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Risk factors associated with non-fatal adolescent firearm injuries

¹ Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital and Regional Medical Center, Seattle, Washington and Department of Pediatrics, Harbor–UCLA Medical Center, Torrance, California
² Department of Pediatrics, Harbor–UCLA Medical Center, Torrance, California
³ Departments of Pediatrics and Emergency Medicine, Harbor–UCLA Medical Center, Torrance, California
⁴ Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California

Correspondence and reprint requests to:
Dr Carolyn A Paris, Division of Pediatric Emergency Medicine, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, P O Box 5371/CH-04, Seattle, WA 98105, USA;
cparis{at}chmc.org

Study objective: To identify behavioral, environmental, and sociodemographic risk factors associated with non-fatal firearm injuries among inner city adolescents in the United States.

Design: A case-control study in which patients with firearm injury serve as cases and those with medical conditions serve as controls.

Setting: A level I trauma center in a metropolitan area serving a predominately lower socioeconomic status population.

Participants: Cases were 45 consecutive patients 11–18 years presenting to the emergency department with a non-fatal firearm injury; controls were 50 age and gender matched patients presenting with acute medical problems.

Outcome measure: Odds ratios (OR) and associated 95% confidence intervals (CI) as estimates of the magnitude of association between risk factors and non-fatal firearm injury.

Results: After adjusting for age, gender and socioeconomic status, multivariate analysis identified four risk factors independently associated with firearm injury: living with less than two parents (OR 3.8, 95% CI 1.2 to 12.2), skipping class (OR 7.1, 95% CI 1.7 to 28.9), previous arrest (OR 6.2, 95% CI 1.9 to 20.7), and being African-American (OR 4.2; 95% CI 1.4 to 14.9).

Conclusion: Risk factors for adolescents sustaining a non-fatal firearm injury are sociodemographic and environmental, not just behavioral. Thus interventions that foster protective and supportive environments may help prevent firearm injuries.

Keywords: firearms; risk factors; adolescents

Abbreviations: CI, confidence interval; HEADSS, home environment, educational habits or employment status, peer group related activities, drug use, sexual activity, and suicide; OR, odds ratio