CMAJ
Volume 189, Issue 12, 2017, Pages E452-E458

Risk of firearm injuries among children and youth of immigrant families (Article) (Open Access)

Saunders N.R. , Lee H. , Macpherson A. , Guan J. , Guttmann A.*
  • a Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, School of Kinesiology and Health Science, York University, Toronto, ON, Canada, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
  • b Institute for Clinical Evaluative Sciences, School of Kinesiology and Health Science, York University, Toronto, ON, Canada
  • c Institute for Clinical Evaluative Sciences, School of Kinesiology and Health Science, York University, Toronto, ON, Canada, Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, ON, Canada
  • d Institute for Clinical Evaluative Sciences, School of Kinesiology and Health Science, York University, Toronto, ON, Canada
  • e Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, School of Kinesiology and Health Science, York University, Toronto, ON, Canada, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada

Abstract

BACKGROUND: Firearm injuries contribute to substantial morbidity and mortality. The immigrant paradox suggests that, despite being more socially disadvantaged, immigrants are less likely than nonimmigrants to have poor outcomes. We tested the association of immigrant characteristics with firearm injuries among children and youth. METHODS: We conducted a populationbased cohort study involving residents of Ontario aged 24 years and younger from 2008-2012 using health and administrative databases. We estimated rate ratios of unintentional and assault-related firearm injuries by immigrant status using Poisson regression models with Generalized Estimating Equations. RESULTS: We included 15 866 954 nonimmigrant and 4 551 291 immigrant personyears in our analysis. Nonimmigrant males had 1032 unintentional (12.4 per 100 000, 95% confidence interval [CI] 11.7-13.2) and 304 assault-related (3.6 per 100 000, 95% CI 3.2-4.0) firearm injuries. Immigrant males had 148 unintentional (7.2 per 100 000, 95% CI 6.1-8.5) and 113 assault-related (5.5 per 100 000, 95% CI 4.5-6.6) firearm injuries. Compared with nonimmigrants, immigrants had a lower rate of unintentional firearm injury (adjusted rate ratio 0.5, 95% CI 0.4-0.6) but a similar rate of assaultrelated firearm injury. Among immigrants, refugees had a 43% higher risk of assault-related firearm injury compared with nonrefugees (adjusted rate ratio 1.4, 95% CI 1.0-2.0). Immigrants from Central America and Africa accounted for 68% of immigrants with assaultrelated firearm injuries. INTERPRETATION: Compared with nonimmigrants, immigrant children and youth had a lower risk of unintentional firearm injury, although the risk of assault-related firearm injury was higher among refugees and immigrants from Central America and Africa. The results suggest that prevention strategies for firearm safety should target nonimmigrant youth as well as these newly identified high-risk immigrant populations. © 2017 Joule Inc.

Author Keywords

[No Keywords available]

Index Keywords

urban area rural area immigrant regression analysis lowest income group Wounds and Injuries human risk assessment Cohort Studies statistics and numerical data controlled study Databases, Factual factual database Central America assault Young Adult Humans migrant classification Adolescent male Canada Emigrants and Immigrants female safety Multivariate Analysis juvenile Africa population research Article Ontario adult Firearms age cohort analysis firearm gunshot injury sex Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016931659&doi=10.1503%2fcmaj.160850&partnerID=40&md5=5df3ebb6e6b9aeb9993b98d90cf95f6d
DOI: 10.1503/cmaj.160850
ISSN: 08203946
Cited by: 4
Original Language: English