O3307: Single-state Experience in Pediatric Firearm Violence, Social Vulnerability Index, and Child Opportunity Index

Background: There is scant research examining the impact of socioeconomic disparities on pediatric firearm injuries despite increasing incidence of these injuries. Social Vulnerability Index (SVI) and Child Opportunity Index (COI) are two tools that utilize composite variables to quantify these disparities. We aimed to investigate the association between SVI, COI, and pediatric firearm injuries that were seen at a state verified pediatric level one trauma center.

Methods: We included children evaluated for firearm injury from 2016-2023. Patient’s residence was linked to concordant year SVI (high indicating poor vulnerability) and state COI (high indicating improved opportunity). SVI and COI quartiles were created; univariate analysis compared demographics and patient outcomes by quartiles for each index. Incidence rate ratios (IRR) of firearm injuries compared SVI and COI quartiles using CDC pediatric population variables. SVI was mapped based on patient address.

Results: 554 children were included. The majority were black (68.2%) and male (70.4%) with a median (IQR) age of 11.4 years (4.3-15.0). A higher proportion of black children and patients using government insurance were in higher SVI and lower COI cohorts (p < 0.001). Sex, age, hospital length of stay, and mortality was similar between the SVI and COI quartiles. The IRR increased with increasing SVI and decreasing COI quartiles, compared to the Very Low quartiles, respectively (Figure 1) which persisted when examining the themes of each database. Figure 2 shows geospatial analysis of SVI compared to density of patients being seen at the institution for firearm injury.

Conclusion: We found that incidence of firearm injury was increased in children from areas with increased socioeconomic, racial, ethnic inequities and in those from less advantaged neighborhoods, shown with high SVI and low COI. These data will be useful identifying areas to target future interventions to address the issue of pediatric firearm injuries.