Healthcare indicators and firearm homicide: an ecologic study
| Published date | 08 April 2019 |
| DOI | https://doi.org/10.1108/JACPR-10-2018-0385 |
| Date | 08 April 2019 |
| Pages | 88-99 |
| Author | Margaret K. Formica,Sonali Rajan,Nicholas Simons |
| Subject Matter | Health & social care,Criminology & forensic psychology,Sociology,Gender studies,Gender violence,Social conflicts,War/peace |
Healthcare indicators and firearm
homicide: an ecologic study
Margaret K. Formica, Sonali Rajan and Nicholas Simons
Abstract
Purpose –The purpose of this paper is to investigate the relationship between rates of firearm homicide in
New York State (NYS) and indicators of access to and quality of healthcare from 2011 to 2017.
Design/methodology/approach –Utilizing data from the NYS Division of Criminal Justice Services Uniform
Crime Reporting Supplemental Homicide Reports and Robert Wood Johnson Foundation County Health
Rankings Program, a county-level ecologic study was conducted, descriptive statistics provided and
multivariable analyses conducted to determine the associations between critical indicators of county health
and firearm homicide.
Findings –The majority of firearm homicide victims (n¼2,619) were young, Black, men and the highest
rates of firearm homicide were situated in urban centers. Subgroup analyses excluding large urban centers
and controlling for key demographics illustrated that those counties with lower rates of clinicians were
significantly associated with higher rates of firearm homicide.
Research limitations/implications –Despite challenges integrating two large data sets, the present
findings were able to illustrate the critical relationship between access to healthcare and prevalence of
firearm homicide.
Practical implications –The results of this study reinforce the importance of access to primary healthcare
services and its relationship to critical health outcomes.
Social implications –In urban settings, firearm homicides disproportionately impact young Black men, who
are among the least likely to have access to healthcare. In more rural areas, access to healthcare is related
directly to improved health outcomes, including reduced rates of firearm homicides.
Originality/value –This is the first study to explore and subsequently establish the relationship between
indicators of community health and firearm homicide in NYS.
Keywords Community health, Mental health,Primary care, Homicide, Healthcareaccess, Firearm violence
Paper type Research paper
Introduction
During the past two decades, over 500,000 Americans have been killed with firearms whether via
homicide, suicides or other circumstances (Centers for Disease Control and Prevention, 2018).
Although annual rates of gun violence (including firearm homicide and firearm suicide) in New
York State (NYS) are lower than the national prevalence, gun violence persists as a deeply
complex public health concern. Each year nearly 1,000 New Yorkers are killed with guns and
over 84,000 are injured (New Yorkers Against Gun Violence, 2015). And these statistics do not
reflect the broader spectrum of gun violence experiences (e.g. witnessing gunfire or hearing
gunshots) that likely also have negative repercussions on one’s well-being (Rajan et al., 2017).
At the same time, the relationship between access to healthcare and a wide range of improved
health outcomes (e.g. reduced rates of chronic disease, better maternal health and increased
likelihood of detecting cancer early) is well-documented (Fang et al., 2014; Hall et al., 2018).
Increased access to healthcare provides individuals with critical opportunities for screening and
other preventive services, vaccinations, opportunities for physicians to answer questions and
make referrals for other services as needed, and of course for individuals to receive necessary
treatment in the case of illness or injury. Research confirms that ensuring individuals across age
Received 15 October 2018
Revised 20 December 2018
Accepted 22 January 2019
This paper forms part of a special
section “Novel firearms-related
research and scholarship”.
Margaret K. Formica is based
at the Department of Public
Health and Preventive
Medicine, State University of
New York Upstate Medical
University, Syracuse, New
York, USA.
Sonali Rajan is based at the
Department of Health and
Behavior Studies, Teachers
College, Columbia University,
New York, New York, USA.
Nicholas Simons is based at
Regional Gun Violence
Research Consortium,
Rockefeller Institute of
Government, Albany,
New York, USA.
PAGE88
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JOURNAL OF AGGRESSION, CONFLICTAND PEACE RESEARCH
j
VOL. 11 NO. 2 2019, pp. 88-99, © Emerald Publishing Limited, ISSN 1759-6599 DOI 10.1108/JACPR-10-2018-0385
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