Effects of demolishing abandoned buildings on firearm violence: a moderation analysis using aerial imagery and deep learning

PurposeDemolishing abandoned buildings has been found to reduce nearby firearm violence. However, these effects might vary within cities and across time scales. We aimed to identify potential moderators of the effects of demolitions on firearm violence using a novel approach that combined machine learning and aerial imagery.MethodsOutcomes were annual counts of fatal and non-fatal shootings in Rochester, New York, from 2000 to 2020. Treatment was demolitions conducted from 2009 to 2019. Units of analysis were 152×152 m grid squares. We used a difference-in-differences approach to test effects: (A) the year after each demolition and (B) as demolitions accumulated over time. As moderators, we used a built environment typology generated by extracting information from aerial imagery using convolutional neural networks, a deep learning approach, combined with k-means clustering. We stratified our main models by built environment cluster to test for moderation.ResultsOne demolition was associated with a 14% shootings reduction (incident rate ratio (IRR)=0.86, 95% CI 0.83 to 0.90, p<0.001) the following year. Demolitions were also associated with a long-term, 2% reduction in shootings per year for each cumulative demolition (IRR=0.98, 95% CI 0.95 to 1.00, p=0.02). In the stratified models, densely built areas with higher street connectivity displayed following-year effects, but not long-term effects. Areas with lower density and larger parcels displayed long-term effects but not following-year effects.ConclusionsThe built environment might influence the magnitude and duration of the effects of demolitions on firearm violence. Policymakers may consider complementary programmes to help sustain these effects in high-density areas.

On The Dynamics of Interstate Diffusion of Firearm Violence and Impact of Firearm Regulations

Objectives : Our purpose was to test the impact of firearm regulations on the firearm violence flow across US state borders. Further we assessed the spatial variations in these impacts across different regions with the goal of identifying state groups that are especially vulnerable to cross-border firearm violence. Methods : Incidence of firearm violence (2000 to 2017) has been modelled as an inhomogeneous diffusion process whose parameters depend on state firearm regulations. Firearm regulations measurement for a state accounted for all 14 law categories across 54 states since 1991 as per State Firearm Law Database. The effects of regulations and other covariates were estimated across all states. Results : Six clusters of states were identified based on the variations of effects within and across those clusters. For 3 of these clusters the diffusive flow parameters were statistically significant. In all of these clusters the deterring effect of regulations on incidence and flow of crime was statistically significant. Conclusion : The clusters can be assigned to 5 descriptive categories based on their roles in the flow of firearm violence : Source states, Transitive states, Destination states, Isolated issue states and Stable . It was found that flow of firearm violence indeed does follow a diffusive process for most categories of states. It has also been recommended that while in-state regulations are important to curb firearm violence flowing into Destination states, they are not adequate unless regulatory stringency is also applied to neighbouring Source and Transitive States.

On The Dynamics of Interstate Diffusion of Firearm Violence and Impact of Firearm Regulations

Objectives – Our purpose was to test the impact of firearm regulations on the firearm violence flow across US state borders. Further we assessed the spatial variations in these impacts across different regions with the goal of identifying state-groups that are especially vulnerable to cross-border firearm violence.Methods – Incidence of firearm violence (2000-2017) has been modelled as an inhomogeneous diffusion process whose parameters depend on state firearm regulations. Firearm regulations measurement for a state accounted for all 14 law categories across 54 states since 1991 as per State Firearm Law Database. The effects of regulations and other covariates were estimated across all states. Results – Six clusters of states were identified based on the variations of effects within and across those clusters. For 3 of these clusters the diffusive flow parameters were statistically significant. In all of these clusters the deterring effect of regulations on incidence and flow of crime was statistically significant.Conclusion – The clusters can be assigned to 5 descriptive categories based on their roles in the flow of firearm violence – Source states, Transitive states, Destination states, Isolated issue states and Stable states. It was found that flow of firearm violence indeed does follow a diffusive process for most categories of states. It has also been recommended that while in-state regulations are important to curb firearm violence flowing into Destination states, they are not adequate unless regulatory stringency is also applied to neighboring Source and Transitive States.

A Scoping Review of Current Social Emergency Medicine Research

Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

Firearm violence: a neglected “Global Health” issue

Populations around the world are facing an increasing burden of firearm violence on mortality and disability. While firearm violence affects every country globally, the burden is significantly higher in many low- and middle-income countries. However, despite overwhelming statistics, there is a lack of research, reporting, and prioritization of firearm violence as a global public health issue, and when attention is given it is focused on high-income countries. This paper discusses the impact of firearm violence, the factors which shape such violence, and how it fits into global public health frameworks in order to illustrate how firearm violence is a global health issue which warrants evidence-based advocacy around the world.