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Transportation Access as a Structural Determinant of Firearm Violence
Jessica Altman1, Alexandra Campbell1, Ethan Smith2
1Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.
The American Surgeon
|June 12, 2026
Summary
Poor transportation access is not linked to increased gun violence. Instead, lower transit and auto access scores showed a slight association with reduced firearm injuries and deaths, highlighting complex urban violence factors.
Area of Science:
- Public Health
- Urban Studies
- Criminology
Background:
- Transportation access is a key social determinant of health with an understudied link to gun violence.
- Previous research has not fully explored the relationship between transportation accessibility and firearm violence rates.
Purpose of the Study:
- To investigate the association between transportation access and firearm violence.
- To determine if poor transportation access correlates with increased firearm injuries and deaths.
Main Methods:
- Cross-sectional analysis using University of Minnesota Access Across America (UMAAA) data for transportation access (transit, auto, biking, walking).
- Utilized Gun Violence Archive (GVA) data for violent firearm injuries and deaths.
- Employed Negative Binomial Poisson regression models on data aggregated from 2019-2021 for 56 large US metropolitan statistical areas (MSAs), adjusting for socioeconomic factors.
Main Results:
- Lowered overall transit and auto access scores were associated with a slightly lower risk of violent firearm injury and death.
- This inverse relationship between transportation access and firearm violence persisted after adjusting for socioeconomic variables like Gini and income inequality.
- Poverty, unemployment, and lack of vehicle access showed a direct association with higher firearm violence rates, with greater impact than transportation access scores.
Conclusions:
- The study does not support a protective effect of transportation access against firearm violence; a small, inverse relationship was observed.
- Findings suggest that urban violence is multifactorial, influenced by various socioeconomic and community elements.
- Further research is needed to identify effective injury prevention strategies targeting key determinants of firearm injury.
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