Restricted accessResearch articleFirst published online 2023-4
Utilizing a combined hospital and criminal justice database to identify risk factors for repeat firearm injury or violent-crime arrest among firearm victims
Introduction: Identifying firearm victims with the greatest risk of repeat-firearm exposure and offering interventions has the potential to disrupt recurrent violence. This study explored risk factors associated with repeat violence among survivors of intentional firearm injury in a unique clinical and criminal justice (CJ) dataset. Methods: This study analyzed a retrospective cohort (n = 4058) of persons injured by nonfatal intentional firearm violence from 2013 to 2016 in one metropolitan area. Data were collected from a single level I trauma center, city police records, and state CJ databases from 1948 to 2019. The primary outcome of interest was another firearm injury or violent-crime arrest (defined as a violent or firearm felony offense). Results: Among 4058 nonfatal intentional firearm victims, 1202 (29.6%) individuals had a repeat-firearm injury or violent-crime arrest. In a bivariate analysis, history of mental, physical, and/or emotional abuse (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.40–1.86), mental health diagnosis (OR, 1.88; 95% CI, 1.51–2.35), or illegal substance use (OR, 2.87; 95% CI, 2.48–3.32) was associated with increased risk of repeat-firearm injury or violent-crime arrest. Prior felony arrest (OR, 3.68; 95% CI, 3.19–4.24), prior incarceration (OR, 3.72; 95% CI, 3.04–4.56), prior firearm charge (OR, 4.06; 95% CI, 3.33–4.96), and suspected gang membership (OR, 8.69; 95% CI, 6.14–12.32) demonstrated the greatest association with significant repeat violence. Conclusions: Thirty percent of those who experienced an intentional firearm injury were found to have a repeat-firearm injury or violent-crime arrest multi-disciplinary interventions that address the complex needs of a CJ-involved population are needed to mitigate significant repeat violence.
GrinshteynEHemenwayD. Violent death rates: The US compared with other high-income OECD countries, 2010. Am J Med2016; 129: 266–273.
2.
Peek-AsaCButcherBCavanaughJE. Cost of hospitalization for firearm injuries by firearm type, intent, and payer in the United States. Inj Epidemiol2017; 4: 20.
3.
CorsoPSMercyJASimonTR,et al.Medical costs and productivity losses due to interpersonal and self-directed violence in the United States. Am J Prev Med2007; 32: 474–482.e2.
4.
JaycoxLHMarshallGNSchellT. Use of mental health services by men injured through community violence. Psychiatr Serv2004; 55: 415–420.
5.
GaniFSakranJVCannerJK. Emergency department visits for firearm-related injuries in the United States, 2006–14. Health Aff2017; 36: 1729–1738.
6.
VellaMAWarshauerATortorelloG, et al.Long-term functional, psychological, emotional, and social outcomes in survivors of firearm injuries. JAMA Surg2020; 155; 51–59.
7.
WeisburdDCaveBNelsonM, et al.Mean streets and mental health: depression and post-traumatic stress disorder at crime hot spots. Am J Commun Psychol2018; 61: 285–295.
8.
PurtleJDickerRCooperC, et al.Hospital-based violence intervention programs save lives and money. J Trauma Acute Care Surg2013; 75: 331–333.
SmithRDobbinsSEvansA,et al.Hospital-based violence intervention: Risk reduction resources that are essential for success. J Trauma Acute Care Surg2013; 74: 976–982.
11.
ChongVELeeWSVictorinoGP. Neighborhood socioeconomic status is associated with violent reinjury. J Surg Res2015; 199: 177–182.
12.
JuillardCCoopermanLAllenI, et al.A decade of hospital-based violence intervention: Benefits and shortcomings. J Trauma Acute Care Surg2016; 81: 1156–1161.
13.
The Health Alliance for Violence Intervention. What is a hospital-based violence intervention program (HVIP)?https://www.thehavi.org/what-is-an-hvip(2022, accessed 4 June 2022).
14.
BranasCCHanSWiebeDJ. Alcohol use and firearm violence. Epidemiol Rev2016; 38: 32–45.
15.
CooperCEslingerDNashD,et al.Repeat victims of violence: report of a large concurrent case-control study. Arch Surg2000; 135: 837–843.
16.
CrandallCSJostPFBroidyLM,et al.Previous emergency department use among homicide victims and offenders: A case-control study. Ann Emerg Med2004; 44: 646–655.
17.
PapachristosAVBragaAAHureauDM. Social networks and the risk of gunshot injury. J Urban Heal2012; 89: 992–1003.
18.
PapachristosAVWildemanC. Network exposure and homicide victimization in an African American community. Am J Public Health2014; 104: 143–150.
19.
BeardJHMorrisonCNJacobySF, et al.Quantifying disparities in urban firearm violence by race and place in Philadelphia, Pennsylvania: a cartographic study. Am J Public Health2017; 107: 371–373.
20.
CarterPMWaltonMARoehlerDR, et al.Firearm violence among high-risk emergency department youth after an assault injury. Pediatrics2015; 135: 805–815.
21.
ChongVESmithRGarciaA, et al.Hospital-centered violence intervention programs: A cost-effectiveness analysis. Am J Surg2015; 209: 597–603.
22.
GreenBHorelTPapachristos AV. Modeling contagion through social networks to explain and predict gunshot violence in Chicago, 2006 to 2014. JAMA Intern Med2017; 177: 26.
23.
ClaassenCALarkinGLHodgesG,et al.Criminal correlates of injury-related emergency department recidivism. J Emerg Med2007; 32: 141–147.
24.
McGlincyMH. A Bayesian record linkage methodology for multiple imputation of missing links. ASA Proc Jt Stat Meet2004: 4001–4008.
25.
FellegiIPSunterAB. A theory for record linkage. J Am Stat Assoc1969; 64: 1183–1210.
RobertoEBragaAAPapachristosAV. Closer to guns: The role of street gangs in facilitating access to illegal firearms. J Urban Heal2018; 95: 372–382.
28.
Rowhani-RahbarAZatzickDWangJ, et al.Firearm-related hospitalization and risk for subsequent violent injury, death, or crime perpetration: A cohort study. Ann Intern Med2015; 162: 492–500.
29.
SpaccarelliSCoatsworthJDBowdenBS. Exposure to serious family violence among incarcerated boys: Its association with violent offending and potential mediating variables. Violence Vict1995; 10: 163–182.
30.
LevensonJSWillisGMPrescottDS. Adverse childhood experiences in the lives of male sex offenders: Implications for trauma-informed care. Sex Abus J Res Treat2016; 28: 340–359.
31.
JäggiLJMezukBWatkinsDC,et al.The relationship between trauma, arrest, and incarceration history among black Americans: Findings from the National Survey of American Life. Soc Ment Health2016; 6: 187–206.
32.
DeCandiaCGuarinoK. Trauma-Informed care: An ecological response. J Child Youth Care Work2020; 25: 7–32.
33.
BeharieNScheidellJDQuinnK, et al.Associations of adolescent exposure to severe violence with substance use from adolescence into adulthood: Direct versus indirect exposures. Subst Use Misuse2019; 54: 191–202.
34.
FelittiVJAndaRFNordenbergD, et al.Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. Am J Prev Med1998; 14: 245–258.
35.
De AndradeDRitchieJRowlandsM,et al.Substance use and recidivism outcomes for prison-based drug and alcohol interventions. Epidemiol Rev2018; 40: 121–133.
36.
Al-RousanTRubensteinLSieleniB,et al.Inside the nation’s largest mental health institution: A prevalence study in a state prison system. BMC Public Health2017; 17: 42.
37.
FlorenceCShepherdJBrennanI,et al.Effectiveness of anonymised information sharing and use in health service, police, and local government partnership for preventing violence related injury: experimental study and time series analysis. Br Med J2011; 342: d3313.
38.
ButtsJARomanCGBostwickL,et al.Cure violence: A public health model to reduce gun violence. Annu Rev Public Health2015; 36: 39–53.
39.
WellsWChermakS. Individual-level risk factors for gun victimization in a sample of probationers. J Interpers Violence2011; 26: 2143–2164.
40.
FabioASauber-SchatzEKBarbourKE,et al.The association between county-level injury rates and racial segregation revisited: A multilevel analysis. Am J Public Health2009; 99: 748–753.
41.
AmbinakudigeSParisiDCappelloGC,et al.Diversity or segregation? A multi-decadal spatial analysis of demographics of Atlanta neighborhoods. Spat Demogr2017; 5: 123–144.
42.
FreemanE. The shifting geography of urban education. Educ Urban Soc2010; 42: 674–704.
43.
WiebeDJRichmondTSGuoW, et al.Mapping activity patterns to quantify risk of violent assault in urban environments. Epidemiology2016; 27: 32–41.
44.
LiptonRYangXBragaAA,et al.The geography of violence, alcohol outlets, and drug arrests in Boston. Am J Public Health2013; 103: 657–664.
45.
TracyMBragaAAPapachristos AV. The transmission of gun and other weapon-involved violence within social networks. Epidemiol Rev2016; 38: 70–86.
46.
RossLArsenaultS. Problem analysis in community violence assessment: revealing early childhood trauma as a driver of youth and gang violence. Int J Offender Ther Comp Criminol2018; 62: 2726–2741.
47.
LeeBSellsDHassonJ,et al.The connection’s approach: A model for integrating criminal justice, mental health, and other social services in the U.S. state of Connecticut. Aggress Violent Behav2019; 47: 240–244.
48.
DuncanTKWaxmanKRomeroJ,et al.Operation PeaceWorks: A community program with the participation of a level II trauma center to decrease gang-related violence. J Trauma Acute Care Surg2014; 76: 1208–1213.
49.
LoefflerCE. Does imprisonment alter the life course? Evidence on crime and employment from a natural experiment. Criminology2013; 51: 137–166.
50.
PagerDWesternBSugieN. Sequencing disadvantage: Barriers to employment facing young black and white men with criminal records. Ann Am Acad Pol Soc Sci2009; 623: 195–213.
51.
FleeglerEWLeeLKMonuteauxMC,et al.Firearm legislation and firearm-related fatalities in the United States. JAMA Intern Med2013; 173: 732–740.
52.
KalesanBMobilyMEKeiserO,et al.Firearm legislation and firearm mortality in the USA: A cross-sectional, state-level study. Lancet2016; 387: 1847–1855.
53.
LeeLKFleeglerEWFarrellC, et al.Firearm laws and firearm homicides. JAMA Intern Med2017; 177: 06.
54.
Santaella-TenorioJCerdáMVillavecesA,et al.What do we know about the association between firearm legislation and firearm-related injuries?Epidemiol Rev2016; 38: 140–157.
55.
ZeoliAMGoldstickJMauriA,et al.The association of firearm laws with firearm outcomes among children and adolescents: a scoping review. J Behav Med2019; 42: 741–762.
KaufmanERisingKWiebeDJ,et al.Recurrent violent injury: Magnitude, risk factors, and opportunities for intervention from a statewide analysis. Am J Emerg Med2016; 34: 1823–1830.
58.
AffinatiSPattonDHansenL, et al.Hospital-based violence intervention programs targeting adult populations: An eastern association for the surgery of trauma evidence-based review. Trauma Surg Acute Care Open2016; 1: 1–7.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
