Addressing structural racism to reduce racial disparities in youth firearm injuries

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PROJECT SUMMARY Dr. Jay’s long-term career goal is to become a leading independent investigator whose research contributes to the elimination of racial/ethnic disparities in firearm violence, with a focus on city-dwelling youth. Most firearm violence occurs in cities, where Black youth are 20 times more likely, and Hispanic youth are 4.4 times more likely, to be fatally shot than non-Hispanic White youth at ages 18-24. The overarching goal of Dr. Jay’s research project is to identify optimal strategies for reducing racial/ethnic disparities in youth firearm injuries in cities. Specifically, this K01 tests whether disparities in youth firearm injuries can be reduced by bolstering individual-level programs with two related interventions: (a) Desegregation policies, i.e., changing public policy to decrease racial segregation across neighborhoods, and (b) Physical investments, i.e., improving the built environment in disinvested areas. Dr. Jay will assess disinvestment as a pathway linking segregation with youth firearm injury disparities (Aim 1); conduct participatory mapping with racial/ethnic minority youth in Boston, MA to identify novel targets for physical investments (Aim 2); and test possible intervention strategies in a computer-simulated environment to determine which strategies produce the greatest reductions in youth firearm injury disparities, within realistic budgetary constraints (Aim 3). The proposed research builds upon Dr. Jay’s prior research on place-based interventions for violence prevention and his postdoctoral training in youth firearm injury and computational epidemiology. He will pursue the following K01 training goals to prepare him for the proposed research and for his career goals: (1) Structural racism and discrimination as drivers of health disparities; (2) Community-engaged research; (3) Computer simulation modeling; and (4) Economic evaluation. Dr. Jay has assembled a mentorship team led by his primary mentor, Dr. Emily Rothman, Professor of Community Health Sciences at Boston University School of Public Health (BUSPH). Co-mentors include Dr. David Williams, the Chair of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health (HSPH); Dr. Melissa Tracy, Associate Professor of Epidemiology and Biostatistics at SUNY-Albany; Dr. Ankur Pandya, Associate Professor of Health Decision Science at HSPH. Advisors are Dr. Sandro Galea, the Dean and Robert A. Knox Professor at BUSPH and Dr. Charles Branas, the Chair of Epidemiology at the Columbia Mailman School of Public Health. The resources available at BUSPH, coupled with the expertise of Dr. Jay’s mentorship team, will ensure Dr. Jay’s successful completion of the research and training aims and his development as an independent investigator.