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ObjectiveTo examine victimisation rates, geographic patterns and neighbourhood characteristics associated with non-fatal firearm injury rates before and during the COVID-19 pandemic.DesignA retrospective cohort study.SettingCity of Indianapolis, Indiana, USA, 1 January 2017–30 June 2021.ParticipantsIntentional non-fatal firearm injury victims from Indianapolis Metropolitan Police Department records. The study included information on 2578 non-fatal firearm injury victims between ages 0 and 77 years. Of these victims, 82.5% were male and 77.4% were black.Primary and secondary outcome measuresRates of non-fatal firearm injuries per 100 000 population by victim age, race, sex and incident motive. Prepandemic and peripandemic non-fatal firearm injury rates.ResultsNon-fatal shooting rates increased 8.60%, from 57.0 per 100 000 person-years in prepandemic years to 65.6 per 100 000 person-years during the pandemic (p<0.001). Rates of female victims (15.2 vs 23.8 per 100,000; p<0.001) and older victims (91.3 vs 120.4 per 100,000; p<0.001) increased significantly during the pandemic compared with the prepandemic period. Neighbourhoods with higher levels of structural disadvantage (IRR: 1.157, 95% CI 1.012 to 1.324) and prepandemic firearm injury rates (IRR: 1.001, 95% CI 1.001 to 1.002) was positively associated with higher rates of non-fatal firearm injuries during the pandemic, adjusting for neighbourhood characteristics.ConclusionsNon-fatal firearm injuries increased significantly during the COVID-19 pandemic, particularly among female and older victims. Efforts are needed to expand and rethink current firearm prevention efforts that both address the diversification of victimisation and the larger societal trauma of firearm violence.

Firearm violence is a leading public health issue that contributes to significant health inequalities within communities. Relatively little is known about the community-level social processes that occur at the street segment level and contributed to the community variation of firearm violence. This study examines the spatial patterns of firearm shooting events on street segments and the associated community-level social processes at both the street segment and neighborhood level. Multilevel mixed-effects Poisson regression was used to assess the relationship between measures of social disorder, physical disorder, and collective efficacy at the street segment-level and neighborhood-level measures of social disorganization theory. The results demonstrate that firearm shooting events occur on a small number of street segments across the city. Street segments with higher levels of social and physical disorder, along with lower levels of collective efficacy, are expected to have higher rates of firearm shooting events when accounting for neighborhood-level measures. Overall, the findings indicate specific street segments are experiencing higher rates of firearm shooting events and that these events are influenced by social processes. Prevention efforts should be focused on street segments experiencing higher rates of shootings.

BackgroundIndividuals with mental illness and co-occurring substance use disorders often rapidly cycle through the justice system with multiple arrests. Therefore, is it imperative to examine the prevalence of mental health and substance use diagnoses among arrestees and repeat arrestees to identify opportunities for intervention.MethodsWe linked police arrest and clinical care data at the individual level to conduct a retrospective cohort study of all individuals arrested in 2016 in Indianapolis, Indiana. We classified arrestees into three levels: 1 arrest, 2 arrests, or 3 or more arrests. We included data on clinical diagnoses between January 1, 2014 and December 31, 2015 and classified mental health diagnoses and substance use disorder (SUD) based on DSM categories using ICD9/10 diagnoses codes.ResultsOf those arrested in 2016, 18,236 (79.5%) were arrested once, 3167 (13.8%) were arrested twice, and 1536 (6.7%) were arrested three or more times. In the 2 years before the arrest, nearly one-third (31.3%) of arrestees had a mental health diagnosis, and over a quarter (27.7%) of arrestees had an SUD diagnosis. Most of those with a mental health or SUD diagnosis had both (22.5% of all arrestees). Arrestees with multiple mental health (OR 2.68, 95% CI 2.23, 3.23), SUD diagnoses (OR 1.59, 95% CI 1.38, 1,82), or co-occurring conditions (1.72, 95% CI 1.48, 2.01) in the preceding 2 years had higher odds of repeat arrest.ConclusionsOur findings show that linked clinical and criminal justice data systems identify individuals at risk of repeat arrest and inform opportunities for interventions aimed at low-level offenders with behavioral health needs.

Objectives To compare the differences in US federal funding sources for firearm injury prevention and publications. Methods We extracted publications from three literature databases and grant data for five federal agencies (CDC, NIH, SAMHSA, NSF, NIJ) through federal archives from 2020 to 2022, excluding case studies, editorials, and literature reviews. Specific funding sources for publications were further extracted. We calculated funding-to-publication (F-P) ratios for federal public health, science, and criminal justice agencies and tested associations. Health agencies with grant data included the CDC, NIH, and SAMHSA and were categorized as public health agencies. The NSF was classified as science and engineering. The NIJ was classified as criminal justice. Results The three largest funders were the NIH, CDC, and NIJ, and were associated with the most publications, with health agencies funding most studies (86%). Health agencies had higher F-P ratios than the NSF and NIJ. Public health funders were more likely to fund experimental studies, studies related to suicide, and unintentional firearm injury prevention. NIJ and NSF were more likely to support research on mass shootings. Most studies funded by all agencies examined community violence. Conclusions The NIH and CDC supported most firearm-injury-related grant funding and subsequent publications from 2020 to 2022. Differences in funding existed depending on the types of firearm injury. Federal funding is imperative to advance the science of firearm injury prevention, and future funding across federal agencies should be aligned with national public health and safety needs.

BackgroundDrug overdose and firearm injury are two of the United States (US) most unrelenting public health crises, both of which have been compounded by the COVID-19 pandemic. Programs and policies typically focus on each epidemic, alone, which may produce less efficient interventions if overlap does exist. The objective is to examine whether drug overdose correlates with and is associated with firearm injury at the census tract level while controlling for neighborhood characteristics.MethodsAn ecological study of census tracts in Indianapolis, Indiana from 2018 to 2020. Population rates per 100,000 and census tracts with the highest overlap of overdose and firearm injury were identified based on spatial clusters. Bivariate association between census tract characteristic and drug overdose and firearm violence rate within spatial clusters. Zero-inflated negative binominal regression was used to estimate if the drug overdose activity is associated with higher future firearm injury.ResultsIn high overdose—high firearm injury census tracts, rates of firearm injury and drug overdose are two times higher compared to city wide rates. Indicators of structural disadvantage and structural racism are higher in high overdose—high firearm injury census tracts compared to city-wide averages. Drug overdoses are associated with higher rates of firearm injury in the following year (IRR: 1.004, 95% CI 1.001, 1.007, p < 0.05), adjusting for census tract characteristics and spatial dependence.ConclusionsDrug overdose and firearm injury co-spatially concentrate within census tracts. Moreover, drug overdoses are associated with future firearm injury. Interventions to reduce firearm injuries and drug overdoses should be a co-response in high drug overdose—high firearm injury communities.

BackgroundHomicide is a widely acknowledged public health problem in the United States. The majority of homicides are committed with a firearm and have long-term health consequences for family members and entire communities. When left unsolved, violence may be perpetuated due to the retaliatory nature of homicides. Improving homicide clearance rates may help prevent future violence, however, we know little about the community-level social dynamics associated with unsolved homicides.MethodsThis study examines the individual-and-community-level social processes associated with low homicide clearance rates in Indianapolis, Indiana between 2007 and 2017. Homicide clearance is the primary outcome, defined as if a perpetrator was arrested for that homicide case between 2007 and 2017. Individual-level variables include the victim’s race/ethnicity, sex, and age. Community-level (i.e., census tracts) variables include the number of resident complaints against the police, resident complains of community disorder, income inequality, number of police interactions, and proportion of African American residents.ResultsIn Indianapolis over a 11-year period, the homicide clearance rate decreased to a low of 38% in 2017, compared to a national clearance rate of 60%. Homicide case clearance was less likely for minority (OR 0.566; 95% CI, 0.407–0.787; p < 0.01) and male (OR 0.576; 95% CI, 0.411–0.807; p < 0.01) victims. Resident complaints of community disorder were associated with a decreased odds of case clearance (OR 0.687; 95% CI, 0.485–0.973; p < .01)., African American victim’s cases were less likely to be cleared in 2014–2017 (OR 0.640; 95% CI, 0.437–0.938; p < 0.05), compared to 2007.ConclusionsOur study identified differences in neighborhood social processes associated with homicide clearance, indicating existing measures on these community factors are complex. Programs aimed at improving signs of community disorder and building community engagement may improve neighborhood clearance rates, lower violence, and improve the health of these communities.

Objective: There has been a dramatic increase in firearm purchases contributing to demographic shifts in firearm ownership and the need for safe firearm storage in American households. Safely securing firearms is essential for preventing firearm injuries, but more research is needed to understand and identify potential motivators and barriers that can be addressed with public health interventions. The purpose of this study was to elicit salient beliefs (behavioral, normative, and control) pertaining to safely storing handguns among gun owners. Methods: We used the theoretical underpinnings of the Theory of Planned Behavior in this study. We recruited handgunowners (n = 31) between the ages of 24 and 74 via Forthright Access, a third-party paneling service. Participants completed a survey of open-ended questions about safely storing their handgun. Results: Key motivating beliefs for safe handgun storage included the desire to have home defense and to protect children in the home. Participants also expressed that they were more likely to store their handgun safely when encouraged by law enforcement and family members. Conclusions : Findings from this study can be used to inform subsequent studies that recruit larger, representativesamples to test which theoretical factors most strongly predict safe storage behaviors.

Background Communication and collaboration between healthcare, community, and government organizations is key for community violence prevention. This qualitative study aimed to assess Innovation Forum (IF) participant solutions’ alignment with recommended strategies, to identify innovative solutions, and to identify the most common participant priorities. Methods IF were held via teleconference in August 2022 in Indianapolis, Indiana with participants from healthcare organizations, the community, and local government. Forum solutions were documented, coded, and categorized to eight recommended violence prevention strategies from the Centers for Disease Control and Prevention (CDC) and the National Institute for Criminal Justice Reform (NICJR). Uncategorized solutions were considered innovative. Solutions were analyzed by descriptive thematic analysis to identify participant priorities. Results Seventy-seven participants and 11 facilitators participated in 10 IF. Participants generated 162 solutions. Twenty-two solutions were unable to be categorized according to the CDC and NICJR strategies. The most common participant priorities were: 1. Improve collaboration between existing community organizations and dissemination of resources (42, 21.9%), 2. Improve the community’s physical and social environment (27, 14.1%), 3. Increase public awareness and media campaigns (26, 13.5%), 4. Promote a nurturing environment and supports for children and youth (26, 13.5%), and 5. Increase employment, vocational skills, and trade programs (19, 9.9%). Conclusions Innovation forums identified innovative solutions and participant priorities for violence prevention with representatives from healthcare, the community, and government organizations. Most solutions and priorities aligned with national recommendations, reinforcing their relevance at the community level.

Objective: There has been a dramatic increase in firearm purchases contributing to demographic shifts in firearm ownership and the need for safe firearm storage in American households. Safely securing firearms is essential for preventing firearm injuries, but more research is needed to understand and identify potential motivators and barriers that can be addressed with public health interventions. The purpose of this study was to elicit salient beliefs (behavioral, normative, and control) pertaining to safely storing handguns among gun owners. Methods: We used the theoretical underpinnings of the Theory of Planned Behavior in this study. We recruited handgun owners (n = 31) between the ages of 24 and 74 via Forthright Access, a third-party paneling service. Participants completed a survey of open-ended questions about safely storing their handgun.Results: Key motivating beliefs for safe handgun storage included the desire to have home defense and to protect children in the home. Participants also expressed that they were more likely to store their handgun safely when encouraged by law enforcement and family members. Conclusions: Findings from this study can be used to inform subsequent studies that recruit larger, representative samples to test which theoretical factors most strongly predict safe storage behaviors.

Firearm violence continues to plague American cities across the United States. For example, the overall homicide rate was 5.3 per 100,000 in 2016 (Federal Bureau of Investigation, 2016). More simply stated, over five people become victims of lethal violence per 100,000 people across the country. Research demonstrates that firearm violence is higher in areas of social disadvantage and clusters in neighborhoods with high levels of socioeconomic disadvantage (Cohen & Tita, 1999; Rosenfeld, Bray, Egley, 1999). Neighborhood and crime researchers have historically focused on the macro level of analysis when studying crime within and across neighborhoods, but more recent research displays that crime spatially clusters at the micro level (Braga et al., 2010, Weisburd et al., 2004). It is still unclear if specific measures of neighborhood characteristics, such as collective efficacy influences crime at the street segment level (Braga and Clark, 2014). Similarly, much firearm research is based on homicide incidents and omits more common non-fatal shootings. This study addresses these limitations by including both the macro (i.e., census tract) and micro (i.e., street segment) levels of analyses and includes both fatal and non-fatal shootings. Using the theoretical framework of social disorganization theory and collective efficacy theory, this research seeks to examine how fatal and non-fatal shootings cluster across neighborhoods, examine the patterns of disorder and disadvantage across neighborhoods and street segments, and improve the construct of collective efficacy through a unique measurement system. The study examines over 1500 fatal and non-fatal shootings in Indianapolis, Indiana, over a three-year time period. Independent measures of neighborhood disadvantage are drawn from the US Census Bureau, as well as a unique dataset from the City of Indianapolis. The data measures for disorder and collective efficacy allow for analyses at the neighborhood and street segment level. Descriptive statistics explain where fatal and non-fatal shootings cluster across the city and generalized hierarchical linear modeling was conducted to explain how disorder, social disadvantage and collective efficacy correlate with firearm violence. Results suggest fatal and non-fatal shootings cluster at both the neighborhood and street segment level and including non-fatal shootings into the study of gun violence gives a more robust picture of where firearm violence is occurring within the community. Additionally, community level measures vary at the street segment level when accounting for neighborhood levels of poverty. These findings have both methodological and policy implications that contribute to the study of communities and crime and firearm violence.