The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA

Abstract

Recent increases in firearm violence in U.S. cities are well-documented, however dynamic changes in the people, places and intensity of this public health threat during the COVID-19 pandemic are relatively unexplored. This descriptive epidemiologic study spanning from January 1, 2015 - March 31, 2021 utilizes the Philadelphia Police Department's registry of shooting victims, a database which includes all individuals shot and/or killed due to interpersonal firearm violence in the city of Philadelphia. We compared victim and event characteristics prior to the pandemic with those following implementation of pandemic containment measures. In this study, containment began on March 16, 2020, when non-essential businesses were ordered to close in Philadelphia. There were 331 (SE = 13.9) individuals shot/quarter pre-containment vs. 545 (SE = 66.4) individuals shot/quarter post-containment (p = 0.031). Post-containment, the proportion of women shot increased by 39% (95% CI: 1.21, 1.59), and the proportion of children shot increased by 17% (95% CI: 1.00, 1.35). Black women and children were more likely to be shot post-containment (RR 1.11, 95% CI: 1.02, 1.20 and RR 1.08, 95% CI: 1.03, 1.14, respectively). The proportion of mass shootings (≥4 individuals shot within 100 m within 1 h) increased by 53% post-containment (95% CI: 1.25, 1.88). Geographic analysis revealed relative increases in all shootings and mass shootings in specific city locations post-containment. The observed changes in firearm injury epidemiology following COVID-19 containment in Philadelphia demonstrate an intensification in firearm violence, which is increasingly impacting people who are likely made more vulnerable by existing social and structural disadvantage. These findings support existing knowledge about structural causes of interpersonal firearm violence and suggest structural solutions are required to address this public health threat.

Keywords: COVID-19 pandemic; Containment policies; Epidemiology; Firearm injury; Firearm violence; Public health; Social determinants; Structural racism; Trauma.

Fig. 1

Quarterly counts of all individuals shot (A); women shot (B); children shot (C); and mass shootings (D); in Philadelphia, PA from January 2015 – March 2021. The dashed red line marks the quarter during which the first containment policy was enacted in Philadelphia (March 16, 2020). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

Fig. 2

Kernel density maps of all shootings pre-containment (January 1, 2015 – March 15, 2020) (A); all shootings post-containment (March 16, 2020 – March 31, 2021) (B); ratio of shootings post-containment to pre-containment (C); mass shootings pre-containment (D); mass shootings post-containment (E); ratio of mass shootings post-containment to pre-containment (F). Mass shootings are defined as 4 or more individuals shot within 100 m within 1 h.