Factors associated with firearm injury among pediatric members of a large integrated healthcare system

Published:September 16, 2022DOI:


      Background and Objectives

      Few studies have tested multiple socio-ecological predictors of firearm injury among pediatric populations and distinguished self-inflicted from non-self-inflicted injury. To address this gap, the current study examined demographic, individual psychosocial, and neighborhood variables as predictors of firearm injury among a large cohort of children and adolescents.


      Retrospective cohort study. Data were obtained from the electronic health records of a large integrated healthcare system. The cohort included children <18 years with at least one clinical encounter between January 1, 2010 and December 31, 2018. Poisson regression was used to examine demographic (age, gender, race/ethnicity, Medicaid status), psychosocial (depression, substance use disorder, medical comorbidities), and neighborhood education variables as potential risk factors for non-self-inflicted and self-inflicted firearm injuries.


      For non-self-inflicted injury, the highest relative risk was found for children age 12-17 years old compared to 0-5 year olds (RR= 37.57); other risk factors included male gender, Black and Hispanic race/ethnicity (compared to White race), being a Medicaid recipient, lower neighborhood education, and substance use disorder diagnosis.  For self-inflicted injury, only age 12-17 years old and male gender were associated with increased risk.


      These results reinforce the established higher risk for firearm injury among adolescent males, highlight differences between self-inflicted and non-self-inflicted injuries, and the need to consider demographic, psychosocial, and neighborhood variables as risk factors to inform interventions aimed to reduce firearm injuries among adolescents into adulthood


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