Addressing social determinants of health may improve emergency department utilization after firearm violence

Interpersonal firearm violence (FV) is a pervasive, preventable public health problem disproportionately affecting minoritized and marginalized youth, particularly black and Latinx populations living in socioeconomically deprived neighborhoods. Each year in the USA, over 48 000 people die and 120 000 are injured by firearms equating to nearly 1.42 million years of potential life lost and over $229 billion. While the distribution of costs for FV is highest during the index hospitalization, subsequent disability, lost wages, emergency department (ED) utilization and need for readmission also heavily contribute to the overall total. Understanding the root causes of FV requires a critical look into social risk factors. Unfortunately, this task has proven challenging; time, staff shortages, resource limitations, patient reluctance and trust issues, and lack of guidance are several barriers that prevent effective screening of social risks in patients impacted by FV.