The Rural-Urban Continuum

Michael L. Nance · Lex Denysenko · Dennis R. Durbin · Charles C. Branas · Perry W. Stafford · C. William Schwab

57 citations0/0 files storedArchives of Pediatrics and Adolescent Medicine

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Gun Ownership and Violence Research Crime Patterns and Interventions Injury Epidemiology and Prevention

Abstract

OBJECTIVE: To compare rates of serious firearm injuries among children and adolescents treated in a statewide trauma system. MATERIALS AND METHODS: We reviewed the Pennsylvania Trauma Systems Foundation (Mechanicsburg) registry from January 1, 1987, through December 31, 2000, for all pediatric and adolescent patients (age 0-19 years) who sustained a serious firearm injury. Data included age, sex, weapon, geographic region, injury circumstance, and outcome. RESULTS: During the 14-year period, 3781 children and adolescents sustained a serious firearm injury and were treated at a participating Pennsylvania trauma center. The population was 90.7% male, with a mean age of 16.5 years. Adolescents (age 15-19 years) represented more than 85% of the study population. There were 744 deaths (19.7%). The urban counties had an average annual population-based rate of serious firearm injury of 28.3/100 000; suburban counties, 2.8/100 000; metropolitan counties, 2.4/100 000; and nonmetropolitan counties, 2.4/100 000. Urban counties had a higher rate for all injury circumstances (unintentional, assault, and self-inflicted) than all nonurban counties. Assault was the most common overall injury circumstance (78.7%), and was the most common circumstance in urban counties (88.5%) and among adolescents (age 15-19 years [84.2 %]). Unintentional injuries predominated in nonmetropolitan counties (56.7%) and in young children (aged <5 years [50.6%] and 5-9 years [61.4%]). Handguns were the most common weapon type in all age groups, geographic regions, and injury circumstances. CONCLUSIONS: Rates of serious firearm injuries among children and adolescents are 10-fold higher in urban than nonurban regions. Assaultive injury mechanisms predominated in urban areas, unintentional injuries in the nonurban counties. Firearm injury statistics are heavily influenced by events in the urban counties. Intervention and prevention strategies need to account for these regional discordances to optimize efficacy.

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References

1992Firearm and nonfirearm homicide among persons 15 through 19 years of age. Differences by level of urbanization, United States, 1979 through 1989 1990Characteristics of pediatric firearm fatalities 1998Homicide Rates Among US Teenagers and Young Adults 1988Gunshot Wounds in Children Under 10 Years of Age

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2019Pediatric firearm mortality in the United States, 2010 to 2016: A National Trauma Data Bank analysis 2013Twenty years of pediatric gunshot wounds: an urban trauma center’s experience 2009Homicide and geographic access to gun dealers in the United States 2013Gunshot Injuries in Children Served by Emergency Services 2015Armed Kids, Armed Adults? Weapon Carrying From Adolescence to Adulthood 2018In harm's way: Unintentional firearm injuries in young children 2020Pediatric firearm injuries: Anatomy of an epidemic 2004Association of Selected Risk Factors with Variation in Child and Adolescent Firearm Mortality by State

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