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The gun assault case fatality rate measures the fraction of shooting victims who die from their wounds. Considerable debate has surrounded whether gun assault case fatality rates have changed over time and what factors may be involved. We use crime event data from Los Angeles to examine the victim and situational correlates of gun assault case fatality rates over time. We estimated log binomial regression models for the probability of death in each year from 2005 to 2021, conditioned on situational and victim characteristics of the crime. Case fatality rates increased by around 1.3% per year between 2005 and 2021 from around 15.9 to 19.7%. Baseline case fatality rates differed systematically by most situational and victim but followed similar temporal trends. Only victim age significantly covaried with the temporal trend in case fatality rates. An individual shot in Los Angeles in 2021 was 23.7% more likely to die than the equivalent victim in 2005. The steady increase in case fatality rates suggests that there were around 394 excess fatalities over what would have occurred if case fatality rates remained at the 2005 level. Increases in the average age of victims over time may contribute to the general temporal trend. We hypothesize that older victims are more likely to be shot indoors where lethal close-range wounds are more likely.

Background: Approximately 15% of pediatric firearm injuries are unintentional. While demographic characteristics of unintentional firearm injuries have been described, the relationship between injury characteristics and mortality is not well understood. In this study, we identified injury characteristics associated with fatality among unintentional firearm injuries in adolescents. Methods: We conducted a retrospective (May 2022-May 2023) cross-sectional study of unintentional firearm injuries among adolescents 12–17 years old using the Gun Violence Archive. Variables included victim age and sex, shooter age and sex, injury location, injury circumstance, number of firearms, type of firearm, firearm owner, census region, and shooter relationship to the victim. Logistic regression was used to identify variables associated with fatality. Results: Of 319 unintentional incidents, 212 (66.5%) were non-fatal and 107 (34.5%) were fatal. Of all shootings, 176 (55.2%) occurred in a residence. A shooter was identified in 256 (80.3%) cases; 43.0% of these were a peer of the victim. The adjusted odds of fatality were higher when a peer was the shooter (aOR 5.38, 95% CI 2.57, 11.80) compared to self-inflicted injury and when the shooting took place in the victim's residence (aOR 2.87, 95% CI 1.07, 7.88) or another residence (aOR 3.03, 95% CI 1.45, 6.67) versus a public location (Fig. 1). Conclusions: Unintentional firearm injuries were more likely fatal when a peer was the shooter and when the shooting occurred at a residence. This amplifies the importance of safe home firearm storage and exploring other evidence-based approaches to decreasing youth access to firearms. [ABSTRACT FROM AUTHOR]

Research Summary: We apply the microsynthetic control method to evaluate the gun violence prevention effect of gunshot detection technology (GDT) in Kansas City, MO. We measure the influence of GDT on process measures (ballistic evidence collection and gun recoveries) and outcome measures (shots fired calls for service, non‐fatal shootings, fatal shootings, and aggravated assaults and robberies committed with a firearm). The GDT system was associated with higher levels of ballistic evidence collection in the GDT target area and surrounding catchment area, higher levels of gun recoveries in the surrounding catchment area, and lower levels of shots fired calls for service in the GDT target area. The GDT system did not influence any of the gun violence categories involving confirmed victims (non‐fatal shootings, fatal shootings, and aggravated assaults and robberies committed with a firearm). Policy Implications: Agencies that highly prioritize increasing evidence collection and reducing unauthorized firearm discharges may consider dedicating necessary resources to acquire GDT. Agencies that prioritize the reduction of gun violence victimization, however, should consider whether resources are better used for solutions other than GDT. Moving forward, violence prevention scholars should strive to identify contextual factors that facilitate or mitigate the GDT system effect, in an attempt to better understand how to deploy GDT in a manner that maximizes the likelihood of success. This would provide additional guidance to public safety agencies looking to maximize return on investment. Continued adoption of GDT should perhaps be contingent upon the development of such research, given the high cost of the technology. [ABSTRACT FROM AUTHOR]

Chicago's broader notorious reputation of gang and gun violence dominates popular discursive conversations about the city's safety and stability. Through a critical structural perspective, this article explores the constitutive historical continuity and spatialized contours of racial capitalism in the facilitation of structured violence and organized death in city neighborhoods. These dynamics are most relevant where individualized and pathological narratives of interpersonal gang-based gun violence are rampant. The focus is on the context of Mexican Chicago, particularly the transnational site of Little Village. Using hyper-local examples on the environment, education, and labor-based economic markets, I showcase how this diasporic Mexican community is an instructive site highlighting the ongoing presence of colonially constituted structures of expropriation, dispossession, exploitation, and displacement endemic to the United States empire and its resultant violence. I suggest that gang-based gun violence is tied to broader death-making machinery, leading us to robust alternative conceptual frames and reactions when socio-politically engineered 'crime' and violence take place across urban city neighborhood spaces. I conclude with a paired abolitionist perspective and implications for critical sociology and the study of gangs specifically. [ABSTRACT FROM AUTHOR]

Background: The burden of firearm injury (FI) extends beyond hospitalization; however, literature focuses mostly on short-term physical outcomes. This study aimed to assess changes in patient-reported outcomes following firearm-related trauma. We hypothesized long-term patient-reported socioeconomic, mental health, and quality-of-life (QoL) outcomes are worse post-FI compared to pre-FI.Methods: This was a retrospective study where a phone survey was conducted with FI survivors admitted between January 2017 and August 2022 at a level 1 trauma center. Survey questions assessed demographics, socioeconomics, and mental and physical health pre-FI vs ≥ 6 months post-FI; the McNemar test was used for comparisons. The PROMIS-29 + 2v2.1 NIH validated instrument was used to assess long-term QoL. Standardized NIH PROMIS T-scores were calculated using the HealthMeasures Scoring Service.Results: Of 204 eligible FI survivors, 71 were successfully contacted and 38 surveyed. Respondents were male (86.8%), Black (76%), and aged 18-29 (55.3%), and 68.4% had high school level education. Post-FI, patients were more likely to be unemployed (55.2% vs 13.2%, P < .001) and report increased mental health needs (84.2% vs 21%, P < .001) compared to pre-FI. Most (73.7%) also reported lasting physical disability. Similarly, the PROMIS instrument demonstrated largely worse health-related QoL scores post-FI, particularly high anxiety/fear (T-score 60.2, SE 3.1, CI 54.6-66.3, Table 2), pain resulting in life interference (T-score 60.0, SE 2.3, CI 55.7-63.9), and worse physical function (T-score 42.5, SE 3.0, CI 38.2-46.9).Conclusions: Firearm injury survivors had more unemployment and worse mental health post-FI compared to pre-FI. Firearm injury survivors also reported significantly worse health-related QoL metrics including pain, anxiety, and physical function 6 months following their trauma. These long-term patient-reported outcomes are a framework to build future outpatient resources.Level of Evidence: IV. [ABSTRACT FROM AUTHOR]

Direct and indirect gun violence exposure (GVE) is associated with a broad range of detrimental health effects. However, much of this research has examined the effects of a single type of GVE (e.g., being shot) on discrete outcomes (e.g., daily pain, PTSD). Since people may experience numerous types of GVE (e.g., being threatened with a gun and hearing gunshots in their neighborhood) with broad effects on their well-being, we study the association between four types of direct and indirect GVE and five aspects of quality of life (overall, physical, psychological, social, and environmental). Using a representative sample of adults from nine states (N = 7455), we find that witnessing/hearing about a shooting in one's neighborhood was the most commonly experienced GVE associated with significant decreases in all five types of quality of life. Cumulative GVE was also associated with significant decreases in overall physical, psychological, social, and environmental quality of life. For example, individuals with four GVEs had an adjusted average physical quality of life that was 11.14 points lower and environmental quality of life that was 7.18 points lower than individuals with no GVE. Decreasing gun violence is a critical component of improving community health and well-being. [ABSTRACT FROM AUTHOR]

This article is a case study of a college-based storytelling initiative in Boston that seeks to transform dominant narratives of gun violence that are harmful and dehumanising by centring those most impacted. It builds on practices of critical making which can be understood as the externalisation of critical thinking into the creation of a shared artefact. When done collaboratively with community partners directly impacted by the intended outcome of the artefact, critical making can foster multiperspectivalism, awareness of injustices, and motivation to bring about change. In order for collaborative critical making to be adequately supported within higher education for these ends, novel infrastructure is necessary. Through an in depth analysis of the Transforming Narratives of Gun Violence initiative, we examine the infrastructure that supports collaborative critical making across three scales: the classroom, the college, and the community. We look across three dimensions: listening, expression, and governance. The article describes challenges and opportunities of working within higher education, and concludes with suggestions for future research. [ABSTRACT FROM AUTHOR]

Gun violence, often characterized as a singular issue, is not one cohesive problem. Instead, it takes many forms resulting from the complex interplay of multiple factors. Outcomes of gun violence also vary significantly. They may be (a) physically non-injurious (a gun is brandished), (b) injurious but non-lethal, or (c) lethal. To understand and address gun violence effectively, it is essential to consider various risk factors for both non-lethal and lethal gun violence victimization, using a comprehensive, comparative framework. We present a novel comparative framework for better understanding gun violence, and for developing policy responses to this violence. We disaggregate gun violence into its various forms and propose a conceptualization of risk factors in discrete categories, each with important implications for policy intervention. While we emphasize the value of this framework for understanding and combatting interpersonal gun violence in America, the research and policy approaches discussed here should be equally applicable to other international contexts with gun violence as a serious public health issue as well. [ABSTRACT FROM AUTHOR]

This piece documents the collaboration between a team of four University of Pennsylvania students and seven youth partners from across the Greater Philadelphia area who came together to discuss, understand, and take action toward civic issues impacting their communities. As youth arrived at the Civic Engagement Summer Program, a joint Philadelphia Youth Network and Netter Center for Community Partnerships High School Voter Project iteration, alongside adult facilitators, they navigated the complexities of civic literacy discussions and spaces. Together, the adult facilitators and youth participants engaged in dialogue about local government, pervasive gun violence impacting their communities, and voter registration inequities. This piece centers the following inquiries: What happens when educators consider the self-efficacy youth have with regard to addressing civic issues in their communities? What out-of-school civic literacy spaces and experiences might youth need to feel empowered to use their voices? What are the ways in which youths' existing literacies and knowledge inform the way they talk about the issues they wish to address? What role do local universities have in working with youth through educational forums to learn more about the roles voting and local government play in ameliorating community issues, such as gun violence? Furthermore, this piece considers how these questions arose as the collaborative worked toward shared goals together (Plummer et al., 2019). To address these collaborative inquiries, the team highlights five aspects of the Civic Engagement Summer partnership that enabled facilitators and youth to build trust: sustaining community partnerships, highlighting youths' existing funds of knowledge (Moll et al., 1992), cultivating civic efficacy, reimagining critical civic literacy alongside youth, navigating intergenerational relationships and learning, and centering relationships (Campano, Ghiso & Welch, 2018; Plummer et al., 2019). With youths' consent, this article shares the history of the Civic Engagement Summer, and the discussions and experiences sparked by the 2023 iteration. [ABSTRACT FROM AUTHOR]

This article aims to analyze temporal trends in female firearm homicides in the Northeast of Brazil during the period 2000-2019. We conducted an ecological study using data on firearm homicides of women aged 10 years and over obtained from the Mortality Information System. The population data were taken from the 2010 Census. Homicide rates were calculated after correcting the data to account for differences in the quality and coverage of death records. Trends were assessed using negative binomial regression and described using relative risk and p values. Average annual percentage changes in homicide rates were also calculated. The regional firearm homicide rate during the study period was 4.40 per 100,000 women. Rates were highest in the state of Alagoas (5.40), the 15-19 age group (5.84) and in public thoroughfares (1.58). Trends were upward across all states except Pernambuco, where they were downward, and Alagoas, where rates were stationary. The place of occurrence with the highest percentage increase in firearm homicides over the study period was public thoroughfares. Female firearm homicides showed an upward trend across most northeastern states. [ABSTRACT FROM AUTHOR]

The purpose of this manuscript is to provide holistic practice strategies for the care of victims of gun violence. Gun violence is a public health crisis with a significant increase following the pandemic. The impact of Covid-19 restrictions placed an increase burden on some communities already overwhelmed with poverty, crime, and deteriorating homes. The overrepresentation of African American males as victim of gun violence indicates a health care disparity which needs to be addressed. The Theory of Reasoned Action and Theory of Planned Behavior are a theoretical framework that provides insight to the social behaviors associated with gun violence. The holistic approach recognizes the interconnection between individuals and environment, in order to facilitate the healing process for victims of gun violence, social factors and environment must be incorporated into their care. [ABSTRACT FROM AUTHOR]

Gun violence is a widespread problem in the United States. Using the case study of Milwaukee, Wisconsin, we analyze gun violence stories shared through the public humanities project, Voices of Gun Violence. We argue that the rhetoric of gun violence in Milwaukee helps constitute and naturalize racialized spatial imaginaries in ways that are imbricated in people's daily lives. Through critically engaging stories of gun violence, we find that gun violence often constructs Black space as inherently dangerous and reinforces racialized containment. However, we argue there are possibilities for resistant Black spatial imaginaries. [ABSTRACT FROM AUTHOR]

Abstract Background Approximately 15% of pediatric firearm injuries are unintentional. While demographic characteristics of unintentional firearm injuries have been described, the relationship between injury characteristics and mortality is not well understood. In this study, we identified injury characteristics associated with fatality among unintentional firearm injuries in adolescents. Methods We conducted a retrospective (May 2022-May 2023) cross-sectional study of unintentional firearm injuries among adolescents 12–17 years old using the Gun Violence Archive. Variables included victim age and sex, shooter age and sex, injury location, injury circumstance, number of firearms, type of firearm, firearm owner, census region, and shooter relationship to the victim. Logistic regression was used to identify variables associated with fatality. Results Of 319 unintentional incidents, 212 (66.5%) were non-fatal and 107 (34.5%) were fatal. Of all shootings, 176 (55.2%) occurred in a residence. A shooter was identified in 256 (80.3%) cases; 43.0% of these were a peer of the victim. The adjusted odds of fatality were higher when a peer was the shooter (aOR 5.38, 95% CI 2.57, 11.80) compared to self-inflicted injury and when the shooting took place in the victim’s residence (aOR 2.87, 95% CI 1.07, 7.88) or another residence (aOR 3.03, 95% CI 1.45, 6.67) versus a public location (Fig. 1). Conclusions Unintentional firearm injuries were more likely fatal when a peer was the shooter and when the shooting occurred at a residence. This amplifies the importance of safe home firearm storage and exploring other evidence-based approaches to decreasing youth access to firearms.

Background: Gun violence is a public health crisis, but nurses report receiving little education related to gun violence prevention (GVP). Purpose: This study aimed to describe undergraduate nursing faculty teaching behaviors and perceptions related to GVP and explore factors associated with teaching it. Methods: A cross-sectional survey design was used. Results: Less than one-third of faculty taught GVP. Knowledge, confidence, and beliefs were significantly associated with teaching GVP. Most were favorable to include GVP in curricula and agreed assessing for gun access, counseling about safe gun storage, and counseling about lethal means restriction should be taught. Key barriers included content saturation, political atmosphere, lack of educational materials, and lack of topic expertise. Conclusion: Faculty agree that GVP should be taught, but most do not teach it in undergraduate nursing programs. Faculty development programs focused on GVP and support from national nursing organizations may decrease barriers in incorporating GVP into curricula. [ABSTRACT FROM AUTHOR]

Firearm carriage and possession predicts youth firearm violence victimization and perpetration. This study describes self-reported factors associated with firearm access, carriage, and possession among justice-involved youth. We conducted an exploratory, mixed-methods study. Participants were recruited from May 2022 to February 2023 from the Juvenile Justice Collaborative, a diversion program for justice-involved youth. We used online anonymous surveys to investigate exposures related to firearm access, carriage, and possession. We performed semi-structured interviews using the phenomenology framework. We used descriptive statistics to examine firearm exposures by participant demographics. We performed qualitative analyses using an iterative approach with constant comparison to identify key themes. We completed 28 surveys and 5 interviews. Most survey participants identified as male (57%) and Black (61%) with a median age of 18 years. Interview participants described the socialization and cultural normalization of firearms, most prominently among peers. Survey participants reported whether they had ever carried (25%) or possessed (21%) a firearm. Survey and interview participants endorsed protection in the context of increasing violence exposure over time as the primary motivation for firearm possession. Interview participants describe accessing firearms primarily through social networks while survey participants also reported access from strangers (25%) and licensed sellers/gun dealers (18%). In conclusion, justice-involved youth believe firearm carriage and possession may be needed for protection due to increasing violence exposure. Further investigation is necessary to determine interventions that may decrease firearm access, carriage, and possession among justice-involved youth. [ABSTRACT FROM AUTHOR]

Firearm violence has led many U.S. cities to invest in gunshot detection technology (GDT). Research on GDT remains limited and focuses mainly on whether it impacts police response times, arrests, and injuries. Public opinion about this technology has received limited attention. The current study addresses this gap using surveys in 23 Portland, Oregon neighborhoods with above-average firearm discharges. Respondents were evenly distributed between those opposing GDT and those supporting its use. People with prior knowledge of the technology and those with privacy concerns were more likely to be opposed whereas those who worried about gun violence and those who had greater trust in the local police were more likely to support GDT. The findings highlight the value of assessing community sentiments prior to investing in new surveillance technologies. [ABSTRACT FROM AUTHOR]

Gun violence significantly threatens tens of thousands of people annually in the United States. This paper proposes a multidisciplinary approach to address this issue. Specifically, we bridge the gap between criminology and computer vision by exploring the applicability of firearm object detection algorithms to the criminal justice system. By situating firearm object detection algorithms in situational crime prevention, we outline how they could enhance the current use of closed-circuit television (CCTV) systems to mitigate gun violence. We elucidate our approach to training a firearm object detection algorithm and describe why its results are meaningful to scholars beyond the realm of computer vision. Lastly, we discuss limitations associated with object detection algorithms and why they are valuable to criminal justice practices. [ABSTRACT FROM AUTHOR]

Our overarching theme for Creative Nursing Volume 30 is The Impact of Social Forces on Nursing and Health. The theme of this current journal issue was originally called Social Violence. In planning this issue, our Editorial Board had to confront head-on the many ways in which overt violence or the threat of violence pervades our lives, as nurses and as individuals. We broadened the title to Consequences and Disruptive Solutions for Social Violence, choosing to focus on what we can do to recognize the interlocking processes that enable, promote, reward, and sustain violent behavior, and to mitigate those effects when and where we can. The sobering content in this issue is the business of each of us. The realities of domestic violence and gun violence, the impact of othering and marginalization, the effects of substance use on family members and of students' experiences of trauma on the school nurses who care for them, and the lethal legacy of unthinking adherence to policies and procedures that is still relevant today—Awareness of this part of our lives and of our practice is where we must start. [ABSTRACT FROM AUTHOR]

Gun violence in the United States is a serious problem. Addressing the problem will require not only strong leadership but also a unique approach. One such approach was utilized by U.S. President Abraham Lincoln, who assembled a "Team of Rivals" with positions different than his own that provided helpful perspective in finding solutions to the problems of the time. This article applies the team of rivals approach to the problem of gun violence. [ABSTRACT FROM AUTHOR]

Our previous work demonstrated that use of ShotSpotter (SS), a gunfire detection system, and use of police department (PD) transport decreased response and transport time for gunshot wound (GSW) victims versus events with non-ShotSpotter (NSS). The purpose of this study was to evaluate transport trends and how they are linked to SS in the period of 2016-2021 in Camden, NJ. This was a single-center, retrospective observational study. Demographics, response time, transport time, and clinical data were collected. Independent t -test, Mann–Whitney U test, chi-squared test, and linear regression to correct for transport time and method of transport were used to compare outcomes (P < 0.05). A total of 267 GSWs were included: 77 emergency medical technicians (EMS)-SS, 41 EMS-NSS, 116 PD-SS, and 33 PD-NSS. When comparing response from 2016 to 2021, PD improved from 4 to 2 min (P = 0.001). EMS improved from 6.4 min (EMS-NSS) and 4.5 min (EMS-SS) to 5 min (EMS- NSS) and 4 min (EMS-SS) (P = 0.281). In addition, PD transport times, 5 min (SS) and 4 min (NSS), were faster than EMS, 9 min (SS and NSS) (P < 0.001). Overall PD transport volume increased with a peak in 2020 (68.3%). There was also an increase in PD-NSS transport 4% to 37.9% (P < 0.001). EMS-SS transport decreased from 54.7% to 6.9% (P < 0.001). The presence of SS technology in a small urban setting continues to be associated with a higher rate of PD transport of GSW victims. The critical time of dispatch and transport for both PD and EMS has shown durable improvement. • Police response and transport times still faster in small US city. • Continued improvement of police transport times in small US city. • Increased police transport without ShotSpotter attributed to community policing policy. • Decreased emergency medical technicians transport attributed to emergency medical technicians shortage in light of COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

This study analyzes the trend in firearm and criminal milieu–related homicides in Sweden in the past three decades. A particular focus is on the 2010–2019 period, during which a dramatic increase was noted, although an increase in firearm homicides with illegal guns had already started in the late 1990s. In extant literature, the rapid increase in the 2010s is posited to be associated with fast access to illegal weapons, especially among youth in the most urban regions, Stockholm and Skaane County in particular. As a result, many victims and perpetrators are young men. This issue is proposed to be exacerbated by the new possibilities for organized crime setups in the wake of the digital revolution, a heightened level of social problems in the aftermath of high immigration from developing countries in combination with the dismantling of welfare institutions, and a self-increasing chain reaction of violence triggered by random episodes in the criminal milieu. These hypotheses are largely supported by this study's findings. [ABSTRACT FROM AUTHOR]

Gun violence (GV) and safety is a contentious topic in the United States, despite increasing morbidity and mortality among children and adolescents. It is important for physicians to take a role in preventing future GV. This article aims to present several methods that physicians can use to prevent GV in their own communities, ranging from implementation of large-scale intervention programs to simple screenings and anticipatory guidance. As the problem of GV persists, it is important for physicians to use their role to identify individuals who are at high-risk and advocate for changes that will benefit their future health. [ABSTRACT FROM AUTHOR]

In a society plagued by the implications of gun violence, the need for effective risk assessment measures has become evident. This project addresses the challenge of predicting gun violence risks at the county level in the United States by harnessing the power of machine learning-based predictive modeling. We hypothesize that demographic and socioeconomic factors, such as unemployment and poverty rates in 2021, influence the likelihood of gun violence in various regions. Through an intricate analysis of multifaceted datasets encompassing crime rates, socioeconomic indicators, and geographic characteristics, this research seeks to uncover the extent to which these factors impact the risk of gun violence at the county level. Analyzing 2021 data, the research identifies counties with specific poverty-related characteristics that significantly elevate the risk of shootings. The study’s use of decision trees provides a glimpse into the predictive model’s classification process. By decoding the complex dynamics of gun violence, this research opens new avenues for understanding and addressing the factors contributing to shootings, ultimately guiding the way toward a safer society. [ABSTRACT FROM AUTHOR]

The financial fallout of American gun violence profoundly impacts both victims and survivors. While employers, insurance companies, and victim compensation programs provide some support for navigating this fallout, many look to private channels—such as crowdfunding—to supplement these often-inadequate resources. We ask: How do those seeking material support on behalf of murdered women and girls assert worthiness and frame claims for restitution in the aftermath of gun violence? On whose behalf is material support requested, and what kinds of support are solicited? Using scholarship on digital sharing economies and the literature on gendered racialization to understand how broader systems of social inequality shape who seeks support and how, we examine GoFundMe crowdfunding campaigns in California and Florida from 2016 through 2018. We find that gendered-racialized strategies of solicitation in campaigns shape how victims are presented as deserving of support. This reinforces a distorted vision of gun violence, with campaigns emphasizing white women and girls as victims through calls for public grief, whereas campaigns for Black and Latinx women and girls frame loss as private trouble. Plain Language Summary: How Gendered Racialization Shapes Crowdfunding for Women and Girls Murdered by Gun Violence The financial fallout of American gun violence profoundly impacts victims and survivors. While employers, insurance companies, and victim compensation programs provide some support for navigating this fallout, many look to private channels—such as crowdfunding—to supplement these often-inadequate resources. We ask: How do those seeking material support on behalf of murdered women and girls assert worthiness and frame claims for restitution in the aftermath of gun violence? On whose behalf is material support requested, and what kinds of support are solicited? Using scholarship on digital sharing economies and the literature on gendered racialization to understand how broader systems of social inequality shape who seeks support and how, we examine GoFundMe crowdfunding campaigns in California and Florida from 2016 to 2018. We find that gendered-racialized strategies of solicitation in campaigns shape the legibility and grieve-ability of victims and reinforce a distorted vision of gun violence, with campaigns emphasizing white women and girls as victims through calls for public grief, while campaigns for Black and Latinx women and girls constructing loss as private trouble. [ABSTRACT FROM AUTHOR]

Research has indicated the relevance of gang membership and victimisation as risk factors for predicting the perpetration of gun violence. However, there is a dearth of research that has examined the potential that gang membership may moderate the impact of victimisation on gun violence perpetration. This study examined this prospect within a sample of justice-involved youth. The Pathways to Desistance dataset was analysed. Generalised estimating equations were used to test for direct and interactive effects of gang membership and victimisation while accounting for nested error corresponding to the repeated measures in this 11-wave longitudinal dataset. Results indicated that gang membership was associated with an increased risk of gun violence perpetration, but not victimisation. The hypothesised interaction effect was also nonsignificant. [ABSTRACT FROM AUTHOR]

Introduction: Witnessing violence and violent victimization have detrimental effects on adolescents' emotional functioning and ability to envision and plan for their futures. However, research is limited on the impact of violence that occurs in adolescents' communities—whether or not it was witnessed or experienced firsthand. This paper investigated the associations between community exposure to gun homicide and adolescents' high school and college graduation aspirations. Methods: We analyzed data from the Future of Families and Child Wellbeing Study (N = 3031), a cohort study of children born 1998–2000 in 20 large US cities, merged with incident‐level data on deadly gun violence from the Gun Violence Archive (2014–2017). Outcomes were reported by adolescents (girls and boys) during wave 6 (2014–2017) of the study, conducted when the children were 15 years of age. We employed ordinary least squares regression, ordered logistic regression, and multilevel stratification to examine the average and heterogeneous impacts of community exposure to gun homicide on adolescents' educational aspirations. Results: Community exposure to gun homicide was associated with reduced high school graduation aspirations, particularly among adolescents with the lowest risk of exposure to gun homicide. Gun homicide exposure was also associated with increased college graduation aspirations; this association was concentrated among adolescents with moderate‐high risk of exposure. Conclusions: Given the importance of education for job opportunities and the better health that accompanies education and occupational attainment, preventing early exposure to gun violence and providing institutional supports to help adolescents facing adversity realize their goals is essential to their long‐term health and success. [ABSTRACT FROM AUTHOR]

Mass violence incidents (MVIs) involving firearms, commonly referred to as "mass shootings" have become increasingly frequent in the United States. These shootings often result in immediate casualties and have far-reaching psychological impacts on survivors, witnesses, and the broader community. This study aimed to assess the prevalence and risk factors of depression within affected communities. Population-based cross-sectional study. Data were collected from six communities affected by MVIs involving firearms that occurred between 2015 and 2020. Participants were randomly selected through address-based sampling, and depression was assessed using Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic-level major depressive episode (MDE). Overall, the MDE prevalence was 17·2% since the MVI, 15·4% in the past year, and 8·2% in the past month. Significant risk factors for MDE since MVIs include high exposure to the incident (adjusted relative risk [aRR] = 1·32, 95% confidence interval [CI]: 19–1·60), being aged 18–29 years (aRR = 2·52, 95% CI: 1·61–3·95), being a woman (aRR = 1·58, 95% CI: 1·27–1·96), having low social support (aRR = 1·80, 95% CI: 1·46–2·22), and experiencing past sexual or physical trauma (aRR = 2·20, 1·52–3·19). Our study reveals a high burden of depression within communities affected by MVIs involving firearm use. Persons with high exposure to the MVIs and certain demographic groups had greater risks for MDE. These findings highlight the long-term mental health burden in communities affected by MVIs and underscore the necessity of providing mental health services in its aftermath. [ABSTRACT FROM AUTHOR]

Working with data about homicide victims and perpetrators from 50 of America's largest cities, we investigate the explanatory power of some familiar explanations for why murder in those cities rose sharply in 2020. The analysis reveals that the distribution of risk by race was essentially the same in 2020 as in 2019. That empirical finding challenges some theories of how racial tensions after the death of George Floyd may have driven homicide increases. Similarly, homicide growth was not concentrated in those cities with the greatest availability in 2020 of new and older guns, or among the cities that suffered the most from the COVID‐19 pandemic. At a minimum, the cross‐city outcomes should reduce confidence that some combination of "race, guns, and COVID‐19" explains all of the most important aspects of what happened in 2020. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusion\nHIGHLIGHTSThe rate of worldwide mass shootings increased almost 400% over the last 40 years. About 30% are followed by the perpetrator’s fatal or nonfatal suicide attempt.We examined the rate of fatal and nonfatal attempts among 528 mass shooters over the last 40 years and their relationship to detected mental illness to better understand this specific context of suicide. We collected information on U.S.-based, personal-cause mass murders that involved one or more firearms, from online sources.A greater proportion of mass shooters from 2000 to 2019 took or attempted to take their own lives (40.5%) compared with those from 1980 to 1999 (23.2%, p < 0.001). More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with perpetrators who did not make a fatal or nonfatal suicide attempt (18.1%; p < 0.001). Among mass shooters who made fatal or nonfatal suicide attempts, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. Of the 98 mass shooters who made fatal or non-fatal suicide attempts and had a psychiatric, substance use, or neurologic condition, 41 had depressive disorders.It is possible that a lack of information about the perpetrators’ mental health or suicidal ideation led to an underestimation of their prevalence. These data suggest that suicide associated with mass shootings may represent a specific context for suicide, and approaches such as psychological autopsy can help to ascertain when psychiatric illness mediates the relationship between mass shootings and suicide.We examined 528 mass shootings.A greater proportion of mass shooters from 2000-2019 made a fatal or nonfatal suicide attempt (123/304, 40.5%) compared with mass shooters from 1980-1999 (52/224, 23.2%), χ2 = 17.3, p<.001.More than double the proportion of perpetrators who made a fatal or nonfatal suicide attempt had a history of non-psychotic psychiatric/neurologic symptoms (38.9%), compared with those who did not (18.1%; p < 0.001).Among mass shooters who made a fatal or nonfatal suicide attempt, 77 of 175 (44%) did not have any recorded psychiatric, neurologic, or substance use condition. However, it is possible that a lack of information about the perpetrators’ mental health or suicidal ideation led to an underestimation of their prevalence.These results suggest that perpetrators may have considered suicide a potential outcome of such an event, and/or that the perpetrators’ high levels of aggression and anger, accompanied by an impaired capacity for restraint, resulted in homicide followed by suicidal behavior.Psychological autopsies can clarify the role of psychiatric illness and more extreme aggressive traits in homicide-suicide instances of mass shootings. [ABSTRACT FROM AUTHOR]

Background: Although firearms are implicated in the majority of law enforcement intervention (LEI)-related deaths, scientific research is lacking. The present study sought to characterize clinical and financial outcomes between injured suspects and other gunshot wound (GSW) patients. Study Design: The 2016-2020 National Inpatient Sample was queried for patients ≥16 years old admitted following GSW. Patients were categorized as injured suspects (ISs) if they were injured in LEI and non-IS otherwise. The primary outcome was in-hospital mortality with complications, hospitalization duration (LOS), and costs secondarily considered. Multivariable regression models were used to adjust for patient characteristics, injury burden using the Trauma Mortality Prediction Model (TMPM), and hospital factors. Results: Of 143,125 hospitalizations, 1575 (1.10%) were IS. Compared to non-IS, ISs were less frequently Black (24.4% vs 54.3%) but had a higher proportion of psychiatric conditions (19.4% vs 6.4%) (P <.05). Although having a similar requirement for major operations and TMPM score, ISs more frequently underwent thoracic (11.4% vs 4.1%) and gastrointestinal operations (33.0% vs 25.7%) (P <.05). After adjustment, IS was associated with similar odds of mortality but was associated with greater odds of cardiac complications, respiratory failure, and need for intensive care. While LOS was similar, IS was associated with greater costs (β: +$14,300, 95% CI: 6,200-22,400). Conclusions: Suspects injured during law enforcement intervention have similar in-hospital mortality but greater complication rates and costs. Through the quantification of the clinical and financial burden of IS, our findings may help inform further policy discussions regarding use of potentially lethal force in law enforcement intervention. [ABSTRACT FROM AUTHOR]

This study examines and describes circumstances involving non-fatal firearm injuries in a pediatric population from a Level I Pediatric Trauma Center in the southeastern U.S. Researchers analyzed Firearm Injury Questionnaire (FIQ) data collected from 144 children and adolescents, aged 2–17 years, who were treated in the emergency department and/or admitted to the hospital for non-fatal firearm injuries. Descriptive statistics are presented regarding participant demographics and FIQ responses, such as caregiver information, mental health history, adverse childhood experience (ACE) exposure, firearm access, injury intent, relationship to shooter, type of firearm used, and context of injury. Most patients identified as Black (82%) and male (75%), with most injuries categorized as intentional (72%) versus unintentional (24%) assaults. The average ACEs score was.60, with only 37% of patients' reporting any ACE experience; however, nearly half (47%) of patients reported experiencing a traumatic event beyond an identified ACE. Community violence was the most common context that attributed to patients' assaults (56%). As U.S. pediatric gun injury and fatality trends are increasing, this study provides timely data regarding pediatric firearm injuries and exposure to community violence. These findings highlight the need to provide integrated health services to pediatric patients experiencing non-fatal firearm injuries. Researchers discuss public health implications for integrated mental health care services, hospital- and school-based violence intervention programs, policy recommendations, and directions for future research. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic created difficulties in access to care. There was also increased penetrating trauma in adults, which has been attributed to factors including increased firearm sales and social isolation. However, less is known about the relationship between the pandemic and pediatric trauma patients (PTPs). This study aimed to investigate the national incidence of penetrating trauma in PTPs, hypothesizing a higher rate with onset of the pandemic. We additionally hypothesized increased risk of complications and death in penetrating PTPs after the pandemic versus prepandemic. We included all PTPs (aged ≤17-years-old) from the 2017-2020 Trauma Quality Improvement Program database, dividing the dataset into two eras: prepandemic (2017-2019) and pandemic (2020). We performed subset analyses of the pandemic and prepandemic penetrating PTPs. Bivariate analyses and a multivariable logistic regression analysis were performed. Of the 474,524 PTPs, 123,804 (26.1%) were from the pandemic year. The pandemic era had increased stab wounds (3.3% versus 2.8%, P > 0.001) and gunshot wounds (5.5% versus 4.0%, P < 0.001) compared to the prepandemic era. Among penetrating PTPs, the rates and associated risk of in-hospital complications (2.6% versus 2.8%, P = 0.23) (odds ratio 0.90, confidence interval 0.79-1.02, P = 0.11) and mortality (4.9% versus 5.0%, P = 0.58) (odds ratio 0.90, confidence interval 0.78-1.03, P = 0.12) were similar between time periods. This national analysis confirms increased penetrating trauma, particularly gunshot wounds in pediatric patients following onset of the COVID-19 pandemic. Despite this increase, there was no elevated risk of death or complications, suggesting that trauma systems adapted to the "dual pandemic" of COVID-19 and firearm violence in the pediatric population. [ABSTRACT FROM AUTHOR]

Gun violence is a principal cause of premature death in America. It has been suggested that solutions to gun violence may be found using a public health approach, which is broader than dealing with the problem via law enforcement alone. A component of a public health approach to gun violence is the implementation of policies or laws. Unfortunately, there is a serious gap in our understanding of how street-level police officers view proposed or existing firearms legislation. This is an important omission, because it is line-level personnel who are tasked with enforcing these policies within highly discretionary contexts. We surveyed police from three jurisdictions to establish a baseline understanding of officers' views about potential gun legislation and identify possible resistance and implementation barriers of firearms laws. The findings suggest that those responsible for enforcing new laws show limited or mixed support for the same. Officers were most supportive of laws that increase the presence of trained gun owners within certain contexts and ensure that individuals with criminal backgrounds or mental health concerns do not have access to firearms. Most officers support prohibiting gun ownership following conviction of a domestic violence offense. However, officers generally opposed gun legislation banning assault weapons, large capacity magazines, and internet ammunition purchases. Finally, officers with the Buffalo Police Department—which recently had experienced an active-shooter event—were more supportive of almost all types of legislation. Respondents expressing greater concern about officer safety related to firearms were supportive of several types of firearm legislation. [ABSTRACT FROM AUTHOR]

Gun violence has continued to be the leading cause of pediatric injuries in recent years (CDC, 2022). Given the sparse literature on this topic, the current study examined correlates of the types of firearm-related injuries (i.e. intentional and unintentional) among pediatric patients within the Trauma Services Division of a Level-1 pediatric hospital (N = 87). The results indicated that patients in later developmental stages, particularly adolescence, and those with higher ACE score were significantly more likely to experience an intentional firearm injury, whereas white patients were significantly less likely to experience an intentional firearm injury, highlighting the structural factors that increase the risk of firearm violence including poverty and systemic racism. We discuss the implications and need for expanded hospital- and school-based violence prevention programs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine psychosocial, experiential, and demographic correlates of firearm ownership, carrying, and storage methods. We used a representative survey of 3,510 people living in five US states (Colorado, Minnesota, Mississippi, New Jersey, and Texas) conducted in 2022. Individuals provided information on past experiences with firearms, perceptions of threat and neighborhood safety, discrimination, and tolerance of uncertainty alongside demographic items. The analysis was conducted in November 2022. Past experiences with firearms and prior victimization are associated with increased firearm ownership and carrying practices. Threat sensitivity is associated with owning more guns while poorer perceptions of neighborhood safety correspond with owning fewer guns but greater risk for unsafe storage practices like storing a loaded gun in a closet or drawer. Intolerance of uncertainty is associated with owning fewer guns and lower risk for carrying outside of the home but greater risk for unsafe storage. Prior experience of discrimination is associated with risk for carrying firearms outside of the home. Demographic characteristics related to sex, rurality, military service, and political conservatism predict risky firearm-related behaviors related to firearm ownership, carrying frequency, and unsecure storage. Taken together, we find firearm ownership and risky firearm behaviors (e.g. carrying, unsafe storage) are more prominent among groups such as politically conservative males living in rural areas while also being influenced by threatening experiences, uncertainty, and perceptions of safety.

BackgroundFirearm violence is a major public health problem in the United States, yet most states lack a mechanism to temporarily remove firearms from individuals who are at high and imminent risk of harming themselves or others and are not otherwise prohibited. Extreme risk protection order (ERPO) laws are intended to close this gap. The current study examines the passage of California's gun violence restraining order (GVRO) bill using Kingdon's multiple streams framework.MethodsThis study was based on an analysis of interview data from six key informants involved in the passage of the GVRO legislation.ResultsFindings indicate policy entrepreneurs framed the problem and designed the policy to target individuals at behavioral risk of imminent firearm violence. Policy entrepreneurs comprised an integrated policy network that engaged in a lengthy period of collaboration and bargained with interest groups to yield a bill that satisfied diverse concerns.ConclusionsThis case study may inform efforts in other states to pass ERPO policies and other firearm safety laws.

Summary: Background: Most Americans believe that gun-free zones make locations more vulnerable to violent crimes, particularly active shootings. However, there is no empirical evidence regarding the impact of gun-free zones on protecting locations from violence. The objective of this study was to estimate the association between gun-free zones and active shootings. Methods: We used a pair-matched case-control study where cases were all US establishments where active shootings occurred between 2014 and 2020, and controls were randomly selected US establishments where active shootings could have but did not occur, pair-matched by establishment type, year, and county. Gun-free status of included establishments was determined via local laws, company policy, news reporting, Google Maps and posted signage, and calling establishments. Findings: Of 150 active shooting cases, 72 (48.0%) were determined to have occurred in a gun-free zone. Of 150 controls where no active shooting occurred, 92 (61.3%) were determined to be gun-free. After accounting for matched pairs, the conditional odds of an active shooting in gun-free establishments were 0.38 times those in non-gun-free establishments, with a 95% confidence interval of 0.19–0.73 (p-value = 0.0038). Several robustness analyses affirmed these findings. Interpretation: It is unlikely that gun-free zones attract active shooters; gun-free zones may be protective against active shootings. This study challenges the proposition of repealing gun-free zones based on safety concerns. Funding: This work was funded in part by the National Collaborative on Gun Violence Research and the Arnold Foundation.

IntroductionPast research has demonstrated a "reopening phenomenon" of increased firearm violence associated with the initial lifting of coronavirus disease 2019 (COVID-19) pandemic-related restrictions after the first wave. Now, with widespread societal reemergence from stay-at-home measures, we hypothesize another spike in firearm violence in the United States (US). Thus, the purpose of this study was to evaluate the trends in firearm violence before and after extensive community reopenings during the COVID-19 pandemic.MethodsThe Gun Violence Archive was utilized to collect data on daily firearm violence incidents, injuries, and deaths as well as on types of firearm violence. Mann-Whitney U-tests were performed for trends and types of firearm violence "before" (12/14/20-4/9/21) versus "after" (4/10/21-7/31/21) widespread societal reopening in the US. Additional analyses also sought to compare the after reopening time-period to historical data (2017-2020) of similar calendar dates, to better control for possible annual/seasonal variation.ResultsMedian daily firearm violence incidents (153 versus 176, P

BackgroundSuicide is a major public health problem with immediate and long-term effects on individuals, families, and communities. In 2020 and 2021, stressors wrought by the COVID-19 pandemic, stay-at-home mandates, economic turmoil, social unrest, and growing inequality likely modified risk for self-harm. The coinciding surge in firearm purchasing may have increased risk for firearm suicide. In this study, we examined changes in counts and rates of suicide in California across sociodemographic groups during the first two years of the COVID-19 pandemic relative to prior years.MethodsWe used California-wide death data to summarize suicide and firearm suicide across race/ethnicity, age, education, gender, and urbanicity. We compared case counts and rates in 2020 and 2021 with 2017-2019 averages.ResultsSuicide decreased overall in 2020 (4123 deaths; 10.5 per 100,000) and 2021 (4104; 10.4 per 100,000), compared to pre-pandemic (4484; 11.4 per 100,000). The decrease in counts was driven largely by males, white, and middle-aged Californians. Conversely, Black Californians and young people (age 10 to 19) experienced increased burden and rates of suicide. Firearm suicide also decreased following the onset of the pandemic, but relatively less than overall suicide; as a result, the proportion of suicides that involved a firearm increased (from 36.1% pre-pandemic to 37.6% in 2020 and 38.1% in 2021). Females, people aged 20 to 29, and Black Californians had the largest increase in the likelihood of using a firearm in suicide following the onset of the pandemic. The proportion of suicides that involved a firearm in 2020 and 2021 decreased in rural areas compared to prior years, while there were modest increases in urban areas.ConclusionsThe COVID-19 pandemic and co-occurring stressors coincided with heterogeneous changes in risk of suicide across the California population. Marginalized racial groups and younger people experienced increased risk for suicide, particularly involving a firearm. Public health intervention and policy action are necessary to prevent fatal self-harm injuries and reduce related inequities.