(1717) Non-Fatal Firearm Injuries in Chicago: Description and Analysis by Neighborhood Health Equity Zone

Introduction: Firearm injuries are a leading cause of death for US adolescents and adults; Chicago is an epicenter of firearm violence with a firearm homicide rate 4 times the US average. Prior studies have focused more on fatal firearm violence rather than non-fatal firearm violence (NFFV). We sought to explore NFFV trends in the city of Chicago and describe NFFV through the lens of Chicago’s health equity zones (HEZ), distinct geographic areas designated to address health inequities across neighborhoods.

Methods: Data for this retrospective cohort study from April 2021 to March 2024 came from Illinois Health and Hospital Association COMPdata. ICD-10 diagnosis codes were used to identify non-fatal firearm injuries and determine intent category. Demographics (age, sex, race/ethnicity, insurance type), incident location, and date of incident were abstracted. Chi-squared tests were used to determine associations between demographic characteristics and the 6 HEZs and NFFV injuries.

Results: There were 9472 NFFV injury hospital encounters in Chicago during the study period. Most NFFV injuries were related to accidental discharges (n=5868, 62.0%) and assault (n=3420, 36.1%). The majority were male (n=8088, 85.4%), aged 25-34 years old (n=3249, 34.4%) or 18-24 years old (n=2582, 27.3%), and black (n=7156, 75.6%). Most NFFV injuries had Medicaid insurance (n=6114, 64.6%). There was a significant association between HEZ and NFFV injuries for both assault and accidental discharge intents (p < 0.001). Mean NFFV injury incident rates (IRs) for assault were highest in HEZ Near South (9.9 per 10,000 persons), Far South (9.0 per 10,000 persons), and West (7.1 per 10,000 persons), all primarily low socio-economic and black HEZs that have suffered historic disinvestment. Mean NFFV injury IRs for accidental discharge were highest in HEZ Near South (16.9 per 10,000 persons), West (12.3 per 10,000 persons), and Far South (11.6 per 10,000 persons). North Central HEZ had the lowest NFFV injury IRs for both assault and accidental discharge (0.8 and 1.4 per 10,000 persons), a primarily white affluent HEZ.

Conclusions: NFFV in Chicago disproportionately affects adolescent and young adult black men on Chicago’s South and West sides. Violence prevention efforts should focus on these high-risk HEZs.