Infant Deaths and Mortality from Gun Violence: Causal or Casual?

J Natl Med Assoc. 2017;109(4):246-251. doi: 10.1016/j.jnma.2017.08.005. Epub 2017 Sep 21.

Abstract

Objective: Describe trends in non-Hispanic black infant mortality (IM) in the New York City (NYC) counties of Bronx, Kings, Queens, and Manhattan and correlations with gun-related assault mortality.

Methods: Linked Birth/Infant Death data (1999-2013) and Compressed Mortality data at ages 1 to ≥85 years (1999-2013). NYC and United States (US) Census data for income inequality and poverty. Pearson coefficients were used to describe correlations of IM with gun-related assault mortality and other causes of death.

Results: In NYC, the risk of non-Hispanic black IM in 2013 was 49% lower than in 1995 (rate ratio: 0.51; 95% CI: 0.43, 0.61). Yearly declines between 1999 and 2013 were significantly correlated with declines in gun-related assault mortality (correlation coefficient (r) = 0.70, p = 0.004), drug-related mortality (r = 0.59, p = 0.020), major heart disease and stroke (r = 0.85, p < 0.001), malignant neoplasms (r = 0.57, p = 0.026), diabetes mellitus (r = 0.63, p = 0.011), and pneumonia and influenza (r = 0.78, p < 0.001). There were no significant correlations of IM with chronic lower respiratory or liver disease, non-drug-related accidental deaths, and non-gun-related assault. Yearly IM (1995-2012) was inversely correlated with income share of the top 1% of the population (r = -0.66, p = 0.007).

Conclusions: In NYC, non-Hispanic black IM declined significantly despite increasing income inequality and was strongly correlated with gun-related assault mortality and other major causes of death. These data are compatible with the hypothesis that activities related to overall population health, including those pertaining to gun-related homicide, may provide clues to reducing IM. Analytic epidemiological studies are needed to test these and other hypotheses formulated from these descriptive data.

Keywords: African American; Assault; Infant Mortality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Black or African American*
  • Cause of Death / trends*
  • Child
  • Child, Preschool
  • Female
  • Gun Violence / ethnology
  • Gun Violence / trends*
  • Humans
  • Infant
  • Infant Death / etiology*
  • Infant Mortality / ethnology
  • Infant Mortality / trends*
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Socioeconomic Factors
  • Urban Health / ethnology
  • Urban Health / trends*
  • Young Adult