Firearm Injuries: Epidemic Then, Endemic Now

Children's Memorial Research Center and the Department of Pediatrics, Fein-berg School of Medicine, Northwestern University, Chicago, Ill, USA.
American Journal of Public Health (Impact Factor: 4.55). 05/2007; 97(4):626-9. DOI: 10.2105/AJPH.2005.085340
Source: PubMed


There has been a transition in US firearm injuries from an epidemic phase (mid-1980s to early 1990s) to an endemic one (since the mid-1990s). Endemic US firearm injuries merit public health attention because they exact an ongoing toll, may give rise to new epidemic outbreaks, and can foster firearm injuries in other parts of the world. The endemic period is a good time for the development of ongoing prevention approaches, including assessment and monitoring of local risk factors over time and application of proven measures to reduce these risk factors, development of means to address changing circumstances, and ongoing professional and public education designed to weave firearm injury prevention into the fabric of public health work and everyday life.

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    • "An even more widespread problem is the number of nonfatal firearm injuries attributed to assault, which was 6.25 times more common among African American youth compared to firearm related fatalities in 2006 (CDC, 2006, 2009a). Christoffel (2007) recently argued that firearm injuries in the U.S. represented an endemic public health threat since the rate of firearm injuries has remained stable over time. Garborino, Bradshaw, and Vorrasi (2002) suggested that youth gun violence should be examined as an outgrowth of youth gun carrying , which changed the dynamic of ordinary fights and other violent encounters between urban minority youth. "
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    ABSTRACT: First time gun carrying is specified as a logical starting point for the primary prevention of youth gun violence, which is also consistent with the public health approach to the prevention of firearm injuries for at risk African American youth. However, it is difficult to disentangle youth gun violence from other aspects of violence that are concentrated in high poverty settings. Insights from developmental life-course criminology (DLC) are used to: (1) categorize first time gun carrying as a critical inflection point in the development of youth violence; and (2) categorize exposure to violence in the community as a developmental pathway for first time gun carrying for youth attempting to prevent and/or deter future violent victimization. The ecological–transactional model of community violence provides a more nuanced breakdown of the impact of exposure to violence in the community on first time gun carrying given the embeddedness of contexts that shape child and adolescent development in high poverty settings. Finally, several areas for future research are outlined that include a need to better integrate gun carrying into existing theories as well as future longitudinal studies of high risk African American youth.
    Full-text · Article · Jan 2012 · Aggression and Violent Behavior
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    ABSTRACT: Injuries from small arms are of concern internationally. The health perspective is an emerging aspect of international work to reduce these injuries. This aspect has been evident in US firearm injury prevention work for over a decade, exhibited by strong statements from the American Academy of Pediatrics (AAP) to remove firearms from children's environments. To assess trends among US pediatricians related to firearm injury prevention counseling practices and attitudes toward gun legislation. National random sample, mailed surveys of AAP members: (1) 1994 (response rate = 68.9%, n = 982); (2) 2000 (response rate = 62.4%, n = 922). chi(2) Tests were used to assess bivariate relationships and logistic regression to assess multivariate relationships regarding counseling practices. Respondents in both years believed that violence prevention should be a priority for pediatricians (91.4% and 92.0%) and reported always or sometimes recommending handgun removal from the home (46.2% and 55.9%, respectively). In 2000, 74% of the respondents were comfortable discussing firearm safety; fewer thought they had sufficient training (32.7%) or time (27.5%) to discuss firearms. In 1994 and 2000, the likelihood of counseling on handgun removal was positively related to recent experience treating a gun injury, female sex and not owning a gun. In both years, >80% of pediatricians thought that gun control legislation or regulations would reduce injury and death. US pediatricians continue to adopt policies promoting gun injury prevention. The practices and attitudes of pediatricians may be important for public education strategies regarding firearm injury prevention in the US and internationally.
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