C. Griest1, J. Song2, M. D. Esposti3,4, D. J. Wiebe5, C. L. Jacovides2, M. J. Seamon2, E. J. Kaufman2 3University of Oxford, Department Of Social Policy & Intervention, Oxford, United Kingdom 4Federal University of Pelotas, Human Development And Violence Research Centre, Pelotas, Brazil 5University Of Pennsylvania, Department Of Biostatistics, Epidemiology And Informatics, Philadelphia, PA, USA 1The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA 2Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
Introduction: Firearm homicide and suicide are growing challenges throughout the United States, but not all communities are equally affected. Key social, economic, and environmental differences shape geographic variation in firearm death rates. In this study, we examine firearm homicide and suicide in a distinctive set of communities: United States college towns. These communities, disproportionately dominated by one or more universities, may share specific characteristics that increase or decrease risk. We hypothesized that counties considered to be “college towns” have higher rates of total- and firearm homicide and suicide than otherwise similar counties that are not college towns.
Methods: County population and characteristics were drawn from the American Community Survey via Social Explorer (2020). The American Communities Project used K-means clustering on a set of 36 demographic variables to generate county-level community type designations, including a “college town” designation. Homicide and suicide rates were obtained from CDC death certificate data for 2015-2019. County characteristics were compared using Kruskal-Wallis rank sum tests for continuous variables and chi squared tests for categorical variables. Multivariable negative binomial regression was used to identify significant factors associated with firearm homicide, total homicide, firearm suicide, and total suicide. Finally, counties previously identified as high and low outliers for firearm homicide in a geospatial analysis were compared with regard to college town status using chi-squared tests.
Results: Of 3113 counties, 154 were college towns. College towns were whiter, wealthier, more educated, and had more income inequality than non-college towns. Homicide and suicide rates are shown in the table. In multivariable analysis, college towns had lower rates of total homicide (incidence rate ratio [IRR] 0.82, p = 0.002) and firearm homicide (IRR 0.79, p = 0.002). There were no statistically significant differences in suicide rates. College towns were disproportionately represented among high outliers for firearm homicides (p = 0.02), but not low outliers (p = 0.40).
Conclusion: College towns had significantly lower homicide rates and equivalent suicide rates to other counties, which may relate to a combination of social, economic, and environmental factors. Those college towns that stood out as outliers for homicide may share additional characteristics that account for this elevated risk. Understanding the roots of geographic variation in firearm death can yield new insights and opportunities for prevention that may be shared among communities.
