Race disparities in firearm injuries and outcomes among Tennessee children.
OBJECTIVE
The aim of this study was to identify race and socioeconomic factors associated with worse outcomes among Tennessee children who sustain firearm injuries.


METHODS
We queried our institutional pediatric trauma registry and the Davidson County Regional Medical Examiner database for children ages 15 years and younger who sustained firearm injuries between July 1998 and July 2010. Descriptive statistics and logistic regression modeling were used to analyze demographic data, circumstance of injury (unintentional or intentional), odds of death, and characteristics of zip codes (total population, race distribution, and median income) where injuries occurred.


RESULTS
One hundred eighty-eight children (median age, 13.2 years; range, 1.1-15.8 years) sustained a firearm injury and were either admitted to our institution or were referred directly to the medical examiner. More whites (n = 109, or 58%) sustained a firearm injury than blacks (n = 79, or 42%), but blacks were overrepresented 2.5-fold more compared with the general Tennessee population. Fifty-four children (29%) died, of whom 35 (65%) were black and 19 (35%) were white (P < .001). Ninety-three children sustained unintentional firearm injuries, and 84 were intentional (n = 67, assault; n = 17, suicide). When data were stratified by intent, 67% of blacks and 12% of whites were assaulted (P < .001). After controlling for age and intent, black children were 4 times more likely to die of firearm injuries than whites (P = .008; 95% confidence interval, 1.4-11.3).


CONCLUSIONS
In a sample of firearm-injured Tennessee children, blacks were notably overrepresented and far more likely to die than whites. Using zip code data will help to establish firearm injury prevention programs specific to disparate populations and to reduce both violent and accidental childhood firearm injuries.
Monroe Carell, Jr. Children's Hospital at Vanderbilt University, Department of Pediatric Surgery, Nashville, TN 37232-9780, USA. colin.a.martin@vanderbilt.edu
Colin A
CA
Martin
Purnima
P
Unni
Matthew P
MP
Landman
Irene D
ID
Feurer
Amy
A
McMaster
Mary
M
Dabrowiak
Stephen E
SE
Morrow
Harold N
HN
Lovvorn
D000061:Accidents, Home / Q000706:statistics & numerical data; D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D013405:Suicide / Q000208:ethnology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000208:ethnology / Q000706:statistics & numerical data; D013714:Tennessee / Q000453:epidemiology; D016896:Treatment Outcome; D014505:Urban Population / Q000706:statistics & numerical data; D014754:Violence / Q000208:ethnology / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000208:ethnology* / Q000401:mortality