Subject(s)
Accidents, Traffic , Firearms , Wounds, Gunshot , Adolescent , Child , Humans , Firearms/legislation & jurisprudence , Firearms/statistics & numerical data , United States/epidemiology , Wounds, Gunshot/epidemiology , Wounds, Gunshot/ethnology , Wounds, Gunshot/prevention & control , Infant , Child, Preschool , Young Adult , Child Health , Wounds and Injuries/epidemiology , Wounds and Injuries/prevention & control , Black or African American/statistics & numerical data , American Indian or Alaska Native/statistics & numerical data , Homicide/ethnology , Homicide/statistics & numerical data , Homicide/trends , Suicide/ethnology , Suicide/statistics & numerical data , Suicide/trends , Accidents, Traffic/history , Accidents, Traffic/prevention & control , Accidents, Traffic/statistics & numerical data , Accidents, Traffic/trends , History, 20th Century , History, 21st Century , Health Inequities , Public Health Practice , Accident Prevention/legislation & jurisprudence , Accident Prevention/methodsABSTRACT
Importance: Mortality rates in US youth have increased in recent years. An understanding of the role of racial and ethnic disparities in these increases is lacking. Objective: To compare all-cause and cause-specific mortality trends and rates among youth with Hispanic ethnicity and non-Hispanic American Indian or Alaska Native, Asian or Pacific Islander, Black, and White race. Design, Setting, and Participants: This cross-sectional study conducted temporal analysis (1999-2020) and comparison of aggregate mortality rates (2016-2020) for youth aged 1 to 19 years using US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Data were analyzed from June 30, 2023, to January 17, 2024. Main Outcomes and Measures: Pooled, all-cause, and cause-specific mortality rates per 100â¯000 youth (hereinafter, per 100â¯000) for leading underlying causes of death were compared. Injuries were classified by mechanism and intent. Results: Between 1999 and 2020, there were 491â¯680 deaths among US youth, including 8894 (1.8%) American Indian or Alaska Native, 14â¯507 (3.0%) Asian or Pacific Islander, 110â¯154 (22.4%) Black, 89â¯251 (18.2%) Hispanic, and 267â¯452 (54.4%) White youth. Between 2016 and 2020, pooled all-cause mortality rates were 48.79 per 100â¯000 (95% CI, 46.58-51.00) in American Indian or Alaska Native youth, 15.25 per 100â¯000 (95% CI, 14.75-15.76) in Asian or Pacific Islander youth, 42.33 per 100â¯000 (95% CI, 41.81-42.86) in Black youth, 21.48 per 100â¯000 (95% CI, 21.19-21.77) in Hispanic youth, and 24.07 per 100â¯000 (95% CI, 23.86-24.28) in White youth. All-cause mortality ratios compared with White youth were 2.03 (95% CI, 1.93-2.12) among American Indian or Alaska Native youth, 0.63 (95% CI, 0.61-0.66) among Asian or Pacific Islander youth, 1.76 (95% CI, 1.73-1.79) among Black youth, and 0.89 (95% CI, 0.88-0.91) among Hispanic youth. From 2016 to 2020, the homicide rate in Black youth was 12.81 (95% CI, 12.52-13.10) per 100â¯000, which was 10.20 (95% CI, 9.75-10.66) times that of White youth. The suicide rate for American Indian or Alaska Native youth was 11.37 (95% CI, 10.30-12.43) per 100â¯000, which was 2.60 (95% CI, 2.35-2.86) times that of White youth. The firearm mortality rate for Black youth was 12.88 (95% CI, 12.59-13.17) per 100â¯000, which was 4.14 (95% CI, 4.00-4.28) times that of White youth. American Indian or Alaska Native youth had a firearm mortality rate of 6.67 (95% CI, 5.85-7.49) per 100â¯000, which was 2.14 (95% CI, 1.88- 2.43) times that of White youth. Black youth had an asthma mortality rate of 1.10 (95% CI, 1.01-1.18) per 100â¯000, which was 7.80 (95% CI, 6.78-8.99) times that of White youth. Conclusions and Relevance: In this study, racial and ethnic disparities were observed for almost all leading causes of injury and disease that were associated with recent increases in youth mortality rates. Addressing the increasing disparities affecting American Indian or Alaska Native and Black youth will require efforts to prevent homicide and suicide, especially those events involving firearms.
Subject(s)
Asthma , Health Status Disparities , Mortality , Substance-Related Disorders , Suicide , Wounds and Injuries , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Young Adult , Cause of Death/trends , Cross-Sectional Studies , Ethnicity/statistics & numerical data , Mortality/ethnology , Mortality/trends , Suicide/ethnology , Suicide/statistics & numerical data , United States/epidemiology , Wounds and Injuries/epidemiology , Wounds and Injuries/ethnology , Wounds and Injuries/mortality , Racial Groups/ethnology , Racial Groups/statistics & numerical data , American Indian or Alaska Native/statistics & numerical data , White/statistics & numerical data , Black or African American/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Asian American Native Hawaiian and Pacific Islander/statistics & numerical data , Asthma/epidemiology , Asthma/ethnology , Asthma/mortality , Homicide/ethnology , Homicide/statistics & numerical data , Firearms/statistics & numerical data , Wounds, Gunshot/epidemiology , Wounds, Gunshot/ethnology , Wounds, Gunshot/mortality , Accidents, Traffic/mortality , Accidents, Traffic/statistics & numerical data , Accidents, Traffic/trends , Substance-Related Disorders/epidemiology , Substance-Related Disorders/ethnology , Substance-Related Disorders/mortalitySubject(s)
Black or African American , Firearms , Gun Violence , Homicide , Mortality , Rural Population , Adolescent , Child , Female , Humans , Male , Black or African American/statistics & numerical data , Firearms/statistics & numerical data , Gun Violence/ethnology , Gun Violence/statistics & numerical data , Gun Violence/trends , Homicide/ethnology , Homicide/statistics & numerical data , Homicide/trends , Mortality/ethnology , Mortality/trends , Rural Population/statistics & numerical data , Rural Population/trends , United States/epidemiology , Urban Population/statistics & numerical data , Urban Population/trends , White/statistics & numerical data , Wounds, Gunshot/epidemiology , Wounds, Gunshot/ethnology , Wounds, Gunshot/mortalityABSTRACT
Exploring the post-injury lives of those who have survived gunshot wounds is essential to understanding the entire scope of firearm violence. The lives of Black male firearm violence survivors are transformed in various ways due to their injuries both visible and invisible. This study explored how Black men who suffer from disabilities via a firearm negotiated their masculine identities. Semi-structured, qualitative interviews were conducted with 10 violently injured Black men participating in a hospital-based violence intervention program. Survivors expressed their thoughts on how their injuries impacted their manhood and masculinities. Three themes emerged: (1) perceptions of manhood, (2) loss of independence and burden on others, and (3) and mobility. These themes highlighted and described how their lives were impacted post-injury and characterized their psychological and physical experience of recovery. The research findings suggest the need for more qualitative studies to further explore the relationship between firearm injury, Black masculinity, and perceptions of manhood. While Black men are understudied in health research and invisible in disability research, they continue to be hyper-invisible when discussing violently acquired disabilities.