RESUMO
Importance: Every day in the United States, more than 200 people are murdered or assaulted with a firearm. Little research has considered the role of interpersonal ties in the pathways through which gun violence spreads. Objective: To evaluate the extent to which the people who will become subjects of gun violence can be predicted by modeling gun violence as an epidemic that is transmitted between individuals through social interactions. Design, Setting, and Participants: This study was an epidemiological analysis of a social network of individuals who were arrested during an 8-year period in Chicago, Illinois, with connections between people who were arrested together for the same offense. Modeling of the spread of gunshot violence over the network was assessed using a probabilistic contagion model that assumed individuals were subject to risks associated with being arrested together, in addition to demographic factors, such as age, sex, and neighborhood residence. Participants represented a network of 138â¯163 individuals who were arrested between January 1, 2006, and March 31, 2014 (29.9% of all individuals arrested in Chicago during this period), 9773 of whom were subjects of gun violence. Individuals were on average 27 years old at the midpoint of the study, predominantly male (82.0%) and black (75.6%), and often members of a gang (26.2%). Main Outcomes and Measures: Explanation and prediction of becoming a subject of gun violence (fatal or nonfatal) using epidemic models based on person-to-person transmission through a social network. Results: Social contagion accounted for 63.1% of the 11â¯123 gunshot violence episodes; subjects of gun violence were shot on average 125 days after their infector (the person most responsible for exposing the subject to gunshot violence). Some subjects of gun violence were shot more than once. Models based on both social contagion and demographics performed best; when determining the 1.0% of people (n = 1382) considered at highest risk to be shot each day, the combined model identified 728 subjects of gun violence (6.5%) compared with 475 subjects of gun violence (4.3%) for the demographics model (53.3% increase) and 589 subjects of gun violence (5.3%) for the social contagion model (23.6% increase). Conclusions and Relevance: Gunshot violence follows an epidemic-like process of social contagion that is transmitted through networks of people by social interactions. Violence prevention efforts that account for social contagion, in addition to demographics, have the potential to prevent more shootings than efforts that focus on only demographics.