Association of childhood opportunity index and firearm ownership and storage in two emergency departments in Texas.

Abstract

Despite the association of safe firearm storage and reduced risk of injury and death, many children live in homes with unsecured firearms. The Child Opportunity Index (COI) assesses neighborhood resources that impact health; lower COI levels have been linked to higher rates of firearm-related injuries. This study examined the relationship between COI and firearm ownership and storage practices. This was a cross-sectional survey study that took place between November 2022 and October 2023 in two geographically separate Level 1 Emergency Departments in Texas. English and Spanish speaking patients assigned triage acuity levels of 3, 4, or 5 were included, and survey questions were derived from the National Health Interview Survey to examine firearm injury ownership and storage practices. 4,248 patient families were approached, with 2,882 (68 %) participating. 690 (23.9 %) self-reported as firearm owners, 541(78.4 %) reported storing guns locked and 392(56.8 %) reported keeping the firearm unloaded. Over half (50.4 %) of respondents were in the very low (692) or low COI (750) quintiles. Participants in the very high COI levels were associated with a higher risk of living in a home with firearms compared with those in the very low COI levels (very high COI RR 1.81, p < 0.001, 95 % CI [1.39, 2.37]). There was no association between a respondent's COI level and the method or rates of firearm storage. While children in higher COI quintiles were more likely to live in homes with firearms, storage practices are suboptimal across all COI quintiles. Future work should focus on creating effective and consistent messaging on the importance of firearm storage practices across individuals in all COI quintiles.