Social-Ecological Correlates of Involvement in Firearm-Related Violence in a Nationally Representative Survey of...

Objectives. To examine social-ecological correlates of firearm-related violence involvement among adults. Methods. Cross-sectional surveys were collected in the United States between August 2023 and September 2023 through an AmeriSpeak Panel (n = 1681), weighted to be nationally representative. Measures included self-reported involvement in firearm-related violence victimization and perpetration and hypothesized social-ecological risk factors. Results. About 5.9% reported ever perpetrating firearm-related violence; 6.9% reported experiencing firearm-related victimization. In a fully adjusted model, factors associated with perpetration were greater traumatic stress symptoms, beliefs about gun use to enforce respect, positive attitudes about firearms, and firearm-related victimization. Factors associated with victimization were adverse childhood experiences, family and friends' histories of violence and suicide, traumatic stress symptoms, witnessing community violence, firearm-related perpetration, male sex, and lower income. Conclusions. A range of factors across social-ecological domains were associated with firearm-related violence, emphasizing the need for a contextualized approach to understand firearm-related injuries and deaths. Posttraumatic stress and exposure to violence may be particularly important to understanding the cycle of firearm violence. Intervention strategies should be expanded to include individuals vicariously exposed to violence, not just those directly victimized. (Am J Public Health. 2025;115(11):1903-1912. https://doi.org/10.2105/AJPH.2025.308213).