Citation

Ali A, Broome J, Tatum D, Fleckman J, Theall K, Chaparro MP, Duchesne J, Taghavi S. J. Trauma Acute Care Surg. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000003578

PMID

35234710

Abstract

BACKGROUND: Food insecurity (FI) is an important social determinant of health that is associated with many forms of violence. We hypothesized that FI would be associated with gun violence.

METHODS: Firearm injury data was collected from 2016-2020 (n = 3115) at a single institution that serves as the only Level I trauma center in a major southern US city. The data was linked with Map the Meal Gap data, a publicly available dataset which estimates rates of county-level FI based on state-level FI and social determinants, including unemployment, poverty, disability, and other factors. Regression analysis was utilized to examine the relationship between FI with rates of overall gun trauma and odds of gun-related violence. FI by county of patient residence was categorized by rates less than the national average of 11.5% (Low), between the national and state average (16.5%) (Moderate), and greater than the state average (High). Out of state residents were excluded from the analyses.

RESULTS: Of the 3115 patients with firearm injuries identified, 138 (4.4%) resided in counties with low FI rates, 1048 (33.6%) in moderate FI, and 1929 (62.0%) in counties with high FI. Patients in regions of high FI were more likely to be a level 1 trauma activation, a victim of assault, and have Medicaid or be self-pay. There was no significant difference in mortality by levels of FI. FI was significantly associated with firearm injury, with each percent increase in FI being related to approximately 56 additional gun-related injuries per 100,000 people (95% confidence interval (CI): 54 - 59) and increased odds of the injury classified as assault (odds ratio: 1.13, 95% CI 1.07-1.19).

CONCLUSION: Violence prevention initiatives targeting food insecure communities may help alleviate the US gun violence epidemic. Further, trauma center screening for household FI and in-hospital interventions addressing FI may help reduce gun violence recidivism. LEVEL OF EVIDENCE: IV.

Language: en