RFA-CE-24-030, Social policies to prevent firearm assault

New York University School Of Medicine, New York NY

Investigators

Abstract

PROJECT SUMMARY Firearm violence is a persistent public health crisis that disproportionately affects young Black and Brown people. From 2019 to 2021, firearm homicide rates rose an alarming 46% among people aged 10–34 years, peaking at the highest levels seen in 20 years and exacerbating stark racial/ethnic inequities. Policies that address the conditions contributing to persistently high rates of firearm violence are needed. Two major categories of policies have a strong scientific premise but lack rigorous evaluations of their effectiveness in reducing firearm homicide and nonfatal firearm assault injuries (herein referred to as “firearm assault”). First, alcohol control policies (e.g., alcohol outlet density restrictions) are a well-established means of limiting alcohol availability thereby reducing alcohol-related harms. No studies have clearly established whether alcohol control policies prevent firearm assault. Second, economic support policies (e.g., income supplements) influence upstream causes of firearm assault including poverty and income inequality, but the impacts of these policies on racial/ethnic inequities in firearm assault are unknown. Local (city and county) policies, in particular, are likely to shape the environments in which firearm assault unfolds. Further, research assessing the synergy between these sets of policies is absent but essential to identify multifaceted solutions that maximize impact. This will be the first quasi-experimental study to test the impacts of a range of local alcohol control and economic support policies on overall rates and racial/ethnic inequities in firearm assault among young people. The study will leverage heterogenous policy changes introduced by county governments during the COVID-19 pandemic, which provide an unprecedented opportunity to rigorously assess impacts on firearm assault. The investigators will establish a cohort of ~90% of California residents ages 10-32 years, and construct a longitudinal hierarchical database by individually linking birth records, emergency department encounters, inpatient hospitalizations, and deaths, combined with comprehensive legal epidemiologic research on county policies from 1/1/2018 to 12/31/2022. The Specific Aims are to evaluate the impacts of county 1) alcohol control policies, 2) economic support policies, and 3) their interaction, on firearm assault, overall and by race/ethnicity among California young people. This study will provide critical evidence that local governments are urgently seeking on which policies they could enact or avoid to reduce firearm assault and promote health equity in communities. This project addresses Objectives 2 and 3 of RFA-CE-24-030 as it entails effectiveness research to evaluate alcohol control policies as place-based prevention approaches and economic support polices as structural approaches to reduce firearm assault. It also addresses NCIPC’s Cross Cutting Violence Prevention priority to “evaluate the effectiveness… of policies or community-level change strategies designed to enhance the economic and social environment to reduce multiple forms of violence throughout the lifespan.”