Longitudinal Associations Between Healthcare Resources, Policy, and Firearm-Related Suicide and Homicide from 2012 to 2016
Longitudinal Associations Between Healthcare Resources, Policy, and Firearm-Related Suicide and Homicide from 2012 to 2016
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DOI：
10.1007/s11606-019-05613-3
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发表时间：
2020-01-02
影响因子：
5.7
通讯作者：
Zimmerman, Frederick J.
中科院分区：
文献类型：
--
作者：
Choi, Kristen R.;Saadi, Altaf;Zimmerman, Frederick J.
背景：在美国，与枪支有关的暴力是导致死亡的主要原因。先前的研究表明，公共政策在枪支死亡率中发挥了作用，但医疗资源的作用目的：研究医疗资源和社会/枪支政策如何影响美国与枪支有关的自杀和杀人率。设计：纵向生态研究。地点：美国。参与者：2012年至2016年的美国各州（N = 242）。测量：结果变量为年龄调整后的枪支相关自杀和凶杀率。预测变量是医疗资源（医生，医疗补助福利慷慨）和政策背景（社会政策，枪支政策）与社会人口学因素的协变量sociodemographic factors.RESULTS：医疗服务提供者变量没有显着的关联枪支相关的自杀或杀人。在完全饱和的模型中，更多的工人保护法，更大的平均人口密度，更多的酒精管制，以及更多的枪支禁令政策与更少的枪支相关的自杀。医疗补助福利的慷慨程度越高，与枪支有关的凶杀案就越少。贫困率是这两个结果的预测因子。局限性：这个国家级的研究不能做出个人层面的推论。只有代理变量可用于测量枪支所有权和实际的枪支拥有率可能没有被理想地捕获在state level.CONCLUSIONS：在国家一级，有一定的社会，医疗保健和枪支政策的保护协会枪支相关的自杀和杀人率。医疗保健资源在人口水平的枪支结果中发挥作用，但单独不足以减少与枪支有关的凶杀或自杀。
BACKGROUND: Firearm-related violence is a leading cause of mortality in the United States (US). Prior research suggests that public policy plays a role in firearm mortality, but the role of healthcare resources (physicians, insurance coverage) within the US policy context has not yet been studied.OBJECTIVE: To examine how healthcare resources and social/firearm policy affect firearm-related suicide and homicide rates in the US.DESIGN: Longitudinal, ecological study.SETTING: US.PARTICIPANTS: US states from 2012 to 2016 (N = 242).MEASUREMENT: The outcome variables were age-adjusted, firearm-related suicide and homicide rates. Predictor variables were healthcare resources (physicians, Medicaid benefits generosity) and policy context (social policy, firearm policy) with covariates for sociodemographic factors.RESULTS: Healthcare provider variables did not have significant associations to firearm-related suicide or homicide. In fully saturated models, more worker protection laws, greater average population density, more alcohol regulation, and more firearm prohibition policies were associated with fewer firearm-related suicides. Higher generosity of Medicaid benefits was associated with fewer firearm-related homicides. Poverty rate was a predictor of both outcomes.LIMITATIONS: This state-level study cannot make individual-level inferences. Only proxy variables were available for measuring gun ownership and actual gun ownership rates may not have been ideally captured at the state level.CONCLUSIONS: At the state level, there are protective associations of certain social, healthcare, and firearm policies to firearm-related suicide and homicide rates. Healthcare resources play a role in population-level firearm outcomes but alone are not sufficient to decrease firearm-related homicide or suicide.