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Abstract
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The burden of firearm violence in American communities is well documented--in 2021, the Centers for Disease Control and Prevention estimated there were 48,830 firearm-related deaths, with data suggesting that twice as many individuals suffer non-fatal injuries annually.1,2 Firearm injuries and deaths have very heterogenous intents--most firearm deaths are suicides, while non-fatal injuries occur overwhelmingly from willful or malicious assaults on others. Even among this latter group, interpersonal violence may include intimate partner violence, mass violence, or peer/community violence. The annual cost of this epidemic may exceed $500 billion in the United States (US).3
Missing in these staggering statistics are the lives and stories of individuals who live in communities plagued by firearm violence, affecting the social, structural, and economic environments in which they live, work, learn, and sleep. In this issue of Journal of General Internal Medicine, Robbins et al. use time and space dimensions in major US cities to go beyond the epidemiology of when and where firearms go off but extrapolate that data to inform how this may specifically disrupt sleep. Using publicly available data from six major US cities over 7 years, they created heat maps to identify the timing of gunshots in the community as well as the burden during nighttime. Unsurprisingly, the spatial analysis showed an inverse relationship with household income, suggesting gunshots occur in more economically vulnerable communities, while the temporal analysis identified a 2.5 times higher rate of firearm activity at night. Using various radii around geolocated centers of gunshots, the authors report potential person-nights affected based on population density within earshot of the event. They estimate a disruption of between 12.5 and 77.9 million person-nights each year in these six cities alone due to gunshots. While the analysis has various limitations, most notably that they estimated potential sleep disruption from gunshots as opposed to directly measuring sleep activity, the scale of impact is nonetheless staggering with implications for healthcare providers, public health officials, social services, and community organizations that interface with individuals in these communities. ...
Language: en |