title: Race and ethnicity, neighborhood poverty and pediatric firearm hospitalizations in the United States.
abstract: OBJECTIVE
  To better understand the effects of race and/or ethnicity and neighborhood poverty on pediatric firearm injuries in the United States, we compared overall and intent-specific firearm hospitalizations (FH) with those of pedestrian motor vehicle crash hospitalizations (PMVH).
  
  
  METHODS
  We used Nationwide Inpatient Sample data (1998-2011) among 0-15 year-olds in a 1:1 case-case study; 4725 FH and 4725 PMVH matched by age, year, and region.
  
  
  RESULTS
  Risk of FH versus PMVH was 64% higher among black children, Odds ratio (OR) = 1.64, 95% confidence interval (95% CI) = 1.44-1.87, as compared to white children (P < .0001); this risk did not vary by neighborhood poverty (P interaction = .52). Risk of homicide FH versus PMVH was 842% higher among black (OR = 8.42, 95% CI = 6.27-11.3), 452% higher among Hispanics (OR = 4.52, 95% CI = 3.33-6.13) and 233% higher among other race (OR = 2.33, 95% CI = 1.52-3.59) compared to white children. There was a lower risk for unintentional FH among black OR = 0.73, 95% CI = 0.62-0.87, Hispanics (OR = 0.60, 95% CI = 0.49-0.74), and other (OR = 0.63, 95% CI = 0.47-0.83) compared to whites. These intent-specific risks attributed to race did not vary by neighborhood affluence.
  
  
  CONCLUSIONS
  Black children were at greater likelihood of FH compared to white children regardless of neighborhood economic status. Minority children had an increased likelihood of intentional FH and a decreased likelihood of unintentional FH as compared to white children irrespective of neighborhood income.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Medicine, Boston University School of Medicine, Boston University, MA. Electronic address: kalesan@bu.edu.
authors.forename: Bindu
authors.initials: B
authors.lastname: Kalesan
authors.affiliation: Fort Lee High School, Fort Lee, NJ.
authors.forename: Mrithyunjay A
authors.initials: MA
authors.lastname: Vyliparambil
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Erin
authors.initials: E
authors.lastname: Bogue
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Marcos D
authors.initials: MD
authors.lastname: Villarreal
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Vasan
authors.affiliation: Department of Epidemiology, Mailman School of Public Health and Columbia Law School, New York, NY.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fagan
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: DiMaggio
authors.affiliation: Department of Surgery, Columbia University Medical Center, Columbia University, New York, NY.
authors.forename: Steven
authors.initials: S
authors.lastname: Stylianos
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; School of Public Health, Boston University, MA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005006:Ethnicity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011204:Poverty Areas; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D014948:Wounds, Gunshot / Q000191:economics* / Q000208:ethnology*
keywords: Firearm; In-hospital mortality; Injury; Motor vehicle accidents; Pediatric; Trends