Differences in Mortality Rates of Gunshot Victims: The Influence of Neighborhood Social Processes

• Published date: 01 August 2023
• DOI: http://doi.org/10.1177/10887679211047162
• Author: Lauren A. Magee
• Date: 01 August 2023
• Subject Matter: Articles

https://doi.org/10.1177/10887679211047162

Homicide Studies

2023, Vol. 27(3) 299 –320

© 2021 SAGE Publications

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DOI: 10.1177/10887679211047162

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Article

Differences in Mortality Rates

of Gunshot Victims: The

Influence of Neighborhood

Social Processes

Lauren A. Magee1

Abstract

Firearm violence is considered a public health crisis in the United States. Firearm

violence spatially concentrates within neighborhoods and is associated with community

factors; however, little is understood about the geographic differences in gunshot

wound mortality and associated neighborhood social processes. Applying a public

health approach through the Haddon’s Matrix, the results demonstrate systematic

differences in social and physical features associated with gunshot mortality. These

findings have important implications to improve neighborhood physical and social

conditions, police transporting gunshot victims, and police-public health partnerships

to improve data collection on nonfatal shootings and shots fired.

Keywords

firearm assault, community characteristics, public health, firearm mortality

Keywords

gun homicide, nonfatal shootings, neighborhood social processes, public health,

mortality

Introduction

Firearm violence is considered a public health crisis in the United States. Both fatal

and nonfatal urban firearm violence spatially concentrates within neighborhoods

(Braga et al., 2010; Cohen & Tita, 1999) and contributes to individual, family, and

1Indiana University–Purdue University Indianapolis O’Neill School of Public and Environmental Affairs,

USA

Corresponding Author:

Lauren A. Magee, O’Neill School of Public and Environmental Affairs, Indiana University–Purdue

University Indianapolis, 801 W. Michigan Street, Indianapolis, IN 46202, USA.

Email: lamagee@iu.edu

1047162HSXXXX10.1177/10887679211047162Homicide StudiesMagee

research-article2021

300 Homicide Studies 27(3)

community trauma (Jacoby et al., 2017; McDonald et al., 2011; Smith & Patton, 2016).

Nonfatal firearm shootings result in long-term physical and mental disabilities, such as

substance use disorder, post-traumatic stress disorder (DiScala & Sege, 2004;

Greenspan & Kellermann, 2002; Howell & Abraham, 2013; Rich & Grey, 2005), and

repeat violent victimization (Carter et al., 2015; Cunningham et al., 2015). Scholars

have long studied fatal firearm violence, however, nonfatal firearm violence has dra-

matically increased over the last decade (Jena et al., 2014) and typically occurs at rates

three times higher than fatal firearm assaults (i.e., homicide) (Hipple & Magee, 2017).

For instance, in the US, approximately 34,538 fatal firearm assaults and 85,694 non-

fatal firearm assaults occur annually (Kaufman et al., 2021). Despite the prevalence

of firearm violence, relatively little is understood about the geographic differences in

gunshot wound mortality and associated neighborhood social processes. Therefore,

this study extends our current knowledge in three ways: (1) by applying a public

health conceptual framework, (2) assessing the proportion of fatal and nonfatal shoot-

ings to overall reported firearm discharges (i.e., shots fired), and (3) examining geo-

graphic differences and associated neighborhood social processes with gunshot

wound mortality.

Public Health Approach

Criminologists, police leaders, local, state, and national leaders have stated the need

for a public health approach to prevent and end firearm violence within many large

urban communities in the United States. A public health approach has successfully

reduced traffic fatalities, work related injuries, and childhood injuries (Hemenway,

2009), by identifying the risk and protective factors to determine the root causes of

injuries. The public health approach is largely focused on prevention of injury and

involves four stages: (1) understanding the epidemiology, (2) program development,

(3) research and evaluation of outcomes, and (4) dissemination of successful interven-

tions (Bulger et al., 2019). Given the dearth of available data on nonfatal shootings at

the local and national level (Magee, Ranney, Fortenberry, Rosenman, et al., 2021;

Hipple & Magee, 2017) this study focuses on the epidemiology of fatal and nonfatal

shootings regarding geographic disparities in gunshot wound mortality and associated

neighborhood social processes through a commonly used public health framework.

The Haddon’s Matrix is a public health conceptual framework to injury prevention

that identifies the temporal natural of injury, across the pre-event, event, and post-

event, and incorporates opportunities for intervention across four domains: the host,

vector, social environment, and physical environment. The framework further assesses

influencing elements of events (victim, agent, physical, and social environment) dur-

ing different event phases (Runyan, 1998). The matrix has been widely used in the

prevention of traffic crashes, for instance, seat belts protect the people in the car (i.e.,

victim), better headlights, brakes and airbags improve the safety of the vehicle (i.e.,

agent), and speed bumps, roundabouts and guardrails improve the safety of the envi-

ronment (i.e., social and physical environment) (Hemenway, 2009). Given the suc-

cess in traffic safety specifically, scholars have more recently began to apply the