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Child and adolescent injury and death from urban firearm assaults: association with age, race, and poverty

¹ Division of Pediatric Emergency Medicine, Children's Memorial Hospital, and the Department of Pediatrics, Northwestern University Medical School, Chicago
² Division of General Academic Pediatrics and the Violent Injury Prevention Center, Children's Memorial Hospital, and the Department of Pediatrics, Northwestern University Medical School, Chicago

Correspondence and reprint requests to:
Dr Elizabeth C Powell, Division of Pediatric Emergency Medicine-Box 62, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA.

Objective—To describe rates and trends in the incidence of non-fatal and fatal firearm assault among children (16 years old or younger) over an 11 year period in Chicago, Illinois and to identify the socioeconomic characteristics of community areas where assaults are common.

Methods—The Chicago Police Department (CPD) records from 1986 through 1996 were reviewed for children assaulted with a firearm. United States census data for 1990 for Chicago were used to calculate incidence rates; census data were also used for community area (defined by census tract) socioeconomic descriptions.

Results—The CPD recorded 11 163 pediatric firearm assaults during the study period: 10 571 non-fatal and 592 (5%) fatal. From 1986 through 1996 non-fatal assaults more than doubled, with the highest rates in 1994; fatal assaults tripled, with rates peaking in 1993–94. Significant increases in non-fatal firearm assaults occurred among black and Hispanic males and females. In 1994, compared with white males, the relative risk of non-fatal assault was 7.0 (95% confidence interval (CI) 5.3 to 9.1) for black males and 3.3 (95% CI 2.5 to 4.4) for Hispanic males; the relative risk was 1.5 (95% CI 1.1 to 2.1) for black females. A handgun was the firearm used in most assaults (88% of non-fatal and 84% of fatal).

Within community areas, the correlation between non-fatal and fatal assault incidence was strong (r=0.80, p<0.001). The proportion of families with income below the 1989 poverty level ($12 674) and the per cent black race in the community area together accounted for 70% of the variance in assault rates.

Conclusions—From 1986 to 1994 there were significant increases in both non-fatal and fatal firearm assaults, usually by handguns; thereafter, rates declined. Urban children who were victims of non-fatal firearm assault appear to come from the same population as those who suffer fatal assaults. Black and Hispanic youth living in poverty were at particular risk.

Keywords: adolescents; assault; firearm; poverty

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