• Maya Haasz, DohKiesha FraserKFDepartment of Pediatrics and Emergency Medicine at Emory University, Atlanta, GA, USA. Electronic address: kiesha.fraser@emory.edu., Holly R Hanson, Wendy J Pomerantz, Nina Agrawal, Kristen Beckworth, Sofia Chaudhary, Lindsay Clukies, Eric W Fleegler, Margaret K Formica, Adrienne Gallardo, Andrew Kiragu, Danielle Laraque-Arena, Michael N Levas, Marla C Levine, Sandra McKay, Terri McFadden, Kathy Monroe, and Lois K Lee.
• Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Maya.Haasz@childrenscolorado.org.
• Am J Emerg Med. 2025 Feb 1; 88: 849084-90.

BackgroundPediatric firearm injuries disproportionately affect groups experiencing socioeconomic disadvantage. Firearm injuries increased during the COVID-19 pandemic, but the impact on communities by degree of socioeconomic disadvantage is unknown. We examined the association between socioeconomic vulnerability and change in pediatric firearm injuries before versus during the pandemic.MethodsThis was a secondary analysis of a multicenter retrospective study comparing pediatric injuries pre- (March 17, 2019-December 31, 2020) versus during (March 15, 2020 - December 31, 2020) the COVID-19 pandemic. The parent study included injury-related visits to one of 40 Pediatric Emergency Departments in patients <18 years old. We examined firearm injuries as a proportion of all injuries. Deprivation Index (DI) was assigned using home zip code and divided into quartiles based on the distribution of DI in our total population, with deprivation increasing from quartile 1 (Q1, least deprivation) to quartile 4 (Q4, most deprivation). Kruskal-Wallis and Chi-square tests were used to compare variables of interest. Interrupted time series analysis was used to estimate pandemic effects on firearm injuries by DI quartile.ResultsThere were 1231 visits for firearm injuries. Mean DI was higher among firearm-injured than non-firearm-injured patients (0.43 vs. 0.35, p < 0.0001). Firearm injuries increased in proportion to all injuries pre- vs during pandemic (0.16 % vs 0.27 %, p < 0.0001). On interrupted time series analysis, the proportion of firearm injuries increased for Q2, Q3, and Q4. On subgroup analysis by intent, assault injuries as a proportion of all injuries increased from pre- to during COVID-19 for Q2 (3.32 % vs 6.94 %, ARD 3.62 %, 95 % CI 1.03, 6.20), Q3 (2.71 % vs 7.01 %, ARD 4.30, 95 % CI 1.99, 6.61), and Q4 (5.97 % vs 17.40 %; ARD 11.42, 95 % CI 0.19, 0.33). Unintentional injuries and injuries in youth 10-17 years old increased for Q2, Q3, and Q4.ConclusionsThe increase in pediatric firearm injuries during the COVID-19 pandemic impacted youth in all but the lowest deprivation quartile. Efforts at curbing gun violence should identify and amplify protective effects in under-resourced communities.Copyright © 2024 Elsevier Inc. All rights reserved.

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