Racial Disparities in Child Exposure to Firearm Violence Before and During COVID-19

Introduction

Childhood exposure to neighborhood firearm violence adversely affects mental and physical health across the life course. Study objectives were to: (1) quantify racial disparities in these exposures across the U.S. and (2) assess changes during the coronavirus disease 2019 (COVID-19) pandemic, when firearm violence increased.

Methods

The study used counts of children aged 5–17 years, disaggregated by U.S. Census racial category, for every census tract (N=73,056). Neighborhood firearm violence was the number of fatal shootings per census tract, based on 2015–2021 Gun Violence Archive data. Quasi-Poisson regressions were used to estimate baseline disparities and COVID-19-related changes and examined differences across geographic regions.

Results

Pre-pandemic exposure was lowest among White children and highest among Black children, who experienced 4.44 times more neighborhood firearm violence exposure (95% CI=4.33, 4.56, p<0.001) than White children. The pandemic increased exposure by 27% in the lowest-risk group (i.e., White children; 95% CI=20%, 34%, p<0.001), but pandemic effects were even greater for children in nearly all non-White categories. Baseline violence levels and racial disparities varied considerably by region, with the highest levels in the South and the largest-magnitude disparities observed in the Northeast and Midwest.

Conclusions

Large-scale racial disparities exist in child exposure to neighborhood firearm violence, and these disparities grew during the pandemic. Equitable access to trauma-informed programs, community-based prevention, and structural reforms are urgently needed.