Healthcare indicators and firearm homicide: an ecologic study

Abstract

Purpose The purpose of this paper is to investigate the relationship between rates of firearm homicide in New York State (NYS) and indicators of access to and quality of healthcare from 2011 to 2017. Design/methodology/approach Utilizing data from the NYS Division of Criminal Justice Services Uniform Crime Reporting Supplemental Homicide Reports and Robert Wood Johnson Foundation County Health Rankings Program, a county-level ecologic study was conducted, descriptive statistics provided and multivariable analyses conducted to determine the associations between critical indicators of county health and firearm homicide. Findings The majority of firearm homicide victims (n=2,619) were young, Black, men and the highest rates of firearm homicide were situated in urban centers. Subgroup analyses excluding large urban centers and controlling for key demographics illustrated that those counties with lower rates of clinicians were significantly associated with higher rates of firearm homicide. Research limitations/implications Despite challenges integrating two large data sets, the present findings were able to illustrate the critical relationship between access to healthcare and prevalence of firearm homicide. Practical implications The results of this study reinforce the importance of access to primary healthcare services and its relationship to critical health outcomes. Social implications In urban settings, firearm homicides disproportionately impact young Black men, who are among the least likely to have access to healthcare. In more rural areas, access to healthcare is related directly to improved health outcomes, including reduced rates of firearm homicides. Originality/value This is the first study to explore and subsequently establish the relationship between indicators of community health and firearm homicide in NYS.