Publication date: May 2025
Source: Journal of Urban Economics, Volume 147
Author(s): John J. Donohue, Samuel V. Cai, Matthew V. Bondy, Philip J. Cook
Publication date: May 2025
Source: Journal of Urban Economics, Volume 147
Author(s): John J. Donohue, Samuel V. Cai, Matthew V. Bondy, Philip J. Cook
Publication date: Available online 4 April 2025
Source: Social Science & Medicine
Author(s): Katherine G. Quinn, Melissa L. Neal, Jesus Valencia, Jana L. Hirschtick, DeJuan Washington, Jacquelyn Jacobs, Bijou R. Hunt
It is a “law” of criminology that urban crime chronically recurs at the same microplaces (i.e., street segments and intersections). An influential study found high concentrations of firearm violence at micropl…
Firearms became the leading cause of death in the United States pediatric population in 2019 and have persisted as the leading cause through 2021, with widening racial and ethnic disparities. We aimed to exami…
Publication date: May 2025
Source: Journal of Urban Economics, Volume 147
Author(s): John J. Donohue, Samuel V. Cai, Matthew V. Bondy, Philip J. Cook
Background
There is consensus on the need and ability to address firearm injury risk in healthcare settings; however, the lack of education for healthcare professionals hinders the implementation of evidence-based firearm injury and mortality prevention strategies. The objectives of this study are to develop, disseminate and evaluate education for team members to facilitate implementation in emergency departments
Method
Two-tiered education was developed in partnership with stakeholders and disseminated to the healthcare team, covering evidence-based screening and interventions for firearm access and violence risk. The implementation, development and dissemination strategies followed the framework used for systemwide Screening, Brief Intervention and Referral to Treatment implementation for substance use. Team members who screened patients for firearm injury risk received screening education and team members meeting with patients who screened positive received intervention education. Participants completed surveys to evaluate the education and learning objectives.
Results
Across three emergency departments from March 2021 to May 2022, 267 team members completed screening education. Key takeaways reported by 173 participants were how to screen (24.9%), the 5L’s of Firearm Safety (19.7%) and the prevalence of firearm injury (11.0%). Participants still had questions about workflow, resources and safety. 34 of 67 (50.7%) intervention education participants completed the postsurvey. 100% were confident they could screen, 79% were confident they could provide brief interventions and 88% were confident their site could implement firearm injury prevention strategies.
Conclusion
Tiered education for firearm injury prevention screening and intervention achieved learning objectives and facilitated programme implementation. Education increased knowledge and confidence regarding firearm injury risk screening and its importance in healthcare settings.
Firearm violence is a major public health problem and the leading cause of death among children and youth aged one to nineteen in the United States (US). School shootings, though a relatively rare form of fire…
American Journal of Public Health, Volume 115, Issue 4, Page 596-604, April 2025.
Background/purpose
Unintentional injuries are the leading cause of death among children and adolescents. The objective of this study was to describe temporal trends of paediatric traumatic injury over an 11-year period by mechanism of injury (MOI), age, sex, race and ethnicity, injury severity and hospital discharge disposition.
Methods
The National Trauma Data Bank was queried to identify paediatric patients (1–17 years old) injured from 2012 to 2022. Two-sided non-parametric Mann-Kendall trend tests were used to evaluate temporal trends of MOI for all patients and within demographic groups.
Results/outcomes
Over the 11-year period, 1 092 308 injury records met study inclusion criteria and had complete demographic and MOI data. Across all patients, there was a significant increase in bites and stings, cut/pierce injuries and firearm injuries, whereas there were decreasing trends in pedestrian and other blunt injuries over time. There was a significant increase in injury over time for Black, Hispanic or Latino, and Pacific Islander patients and those 5–9 years old. The MOIs with the highest injury severity and in-hospital mortality were firearm, pedestrian and motor vehicle transportation occupant injuries.
Conclusions
Though a few MOIs increased for all paediatric patients in the study period, disparities persist for several specific populations. As such, injury prevention strategies should be tailored based on age, sex and race or ethnicity, and relevant education and resources should be provided to both children and their adult guardians. Future research should consider additional socioeconomic and community-based characteristics.
Objective
To evaluate differences in mental health and substance use circumstances by rurality and military affiliations among suicide decedents.
Methods
Multiyear (2009–2019) cross-sectional study of adult suicide decedents reported to the National Violent Death Reporting System. We classified suicide decedents into a four-level variable by geography (urban/rural) and military status and evaluated the prevalence of current and past alcohol and substance use problems, mental health problem recognition and mental illness treatment. We estimated prevalence ratios using multiple imputation chain equations to account for missing data and log-binomial regression models and present stratified estimates by military and rural classification.
Findings
There was no significant relationship between rural-military classification and alcohol use problem. Compared with urban civilians, other groups had a lower risk identified of having a substance use problem: urban military (adjusted prevalence ratio (aPR): 0.65; 95% CI: 0.60 to 0.71), rural military (aPR: 0.57; 95% CI: 0.50 to 0.66) and rural civilians (aPR: 0.95; 95% CI: 0.90 to 1.00). Recognition of a mental health problem was lower among both rural military (aPR: 0.88; 95% CI: 0.81 to 0.96) and rural civilians (aPR: 0.89; 95% CI: 0.86 to 0.92). The likelihood of current mental treatment was lower in other groups (urban military (aPR: 0.93; 95% CI: 0.89 to 0.96); rural military (aPR: 0.87; 95% CI: 0.81 to 0.94); and rural civilian (aPR: 0.89; 95% CI: 0.85 to 0.92)). There was no evidence of effect modification by military and rural classification for any outcome.
Conclusions
Mental health outcomes by military affiliation and urbanicity/rurality may need to be independently assessed as social determinants of health.