Gun violence exposure and population health inequality: a conceptual framework.

This essay establishes a conceptual framework to understand how direct, secondar and community exposures to gun violence converge to influence population health. Our framework asserts that persistent gun violence in structurally disadvantaged communities enacts broad consequences for mental, physical and behavioural health, operating as a key driver of racial and socioeconomic health disparities. We discuss the applications of this framework for research and improved data collection with a focus on establishing timely and accurate measures of gun violence alongside individual and community health measures.

Optimism Bias Among Gun Owners: Associations With Firearm Injury Prevention Practices and Policy Support.

Optimism bias is common across health risk assessments, including firearm injury risk, and can have behavioral consequences. Using data from the 2018 California Safety and Wellbeing Survey, we examine whether optimism bias influences firearm injury prevention practices and policy support by comparing the characteristics, behaviors, and opinions of gun owners who believed having a gun at home is comparatively safer for themselves than for similar others ( group) with (1) those who unequivocally believe guns increase safety for themselves and others ( group), and (2) those who said they "don't know" or "it depends" in both the self and other scenarios ( group). Weighted multinomial logistic regression results indicated that gun owners in the group were more often female, members of minoritized racial or ethnic groups, and new gun owners than the and groups; they also demonstrated greater support for 4 of 5 firearm injury prevention policies/interventions.

The mediating effect of sleep quality on exposure to community violence and posttraumatic stress symptoms in the United States.

Objectives: The role of sleep quality is not yet fully understood in the context of posttraumatic stress disorder (PTSD) following exposure to community violence. Thus, the primary aim of this study is to examine the mediating effect of sleep quality in the relationship between community violence exposure and posttraumatic stress symptoms.

Methods: Utilizing a cross-sectional survey administered to an online opt-in panel of adults in the United States in 2023 (age ≥ 18 years) (N = 342), respondents reported on their exposure to community violence, sleep quality, and posttraumatic stress symptoms.

Community exposure to gun homicide and adolescents' educational aspirations.

Introduction: Witnessing violence and violent victimization have detrimental effects on adolescents' emotional functioning and ability to envision and plan for their futures. However, research is limited on the impact of violence that occurs in adolescents' communities-whether or not it was witnessed or experienced firsthand. This paper investigated the associations between community exposure to gun homicide and adolescents' high school and college graduation aspirations.

Pediatric Firearm Injury Emergency Department Visits From 2017 to 2022: A Multicenter Study.

Background And Objective: Pediatric firearm injuries increased during the coronavirus disease 2019 pandemic, but recent trends in firearm injury emergency department (ED) visits are not well described. We aimed to assess how pediatric firearm injury ED visits during the pandemic differed from expected prepandemic trends.

Methods: We retrospectively studied firearm injury ED visits by children <18 years old at 9 US hospitals participating in the Pediatric Emergency Care Applied Research Network Registry before (January 2017 to February 2020) and during (March 2020 to November 2022) the pandemic.

Effects of Prolonged Exposure to Air Pollution and Neighborhood Disadvantage on Self-Rated Health among Adults in the United States: Evidence from the Panel Study of Income Dynamics.

Background: Although overall air quality has improved in the United States, air pollution remains unevenly distributed across neighborhoods, producing disproportionate environmental burdens for minoritized and socioeconomically disadvantaged residents for whom greater exposure to other structurally rooted neighborhood stressors is also more frequent. These interrelated dynamics and layered vulnerabilities each have well-documented associations with physical and psychological health outcomes; however, much remains unknown about the joint effects of environmental hazards and neighborhood socioeconomic factors on self-reported health status.

Objectives: We examined the nexus of air pollution exposure, neighborhood socioeconomic disadvantage, and self-rated health (SRH) among adults in the United States.

Keeping kin close? Geographies of family networks by race and income, 1981–2017.

Objective:: This study examined changes in geographic proximity to family members among race and income groups in the United States from 1981 to 2017.

Background:: Close geographic proximity to family members can facilitate mutual support and strengthen family bonds. Some scholars argue that institutional sources of support have replaced many core family functions, which might mean that households are likely to live increasingly farther away from family.

Voicing narratives of structural violence in interpersonal firearm violence research and prevention in the United States.

Violence is defined as "the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation." Encompassed in this definition are multiple, interrelated forms of violence, including interpersonal firearm death and injury, but also the systems, policies, and practices enacted by those with power to advantage some groups while depriving others of meaningful opportunities for meeting their basic needs-known as "structural violence". Yet dominant violence prevention narratives too often ignore or deemphasize the deeply intertwined threads of structural violence with other forms of violence, leading to policies and practices that are frequently insufficient, and often harmful, for reducing interpersonal firearm violence and building community safety, particularly in minoritized and structurally marginalized communities.

Neighborhood collective efficacy and environmental exposure to firearm homicide among a national sample of adolescents.

Background: Living near an incident of firearm violence can negatively impact youth, regardless of whether the violence is experienced firsthand. Inequities in household and neighborhood resources may affect the prevalence and consequences of exposure across racial/ethnic groups.

Findings: Using data from the Future of Families and Child Wellbeing Study and the Gun Violence Archive, we estimate that approximately 1 in 4 adolescents in large US cities lived within 800 m (0.

Anticipatory concerns about violence within social networks: Prevalence and implications for prevention.

Most research on exposure to violence focuses on direct victimization, offending, or witnessed violence, yet many people also experience concerns about potential violence in their environments and social networks. Using a state-representative survey of California adults (n = 2870) administered in July 2020, we estimate the prevalence of anticipatory concerns about violence within respondents' social networks and describe characteristics of the persons at perceived risk of violence, reasons for respondents' concerns, and actions undertaken by respondents to reduce that risk. Approximately 1 in 5 respondents knew at least one person, usually a friend or extended family member, whom they perceived to be at risk of other- or self-directed violence.

Heterogeneous effects of spatially proximate firearm homicide exposure on anxiety and depression symptoms among U.S. youth.

The burden of firearm homicide in the United States is not evenly distributed across the population; rather, it disproportionately affects youth in disadvantaged and marginalized communities. Research is limited relevant to the impacts of exposure to firearm violence that occurs near where youth live or attend school - spatially proximate firearm violence - on youths' mental health and whether those impacts vary by characteristics that shape youths' risk for experiencing that exposure in the first place. Using a dataset linking the Fragile Families and Child Wellbeing Study with the Gun Violence Archive (N = 3086), we employed propensity score matching and multilevel stratification to examine average and heterogeneous associations between spatially proximate firearm homicide exposure and anxiety and depression among all youth and then separately for boys and girls.

Emergency department visit patterns in the recently discharged, violently injured patient: Retrospective cohort review.

Background: Analysis of the costs associated with emergency department (ED) visits after discharge for violent injury could highlight subgroups for the development of cost-effective interventions to support healing and prevent treatment failures in violently injured patients.

Methods: A retrospective cohort review was conducted of all patients with return ED visits within 90 days of discharge after treatment for a violent injury occurring between July 1, 2016, and June 30, 2018. Hospital costs were calculated for each incidence and analyzed against demographic and injury type variables to identify trends.

Inequities in Community Exposure to Deadly Gun Violence by Race/Ethnicity, Poverty, and Neighborhood Disadvantage among Youth in Large US Cities.

Understanding the burden of gun violence among youth is a public health imperative. While most estimates are based on direct and witnessed victimization, living nearby gun violence incidents may be consequential too. Yet detailed information about these broader experiences of violence is lacking.

Gun violence restraining orders in California, 2016-2018: case details and respondent mortality.

Background: Gun violence restraining orders (GVROs), implemented in California in 2016, temporarily prohibit individuals at high risk of violence from purchasing or possessing firearms and ammunition. We sought to describe the circumstances giving rise to GVROs issued 2016-2018, provide details about the GVRO process and quantify mortality outcomes for individuals subject to these orders ('respondents').

Methods: For this cross-sectional description of GVRO respondents, 2016-2018, we abstracted case details from court files and used LexisNexis to link respondents to mortality data through August 2020.

A comparative content analysis of newspaper coverage about extreme risk protection order policies in passing and non-passing US states.

Background: Extreme risk protection order (ERPO) laws are a tool for firearm violence prevention (in effect in 19 states), often enacted in the wake of a public mass shooting when media coverage of gun violence tends to spike. We compared news media framing of ERPOs in states that passed and those that considered but did not pass such laws after the 2018 mass shooting in Parkland, Florida.

Methods: We conducted a content analysis of 244 newspaper articles about ERPOs, published in 2018, in three passing (FL, VT, RI) and three non-passing states (PA, OH, CO).

Experiences of violence in daily life among adults in California: a population-representative survey.

Background: Research on violence exposure emphasizes discrete acute events such as direct and witnessed victimization. Little is known about the broad range of experiences of violence (EVs) in daily life. This study assesses the prevalence and patterns of distribution of 6 EVs in an adult general population.

"What does it depend on?": Perceptions of safety related to firearms in homes and neighborhoods.

Background: Though research has established that firearms in the home increase risk for injury and death, a substantial number of Americans, especially gun owners, believe that guns make their homes safer. More than half of gun owners in a nationally-representative survey said "it depends" when asked whether guns make their homes safer or more dangerous, but little is known about the factors that affect perceived safety.

Objective: To determine whether the relationship between the presence of firearms and perceived home or neighborhood safety is fixed or depends on additional factors and to identify the additional factors on which it depends.

News media coverage of extreme risk protection order policies surrounding the Parkland shooting: a mixed-methods analysis.

Background: Following the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, there was a dramatic increase in media coverage of extreme risk protection orders (ERPOs) and in state policy proposals for ERPO laws. This study documents the frequency of news coverage of ERPOs throughout 2018 and examines the narratives used by media outlets to describe this risk-based firearm policy.

Methods: Using a mixed-method descriptive design, we examine the frequency of national news media coverage of ERPO legislation in 2018, before and after the Parkland shooting, and analyze the content of news articles related to a sample of states that considered ERPO legislation after the shooting.

Firearm Practices, Perceptions of Safety, and Opinions on Injury Prevention Strategies Among California Adults.

Importance: Safe firearm storage and other interventions may reduce pediatric firearm deaths and injuries.

Objective: To compare firearm ownership and storage practices, opinions on firearm injury prevention strategies, and perceptions of safety among adults in California households with and without children and/or adolescents.

Design, Setting, And Participants: This survey study used data from the 2018 California Safety and Well-being Survey, a California-representative, probability-based internet survey.

Good Samaritan laws and overdose mortality in the United States in the fentanyl era.

Background: As of July 2018, 45 United States (US) states and the District of Columbia have enacted an overdose Good Samaritan law (GSL). These laws, which provide limited criminal immunity to individuals who request assistance during an overdose, may be of importance in the current wave of the overdose epidemic, which is driven primarily by illicit opioids including heroin and fentanyl. There are substantial differences in the structures of states' GSL laws which may impact their effectiveness.

Public Awareness of and Personal Willingness to Use California's Extreme Risk Protection Order Law to Prevent Firearm-Related Harm.

Importance: Extreme risk protection order (ERPO) laws temporarily suspend firearm and ammunition access by individuals whom a judge has deemed to be at substantial risk of harming themselves or others. Despite widespread recent adoption of these laws, use of ERPOs has been limited. Barriers to ERPO uptake remain unclear.

Firearm purchases without background checks in California.

Background checks are designed to prevent firearm acquisition by people prohibited from purchasing or possessing firearms. There is limited information about background checks, particularly on a state by state basis. We conducted a state-representative, probability-based, Internet survey of California adults in 2018 (n=2558; completion rate 49%) to describe where, when, and how firearms are acquired and to estimate the proportion of current firearm owners who purchased their most recent firearm without a background check.

Public Concern About Violence, Firearms, and the COVID-19 Pandemic in California.

Importance: Violence is a significant public health problem that has become entwined with the coronavirus disease 2019 (COVID-19) pandemic.

Objective: To describe individuals' concerns regarding violence in the context of the pandemic, experiences of pandemic-related unfair treatment, prevalence of and reasons for firearm acquisition, and changes in firearm storage practices due to the pandemic.

Design, Setting, And Participants: This survey study used data from the 2020 California Safety and Well-being Survey, a probability-based internet survey of California adults conducted from July 14 to 27, 2020.