Racialized economic segregation and firearm injuries: a network analysis of home and incident locations

Understanding the factors associated with the relationship between where individuals are shot and where they reside can improve our knowledge of local risk environments and inform violence intervention planning. The objective of this study was to describe the association between residential racialized economic segregation and firearm injury location, conceptualized as spatial networks of shooting incidents within and between neighborhoods. This cross-sectional study linked hospital and death records to examine firearm assaults and homicides in or among residents living within the Boston metro area. Racialized economic segregation was measured using the ‘Index of Concentration at the Extremes’ for race and income at each residential and injury address. For the 802 individuals with gunshot wounds included for analysis, individuals living in more privileged neighborhoods were more likely to be injured: (1) farther from their homes (median [IQR] miles, 3.4[0.9–9.7] for lowest deprivation tertile [T1] vs 0.7[0.1–1.9] for highest deprivation tertile [T3], p = 0.0001), (2) outside their residential census tract (T1:82.8% vs T3:62.9%, p < 0.0001), and (3) in significantly higher deprivation neighborhoods (p = 0.0001). Spatial network analysis revealed that of the 338 census tracts represented in the data, deprived communities displayed higher centrality and connectivity in shooting networks, meaning that firearm violence was more concentrated within and across such neighborhoods. Individuals residing in all communities faced the highest likelihood of being shot in the most deprived neighborhoods, and individuals shot within the highest privilege neighborhoods were most likely to reside in the highest deprivation communities. Interventions prioritizing the most deprived neighborhoods are critical to preventing the spread of gun violence between populations.