Childrens Hospital of Philadelphia Philadelphia, Pennsylvania
Introduction: Firearm injury is the leading cause of death in children. Exposure to a firearm is entirely environmental and is intimately related to the factors which dictate local physical and social environments. The aim of this study was to use geospatial analysis to illustrate the burden of pediatric firearm injury in Philadelphia and identify geographic hot-spots. The secondary aims were to visualize the relationship between Childhood Opportunity Index (COI) and pediatric firearm injury, as well as identify areas that were beyond 15-minute driving distance to Level 1 pediatric trauma centers. The hypothesis was that zip codes with low COI would have higher incidence of injury and that vulnerable neighborhoods (hot-spots and areas beyond 15-minute driving distance from pediatric trauma centers) could be identified.
Methods: Pediatric firearm injury data was obtained from publicly available data from the Office of the Controller for the City of Philadelphia. Data for children aged 0-19 years was obtained from 2015 (earliest data available) through February 2023. Pediatric firearm injury and death were visualized 1) in aggregate 2) by fatal or non-fatal status 3) by race and 4) by COI for zip code. The 15-minute driving radius from the two pediatric Level I trauma centers (Children’s Hospital of Philadelphia and St. Christopher’s Hospital for Children) was illustrated, with pediatric firearm injury superimposed. Analysis was completed using ArcMap (ArcGIS Desktop: Release 10).
Results: During study period, there were 2339 pediatric firearm injuries, 366 (16%) of which were fatal. The mean age of victims was 17 years (SD=3). Males were affected more (89%) compared to females (11%). Non-Hispanic Black children were predominately affected (88%) followed by Hispanic (9%), White (3%) and Asian ( < 1%) children. Geospatial analysis showed highest burden in north and west Philadelphia, which also corresponded with areas of low COI. All but two injuries were within 15-minute driving radius from pediatric Level 1trauma centers in Philadelphia.
Conclusions: Geospatial analysis can be used to visualize community burden of pediatric firearm injury, distance from pediatric trauma centers, and relationship to Childhood Opportunity Index.
