Abstract
Contextualizing the interruption of retaliatory gang assaults and homicides in poor black communities in Los Angeles
Bill Sanders, PhD
California State University Los Angeles, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Gang homicides drive the overall rate of homicide in Los Angeles. Approximately half of all murders in the city have been considered 'gang-related' for over a decade. Approximately 90% of these homicides will occur in poor black or Latino communities. The majority of these homicides are retaliatory in nature. An important asset in homicide reduction strategies in such communities are gang interventionists. They have the ability to 'interrupt' retaliatory gang assaults and homicides. How exactly this occurs remains unclear. Using original interview data collected over a 24 month period, this presentation contextualizes the processes of how one gang interventionist interrupted a series of retaliatory gang assaults and homicides in poor black communities in Los Angeles. From here, the presentation offers a methodology on how to calculate the total potential costs associated with each interruption. These include variables such as the likelihood of homicide had the incident not been interrupted, whether or not the homicide occurred at a later date, loss of productivity per individual due to premature death, medical costs of homicide, and criminal justice-related costs of homicide. Preliminary results indicate that the interventionist interrupted at least a dozen retaliatory gang assaults and homicides and that the overall costs associated with these interruptions is in the tens of millions of dollars.
Epidemiology Other professions or practice related to public health Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Epidemiology of firearm involved deaths and injuries, Riverside County, CA
Aaron Gardner, MA, MPH and Wendy Hetherington, MPH
Riverside University Health System - Public Health, Riverside, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Firearm deaths/injuries are recognized as a public health and a criminal justice issue, with many labeling gun violence an epidemic.
Methods: To assist policy at the local level, we summarized firearm involved deaths/injuries within Riverside County.
Results: An average of 159 people/year were killed with guns, including an average of 65 homicides, 91 suicides and 3 unintentional deaths, from 2005–2014. 87% were men. Firearms were used in 43% of suicides and 66% of homicides.
African-Americans are 10 times more likely to die from a firearm-related homicide; Whites are four times more likely to die from a suicide involving a firearm. Most deaths from firearm violence are suicides, not homicides.
From 2006–2014, an average of 173 people were admitted to emergency departments with firearm injuries/year. 90% were men.
Most gun-involved injuries result from assaults followed by unintentional injuries (54% vs. 43%). The risk of firearm injuries from both assault and unintentional is higher among African-Americans between 15-39 years-old. The rate of emergency department admittance for firearm assault among African-Americans was three times the rate of Hispanics and eight times the rate of Whites. The unintentional gun injury rate for African Americans is over three times the rate of Hispanics and Whites.
Conclusion: With over 60,000 firearms sold in Riverside County per year, firearms are commonplace. The risk is not evenly distributed across all populations. Efforts should focus on the greatest disparities in death/injury, such as young men of color for assault/homicide and middle age/older white men for suicide.
Epidemiology Public health or related research
Abstract
Taking it to the streets: Comparing Houston-area census tracts with and without gun violence incidents to guide local gun injury prevention initiatives
Meredith Rossi, MPH
No Affiliation, Missouri City, TX
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
The national conversation about gun violence has stalled, resurfacing after nationally recognized events as with Las Vegas, Nevada and Parkland, Florida, but often devolving into rhetoric not based in data. Reducing gun injury and mortality may instead arise from community-level public health work with national potential. Characterizing basic risk factors for gun violence is critical to drive local initiatives. Using a geocoded dataset the author analyzed 2015 gun violence incidents in the Houston area, selected for the high rate of gun violence. By linking demographic, education, poverty, and employment Census data, the author examined population characteristics between Houston-area tracts with and without gun violence injury and death. Chi-squared testing revealed the differences between incident and non-incident tracts. Unadjusted odds ratios were calculated to demonstrate the effect size of differences. Of 196 tracts analyzed (816,757 people), 41 (20.9%) had at least one gun incident. The population among incident tracts was significantly more likely to be younger (crude OR 1.60, 95% CI 1.58-1.62), less educated (1.56, 1.54-1.59), living below the federal poverty level (1.07, 1.06-1.09), and have worked full time in the last twelve months (1.29, 1.27-1.31). The incident-tract population was also slightly more likely to be male, white, and non-Hispanic. In the face of great challenges to implementing national solutions to reduce gun violence, a local public health approach may be effective and politically viable. This analysis demonstrates what determinants may guide local data-based efforts, to ultimately drive a more constructive national discussion and lead to more effective national solutions.
Epidemiology Planning of health education strategies, interventions, and programs Public health or related public policy Social and behavioral sciences
Abstract
Firearm Legislation Restrictiveness and Firearm-Related Homicide in US Adolescents in 2015
Wissam Al Khoury, MD, MBA1 and Consuelo Beck-Sague, MD, FAAP2
(1)Florida International University, Miami, FL, (2)Florida International University Robert Stempel College of Public Health and Social Work, Miami, FL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Homicide is the third leading cause of death among US persons aged 15-19 years. Because firearm injuries are more likely to be fatal than non-firearm injuries, we explored whether restricting access to firearms is associated with lower homicide risk.
Methods: States were classified by legislation restrictiveness from least (1) to most (10) restrictive. Numbers of homicides per 100,000 adolescents (rates) in 2015 by firearms and by other means were calculated, limited to states with >10 deaths (uncensored) in each category. Homicide rates were compared by state legislation restrictiveness.
Results: Only California met criteria for maximum firearm law restrictiveness; 24 others had legislation that ranged from somewhat lower to very low restrictiveness. In 25 (50%), firearm legislation was extremely permissive (score=1). States were almost twice as likely to have >10 firearm-related homicides (38/50; 76.0%) than >10 non-firearm homicides (20/50; 40.0%; p<.001) in 2015. Firearm-related homicides rates ranged from 3.62-20.1 (median=8.5) per 100,000 adolescents. Firearm homicide rates were significantly higher in states with legislation scores <4 (median=10.0) than in states with more restrictive firearm legislation (median=6.5; p=.017). Non-firearm homicide rates were far lower than firearm homicide rates (median=1.37; range=.90-3.95). Median non-firearm homicide rate did not differ significantly by lower (<4 [median=1.3]) vs. higher (>4 [median=1.4; p=.50]) legislation score.
Conclusions: Adolescent firearm homicide death rates were much higher than non-firearm rates, consistent with greater fatality risk of firearm injuries. Restrictive firearm legislation was associated with a strong protective effect for adolescent total and firearm-homicide death rates but no effect on non-firearm homicide.
Public health or related education Public health or related laws, regulations, standards, or guidelines Public health or related public policy Public health or related research Social and behavioral sciences
Abstract
Legal Firearm Possession Status of Homicide Suspects and Victims
Jennifer Hernandez-Meier, PhD, MSW1, Cheng Zheng, PhD2, Brenna Akert, BS, CHES1, Clare Guse, MS1 and Stephen W. Hargarten, MD, MPH1
(1)Medical College of Wisconsin, Milwaukee, WI, (2)University Wisconsin Milwaukee, Milwaukee, WI
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: The proportion of legal firearm possessors involved in homicides under current federal/state firearm prohibition criteria is largely unknown, and the expected impact of expanded criteria (e.g., impaired driving, violent misdemeanors, habitual criminality [multiple misdemeanors]) has had limited examination.
Methods: Criminal charge and conviction data for suspects (303 firearm-related, (FR))/victims (378 FR) identified in the Wisconsin Violent Death Reporting System (2008-2011) and a sample of 4,137 matched control Wisconsin driver’s license holders (to estimate a larger control population) were abstracted from Wisconsin court data. Individual legal possession statuses (prohibited/legal) under each current and expanded prohibition criterion were determined. Contingency tables, binomial and chi-square/Fisher’s exact tests and Zero Inflated Negative Binomial regression models tested for differences between groups.
Results: Overall, 144 (48%) suspects and 150 (40%) victims met at least one current or expanded criterion. Of these, 22 (7%) of suspects and 34 (9%) of victims were prohibited only under expanded criteria. Compared to controls, both suspects/victims were significantly more likely to have been precluded under expanded policies for violent misdemeanors (6/5% vs. <1%), drug arrests (5/4% vs. <1%) and habitual criminality (10/10% vs. 1%) in bivariate analyses (all at p<0.05). Multivariate analyses controlling for age, gender and race indicated that expanded criteria for violent misdemeanors, drug arrests, habitual criminality and impaired driving significantly distinguished suspects/victims from controls (all at p<0.05).
Conclusions: A significant proportion of prohibited suspects utilized firearms. Applying expanded criteria increased prohibited persons. These results can inform existing enforcement policies and the consideration to apply expanded criteria.
Epidemiology Public health or related laws, regulations, standards, or guidelines Public health or related public policy Public health or related research Social and behavioral sciences
Abstract
Mass Shootings in the United States: 2009-2017
Sawyeh Maghsoodloo, MPA
Everytown for Gun Safety, New York, NY
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Everytown has comprehensively tracked mass shootings in the US since 2009. We define a "mass shooting" as any incident in which four or more people are shot and killed, not including the shooter. From 2009-2016, we identified 156 mass shootings in the US. The majority of these incidents - 54% - were related to domestic or family violence. In nearly half of the shootings - 42% - the shooter exhibited warning signs before the shooting indicating that they posed a danger to themselves or others. These red flags included acts, attempted acts, or threats of violence towards oneself or others; violations of protective orders; or evidence of ongoing substance abuse. More than one-third of the shootings - 34% - involved a shooter who was prohibited from possessing firearms. Only 10% of the incidents took place in so-called "gun-free zones", or areas where civilians are prohibited from carrying firearms and there is not a regular armed law enforcement presence. These findings suggest the importance of several gun violence prevention policies that address the circumstances underlying mass shootings: strong domestic violence laws that keep guns away from abusers, mechanisms that allow for the temporary removal of guns from individuals who have exhibited dangerous recent behavior, and background checks on all gun sales to prevent people who are prohibited from having guns from buying them. All of this analysis will be updated to include mass shootings that took place in 2017.
Public health or related public policy
Abstract
Sexual orientation differences in gun ownership and beliefs about gun safety policy, General Social Survey 2010-2016
Kirsty Clark, MPH1, John Blosnich, PhD, MPH2, Robert Coulter, PhD3, Patricia Bamwine, PhD4, Robert M. Bossarte, PhD5 and Susan D. Cochran, Ph.D., M.S.6
(1)UCLA Fielding School fo Public Health, Los Angeles, CA, (2)University of Pittsburgh School of Medicine, Pittsburgh, PA, (3)University of Pittsburgh, Pittsburgh, PA, (4)Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, (5)West Virginia University, Morgantown, WV, (6)UCLA Fielding School of Public Health, Los Angeles, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Gun violence in the U.S. is a major public health concern. Sexual minority (e.g., lesbians, gay men, bisexuals) populations are uniquely vulnerable to gun violence given sexual minorities’ disproportionate suicide risk. Whether differences in gun exposure are shaped by sexual orientation is largely unknown, but may represent unrecognized differences in distal risk for suicide. This study investigated sexual orientation differences in gun ownership and gun safety beliefs among U.S. adults.
Methods: We used information from the nationally-representative General Social Survey (2010-2016) to assess presence of guns in the household, being the gun owner, and endorsement of a gun safety law among sexual minority (n=195) vs. heterosexual (n=4,359) respondents. Methods employed multivariable logistic regression analyses adjusted for confounding.
Results. Gay/bisexual men were more likely to endorse a gun safety law (aOR=3.24, 95% CI: 1.79-5.88) and less likely to report guns in the household (aOR=0.34, 95% CI: 0.18-0.65) than heterosexual men. In contrast, lesbian/bisexual and heterosexual women similarly endorsed a gun safety law and reported household guns. However, among women reporting a household gun, lesbian/bisexual women were more likely than heterosexual women to be the gun owner (aOR=3.97, 95% CI: 1.43-11.03).
Conclusions: Both attitudes toward a gun safety law and gun ownership differ by sexual orientation, but patterns vary by gender. As access to guns is a critical factor in suicide, we recommend mental health providers include gun ownership questions in regular screening and counseling materials for sexual minority women.
Epidemiology Public health or related public policy Social and behavioral sciences
Abstract
Results from a Comprehensive Survey on Firearms and Firearm Violence in California
Nicole Kravitz-Wirtz, PhD, MPH1, Rocco Pallin, MPH2 and Garen Wintemute, MD, MPH2
(1)UC Davis School of Medicine, Sacramento, CA, (2)University of California, Davis, Sacramento, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Firearm violence is a significant health and social problem in California, as it is across the country and around the world. In 2016, 3,184 Californians died of a firearm-related injury, approximately the same number of deaths as occurred in motor vehicle crashes. Substantially more people were non-fatally injured. Yet the basic data on which sound policymaking and violence prevention efforts can be based—such as the prevalence of and reasons for firearm ownership, where firearms were acquired and how much they cost, whether they are carried in public, and how they are stored at home—is often unavailable, particularly at the state level. This presentation will share findings from a 2018 probability-based Internet survey on firearms and firearm violence in California (N~2500); the first survey research of its kind to be performed in the state in over 40 years. Results focus on features related to the firearm stock, including its size, type, and distribution, benefits and risks of and reasons for ownership, firearm storage practices inside the home, and carrying practices and use outside the home, as well as information about the flow of firearms, including firearm acquisitions, dispositions, and theft. Data are presented using summary statistics of single items and cross-tabulations of firearm-related items against important individual, household, and community-level socio-demographic characteristics. These results can be compared to recent nationally representative estimates and have the potential to inform firearm violence research and public health, public safety, and public policy development at the local, state, and federal levels.
Public health or related research
Abstract
Pathogen or Vaccine? The Power of Narrative in Preventing Gun Violence
Kevin Kirkpatrick, MS
Metropolitan Group, Portland, OR
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
background/purpose:
In the prevention and control of injuries and violence, narrative can serve as a vaccine(bolstering protective factors) or as a pathogen(undermining protective factors or increasing risk or incidence). With gun violence a key threat to population safety, we sought to analyze whether the Parkland high school shooting represented a turning point toward narrative that is more conducive to messaging about prevention and/or its equity implications.
methods:
We examined narrative as a tool for promoting public health and gun violence prevention. We also analyzed nationwide social media/blog posts and online media coverage after the Las Vegas mass shooting in October 2017 and the Parkland shooting in February 2018 to identify any differences between the two datasets.
results/outcomes:
Narrative is strongest when it is grounded in a core value and is advanced by "authentic voices" who speak from their own perspective.We found significant equity implications in the media narrative on gun violence and validated that existing narratives narrow the discourse and omit population-based solutions. Media coverage of gun violence contributes to an increased risk of some forms of gun violence. Our primary research found statistically significant differences in the online conversations taking place after the Parkland shooting compared to the Las Vegas shooting.
conclusions:
The Parkland shooting generated a shift in the conversations about gun violence, public health, prevention and equity. This shift could provide the foundation for a new narrative and point to a new set of narrative-advancing strategies for prevention advocates.
Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related public policy Social and behavioral sciences
Abstract
Program to Interrupt Violence thru Outreach and Treatment Atlanta: A Cross-Sectoral Approach to Addressing Firearm Violence
Siarra Scott1, Jasmine Moore, MPH, CHES, CPST2, Randi Smith, MD, MPH1, Shila Hawk, PhD3, Elizabeth Williams Mays, MPH, MCHES2, Aric Johnson, LMSW2 and Diane Payne, MD4
(1)Emory University, Atlanta, GA, (2)Grady Memorial Hospital, Atlanta, GA, (3)Applied Research Services, Atlanta, GA, (4)Emory School of Medicine, Atlanta, GA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Firearm-related violence is a public health issue that can have lasting mental and physical health consequences for victims. In Atlanta, Georgia, the overall crime rate has decreased; yet, the proportion of firearm-related crime continues to rise. With at-risk persons and Atlanta neighborhoods experiencing violence at three-times the national average, it is evident that a multidimensional approach is needed to mitigate the inequities caused by violence. In response to this amplifying problem, Grady Memorial Hospital and the Atlanta Police Department have collaborated to design the Program to Interrupt Violence Thru Outreach and Treatment (PIVOT). PIVOT is a violence intervention that focuses on the provision of wrap around services and intensive follow up, community policing, and data sharing. The program successfully launched this year on June 1st . As of July 9, 2018, the PIVOT team has screened 109 patients presenting with firearm-related injury, 20 patients are eligible, and 3 have consented to participate. PIVOT officers have deployed to at-risk neighborhoods to increase community policing efforts. The goal of PIVOT is to ultimately decrease occurrences of firearm-related injury and criminal justice recidivism. Program design, preliminary statistics, and lessons learned will be discussed.
Program planning Public health or related research Social and behavioral sciences