's WISQARS' Health Equity Data for Illinois and stratified into quartiles. Descriptive statistics were used to compare the prioritization of violence prevention by firearm to all-mechanism mortality ratios (highest vs. lowest quartile) and trauma designation.

Of 93 hospitals in 27 counties, 52 (55.9%) identified violence as a community issue. Hospitals in counties with the highest firearm to all-mechanism mortality ratios were more likely to identify violence as a priority than the lowest quartile counties (62.7% vs. 38.5%, p = 0.03). Trauma centers were not more likely than nontrauma centers to prioritize violence in both high ( p = 0.29) and low ( p = 0.77) firearm mortality counties. Among hospitals identifying violence as a community health issue in their CHNA, only 25 (48.1%) outlined a plan to address it.

While hospitals within counties in the highest quartile of firearm mortality were more likely to identify violence as a community issue, few outlined a plan to address it. In addition, trauma centers were not more likely to identify violence as a community issue. Enhanced support for evidence-based programs, such as hospital-based violence intervention programs, may help bridge the gap between identification and intervention.

Prognostic and Epidemiologic; Level IV.