Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.
AddisonH. A.RichmondT. S.LewisL. M.JacobyS. (2022). Mental health outcomes in formerly incarcerated Black men: A systematic mixed studies review. Journal of Advanced Nursing, 78(7), 1851–1869. https://doi.org/10.1111/jan.15235
2.
BarryL. E.CrealeyG. E.NguyenN. T. Q.WeiserT. G.SpitzerS. A.O’NeillC. (2022). Hospital costs and fatality rates of traumatic assaults by mechanism in the US, 2016–2018. JAMA Network Open, 5(6), e2218496. https://doi.org/10.1001/jamanetworkopen.2022.18496
3.
BennsM.RutherM.NashN.BozemanM.HarbrechtB.MillerK. (2020). The impact of historical racism on modern gun violence: Redlining in the city of Louisville, KY. Injury, 51(10), 2192–2198. https://doi.org/10.1016/j.injury.2020.06.042
4.
BlankenshipK. M.del Rio GonzalezA. M.KeeneD. E.GrovesA. K.RosenbergA. P. (2018). Mass incarceration, race inequality, and health: Expanding concepts and assessing impacts on well-being. Social Science & Medicine, 215, 45–52. https://doi.org/10.1016/j.socscimed.2018.08.042
CarterP. M.WaltonM. A.RoehlerD. R.GoldstickJ.ZimmermanM. A.BlowF. C.CunninghamR. M. (2015). Firearm violence among high-risk emergency department youth after an assault injury. Pediatrics (Evanston), 135(5), 805–815. https://doi.org/10.1542/peds.2014-3572
7.
Centers for Disease Control and Prevention. (2021). Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. Retrieved January 1, 2023, from https://www.cdc.gov/injury/wisqars/index.html
8.
CerdáM.TracyM.MessnerS. F.VlahovD.TardiffK.GaleaS. (2009). Misdemeanor policing, physical disorder, and gun-related homicide: A spatial analytic test of “Broken-Windows” theory. Epidemiology, 20(4), 533–541. https://doi.org/10.1097/EDE.0b013e3181a48a99
Crear-PerryJ.Correa-de-AraujoR.Lewis JohnsonT.McLemoreM. R.NeilsonE.WallaceM. (2021). Social and structural determinants of health inequities in maternal health. Journal of Women’s Health, 30(2), 230–235. https://doi.org/10.1089/jwh.2020.8882
11.
CSDH. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. https://doi.org/10.1016/S0140-6736(08)61690-6
12.
CulybaA. J.MillerE.GinsburgK. R.BranasC. C.GuoW.FeinJ. A.RichmondT. S.Halpern-FelsherB. L.WiebeD. J. (2018). Adult connection in assault injury prevention among male youth in low-resource urban environments. Journal of Urban Health, 95(3), 361–371. https://doi.org/10.1007/s11524-018-0260-8
DongB.BranasC. C.RichmondT. S.MorrisonC. N.WiebeD. J. (2017). Youth’s daily activities and situational triggers of gunshot assault in urban environments. Journal of Adolescent Health, 61(6), 779–785. https://doi.org/10.1016/j.jadohealth.2017.06.018
15.
EzenniaO.GeterA.SmithD. K. (2019). The PrEP care continuum and black men who have sex with men: A scoping review of published data on awareness, uptake, adherence, and retention in PrEP care. AIDS and Behavior, 23(10), 2654–2673. https://doi.org/10.1007/s10461-019-02641-2
16.
FormicaM. K.RajanS.SimonsN. (2019). Healthcare indicators and firearm homicide: An ecologic study. Journal of Aggression Conflict and Peace Research, 11(2), 88–99. https://doi.org/10.1108/JACPR-10-2018-0385
GellerA.CurtisM. A. (2011). A sort of homecoming: Incarceration and the housing security of urban men. Social Science Research, 40(4), 1196–1213. https://doi.org/10.1016/j.ssresearch.2011.03.008
HohlB. C.WileyS.WiebeD. J.CulybaA. J.DrakeR.BranasC. C. (2017). Association of drug and alcohol use with adolescent firearm homicide at individual, family, and neighborhood levels. JAMA Internal Medicine, 177(3), 317–324. https://doi.org/10.1001/jamainternmed.2016.8180
22.
HolzerH. J.OffnerP.SorensenE. (2005). Declining employment among young black less-educated men: The role of incarceration and child support. Journal of Policy Analysis and Management, 24(2), 329–350. https://doi.org/10.1002/pam.20092
23.
HulleyS. B.CummingsS. R.BrownerW. S.GradyD. G.NewmanT. B. (2013). Designing clinical research: An epidemiologic approach (2nd ed.). Lippincott, Williams & Wilkins.
24.
JacobyS. F.DongB.BeardJ. H.WiebeD. J.MorrisonC. N. (2018). The enduring impact of historical and structural racism on urban violence in Philadelphia. Social Science & Medicine, 199, 87–95. https://doi.org/10.1016/j.socscimed.2017.05.038
25.
JohnsonL. T.BennettJ. Z. (2017). Drug markets, violence, and the need to incorporate the role of race. Sociology Compass, 11(1), e12441. https://doi.org/10.1111/soc4.12441
26.
Joint Economic Committee. (2019). A state-by-state examination of the economic costs of gun violence. United States Congress, Joint Economic Committee.
27.
KleinB.OgbunugaforC. B.SchaferB. J.BhadrichaZ.KoriP.SheldonJ.KazaN.SharmaA.WangE. A.Eliassi-RadT.ScarpinoS. V.HintonE. (2023). COVID-19 amplified racial disparities in the US criminal legal system. Nature (London), 617(7960), 344–350. https://doi.org/10.1038/s41586-023-05980-2
28.
KondoM. C.SouthE. C.BranasC. C.RichmondT. S.WiebeD. J. (2017). The association between urban tree cover and gun assault: A case-control and case-crossover study. American Journal of Epidemiology, 186(3), 289–296. https://doi.org/10.1093/aje/kwx096
29.
KongkaewpaisanN.El HechiM.El MohebM.OrlasC. P.OrtegaG.MendozaM. A.ParksJ.SaillantN. N.KaafaraniH. M. A.MendozaA. E. (2020). No place like home: A national study on firearm-related injuries in the American household. The American Journal of Surgery, 220(6), 1599–1604. https://doi.org/10.1016/j.amjsurg.2020.04.030
LoveladyN. N.ZallerN. D.StewartM. K.CheneyA. M.Porter IIIA.HaynesT. F. (2022). Characterizing firearm assault injury among young black men using Arkansas Hospital discharge data. Journal of Interpersonal Violence, 37(13–14), NP12609–NP12633. https://doi.org/10.1177/0886260521997947
32.
MehranbodC. A.GobaudA. N.JacobyS. F.UzziM.BushoverB. R.MorrisonC. N. (2022). Historical redlining and the epidemiology of present-day firearm violence in the United States: A multi-city analysis. Preventive Medicine, 165(Pt A), 107207. https://doi.org/10.1016/j.ypmed.2022.107207
33.
MillsB. M.NuriusP. S.MatsuedaR. L.RivaraF. P.Rowhani-RahbarA. (2018). Prior arrest, substance use, mental disorder, and intent-specific firearm injury. American Journal of Preventive Medicine, 55(3), 298–307. https://doi.org/10.1016/j.amepre.2018.04.041
34.
MunnZ.PetersM. D. J.SternC.TufanaruC.McArthurA.AromatarisE. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18(1), 143. https://doi.org/10.1186/s12874-018-0611-x
PalamarJ. J.DaviesS.OmpadD. C.ClelandC. M.WeitzmanM. (2015). Powder cocaine and crack use in the United States: An examination of risk for arrest and socioeconomic disparities in use. Drug and Alcohol Dependence, 149, 108–116. https://doi.org/10.1016/j.drugalcdep.2015.01.029
37.
PapachristosA. V.WildemanC. (2014). Network exposure and homicide victimization in an African American community. American Journal of Public Health (1971), 104(1), 143–150. https://doi.org/10.2105/ajph.2013.301441
38.
PapachristosA. V.WildemanC.RobertoE. (2015). Tragic, but not random: The social contagion of nonfatal gunshot injuries. Social Science & Medicine, 125, 139–150. https://doi.org/10.1016/j.socscimed.2014.01.056
PearV. A.McCortC. D.Kravitz-WirtzN.ShevA. B.Rowhani-RahbarA.WintemuteG. J. (2020). Risk factors for assaultive reinjury and death following a nonfatal firearm assault injury: A population-based retrospective cohort study. Preventive Medicine, 139, 106198. https://doi.org/10.1016/j.ypmed.2020.106198
41.
Peek-AsaC.ButcherB.CavanaughJ. E. (2017). Cost of hospitalization for firearm injuries by firearm type, intent, and payer in the United States. Injury Epidemiology, 4(1), 20. https://doi.org/10.1186/s40621-017-0120-0
42.
PiersonE.SimoiuC.OvergoorJ.Corbett-DaviesS.JensonD.ShoemakerA.RamachandranV.BarghoutyP.PhillipsC.ShroffR.GoelS. (2020). A large-scale analysis of racial disparities in police stops across the United States. Nature Human Behaviour, 4(7), 736–745. https://doi.org/10.1038/s41562-020-0858-1
43.
PowellJ. A. (2008). Structural racism: Building upon the insights of John Calmore. North Carolina Law Review, 86(3), 791.
44.
RichardsonJ. B.St VilC.SharpeT.WagnerM.CooperC. (2016). Risk factors for recurrent violent injury among black men. Journal of Surgical Research, 204(1), 261–266. https://doi.org/10.1016/j.jss.2016.04.027
45.
RoachJ. (2016). ROOTT’s theoretical framework of the web of causation between structural and social determinants of health and wellness—2016. Restoring Our Own Through Transformation (ROOTT). Retrieved October 20, 2023, from https://www.roottrj.org/web-causation
46.
RothsteinR. (2017). The color of law: A forgotten history of how our government segregated America. Liveright Publishing Corporation, a division of W.W. Norton & Company.
47.
SoteroM. M. (2006). A conceptual model of historical trauma: Implications for public health practice and research. Journal of Health Disparities Research and Practice, 1(1), 93–108.
48.
SpitzerS. A.VailD. G.DeyT.SalimA.JarmanM. P. (2023). The impact of redlining on modern-day firearm injuries: A nationwide study of federal policy. Annals of Surgery, 278(5), e1123–e1127. https://doi.org/10.1097/SLA.0000000000005860
49.
UzziM.AuneK. T.MarineauL.JonesF. K.DeanL. T.JacksonJ. W.LatkinC. A. (2023). An intersectional analysis of historical and contemporary structural racism on non-fatal shootings in Baltimore, Maryland. Injury Prevention, 29(1), 85–90. https://doi.org/10.1136/ip-2022-044700
50.
Veritas Health Innovation. (2021). Covidence systematic review software.
51.
WiebeD. J.RichmondT. S.GuoW.AllisonP. D.HollanderJ. E.NanceM. L.BranasC. C. (2016). Mapping activity patterns to quantify risk of violent assault in urban environments. Epidemiology, 27(1), 32–41. https://doi.org/10.1097/EDE.0000000000000395
WilliamsE. C.FletcherO. V.FrostM. C.HarrisA. H. S.WashingtonD. L.HoggattK. J. (2022). Comparison of substance use disorder diagnosis rates from electronic health record data with substance use disorder prevalence rates reported in surveys across sociodemographic groups in the veterans health administration. JAMA Network Open, 5(6), e2219651. https://doi.org/10.1001/jamanetworkopen.2022.19651
54.
ZazaS.Wright-De AgüeroL. K.BrissP. A.TrumanB. I.HopkinsD. P.HennessyM. H.SosinD. M.AndersonL.Carande-KulisV. G.TeutschS. M.PappaioanouM. (2000). Data collection instrument and procedure for systematic reviews in the guide to community preventive services. American Journal of Preventive Medicine, 18(1), 44–74. https://doi.org/10.1016/S0749-3797(99)00122-1
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