Trends in Firearm Injuries Treated in Emergency Departments by Individual- and County-Level Characteristics, 2019 to 2023 - 13/12/24

Doi : 10.1016/j.annemergmed.2024.11.003

Marissa L. Zwald, PhD, MPH ^a,^⁎ , Kristin M. Holland, PhD, MPH ^a, Steven A. Sumner, MD ^a, Michael Sheppard, MS ^b, Yushiuan Chen, MPH ^a, Anika Wallace, MPH ^a, Norah W. Friar, MPH ^a, Thomas R. Simon, PhD ^a
^a CDC’s National Center for Injury Prevention and Control, Division of Violence Prevention, Atlanta, GA
^b CDC’s Office of Public Health Data, Surveillance and Technology, Atlanta, GA

^∗Corresponding Author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 13 December 2024

Abstract

Study objective

To understand trends in nonfatal firearm injuries by examining rates of firearm injury emergency department (ED) visits stratified by individual- and county-level characteristics.

Methods

Data from participating EDs within 10 jurisdictions in the United States funded through the Centers for Disease Control and Prevention’s Firearm Injury Surveillance Through Emergency Rooms program, including the District of Columbia, Florida, Georgia, New Mexico, North Carolina, Oregon, Utah, Virginia, Washington, and West Virginia, were analyzed. We examined trends in firearm injury ED visits by sex, age group, jurisdiction, county-level urbanicity, and county-level social vulnerability from January 2019 to August 2023. Mean weekly rates of firearm injury ED visits and visit ratios (or the proportion of firearm injury-related ED visits of all visits during the surveillance periods with the same period in 2019) were calculated.

Results

Compared with 2019, the proportion of ED visits for firearm injury was elevated each year during 2020 to 2023 overall, with the largest observed increase in 2020 (visit ratio=1.59). All 10 Firearm Injury Surveillance Through Emergency Rooms jurisdictions experienced an increase in the proportion of firearm injury ED visits in 2020 (visit ratios ranging from 1.26 in West Virginia and 2.31 in Washington, DC) when compared with 2019. By county-level social vulnerability, the mean weekly rate of firearm injury ED visits was highest in counties with the highest social vulnerability over the entire study period.

Conclusion

Results highlight the continued burden of firearm injuries in communities with higher social vulnerability. Timely ED data by community social vulnerability can inform public health interventions and resource allocation at local, state, and national levels.

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Keywords : Firearm injuries, Injury surveillance, Health disparities

Plan

Introduction

Background

Importance

Goals of This Investigation

Materials and Methods

Study Design and Setting

	Please see page XX for the Editor’s Capsule Summary of this article.
	Supervising editor: Lois K. Lee, MD, MPH. Specific detailed information about possible conflict of interest for individual editors is available at editors
	Author contributions: MZ conceptualized the study, developed the firearm injury definition, and conducted the analyses. KH conceptualized the study, assisted with the interpretation of the results. SS, MS, and YC assisted with the analyses and interpretation of results. AW oversaw the programmatic management of the surveillance program. NF and TS assisted with the interpretation of the results. All authors contributed to drafting and revising the article. MZ takes responsibility for the paper as a whole.
	Data sharing statement: Conditions of Centers for Disease Control and Prevention’s Firearm Injury Surveillance Through Emergency Rooms program data sharing agreement do not permit the reporting of or sharing of raw data.
	All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
	Funding and support: By Annals' policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org). The authors have declared that no competing interests exist per ICMJE conflict of interest guideline.
	Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.