M. M. Loe1, C. Ghio5, M. Ghio1, J. Constans2, J. Fleckman2,3, P. McGrew1, J. Duchesne1, K. P. Theall2,3, S. Taghavi1,2 1Tulane University School Of Medicine, Surgery, New Orleans, LA, USA 2Tulane University Violence Prevention Institute, New Orleans, LA, USA 3Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA 5Johns Hopkins University, Biomedical Engineering, Baltimore, MD, USA
Introduction: Major metropolitan cities in the US suffer from disproportionate rates of firearm violence, however, the structural and social factors contributing to firearm-related homicides (FH) in these areas is poorly defined. How adequate housing supply and affordability in major US cities contribute to the current gun violence epidemic is not well understood. The goal of this study was to determine how measures of housing availability affect the incidence of FH. We hypothesized that measures of housing instability would be associated with higher rates of FH in major US metropolitan cities.
Methods: This cross-sectional analysis evaluated the largest 51 US metropolitan statistical areas (MSAs) using data from 2021. Measures of housing instability included affordable/available rental homes for < 50% of average median income (AMI) obtained from the National Low-Income Housing Coalition (NLIHC). Data on number of residents with income >30% of the AMI was also obtained from NLIHC. Data providing a point-in-time estimate of homelessness was obtained from the Housing and Urban Development Continuum of Care Program. The National Housing Preservation Database provided the size, number, and funding for all current, federally subsidized housing projects. Firearm homicide mortality rates were obtained from the Centers for Disease Control. Spearman Rho and linear regression were performed.
Results: On Spearman Rho, shortage of affordable/available rental homes for <50% of AMI was associated with more FH (r= 0.36, p<0.05). Number of individuals with income >30% of the AMI (r=-0.28, p=0.03) was associated with less FH. Number of government housing units (r=0.31, p=0.04) and federal housing subsidies (r=0.36, p=0.01) were associated with FH. Overall homelessness (r=0.30, p=0.31) was not associated with FH. In a linear regression model, a shortage of affordable and available rental homes for < 50% average median incomes households (b=0.61, OR:1.84, 95%CI: 0.35–0.87, p<0.001) and income less than 30% of the median (b=0.43, OR:1.54, 95%CI: 0.17-0.69, p=0.002) were associated with firearm homicides.
Conclusion: Housing instability contributes to FH in major US metropolitan cities. Income disparities also contribute to the firearm epidemic. Public health intervention aimed at mitigating structural factors such as housing instability and income inequality may help decrease the number of FH in major US cities.