摘要：Objectives. To describe variability in the burden of firearm violence by race, income, and place in an urban context. Methods. We used Philadelphia Police Department data from 2013 to 2014 to calculate firearm assault rates within census block groups for both victim residence and event locations, stratifying by race and block group income. We used cartographic modeling to determine variations in incidence of firearm assault by race, neighborhood income, and place. Results. The overall rate of firearm assault was 5.0 times higher (95% confidence interval [CI] = 4.5, 5.6) for Black people compared with White people. Firearm assault rates were higher among Black people across all victim residence incomes. Relative risk of firearm assault reached 15.8 times higher (95% CI = 10.7, 23.2) for Black residents in the highest-income block groups when compared with high-income White individuals. Firearm assault events tended to occur in low-income areas and were concentrated in several “hot spot” locations with high proportions of Black residents. Conclusions. Profound disparity in exposure to firearm violence by race and place exists in Philadelphia. Black people were substantially more likely than White people to sustain firearm assault, regardless of neighborhood income. Firearm violence is endemic in the United States. 1 On a national level, disparities exist in firearm victimization; young adults, males, and non-Hispanic Black persons are at highest risk for violent firearm injury. 2 There has been increasing interest in describing factors associated with firearm injury in urban environments. In one of the few published analyses of city-level firearm violence, Walker et al. 3 found that Hispanic and non-Hispanic Black people were significantly more likely than White people to be victims of firearm homicide in Chicago, Illinois. These authors suggested that because race may be a surrogate for income, public health interventions should be aimed at alleviating poverty to reduce firearm violence in the city. 3 The relations between race, socioeconomic status, and place, as they determine firearm injury risk, are complex. To guide local public health interventions, a greater understanding of how these factors potentiate violent firearm injury in the cities where firearm violence is most prevalent is needed. In particular, delineating the unique contributions of race, income, and place as correlates of violent firearm injury risk is an important first step in developing targets for prevention. In this descriptive epidemiological analysis, we used police data to map the burden of firearm violence and quantify its variability by race and neighborhood income in Philadelphia, Pennsylvania, a city with a historically high rate of firearm violence.
