Evaluating Risk Factors for Firearm Violence against Females

Objective:
Firearm violence is a major public health threat for both males and females in the U.S. The increased risk of firearm violence against females in the setting of Intimate Partner Violence (IPV) is well described in literature. However, IPV is not the only cause of firearm violence against females. This study examined trends, demographics, and circumstances surrounding female gunshot wound (GSW) victims at an urban hospital. 

Methods: We obtained a list of female GSW victims from the hospital trauma registry (2012-2016). Chart review was performed to abstract demographics, outcomes and narrative circumstances related to the shooting. These data elements included (1) intent (2) perpetrator (3) weapon (4) transportation (5) location where GSW occurred (6) number of GSWs (7) mortality (8) length of hospital stay (9) social worker notes regarding IPV (10) additional circumstances (11) race (12) ethnicity (13) age (14) previous hospital admissions. Descriptive statistics were performed on the abstracted data elements utilizing SPSS.

Results:  Female GSW victims (2012-2016) accounted for 165 of 1,922 total victims (8.6%) in the 5-year period. Females accounted for 8.1% in 2012, and, 9.0%, 10.7%, 7.2%, and 8.0% respectively for years 2013-2016. The mean age of females was 30.1 (SD 13.3), slightly older than males (mean age 28.8, SD 10.4). African-Americans were 91.6%. Females experienced a higher mortality rate (12.7%) than males (3.9%). Only 5.0% of female GSW incidents were presumed to be IPV related. However, of the 165 incidents, 65 could not be classified as IPV or not IPV due to incomplete data. In addition, 11.8% of female GSW victims were shot inside the home, excluding 72 cases in which the location of the incident was unknown. Finally, 60.6% of female victims arrived by EMS.  

Conclusions: Female GSW victims tend to be slightly older than males, and have a higher in-hospital mortality, largely reflective of higher injury severity. Few of these patients are IPV related suggesting that urban/street violence is not a male-specific problem. Additionally, we found that the number of IPV cases was lower than expected based on literature. It is unknown if IPV is less common in this urban population or if screening for IPV is inadequate. Therefore, better quality screening practices of IPV should be advocated. A multi-center trial is already underway to determine if these results are generalizable.

Table 1 Female Gunshot Wound (GSW) Victims 2012-16 (n=165)

Age (Mean[SD], Median) 30.1 [13.3], 26.0
Race (% Black) 142/155* (91.6%)
Mortality (%) 21/165 (12.7%)
Presumed IPV 5/100* (5.0%)
Shot inside home 11/93*  (11.8%)

*Denominator is < 165 because it represents only known race, IPV status, or GSW incident location.

Project Status:
Completed

Principal Investigator (PI):
Dr. Stephanie Bonne

Co-Principal Investigator (PI):
Ann Tufariello, MPH