O3218: Circumstances Surrounding Pediatric Firearm Injury in New York City

Background: Firearm related injuries are the number one cause of death in U.S. children, 1 to 19 years old. Black youth are disproportionately affected. Primary prevention is lacking in urban settings, where most firearm injuries occur outside the home. A reduction in gun violence has been found with environmental approaches, such as green spaces in high crime neighborhoods. This study was undertaken to better understand the epidemiology of non-fatal firearm related injuries in children in NYC to inform equitable prevention measures.

Methods: A multi-institutional retrospective, descriptive chart review was conducted for children 0 to 17 years old treated at a NYC Health+Hospitals (HHC) Level 1 public hospital trauma center (Bellevue, Kings County, Jacobi, Elmhurst, Lincoln, or Harlem) for a firearm injury over a 5-year period (July 1, 2016 - June 30, 2021). IRB approval was obtained. Eligible patients were identified from hospital trauma registries. Electronic health records (EHR) were reviewed for demographic, injury, and incident information. Additional data was obtained from the Gun Violence Archive (GVA), a public access shooting incident database. Geospatial analysis was utilized to determine location trends.

Results: One hundred and seventy-six children met study criteria. Most were male (91.5%), Black (74.4%) and/or Hispanic (12.5%). Most were older adolescents 15 to 17 years old (87.5%) followed by 10 to 14 years old (12.5%), 5 to 9 years old (2.3%), and 0 to 4 years old (1.7%). Most injuries were non-fatal (94.9%). Most incidents occurred on weekdays (75.6%) and after school hours between 3PM and midnight (61.4%) with a subset of those between 3PM and 9PM (65.7%), and within one mile of the victim’s home address. Seventy-nine percent of incidents occurred outside the home with most occurring on the sidewalk/street (57%) or park/playground (12%). Shooting incident geolocations were determined for 98 of the 176 incidents along with 181 GVA injury location data points and mapped in relationship to greenspaces [Figure 1] and NYC Housing Authority (NYCHA) locations [Figure 2].

Conclusion: Preliminary data analysis indicates that most pediatric firearm injury victims were Black male adolescents who suffered nonfatal injuries that occurred outside of the home, specifically on sidewalks/streets or parks/playgrounds. Geospatial analysis exhibits a high density of incidents in South Bronx, Harlem/East Harlem, Bedford-Stuyvesant, Crown Heights, and Brownsville, which were found to be significant and to exhibit spatial clustering. Most incidents were shown to occur at or within 220 feet (1-minute walking distance) of a greenspace and at or within 0.2 miles (5-minute walking distance) of NYCHA housing. While further analysis of intent is underway, these findings suggest a need for environmental policy interventions in public spaces, which are specific to individual urban environments and not generalization of one preventative strategy for all environments.