2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta10,Firearm injury remains a pressing public health crisis in the US, yet the relative influence of neighborhood deprivation and state firearm laws is not well understood. To assess the associations of neighborhood deprivation, state firearm law strength, and urbanicity with firearm injury rates across the US. This was a population-based cross-sectional study conducted at the Census block group level across the entire US from January 2018 through December 2022. Gun Violence Archive data were used to identify and include fatal and nonfatal firearm injuries in individuals of all ages. Suicide-related firearm injuries were excluded. Data were analyzed from March to June 2025. Neighborhood deprivation measured by the 2020 Area Deprivation Index at the census block group level, state firearm law strength determined by the 2020 Giffords Law Center Annual Gun Law Scorecard, and urbanicity (urban, mixed, and rural categories) based on 2020 Census Bureau urban-rural classifications. A spatial lag variable for neighboring state firearm law strength was also included. Firearm injury rates per 1000 population in a Census block group was evaluated using negative binomial regression to estimate incident rate ratios (IRR). Spatial autocorrelation was assessed using bivariate Moran I statistics. Across 233 386 Census block groups, 206 082 shooting incidents were analyzed (81 241 fatalities and 176 179 nonfatal injuries). On multivariable analysis, each decile increase in Area Deprivation Index (ADI) was associated with a 25% increase in firearm injury rates (IRR, 1.25; 95% CI, 1.25-1.26; P < .001) while incremental strengthening of state firearm law grade was associated with a 5% decrease (IRR, 0.95; 95% CI, 0.95-0.96; P < .001). Neighboring state law strength had a weaker association (IRR, 0.99; 95% CI, 0.99-1.00; P < .001). Compared to urban block groups, mixed (IRR, 0.39; 95% CI, 0.37-0.41) and rural (IRR, 0.22; 95% CI, 0.22-0.23) block groups had significantly lower rates (P < .001 for both). Bivariate global Moran I confirmed positive spatial autocorrelation between ADI and shooting incidents (I, 0.76; P < .001). In this national cross-sectional study, neighborhood deprivation demonstrated a substantially stronger statistical association with firearm injury rates than did state firearm law strength. While firearm legislation is crucial, strategies that prioritize investment in socially and economically deprived communities, especially in urban settings, may yield more meaningful reductions in firearm injuries overall.31:T121a, Importance Firearm injury remains a pressing public health crisis in the US, yet the relative influence of neighborhood deprivation and state firearm laws is not well understood. Objective To assess the associations of neighborhood deprivation, state firearm law strength, and urbanicity with firearm injury rates across the US. Design, Setting, and Participants This was a population-based cross-sectional study conducted at the Census block group level across the entire US from January 2018 through December 2022. Gun Violence Archive data were used to identify and include fatal and nonfatal firearm injuries in individuals of all ages. Suicide-related firearm injuries were excluded. Data were analyzed from March to June 2025. Exposure Neighborhood deprivation measured by the 2020 Area Deprivation Index at the census block group level, state firearm law strength determined by the 2020 Giffords Law Center Annual Gun Law Scorecard, and urbanicity (urban, mixed, and rural categories) based on 2020 Census Bureau urban-rural classifications. A spatial lag variable for neighboring state firearm law strength was also included. Main Outcomes and Measures Firearm injury rates per 1000 population in a Census block group was evaluated using negative binomial regression to estimate incident rate ratios (IRR). Spatial autocorrelation was assessed using bivariate Moran I statistics. Results Across 233 386 Census block groups, 206 082 shooting incidents were analyzed (81 241 fatalities and 176 179 nonfatal injuries). On multivariable analysis, each decile increase in Area Deprivation Index (ADI) was associated with a 25% increase in firearm injury rates (IRR, 1.25; 95% CI, 1.25-1.26; P &lt; .001) while incremental strengthening of state firearm law grade was associated with a 5% decrease (IRR, 0.95; 95% CI, 0.95-0.96; P &lt; .001). Neighboring state law strength had a weaker association (IRR, 0.99; 95% CI, 0.99-1.00; P &lt; .001). Compared to urban block groups, mixed (IRR, 0.39; 95% CI, 0.37-0.41) and rural (IRR, 0.22; 95% CI, 0.22-0.23) block groups had significantly lower rates ( P &lt; .001 for both). Bivariate global Moran I confirmed positive spatial autocorrelation between ADI and shooting incidents ( I , 0.76; P &lt; .001). Conclusions and Relevance In this national cross-sectional study, neighborhood deprivation demonstrated a substantially stronger statistical association with firearm injury rates than did state firearm law strength. While firearm legislation is crucial, strategies that prioritize investment in socially and economically deprived communities, especially in urban settings, may yield more meaningful reductions in firearm injuries overall. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Firearm Injury: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Firearm Injury (condition). Clinician-written summaries and actionable practice insights. 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Four subgroups emerged: firearm-related TDV, non-firearm TDV, psychological TDV only, and uninvolved. Male sex, sexual/gender minority identity, and attending a high-poverty school were each associated with higher odds of firearm-related TDV subgroup membership; this subgroup also showed greater substance use and suicidal ideation than all others.","limitations":"Single-county, Southeastern U.S. sample limits generalizability. Cross-sectional design prevents causal inference. Self-report data introduce potential recall and social desirability bias.","practice_takeaway":"Clinicians working with adolescents—especially males, LGBTQ+ youth, and those in high-poverty schools—should routinely screen for both firearm access and dating violence, given their co-occurrence with substance use and suicidal ideation. Community-level interventions addressing school poverty context are needed alongside individual screening."}},{"doi":"10.1016/j.injury.2026.113426","pmid":"42263518","title":"Association between neighborhood opportunity and incidence of pediatric trauma","journal_title":"Injury","journal_issn":"0020-1383","published_at":"2026-06-05T00:00:00.000Z","url":"https://doi.org/10.1016/j.injury.2026.113426","source_score":1,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-11T13:42:32.672Z","updated_at":"2026-06-11T13:42:32.672Z","tags":[{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"condition","value":"Firearm Injury","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"condition","value":"Pedestrian Injury","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"condition","value":"Pediatric Trauma","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"sample_size","value":"n=28034","value_numeric":28034},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"study_design","value":"Retrospective Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"warning","value":"COI is assigned at the zip code level, which may introduce ecological bias when drawing conclusions about individual children.","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"warning","value":"Mortality (1.8%) is reported for the full sample but is not broken down by COI level in the provided abstract/results — absolute outcome differences by neighborhood opportunity are not quantifiable from this source.","value_numeric":null},{"paper_doi":"10.1016/j.injury.2026.113426","tag_type":"warning","value":"The impact_flag 'practice_changing' is debatable given the observational design; the findings are strongly hypothesis-generating and policy-relevant, but causal claims cannot be made.","value_numeric":null}],"summaries":{"what_studied":"This multicenter, retrospective, cross-sectional study examined the association between neighborhood opportunity (Child Opportunity Index 2.0, COI) and pediatric trauma incidence, mechanism, severity, and disposition among children under 18 in Los Angeles County from 2010 to 2021.","key_result":"Among 28,034 patients (median age 13.0 years; mortality 1.8%, n=493), lower COI zip codes had higher trauma incidence, with more firearm injuries, assaults/stabbings, and pedestrian/bicyclist strikes. Higher COI areas saw more falls and sports-related injuries (all p<0.001).","limitations":"Retrospective, cross-sectional design limits causal inference. Zip code–level COI may not reflect individual-level socioeconomic context (ecological fallacy). Single metropolitan area (LA County) limits generalizability.","practice_takeaway":"Children in low-opportunity neighborhoods face higher rates of violent and traffic-related trauma — injury prevention resources and outreach should be prioritized in these areas. Clinicians and public health teams can use COI mapping to target interventions where trauma burden is greatest."}},{"doi":"10.1097/xcs.0000000000001826","pmid":"41944495","title":"Accessibility and Use of Violence Intervention Programs: A Retrospective Analysis of the National American College of Surgeons Committee on Trauma Firearm Study Research Dataset","journal_title":"Journal of the American College of Surgeons","journal_issn":"1072-7515","published_at":"2026-05-14T00:00:00.000Z","url":"https://doi.org/10.1097/xcs.0000000000001826","source_score":29,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:15.980Z","updated_at":"2026-05-15T13:23:15.980Z","tags":[{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"condition","value":"Firearm Injury","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"condition","value":"Violent Injury","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"modality","value":"Violence Intervention Program","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"sample_size","value":"n=15455","value_numeric":15455},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"warning","value":"Mean age differences between groups, while statistically significant, are small (less than 3 years) and may not be clinically meaningful.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"warning","value":"No outcome data (re-injury, mortality, recidivism) are reported; the study characterizes access patterns only, not program effectiveness.","value_numeric":null},{"paper_doi":"10.1097/xcs.0000000000001826","tag_type":"warning","value":"The study reports demographic associations with VIP use but cannot determine whether under-use reflects patient refusal, provider screening gaps, or structural capacity limits — clinicians should interpret predictors cautiously.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used the National ACS Committee on Trauma Firearm Study Research Dataset to compare patient demographics and injury characteristics between facilities with and without violence intervention programs (VIPs), and to identify predictors of VIP use among 15,455 adult firearm-injured patients.","key_result":"Only 18.5% of patients at VIP-equipped facilities actually received VIP services. Assault-related injury was the strongest independent predictor of VIP use (OR 3.00, 95% CI 1.50–5.99). Black patients, Medicaid recipients, and those with a history of mental illness were also more likely to receive VIPs. Meanwhile, 35.7% of patients were treated at non-VIP facilities — which disproportionately served older and Black patients with no access to these interventions.","limitations":"Retrospective design limits causal inference. The dataset does not capture reasons why eligible patients at VIP facilities did not receive services (e.g., refusal, staff capacity, screening gaps). Long-term outcomes (re-injury, recidivism) are not reported.","practice_takeaway":"At facilities with VIPs, most eligible firearm-injured patients — over 80% — still don't receive services, suggesting major gaps in screening and referral. Trauma programs should audit VIP reach and prioritize expanding access at non-VIP facilities that treat high-risk populations."}},{"doi":"10.1016/j.ajem.2026.05.023","pmid":"42139773","title":"Texas emergency department visits for firearm injury: Trends & correlates 2016–2022","journal_title":"The American Journal of Emergency Medicine","journal_issn":"0735-6757","published_at":"2026-05-12T00:00:00.000Z","url":"https://doi.org/10.1016/j.ajem.2026.05.023","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-27T15:43:00.539Z","updated_at":"2026-05-27T15:43:00.539Z","tags":[{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"category","value":"Emergency Medicine","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"condition","value":"Firearm Injury","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"study_design","value":"Retrospective Longitudinal Study","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"warning","value":"No total sample size (N) is reported in the abstract or results; sample_size tag was omitted.","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"warning","value":"Study design is observational and ecological at the county level for the firearm ownership analysis; causal inference is limited.","value_numeric":null},{"paper_doi":"10.1016/j.ajem.2026.05.023","tag_type":"warning","value":"The DOI year (2026) is consistent with today's date but is ahead of typical publication cycles — paper appears to be a recent ahead-of-print article.","value_numeric":null}],"summaries":{"what_studied":"This study examined ED visits for firearm injuries in Texas from 2016–2022, analyzing trends in utilization and associated charges by patient demographics, payer, admission status, county characteristics, and county-level firearm ownership tercile using negative binomial time series regression.","key_result":"Overall firearm injury ED utilization was stable, but severity likely increased: hospital admission rates rose and average total charges more than doubled. Each step-up in county firearm ownership tercile was associated with >10% more expected firearm injury ED visits.","limitations":"Texas is frequently excluded from national firearm injury datasets, limiting comparability. The study relies on ICD-10 external cause codes, which may miss some cases. County-level firearm ownership is a proxy measure and may not reflect individual exposure.","practice_takeaway":"Clinicians and health systems in Texas should prepare for rising severity and cost of firearm injuries, especially in high-ownership counties. Tracking admission rates and charges alongside visit volume gives a fuller picture of the true burden."}},{"doi":"10.1001/jamasurg.2026.0001","pmid":"41739460","title":"Firearm Mortality and Equitable Access to Trauma Care in Chicago","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-02-25T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12936966/","source_score":53,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:21.643Z","updated_at":"2026-05-07T22:49:21.643Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"condition","value":"Firearm Injury","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"condition","value":"Penetrating Trauma","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"modality","value":"Trauma Center Access","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"sample_size","value":"n=45,150","value_numeric":45150},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"study_design","value":"Cohort Study with Interrupted Time-Series Analysis","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"warning","value":"No drug or device intervention is involved; modality tag reflects the healthcare system intervention studied.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"warning","value":"The 95% CI for the mortality decrease (6.8%–1.1%) appears to be presented in reverse order in the abstract (upper bound listed first); clinicians should note the effect is a 3.9% reduction with the interval spanning approximately 1.1% to 6.8%.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.0001","tag_type":"warning","value":"The study is limited to Chicago and a single trauma center opening, so findings may not generalize to suburban, rural, or differently structured urban trauma systems.","value_numeric":null}],"summaries":{"what_studied":"This cohort study used interrupted time-series analysis to evaluate whether opening a Level 1 trauma center (University of Chicago, May 2018) in an urban trauma desert was associated with reduced firearm injury mortality, examining 45,150 shooting incidents in Chicago from 2010–2024.","key_result":"Opening the trauma center reduced mean travel time by 9.5 minutes (95% CI, 8.8–10.1 min) and mean travel distance by 3.4 miles in the service area, with a 3.9% proportionate decrease in firearm mortality (95% CI, 1.1%–6.8%; P = .007); no significant mortality change was seen outside the service area.","limitations":"- Observational design limits causal inference; unmeasured confounders (e.g., concurrent policy changes, EMS protocol shifts) may affect results.\n- Geographic service area boundaries were defined by the investigators, which could influence which incidents are attributed to the new center.\n- Study spans only one city and one new trauma center, limiting generalizability to other urban settings.","practice_takeaway":"Placing a Level 1 trauma center in a high-violence, underserved urban area can meaningfully cut firearm mortality — a ~4% reduction was seen within just the local service area. Trauma system planners should prioritize geographic equity when siting new trauma centers, especially in communities with high penetrating trauma rates."}},{"doi":"10.1001/jamasurg.2025.5168","pmid":"41296361","title":"Neighborhood Deprivation, State Laws, and Firearm Injury in the US","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2025-11-26T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12658767/","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-16","doi":"10.1001/jamasurg.2025.5168","days":"7","issn":"2168-6254","rank":"10","field":"Clinical Medicine","score":"18","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1001/jamasurg.2025.5168","title":"Neighborhood Deprivation, State Laws, and Firearm Injury in the US.","journal":"JAMA surgery","methods":"","results":"Across 233 386 Census block groups, 206 082 shooting incidents were analyzed (81 241 fatalities and 176 179 nonfatal injuries). On multivariable analysis, each decile increase in Area Deprivation Index (ADI) was associated with a 25% increase in firearm injury rates (IRR, 1.25; 95% CI, 1.25-1.26; P < .001) while incremental strengthening of state firearm law grade was associated with a 5% decrease (IRR, 0.95; 95% CI, 0.95-0.96; P < .001). Neighboring state law strength had a weaker association (IRR, 0.99; 95% CI, 0.99-1.00; P < .001). Compared to urban block groups, mixed (IRR, 0.39; 95% CI, 0.37-0.41) and rural (IRR, 0.22; 95% CI, 0.22-0.23) block groups had significantly lower rates (P < .001 for both). 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