MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that substance use, mental disorders, and arrest are markers of increased risk of firearm injury. However, many studies of firearm injury are limited in scope – looking only at one type of injury (assault-related, for example) and one type of data (often hospital records). Police shootings, although occurring with increasing frequency, have also received relatively less attention in research than other types of firearm injuries.
We combined data from a variety of sources, including both hospital and arrest records, so we could present a more complete picture of firearm injuries in Seattle, including contacts with law enforcement and healthcare in the two years prior to injury. We subdivided substance use, mental disorder, and arrests into more specific categories to present a more nuanced look at how each category may indicate increased risk of a specific type of firearm injury (assault-related, self-inflicted, unintentional, and police intervention).
We found that when you consider both arrest records and hospital records together a distinct pattern of prior contact emerges for people who were shot by police – they have arrest histories similar to people shot during an assault and hospital histories similar to people with self-inflicted firearm injuries. A majority of people shot during an assault or by police were either arrested or hospitalized in the two years prior to their injury. Compared to our control group, people shot by police were 22 times more likely to have a conduct disorder, 11 times more likely to have been diagnosed with a marijuana use disorder, and 7 times more likely to have a felony arrest, psychosis diagnosis, or depression/anxiety diagnosis.
MedicalResearch.com: What should readers take away from your report?
Response: For researchers, this study demonstrates the value of combining multiple sources of data in order to identify connections and distinctions between different types of firearm injuries.
For law enforcement and healthcare professionals, our study shows how many firearm injuries occur after a series of encounters with both law enforcement and health care institutions. Each of these encounters represents a potential opportunity for intervention. Taking advantage of these opportunities requires recognizing someone is at increased risk and having focused, effective interventions available, particularly around connecting people with long-term support.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This study is a snapshot – 5 years of injuries in a single American city. We chose to work with types of data that are widely available because it’s important to replicate our study in other cities. Once we compare results with other cities we’ll have a much better grasp on which of our results are generalizable and which represent community-specific patterns. More broadly, combining multiple data sources and working with narrower, more specific variables leads to much more nuanced results.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our findings shouldn’t be interpreted as evidence that being arrested or having a conduct disorder causes someone to be shot; these are non-causal markers of increased risk, not causal risk factors. We’re interested in collaborating with other researchers to replicate our study elsewhere.
This study was part of my doctoral dissertation in the University of Washington Department of Epidemiology. Partial support came from a Shanahan Endowment Fellowship and a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828, to the Center for Studies in Demography and Ecology at the University of Washington.
Brianna M. Mills, Paula S. Nurius, Ross L. Matsueda, Frederick P. Rivara, Ali Rowhani-Rahbar. Prior Arrest, Substance Use, Mental Disorder, and Intent-Specific Firearm Injury. American Journal of Preventive Medicine, 2018; 55 (3): 298 DOI: 10.1016/j.amepre.2018.04.041
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