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PHILADELPHIA—Exposure to neighborhood gun violence is associated with increased odds of mental health-related pediatric Emergency Department (ED) visits among children living within four to five blocks of a shooting, according to research by the Perelman School of Medicine at the University of Pennsylvania and Children’s Hospital of Philadelphia, published today in JAMA Pediatrics.

The study revealed a significant increase in pediatric mental-health related ED visits following incidents of neighborhood gun violence, most pronounced in the two weeks after the shooting, among children residing closest to where the violence occurred, and among children exposed to multiple shootings.

“Gun violence affects the whole community, beyond the victims who are personally injured,” said lead author Aditi Vasan, MD, MSHP, an instructor of Pediatrics at the Perelman School of Medicine and a pediatric hospitalist and health services researcher at Children’s Hospital of Philadelphia. “Now that we have confirmed exposure to shootings negatively impacts the mental health of children, we can work to develop ways to provide preventive and responsive support for children and families exposed to neighborhood gun violence.”

Using data from Children’s Hospital of Philadelphia (CHOP), researchers examined how many ED visits for children age 0 to 19 years old from 12 Philadelphia ZIP codes were primarily for mental health concerns, such as PTSD, depression, intentional ingestion of harmful substances, and other psychiatric emergencies. Then, they cross-referenced the Philadelphia Police Department’s repository of shootings on the city’s open data website to determine how many of these children were exposed to gun violence in the 60 days prior to the ED visit. A child was considered exposed to gun violence if they lived within a quarter mile (4-5 blocks) of the reported shooting. As a control, researchers also evaluated the cases of mental-health related ED visits in the 60 days prior to a shooting as well.

Of the 54,341 patients included in the study, 43,143 had one or more ED visits in the 60 days following a shooting, and 42,913 had one or more ED visits in the 60 days prior to a shooting. Of the 2,629 shooting incidents in the data set, 814 (31%) had one or more corresponding mental health-related ED visits in the 60 days following the shooting. Children residing within an eighth of a mile, or 2-3 blocks of an episode of gun violence, had greater odds of having a mental health-related ED visit.

“Symptoms of mental health distress in children appear within days of being exposed to a single shooting. What’s more, in Philadelphia and other cities across the United States, gun violence disproportionately affects Black children and families, adding to existing health disparities,” said senior author Eugenia South, MD, MSHP, an assistant professor of Emergency Medicine and Faculty Director of the Penn Urban Health Lab. “This research underscores the need to develop public health interventions aimed at both reducing children’s exposure to gun violence and mitigating the mental health symptoms associated with this exposure.”

The authors recommend a number of interventions that can help reduce community violence and mitigate the health impacts of violence, such as safe storage of firearms and background check laws, as well as funding mental health services and violence prevention programs. Additionally, they suggest that health systems can partner with community-based organizations to provide preventive and responsive support for children and families exposed to neighborhood gun violence, such as proactively reaching out to families of children known to a health system who live close to a shooting in the days or weeks after that shooting, to offer mental health resources and support.

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Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System, which together form a $8.9 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $496 million awarded in the 2020 fiscal year.

The University of Pennsylvania Health System’s patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center—which are recognized as one of the nation’s top “Honor Roll” hospitals by U.S. News & World Report—Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation’s first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 44,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2020, Penn Medicine provided more than $563 million to benefit our community.

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