Racial and Ethnic Differences In Non-Fatal Firearm Injuries, United States, 1993-2017

Although there has been much national discussion, both in scientific literature and popular press, and a growing scientific literature about firearm deaths, much less attention has been paid to non-fatal firearm injury that constitutes 70 percent of the victims of firearm violence. While rates of national fatal firearm mortality rates have stayed more or less stable in the U.S. since the turn of the twenty-first century, the rates of non-fatal firearm injury have, however, increased, driving the epidemic of firearm violence. Rates of non-fatal firearm injuries are inconsistent across the country, with substantial spatial heterogeneity changing over time.
The goal of this project was to understand the drivers of non-fatal firearm injury in order to guide efforts that may reduce related injuries. This study included four aims of analysis:

Document the state-specific (spatial) differences and the changes across time (temporal) of non-fatal firearm injury among all, by racial-ethnic groups and intents of injury.
Assess the state-level factors that influence these changes such as state-specific firearm laws and social characteristics (e.g., minority proportion, rates of unemployment, income inequality, suicide, divorce, firearm ownership, alcohol consumption, drug use, and non-firearm homicide).
Determine the individual socio-demographic and clinical factors that drive both spatial and time trends.
Determine if individual factors modify the spatio-temporal patterns of non-fatal firearm injury, and whether this explains racial-ethnic and intent differences.
The resulting datasets are at state-level analysis.

尽管学界与大众媒体已就枪支死亡（firearm deaths）问题开展了大量全国性讨论，且相关科学研究文献亦日益增多，但占枪支暴力（firearm violence）受害者总数70%的非致命枪支伤害（non-fatal firearm injury）问题，却鲜少获得同等关注。自21世纪之交以来，美国全国枪支致死率基本保持稳定，而非致命枪支伤害率却持续攀升，助推了枪支暴力的流行态势。美国各地的非致命枪支伤害率存在显著差异，且随时间推移呈现出明显的空间异质性（spatial heterogeneity）变化。
本研究的核心目标为厘清非致命枪支伤害的驱动因素，以期为相关伤害防控工作提供指导。本研究共设置四项分析目标：
一是全面记录全人群、不同种族族群群体以及不同伤害意图下，非致命枪支伤害的州级（空间）差异与时间（时序）变化趋势；
二是评估影响上述变化的州级层面因素，包括各州专属枪支法规及社会特征（如少数族裔占比、失业率、收入不平等程度、自杀率、离婚率、枪支拥有率、酒精消费量、药物滥用情况以及非枪支凶杀率等）；
三是明确驱动空间与时间趋势的个体社会人口学（socio-demographic）及临床相关因素；
四是探究个体因素是否会调节非致命枪支伤害的时空分布模式，并以此解释种族族群与伤害意图层面的差异。
本研究最终生成的数据集均基于州级层面的分析。