Pediatric firearm injuries and socioeconomic vulnerability before and during the COVID-19 pandemic.

Autor: Haasz M; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Maya.Haasz@childrenscolorado.org., Doh KF; Department of Pediatrics and Emergency Medicine at Emory University, Atlanta, GA, USA. Electronic address: kiesha.fraser@emory.edu., Hanson HR; University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Division of Emergency Medicine, USA. Electronic address: holly.hanson@cchmc.org., Pomerantz WJ; University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Division of Emergency Medicine, USA. Electronic address: Wendy.Pomerantz@cchmc.org., Agrawal N; City University of New York, School of Public Health and Health Policy, USA., Beckworth K; Center for Childhood Injury Prevention, Texas Children's Hospital, Houston, TX, USA. Electronic address: klbeckwo@texaschildrens.org., Chaudhary S; Department of Pediatrics and Emergency Medicine at Emory University, Atlanta, GA, USA. Electronic address: sofia.s.chaudhary@emory.edu., Clukies L; Washington University in St. Louis, St. Louis Children's Hospital, Division of Emergency Medicine, USA. Electronic address: lindsayedavidson@wustl.edu., Fleegler EW; Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA. Electronic address: Eric.Fleegler@childrens.harvard.edu., Formica MK; Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA. Electronic address: FormicaM@upstate.edu., Gallardo A; HSU Doernbecher Children's Hospital, Doernbecher Injury Prevention Program, USA. Electronic address: gallarda@ohsu.edu., Kiragu A; Department of Pediatrics, University of Minnesota and Children's Minnesota, Minneapolis, MN, USA. Electronic address: Andrew.Kiragu@childrensmn.org., Laraque-Arena D; Clinical Epidemiology and Pediatrics, Mailman School of Public Health and Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA. Electronic address: dl3365@cumc.columbia.edu., Levas MN; Department of Pediatric Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: mnlevas@mcw.edu., Levine MC; Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA. Electronic address: marla.levine@vumc.org., McKay S; University of Texas Health Science Center at Houston, McGovern Medical School, Children's Memorial Hermann Hospital, USA. Electronic address: Sandra.McKay@uth.tmc.edu., McFadden T; Department of Pediatrics, Emory University, Atlanta, GA, USA. Electronic address: tmcfadd@emory.edu., Monroe K; Division of Pediatric Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: krmonroe@uabmc.edu., Lee LK; Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, USA. Electronic address: Lois.Lee@childrens.harvard.edu.
Jazyk: angličtina
Zdroj: The American journal of emergency medicine [Am J Emerg Med] 2024 Nov 18; Vol. 88, pp. 84-90. Date of Electronic Publication: 2024 Nov 18.
DOI: 10.1016/j.ajem.2024.11.028
Abstrakt: Background: Pediatric firearm injuries disproportionately affect groups experiencing socioeconomic disadvantage. Firearm injuries increased during the COVID-19 pandemic, but the impact on communities by degree of socioeconomic disadvantage is unknown. We examined the association between socioeconomic vulnerability and change in pediatric firearm injuries before versus during the pandemic.
Methods: This was a secondary analysis of a multicenter retrospective study comparing pediatric injuries pre- (March 17, 2019-December 31, 2020) versus during (March 15, 2020 - December 31, 2020) the COVID-19 pandemic. The parent study included injury-related visits to one of 40 Pediatric Emergency Departments in patients <18 years old. We examined firearm injuries as a proportion of all injuries. Deprivation Index (DI) was assigned using home zip code and divided into quartiles based on the distribution of DI in our total population, with deprivation increasing from quartile 1 (Q1, least deprivation) to quartile 4 (Q4, most deprivation). Kruskal-Wallis and Chi-square tests were used to compare variables of interest. Interrupted time series analysis was used to estimate pandemic effects on firearm injuries by DI quartile.
Results: There were 1231 visits for firearm injuries. Mean DI was higher among firearm-injured than non-firearm-injured patients (0.43 vs. 0.35, p < 0.0001). Firearm injuries increased in proportion to all injuries pre- vs during pandemic (0.16 % vs 0.27 %, p < 0.0001). On interrupted time series analysis, the proportion of firearm injuries increased for Q2, Q3, and Q4. On subgroup analysis by intent, assault injuries as a proportion of all injuries increased from pre- to during COVID-19 for Q2 (3.32 % vs 6.94 %, ARD 3.62 %, 95 % CI 1.03, 6.20), Q3 (2.71 % vs 7.01 %, ARD 4.30, 95 % CI 1.99, 6.61), and Q4 (5.97 % vs 17.40 %; ARD 11.42, 95 % CI 0.19, 0.33). Unintentional injuries and injuries in youth 10-17 years old increased for Q2, Q3, and Q4.
Conclusions: The increase in pediatric firearm injuries during the COVID-19 pandemic impacted youth in all but the lowest deprivation quartile. Efforts at curbing gun violence should identify and amplify protective effects in under-resourced communities.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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