178680 Geographic variation in black-white firearm assault mortality among 15 to 24 year old males in the United States

Wednesday, October 29, 2008

Robert S. Levine, MD , Department of Family & Community Medicine, Meharry Medical College, Nashville, TN
Vincent K. Agboto, PhD , Family and Community Medicine, Meharry Medical College, Nashville, TN
Vicente B. Sameniego, MPH , Family and Community Medicine, Meharry Medical College, Nashville, TN
Paul Juarez, PhD , Meharry Medical College, Nashville, TN
Roger Zoorob, MD, MPH , Department of Family and Community Medicine, Meharry Medical College, Nashville, TN
Irwin A. Goldzweig, MS , Family & Community Medicine, Meharry Medical College, Nashville, TN
Nancy Horner, RN, BSN , Epidemiology and Research, Metro Public Health Department, Nashville, TN
Baqar A. Husaini, PhD , Center For Health Research, Tennessee State University, Nashville, TN, TN
Pamela Hull, PhD , Center for Health Research, Tennessee State University, Nashville, TN
Background: United States (US) firearm assault mortality among young males showed unprecedented increases beginning in the 1980's.

Objective: Describe national/local youthful firearm assault mortality from 1979 to 2004.

Methods: Compressed Mortality (National Center for Health Statistics) and US Census data were used in negative binomial multiple regression analysis to model firearm assault mortality among 15 to 24 year old black males in counties with reliable mortality rates for 1999-2004 and to identify counties whose rates were significantly higher or lower than expected (residual deviation of < -2.00 or > +2.00) after accounting for socio-economic/demographic factors in the regression model.

Results: The US black:white mortality rate ratio (B:WMRR) for firearm assault (15-24 year-old males) increased from an average of 6.2 (1979-84) to 11.3 in 1993. Yearly values have not been <9.0 since then. Eighty US counties had reliable rates in 1999-2004 (accounting for 7,035 of 13,965 of such deaths). Black rates were unusually low in a stratum comprising Broward, FL (Fort Lauderdale), Cuyahoga, OH (Cleveland), and Harris, TX (Houston), falling to 21.2/100,000 in 2000 before rising to 52.2 in 2004 (when B:WMRR=2.7) In contrast, Lake County, IN (Gary), Mahoning County, OH (Youngstown), Wyandotte County, KS (Kansas City) and Washington, DC had unusually high black rates (274.1 per 100,000 in 2004 (when B:WMRR=18.8).

Conclusions: Successful community models for reducing black:white disparities in firearm assault mortality among young males may already exist. Qualitative and analytic epidemiologic studies including a comparison of unusually successful and unusually vulnerable communities could help characterize such models.

Learning Objectives:
1. Describe the course of firearm assault mortality among 15-24 year old black and white males in the United States from 1979 to 2004. 2. Discuss methods for identification of communities that are unusually resistent or unusually vulnerable to firearm assault mortality among 15 to 24 year old blacks. 3. Identify communities that appear to be unusually resistent or vulnerable to firearm assault mortality among 15 to 24 year old blacks in the United States.

Keywords: Youth Violence, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the study, assisted with development of the analytic methods, obtained the data, collaborated on the analysis, wrote the first draft, and compiled comments from co-authors for the final version.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
State Farm Insurance Motor vehicle crashes; healthy communities Funder of Meharry-State Farm Alliance

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Violence Epidemiology Poster Session
See more of: Epidemiology