TRENDS IN FEMALE ADOLESCENT FIREARM INJURY

Objectives: In 2020, firearm-related injury became the leading cause of death among children and adolescents in the United States. Recent data has demonstrated older, adolescent males tend to be the predominant victims of fire-arm related injury. As a result, there has been little characterization of firearm-related injury patterns in female youth, especially in high-risk communities. Therefore, the purpose of this study was to characterize recent trends in female adolescent firearm injury in an urban US city.

Methods: A city-wide adolescent trauma registry was developed through a collaboration of all Atlanta trauma centers that routinely care for adolescents for January 2016 to June 2021. Adolescents were defined as age 11 to 21 years, in congruence with the American Academy of Pediatrics. Data pertaining to demographics were obtained for all firearm injured individuals and correlated to census data by ZIP code. Dickey-Fuller testing and linear regression were used to determine changes over time in the number and proportion of females injured.

Results: There were 1,456 adolescent firearm victims, 192 (13.2%) of which were females. The median age of both the male and female cohort was 18 and 87% of victims impacted were Black. By ZIP code, the median household income was $31,158, and the median proportion of the population that was Black was 38%. The proportion of all firearm injuries that affected female adolescents was 8% in 2016, 13% in 2017, 13% in 2018, 16% in 2019, 14% in 2020, and 14% in the first six months of 2021. The time series for the number of females injured over time was found to be non-stationary on Dickey-Fuller testing (p < 0.01). The change in number of females injured and proportion of injuries that affected females were 8.1 AFIs/year (p < 0.01) and 1.3%/year (p=0.03).

Conclusion: The incidence of female adolescent firearm-related injury is increasing at a greater rate than that of their male counterparts. Adolescent females represent a high-risk demographic and this alarming trend warrants further investigation and targeted preventative interventions.