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Non-fatal gun violence and community health behaviors: A neighborhood analysis in Philadelphia

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Abstract

Research shows that community violence is associated with an array of negative health outcomes, yet no study has examined the specific association between different types of gun violence and collective health behaviors in local neighborhoods. Using data from neighborhoods in the city of Philadelphia, this study examines the association between total, fatal, and non-fatal gun violence and measures of physical inactivity, obesity, sleep, and smoking. We find the rate of non-fatal shootings is associated with a composite measure of health behaviors, net of all neighborhood-level covariates and general community violence. Ancillary analyses show that non-fatal shootings are particularly associated with physical inactivity and obesity. Notably, fatal shootings are not associated with any behavioral health measure after accounting for nonlethal shootings. The results support improved data collection efforts to measure non-fatal shootings across the U.S. and greater attention to the collective health consequences of gun violence in local communities.

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References

  • Abt, T. (2019). Bleeding out: The devastating consequences of urban violence–and a bold new plan for peace in the streets. Basic Books.

    Google Scholar 

  • Akins, S., Rumbaut, R. G., & Stansfield, R. (2009). Immigration, economic disadvantage, and homicide: A community-level analysis of Austin. Texas. Homicide Studies, 13, 307–314.

    Article  Google Scholar 

  • Anselin, L., Cohen, J., Cook, D., Gorr, W., & Tita, G. (2000). Spatial analyses of crime. Criminal Justice, 4, 213–262.

    Google Scholar 

  • Baller, R. D., Anselin, L., Messner, S. F., Deane, G., & Hawkins, D. F. (2001). Structural covariates of US county homicide rates: Incorporating spatial effects. Criminology, 39, 561–588.

    Article  Google Scholar 

  • Braga, A. A., & Cook, P. J. (2018). The association of firearm caliber with likelihood of death from gunshot injury in criminal assaults. JAMA Network Open, 1, e180833–e180833.

    Article  PubMed  PubMed Central  Google Scholar 

  • Braga, A. A., Kennedy, D. M., Waring, E. J., & Piehl, A. M. (2001). Problem-oriented policing, deterrence, and youth violence: An evaluation of Boston’s Operation Ceasefire. Journal of Research in Crime and Delinquency, 38, 195–225.

    Article  Google Scholar 

  • Braga, A. A., Papachristos, A. V., & Hureau, D. M. (2010). The concentration and stability of gun violence at micro places in Boston, 1980–2008. Journal of Quantitative Criminology, 26, 33–53.

    Article  Google Scholar 

  • Campbell, S., Nass, D., Nguyen, M. (2018). The CDC is publishing unreliable data on gun injuries. People are using it anyway. FiveThirtyEight. Retrieved January 5, from https://fivethirtyeight.com/features/the-cdc-is-publishing-unreliable-data-on-gun-injuries-people-are-using-it-anyway/#:~:text=found%20that%20the%20CDC's%20report,numbers%20have%20changed%20over%20time.

  • Clark, M. M., Warren, B. A., Hagen, P. T., Johnson, B. D., Jenkins, S. M., Werneburg, B. L., & Olsen, K. D. (2011). Stress level, health behaviors, and quality of life in employees joining a wellness center. American Journal of Health Promotion, 26, 21–25.

    Article  PubMed  Google Scholar 

  • Cockerham, W. C. (2005). Health lifestyle theory and the convergence of agency and structure. Journal of Health and Social Behavior, 46, 51–67.

    Article  PubMed  Google Scholar 

  • Cooley-Quille, M., & Lorion, R. (1999). Adolescents’ exposure to community violence: Sleep and psychophysiological functioning. Journal of Community Psychology, 27, 367–375.

    Article  Google Scholar 

  • Crandall, M., Sharp, D., Unger, E., Straus, D., Brasel, K., Hsia, R., & Esposito, T. (2013). Trauma deserts: distance from a trauma center, transport times, and mortality from gunshot wounds in Chicago. American Journal of Public Health, 103, 1103–1109.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cuartas, J., & Leventhal, T. (2020). Exposure to community violence and Children’s mental Health: A quasi-experimental examination. Social Science & Medicine, 246, 112740.

    Article  Google Scholar 

  • Dobaria, V., Aguayo, E., Sanaiha, Y., Tran, Z., Hadaya, J., Sareh, S., Cho, N. Y., & Benharash, P. (2020). National trends and cost burden of surgically treated gunshot wounds in the US. Journal of the American College of Surgeons, 231, 448–459.

    Article  PubMed  Google Scholar 

  • Echeverria, S. E., Kang, A. L., Isasi, C. R., Johnson-Dias, J., & Pacquiao, D. (2014). A community survey on neighborhood violence, park use, and physical activity among urban youth. Journal of Physical Activity and Health, 11, 186–194.

    Article  PubMed  Google Scholar 

  • Everytown for Gun Safety. (2020). A more complete picture: The contours of gun injury in the United States. Retrieved January 5, from https://everytownresearch.org/report/nonfatals-in-the-us/#intro.

  • Fitzpatrick, K. M., Shi, X., Willis, D., & Niemeier, J. (2018). Obesity and place: Chronic disease in the 500 largest US cities. Obesity Research & Clinical Practice, 12, 421–425.

    Article  Google Scholar 

  • Gomez, J. E., Johnson, B. A., Selva, M., & Sallis, J. F. (2004). Violent crime and outdoor physical activity among inner-city youth. Preventive Medicine, 39, 876–881.

    Article  PubMed  Google Scholar 

  • Greenspan, A. I., & Kellermann, A. L. (2002). Physical and psychological outcomes 8 months after serious gunshot injury. Journal of Trauma and Acute Care Surgery, 53, 709–716.

    Article  Google Scholar 

  • Hipple, N. K., Huebner, B. M., Lentz, T. S., McGarrell, E. F., & O’Brien, M. (2020). The case for studying criminal nonfatal shootings: Evidence from four midwest cities. Justice Evaluation Journal, 3, 94–113.

    Article  Google Scholar 

  • Hipple, N. K., & Magee, L. A. (2017). The difference between living and dying: Victim characteristics and motive among nonfatal shootings and gun homicides. Violence and Victims, 32, 977–997.

    Article  PubMed  Google Scholar 

  • Jackson, D. B., Posick, C., & Vaughn, M. G. (2019). New evidence of the nexus between neighborhood violence, perceptions of danger, and child health. Health Affairs, 38, 746–754.

    Article  PubMed  Google Scholar 

  • Jena, A. B., Sun, E. C., & Prasad, V. (2014). Does the declining lethality of gunshot injuries mask a rising epidemic of gun violence in the United States? Journal of General Internal Medicine, 29, 1065–1069.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnson, S. L., Solomon, B. S., Shields, W. C., McDonald, E. M., McKenzie, L. B., & Gielen, A. C. (2009). Neighborhood violence and its association with mothers’ health: Assessing the relative importance of perceived safety and exposure to violence. Journal of Urban Health, 86, 538–550.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kalesan, B., Adhikarla, C., Pressley, J. C., Fagan, J. A., Xuan, Z., Siegel, M. B., & Galea, S. (2017). The hidden epidemic of firearm injury: Increasing firearm injury rates during 2001–2013. American Journal of Epidemiology, 185, 546–553.

    Article  PubMed  Google Scholar 

  • Kamphius, C. B., van Lenthe, F. J., Giskes, K., Brug, J., & Mackenbach, J. P. (2007). Perceived environmental determinants of physical activity and fruit and vegetable consumption among high and low socioeconomic groups in the Netherlands. Health & Place, 13, 493–503.

    Article  Google Scholar 

  • Katz, D. A., Sprang, G., & Cooke, C. (2012). The cost of chronic stress in childhood: Understanding and applying the concept of allostatic load. Psychodynamic Psychiatry, 40, 469–480.

    Article  PubMed  Google Scholar 

  • Kaufman, E. J., Wiebe, D. J., Xiong, R. A., Morrison, C. N., Seamon, M. J., & Delgado, M. K. (2021). Epidemiologic trends in fatal and nonfatal firearm injuries in the US, 2009-2017. JAMA Internal Medicine, 181(2), 237–244.

    Article  PubMed  Google Scholar 

  • Lane, S. D., Rubinstein, R. A., Bergen-Cico, D., Jennings-Bey, T., Fish, L. S., Larsen, D. A., Fullilove, M. T., Schimpff, T. R., Ducre, K. A., & Robinson, J. A. (2017). Neighborhood trauma due to violence: A multilevel analysis. Journal of health care for the poor and underserved., 28, 446–62.

    Article  PubMed  Google Scholar 

  • Lauritsen, J. L., & White, N. A. (2001). Putting violence in its place: The influence of race, ethnicity, gender, and place on the risk for violence. Criminology & Public Policy, 1, 37–60.

    Article  Google Scholar 

  • Lee, J. (2012). Wounded: Life after the shooting. The ANNALS of the American Academy of Political and Social Science, 642, 244–257.

    Article  Google Scholar 

  • Lee, J. (2013). The pill hustle: Risky pain management for a gunshot victim. Social Science & Medicine, 99, 162–168.

    Article  Google Scholar 

  • Liebschutz, J., Schwartz, S., Hoyte, J., Conoscenti, L., Christian, A. B., Sr., Muhammad, L., Harper, D., & James, T. (2010). A chasm between injury and care: Experiences of black male victims of violence. The Journal of trauma, 69, 1372.

    PubMed  PubMed Central  Google Scholar 

  • Liu, S. H., Liu, B., & Li, Y. (2018). Risk factors associated with multiple correlated health outcomes in the 500 Cities Project. Preventive Medicine, 112, 126–129.

    Article  PubMed  Google Scholar 

  • McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 33–44.

    Article  CAS  PubMed  Google Scholar 

  • Newbury, J., Arseneault, L., Caspi, A., Moffitt, T. E., Odgers, C. L., & Fisher, H. L. (2018). Cumulative effects of neighborhood social adversity and personal crime victimization on adolescent psychotic experiences. Schizophrenia Bulletin, 44, 348–358.

    Article  PubMed  Google Scholar 

  • Ng, D. M., & Jeffery, R. W. (2003). Relationships between perceived stress and health behaviors in a sample of working adults. Health Psychology, 22, 638.

    Article  PubMed  Google Scholar 

  • Onufer, E. J., Andrade, E., Cullinan, D. R., Kramer, J., Leonard, J., Stewart, M., Vallar, K., Wise, P. E., Klingensmith, M. E., & Punch, L. J. (2020). Anatomy of gun violence: Contextualized curriculum to train surgical residents in both technical and non-technical skills in the management of gun violence. Journal of the American College of Surgeons, 231, 628–637.

    Article  PubMed  Google Scholar 

  • Patton, D., Sodhi, A., Affinati, S., Lee, J., & Crandall, M. (2019). Post-discharge needs of victims of gun violence in Chicago: A qualitative study. Journal of Interpersonal Violence, 34, 135–155.

    Article  PubMed  Google Scholar 

  • Piro, F. N., Nœss, Ø., & Claussen, B. (2006). Physical activity among elderly people in a city population: The influence of neighbourhood level violence and self perceived safety. Journal of Epidemiology & Community Health, 60, 626–632.

    Article  Google Scholar 

  • Putzke, J. D., Richards, J. S., & DeVivo, M. J. (2001). Quality of life after spinal cord injury caused by gunshot. Archives of Physical Medicine and Rehabilitation, 82, 949–954.

    Article  CAS  PubMed  Google Scholar 

  • Ranney, M., Karb, R., Ehrlich, P., Bromwich, K., Cunningham, R., Beidas, R. S., & FACTS Consortium. (2019). What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review. Journal of Behavioral Medicine, 42, 724–740.

    Article  Google Scholar 

  • Raza, S., Thiruchelvam, D., & Redelmeier, D. A. (2020). Death and long-term disability after gun injury: A cohort analysis. CMAJ Open, 8(3), E469–E478.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rich, J. A. (2009). Wrong place wrong time: Trauma and violence in the lives of young Black men. JHU Press.

    Book  Google Scholar 

  • Rich, J. A., & Grey, C. M. (2005). Pathways to recurrent trauma among young black men: Traumatic stress, substance use, and the “code of the street.” American Journal of Public Health, 95, 816–824.

    Article  PubMed  PubMed Central  Google Scholar 

  • Roman, J.K. (2020). A blueprint for a U.S. firearms data infrastructure. Bethesda, MD: NORC at the University of Chicago. Retrieved January 5, from https://www.norc.org/PDFs/Firearm%20Data%20Infrastructure%20Expert%20Panel/A%20Blueprint%20for%20a%20U.S.%20Firearms%20Data%20Infrastructure_NORC%20Expert%20Panel%20Final%20Report_October%202020.pdf

  • Sampson, R. J., & Bartusch, D. J. (1998). Legal cynicism and (subcultural?) tolerance of deviance: The neighborhood context of racial differences. Law and society review, 32, 777–804.

    Article  Google Scholar 

  • Sharkey, P. (2018). The long reach of violence: A broader perspective on data, theory, and evidence on the prevalence and consequences of exposure to violence. Annual Review of Criminology, 1, 85–102.

    Article  Google Scholar 

  • Short, S. E., & Mollborn, S. (2015). Social determinants and health behaviors: Conceptual frames and empirical advances. Current Opinion in Psychology, 5, 78–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stockdale, S. E., Wells, K. B., Tang, L., Belin, T. R., Zhang, L., & Sherbourne, C. D. (2007). The importance of social context: Neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders. Social Science & Medicine, 65, 1867–1881.

    Article  Google Scholar 

  • Tracy, M., Braga, A. A., & Papachristos, A. V. (2016). The transmission of gun and other weapon-involved violence within social networks. Epidemiologic Reviews, 38, 70–86.

    PubMed  PubMed Central  Google Scholar 

  • Vella, M. A., Warshauer, A., Tortorello, G., Fernandez-Moure, J., Giacolone, J., Chen, B., Cabulong, A., Chreiman, K., Sims, C., Schwab, C. W., & Reilly, P. M. (2020). Long-term functional, psychological, emotional, and social outcomes in survivors of firearm injuries. JAMA surgery, 155, 51–59.

    Article  PubMed  Google Scholar 

  • Webster, D.W. (2019). The need for federal funding of public health research on gun violence and its prevention. Testimony presented before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, March 7, 2019. Retrieved January 5, from https://docs.house.gov/meetings/AP/AP07/20190307/109011/HHRG-116-AP07-Wstate-WebsterD-20190307.pdf.

  • Webster, D. W., Whitehill, J. M., Vernick, J. S., & Curriero, F. C. (2013). Effects of Baltimore’s Safe Streets Program on gun violence: A replication of Chicago’s CeaseFire Program. Journal of Urban Health, 90, 27–40.

    Article  PubMed  Google Scholar 

  • Whitehill, J. M., Webster, D. W., Frattaroli, S., & Parker, E. M. (2014). Interrupting violence: how the CeaseFire program prevents imminent gun violence through conflict mediation. Journal of Urban Health, 91, 84–95.

    Article  PubMed  Google Scholar 

  • Wright, A. W., Austin, M., Booth, C., & Kliewer, W. (2017). Systematic review: Exposure to community violence and physical health outcomes in youth. Journal of Pediatric Psychology, 42, 364–378.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, NJ, 08102, USA

    Daniel C. Semenza & Richard Stansfield

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  1. Daniel C. Semenza
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  2. Richard Stansfield
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All authors contributed equally to the study conception and design. All authors read and approved the final manuscript.

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Correspondence to Daniel C. Semenza.

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All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Semenza, D.C., Stansfield, R. Non-fatal gun violence and community health behaviors: A neighborhood analysis in Philadelphia. J Behav Med 44, 833–841 (2021). https://doi.org/10.1007/s10865-021-00232-y

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