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Prior Arrest, Substance Use, Mental Disorder, and Intent-Specific Firearm Injury

  • Brianna M. Mills
    Correspondence
    Address correspondence to: Brianna M. Mills, PhD, Harborview Injury Prevention and Research Center, 325 Ninth Avenue, Box 359960, Seattle WA 98104
    Affiliations
    Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington

    Harborview Injury Prevention and Research Center, Seattle, Washington

    Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington
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  • Paula S. Nurius
    Affiliations
    Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington

    School of Social Work, University of Washington, Seattle, Washington
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  • Ross L. Matsueda
    Affiliations
    Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington

    Department of Sociology, University of Washington, Seattle, Washington
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  • Frederick P. Rivara
    Affiliations
    Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington

    Harborview Injury Prevention and Research Center, Seattle, Washington

    Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
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  • Ali Rowhani-Rahbar
    Affiliations
    Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington

    Harborview Injury Prevention and Research Center, Seattle, Washington

    Center for Studies in Demography and Ecology, University of Washington, Seattle, Washington
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      Introduction

      Substance use, mental disorders, and arrest are markers of increased firearm injury risk. It is unclear how these markers vary by intent. Examining these interrelated factors together can clarify their associations with assault-related, self-inflicted, unintentional, and legal intervention firearm injuries, informing intent-specific interventions.

      Methods

      In 2017–2018, 2-year diagnosis and arrest histories of intent-specific firearm injury cases were compared with those of unintentionally injured motor vehicle collision passenger controls. Fatal and nonfatal firearm and motor vehicle collision injury records in Seattle (2010–2014) were linked to statewide hospitalization and arrest records. Multinomial logistic regression models compared odds of prior arrest, substance use, and mental disorder diagnoses among intent-specific firearm injury cases relative to controls, adjusting for age, race, and gender.

      Results

      A total of 763 cases and 335 controls were identified. Unintentional and self-inflicted cases did not differ significantly from controls in arrest history. Legal intervention cases resembled assault-related cases in their arrest history, and self-inflicted cases in their hospitalization history. The legal intervention cases were more likely than controls to have a prior felony arrest (OR=7.72, 95% CI=2.63, 20.97), and diagnoses involving alcohol (OR=4.06, 95% CI=1.04, 15.84); cannabis (OR=11.00, 95% CI=1.01, 119.36); depression/anxiety (OR=7.22, 95% CI=1.89, 27.67); psychosis (OR=6.99, 95% CI=1.35, 36.24); or conduct disorder (OR=22.01, 95% CI=1.44, 335.93).

      Conclusions

      Individuals with intent-specific firearm injuries have distinct patterns of prior substance use, mental disorder, and arrest. Many injuries occur after a series of encounters with institutions meant to help individuals during crises that can fail to provide longer-term solutions.
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