Summary
Background
Knowledge remains limited about how people experience different types of exposure to gun violence. We analyzed the prevalence of in-person and media gun violence exposure (GVE) in a nationally representative sample of US adults.
Methods
Data were collected from 8009 US adults in May 2024, using design weights for representativeness. We measured in-person GVE, including direct (e.g., being shot) and indirect (e.g., hearing gunshots) exposures, along with frequency of exposure via traditional and social media. Exposures were analyzed by racial/ethnic group and household income. Multivariable associations were estimated using weighted multilevel mixed-effects regression models.
Findings
Significant racial/ethnic disparities in GVE were observed. Black Americans reported higher prevalence of all individual exposures (e.g., 38.5% of Black Americans [N = 337] know a family member or friend who has been shot vs. 25.53% of Hispanic Americans [N = 265] and 15.78% of White Americans [N = 849]), except firearm suicide. Black adults had higher media GVE, and neighborhood socioeconomic disadvantage was consistently linked to greater in-person exposure. Racial/ethnic disparities remained in multivariable models, including cumulative in-person exposure (Black beta [β] = 0.29, 95% CI: 0.17–0.41, p < 0.0001; Hispanic β = 0.13, 95% CI: 0.03–0.24, p = 0.018) and high media exposure (Black odds ratio [OR] = 1.57, 95% CI: 1.20–2.05, p = 0.001).
Interpretation
Nearly two-thirds of US adults have experienced in-person gun violence. Marked racial/ethnic disparities for both in-person and media GVE call for comprehensive strategies to reduce gun violence.
Funding
Authors are affiliated with the New Jersey Gun Violence Research Center, funded by the NJ Office of the Secretary of Higher Education.
Keywords: Gun violence, Firearms, Media violence, Racial disparities, Neighborhoods
Research in context.
Evidence before this study
From May 24, 2024 through May 30, 2024, we conducted a comprehensive search using databases PubMed, EBSCOhost, Google Scholar, and PubMed as well as reference lists from relevant journals and books. The search included all studies published without restrictions on date or language. We used the following search terms: “gun violence exposure,” “firearm violence,” “racial and ethnic disparities in gun violence,” “media exposure gun violence,” and “socioeconomic neighborhood factors and gun violence.” We included studies that examined the prevalence, types, and impacts of gun violence exposure (GVE) on health outcomes, focusing on both in-person and media exposure. No meta-analyses or systematic reviews were found specifically focused on racial/ethnic disparities in exposure to gun violence. Existing evidence shows there are significant racial disparities in gun violence victimization and perpetration. Individual and neighborhood disadvantage is also consistently associated with greater risk for gun violence victimization and perpetration. Little is known about racial and socioeconomic disparities across specific gun violence exposure types using nationally representative data, particularly related to media exposure across diverse contexts (e.g., social vs. traditional media).
Added value of this study
This study is the first nationally representative investigation to assess diverse types of GVE, both in-person and through media, across different racial/ethnic and socioeconomic groups in the United States. The findings extend existing evidence by documenting the demographic, behavioral, and neighborhood factors contributing to exposure disparities. This provides an understanding of the broad ecosystem of GVE, including indirect and media exposure, which has been underexplored in previous research. Additionally, the analysis highlights significant racial/ethnic and socioeconomic disparities in exposure, emphasizing the disproportionate burden of gun violence on Black and Hispanic communities.
Implications of all the available evidence
The combined evidence from this study and prior research underscores the urgent need for targeted public health interventions and policy measures to address the widespread and inequitable impact of GVE. This includes enhancing community violence intervention programs, increasing support for victims through trauma recovery centers, and implementing policies to reduce firearm access in high-risk areas. Future research should focus on longitudinal studies to understand the causal pathways of GVE and its health impacts, as well as the effectiveness of different intervention strategies. Policymakers and public health officials must prioritize efforts to reduce GVE and mitigate its effects, particularly in marginalized communities, to promote health equity and social justice.
Introduction
In June 2024, the United States (US) Surgeon General declared gun violence a national public health crisis and issued a detailed advisory on its causes and consequences.1 Gun violence affects millions of Americans through direct and indirect exposures such as being shot, being threatened with a firearm, knowing someone shot or killed, and consuming media that depict real-life gun violence. Research increasingly demonstrates that individual types of in-person gun violence exposure (GVE), as well as cumulative exposure, are associated with poorer mental, physical, and behavioral health.2, 3, 4, 5, 6, 7, 8 Understanding the prevalence of different types of GVE, who is exposed, and the factors that increase exposure is imperative for informing comprehensive prevention efforts and programmatic support for victims.
Exposure to gun violence is an intersectional social issue, influenced by overlapping demographic factors including race, ethnicity, age, sex, and socioeconomic status. Researchers have documented clear racial disparities among those directly victimized by gun violence.7 Black Americans account for about 60% of those killed by firearm homicide each year in the US, despite accounting for only 14% of the population.9 Conversely, White Americans have the highest rate of firearm suicide across all racial groups.10 Geographically, violence exposure concentrates in areas of greater socioeconomic disadvantage and those with higher proportions of non-White residents.4 However, much less is known about the prevalence and related disparities for GVE beyond direct victimization, necessitating a consideration of the broader ecosystem of GVE, including indirect and media exposure, to understand its collective burden for Americans. Researchers have recently documented high levels of in-person GVE among Black and Indigenous Americans using nationally representative samples for each group, finding that 60% of Black and 56% of Indigenous adults have experienced at least one type of direct or indirect GVE in their life.11 In a longitudinal multicohort study using data from the Project on Human Development in Chicago Neighborhoods (PHDCN), stark disparities were found in the likelihood of being shot, seeing someone shot, and living near firearm violence by sex and race with particular impacts on Black and Hispanic men.12
Yet significant limitations in knowledge about GVE remain. First, there have been no nationally representative studies to assess the prevalence of diverse types of GVE across racial and ethnic groups, limiting insight regarding disparities in exposure. Second, no study has analyzed the prevalence of media GVE, including both traditional television news and social media platforms. This is a critical omission since millions of Americans may be indirectly yet frequently exposed to gun violence through the media beyond in-person exposure, with broad ramifications for collective mental health and well-being.13 Third, knowledge is constrained regarding how demographic characteristics, firearm behaviors (e.g., ownership, carrying), and contextual neighborhood factors shape individual risk for GVE. Although researchers have examined community-level factors associated with gun violence using city and county level measures,14 limited information remains concerning how neighborhood-level (i.e., census tract) variation in socioeconomic disadvantage and community composition influence GVE.
To address these limitations, we conducted the first nationally representative study of adults in the US to assess the prevalence of diverse types of in-person and media GVE. We use relevant demographic, behavioral, and contextual neighborhood information from the US Census Bureau to analyze the prevalence of in-person and media GVE and associated disparities among adults. The results offer a comprehensive view of the complex landscape of GVE in the US with implications for public safety and population health equity.
Methods
Data
We collected national survey data from 8009 non-institutionalized adults (18+) living in the US in partnership with Ipsos KnowledgePanel, the largest probability-based online panel in the US. Following a preliminary pretest, 12,822 surveys were fielded and 8657 were completed by panel members (67%). The pretest was conducted May 8 and 9 while the main data were collected from May 15 through May 28, 2024. Of those completed, 8009 surveys were qualified as complete for final inclusion in the dataset (93%). Qualified respondents were compensated via entry into the KnowledgePanel sweepstakes.
All design weights were created to adjust for differential nonresponse using geodemographic distribution benchmarks from the 2023 March Supplement of the Current Population Survey (CPS), with the exception of political affiliation benchmarks, which were obtained from the 2023 Pew National Public Opinion Reference Survey (NPORS). Weights were created using an iterative proportional fitting (raking) procedure for geodemographic distributions of those 18+ by gender, race/ethnicity, census region, education level, household income, and political identification. Outliers were trimmed at the extreme upper and lower tails of the weight distribution and the weights were then scaled to aggregate to the total sample size of eligible respondents. Weights are used in all analyses to ensure national representativeness. For supplemental methodological explanation, see the Supplementary Methods and Supplementary Table S1 for full demographic distributions of the benchmarks used for weighting in this study. This study was approved by the Institutional Review Board at Rutgers University and consent was obtained from all participants prior to the commencement of the study.
Measures
In-person GVE
We measured six types of exposure to gun violence by asking respondents whether they had ever: 1) known someone personally who died by suicide with a firearm, 2) been threatened with a firearm by another person, 3) been intentionally shot with a firearm by another person, 4) personally known someone, like a family member or friend, who had been shot on purpose by another person with a firearm, 5) personally witnessed a shooting in the neighborhood where they lived at the time, and 6) heard gun shots in the neighborhood where you lived at the time. Those who indicated having these experiences at any point in their life were then asked how many times each type of exposure had ever happened to them. Responses included: 1 time, 2–4 times, and 5+ times. Respondents were also asked when each of the exposures last occurred with responses ranging from 3+ years ago to within the past month. Respondents were coded “1” to indicate exposure in the past year and “0” for exposure longer than a year. We created a measure of cumulative exposure for in-person GVE based on the variety of exposure types ranging from 0 to 5+ exposure types. Top coding was used due to small numbers of respondents exposed to 5 and 6 total exposure types. We then generated a binary indicator of high cumulative exposure to indicate exposure of 3+ types.
Media GVE
Respondents were asked how often they see stories, images, or videos about gun violence across four media contexts: 1) incidents in their local community on traditional news media (e.g., cable news, newspapers), 2) incidents in their local community on social media (e.g., Instagram, Tik Tok, Facebook, X), 3) incidents outside their local community on traditional news media, and 4) incidents outside their local community on social media. Responses included: never, rarely, sometimes, often, and all the time. We created binary indicators of frequent media exposure (1) for each media context by combining responses of “often” and “all the time” compared to those indicating never, rare, and sometimes (0). To measure cumulative media exposure to gun violence across media contexts, we summed the four binary indicators of frequent exposure. We generated a final binary measure of “consistently high” media exposure, which indicates respondents had frequent media exposure for all four media contexts combined (1) compared to those that did not (0).
Individual measures
Independent variables include self-identified racial/ethnic group (White [Non-Hispanic], Black [Non-Hispanic], Hispanic, and Other/2+ Race), sex (male, female), sexual orientation (heterosexual, lesbian/gay/bisexual/transgender/queer+ (LGBTQ+) [includes gay or lesbian, bisexual, pansexual, asexual, and other]), household income (<$25 K, $25 K–$74,999, $75 K–$149,999, and $150 K+), region (Northeast, Midwest, South, West), age, and military status (none, current/Veteran). The self-identified racial/ethnic categories were provided as standard demographic measures by Ipsos and we conceptualize them here as social constructs without biological meaning.15 Firearm ownership is measured as an affirmative response to the question, “Is there typically a firearm or firearms stored in or around your home?” Frequency of carrying a firearm in public is a categorical measure including the following responses: (0) non-owner/never, (1) rarely/sometimes, and (2) frequently/almost always/always. See Supplementary Table S2 for all individual survey questions used for analysis in this study.
Neighborhood measures
We include four census tract-level measures of neighborhood composition in all multivariable models. All census tract measures were derived from the most recent five-year estimates (2018–2022) of the Census Bureau’s American Communities Survey and linked to individual survey responses using Federal Information Processing Standards (FIPS) codes for geographic identification. We generated a single factor to measure socioeconomic disadvantage (Eigenvalue: 2.58) using standardized z-scores for the following four items: % college education, % poverty, % using the Supplemental Nutrition Assistance Program (SNAP), and median household income. We additionally include neighborhood indicators of % Black, % Hispanic, and the ratio of female to male residents.
Analytic strategy
We generated descriptives statistics for all measures (see Table 1 for demographic and neighborhood descriptions). We then conducted bivariate analyses of individual, cumulative, and media GVE for the full sample and by racial/ethnic group membership (White, Black, and Hispanic). To assess associations between all individual- and neighborhood-level independent variables with dependent measures of GVE, we used weighted multilevel mixed-effects logistic regression models for all binary dependent variables. For linear regression models with continuous dependent variables, we used multilevel mixed-effects linear regression. All models were clustered by census tract using robust standard errors. Statistical significance was defined as p < 0.05. We used listwise deletion to address missing data across all variables included in the multivariable models (5% missing). In a sensitivity analysis, we conducted multiple imputation using chained equations (MICE) with 20 imputed datasets. The results were substantively identical to the main listwise deletion models presented here. All analyses were conducted in Stata 18. This study follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.16
Table 1.
Demographic and neighborhood descriptive statistics for full sample (N = 8009).
| N (%) | 95% CI | Missing (%) | M | SD | 95% CI | Missing (%) | ||
|---|---|---|---|---|---|---|---|---|
| Race/Ethnicity | 0 (0) | Age | 51.75 | 18.12 | 51.37–52.14 | 0 (0) | ||
| White | 5438 (61.29) | 60.04–62.52 | – | Disadvantage | 6.17E-10 | 0.94 | −0.02 to 0.02 | 83 (1.04) |
| Black | 859 (12.08) | 11.128–12.92 | – | % Black | 10.91 | 18.00 | 10.52–11.31 | 70 (0.87) |
| Hispanic | 1003 (17.49) | 16.47–18.57 | – | % Hispanic | 16.85 | 21.10 | 16.39–17.31 | 70 (0.87) |
| Other | 709 (9.14) | 8.38–9.97 | – | M:F ratio | 1.04 | 0.17 | 1.03–1.04 | 70 (0.87) |
| Female | 3990 (51.01) | 49.81–52.21 | 0 (0) | |||||
| LGBTQ+ | 798 (10.86) | 10.10–11.66 | 106 (1.32) | |||||
| Household income | 0 (0) | |||||||
| <$25 K | 851 (11.09) | 10.34–11.89 | – | |||||
| $25 K–$74,999 | 2269 (30.79) | 29.64–31.96 | – | |||||
| $75 K–$149,999 | 2664 (31.84) | 30.75–32.96 | – | |||||
| $150 K+ | 2225 (26.28) | 25.25–27.33 | – | |||||
| Region | 0 (0) | |||||||
| Northeast | 1447 (17.35) | 16.41–18.33 | – | |||||
| Midwest | 1707 (20.47) | 19.49–21.48 | – | |||||
| South | 3011 (38.57) | 37.31–39.84 | – | |||||
| West | 1844 (23.62) | 22.249–24.79 | – | |||||
| Firearm owner | 3146 (38.64) | 37.47–39.82 | 159 (1.98) | |||||
| Firearm carry | 173 (2.16) | |||||||
| Never/non-owner | 6395 (82.10) | 81.18–82.99 | – | |||||
| Rarely/sometimes | 937 (11.35) | 10.63–12.11 | – | |||||
| Frequently/almost always/always | 504 (6.54) | 5.98–7.16 | – | |||||
| Current military/Veteran | 867 (9.22) | 8.60–9.88 | 40 (0.50) |
Note: Counts (N) are unweighted and prevalence estimates (%) are weighted. Prevalence confidence intervals estimated at 95%.
Disadvantage is a standardized Z-score.
Role of the funding source
The study sponsor had no role in the design of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Results
The mean age of the sample was 51.75 (standard deviation = 18.12). Table 2 depicts full sample and racial/ethnic group-specific GVE. Throughout the results, Non-Hispanic White is used as the reference category because it is the largest racial/ethnic group included in the sample (61% [N = 5438] vs. 12% Black [N = 859], 17% Hispanic [N = 1003], and 9% Other [N = 709]). Among all US adults, about 28% (N = 2414; 95% confidence interval [CI]: 26.72–28.89) know someone who has died by firearm suicide, 20% (N = 1589; 95% CI: 19.07–21.00) know a family member or friend that has been shot by another person, and roughly 48% (N = 3762; 95% CI: 46.43–48.87) have heard gunshots in their own neighborhood. In their lifetime, White Americans are much more likely to be exposed to firearm suicide (32% [N = 1822]; 95% CI: 31.09–33.76) than their Black (22% [N = 190]; 95% CI: 18.72–24.65) and Hispanic (21% [N = 234]; 95% CI: 18.77–23.96) counterparts. However, Black Americans exhibit much greater prevalence of all other types of GVE, particularly knowing a family member or friend who has been shot (39%, [N = 337]; 95% CI: 35.10–42.03) and hearing gunshots (60% [N = 524]; 95% CI: 56.54–63.68). Hispanic Americans have similarly elevated levels of all types of GVE except firearm suicide compared to Whites, including being threatened (17% [N = 177]; 95% CI: 14.32–19.09), being shot (2% [N = 26]; 95% CI: 1.54–3.44), knowing someone who has been shot (26% [N = 265]; 95% CI: 22.77–28.49), witnessing a shooting (14% [N = 132]; 95% CI: 11.71–16.43), and hearing shots (56% [N = 560]; 95% CI: 52.82–59.43).
Table 2.
In-person and media lifetime gun violence exposures, by racial/ethnic group.
| Individual, In-Persona | Total (N = 8009) |
White (N = 5438) |
Black (N = 859) |
Hispanic (N = 1003) |
|||||
|---|---|---|---|---|---|---|---|---|---|
| N (%) | 95% CI | Missing (%) | N (%) | 95% CI | N (%) | 95% CI | N (%) | 95% CI | |
| Suicide | 2414 (27.88) | 26.72–28.89 | 41 (0.51) | 1822 (32.41) | 31.09–33.76 | 190 (21.54) | 18.72–24.65 | 234 (21.25) | 18.77–23.96 |
| Threatened | 1243 (15.18) | 14.34–16.05 | 35 (0.44) | 757 (14.05) | 12.09–15.07 | 194 (21.58) | 18.84–24.59 | 177 (16.57) | 14.32–19.09 |
| Shot | 133 (1.59) | 1.32–1.91 | 35 (0.44) | 67 (1.18) | 0.09–1.51 | 26 (3.08) | 2.06–4.58 | 26 (2.31) | 1.54–3.44 |
| Family/Friend | 1589 (20.02) | 19.07–21.00 | 46 (0.57) | 849 (15.78) | 14.76–16.84 | 337 (38.51) | 35.10–42.03 | 265 (25.53) | 22.77–28.49 |
| Witnessed | 573 (7.84) | 7.19–8.55 | 43 (0.54) | 244 (4.80) | 4.20–5.48 | 138 (15.71) | 13.30–18.47 | 132 (13.90) | 11.71–16.43 |
| Heard Shots | 3762 (47.64) | 46.43–48.87 | 48 (0.60) | 2384 (44.69) | 43.28–46.10 | 524 (60.16) | 56.54–63.68 | 560 (56.15) | 52.82–59.43 |
| Cumulative, In-Personb | |||||||||
| Zero | 2743 (35.96) | 34.76–37.19 | 79 (0.98) | 1898 (35.99) | 34.62–37.39 | 223 (27.89) | 24.70–31.33 | 311 (32.27) | 29.18–35.51 |
| One | 2561 (31.65) | 30.52–32.28 | – | 1863 (34.00) | 32.67–35.36 | 223 (26.45) | 23.31–29.84 | 301 (30.94) | 27.89–34.15 |
| Two | 1443 (17.51) | 16.63–18.44 | – | 961 (17.46) | 16.42–18.55 | 188 (20.95) | 18.20–23.99 | 189 (18.12) | 15.71–20.80 |
| Three | 670 (8.18) | 7.55–8.86 | – | 407 (7.45) | 6.74–8.21 | 105 (11.96) | 9.81–14.51 | 96 (9.10) | 7.41–11.13 |
| Four | 370 (4.84) | 4.32–5.41 | – | 195 (3.91) | 3.35–4.55 | 71 (9.11) | 6.38–10.26 | 68 (6.84) | 5.31–8.77 |
| Five or More | 144 (1.86) | 1.56–2.22 | – | 61 (1.19) | 0.09–1.56 | 40 (4.63) | 3.35–6.37 | 30 (2.74) | 1.88–3.96 |
| Mediaa | |||||||||
| Local: traditional media | 2815 (34.06) | 32.94–35.21 | 62 (0.77) | 1828 (32.06) | 30.77–33.38 | 409 (46.52) | 42.91–50.16 | 360 (35.76) | 32.61–39.04 |
| Local: social media | 1419 (19.08) | 18.11–20.08 | 53 (0.29) | 786 (15.11) | 14.09–16.19 | 267 (31.55) | 28.33–34.97 | 237 (24.13) | 21.39–27.09 |
| Outside: traditional media | 4717 (56.36) | 55.15–57.56 | 69 (0.86) | 3301 (58.59) | 57.14–60.02 | 524 (59.47) | 55.82–63.01 | 543 (52.52) | 49.19–55.83 |
| Outside: social media | 2685 (34.60) | 33.47–35.76 | 59 (0.73) | 1694 (32.05) | 30.74–33.40 | 361 (42.59) | 39.07–46.20 | 382 (38.05) | 34.89–41.31 |
Note: Counts (N) are unweighted and prevalence estimates (%) are weighted. Weighted prevalence confidence intervals estimated at 95%.
Survey-adjusted Pearson’s Chi2 statistically significant between all racial/ethnic groups (p < 0.0001) for categorical measures.
Survey-adjusted Kruskal–Wallis test statistically significant between all racial/ethnic groups (p < 0.0001) for cumulative exposure. Missing estimate for full variable.
Overall, approximately 64% of all Americans (N = 5125) have experienced at least one type of GVE in their lifetime, although racial/ethnic disparities are also evident when it comes to cumulative exposure. For instance, roughly 25% Black Americans (N = 216) say they have experienced three or more types of exposure compared to 13% of Whites (N = 663) and 19% of Hispanic Americans (N = 191). At the highest end, about 5% of Black Americans (N = 40; 95% CI: 3.35–6.37) say they have experienced five or more types of GVE, compared to just 1% of Whites (N = 61; 95% CI: 0.09–1.56) and 3% of Hispanic Americans (N = 30; 95% CI: 1.88–3.96).
For media GVE, about 1 in 3 US adults say they see gun violence in their local communities on traditional media (N = 2815) or outside their communities on social media (N = 2685) often or all the time. About 56% of the full sample (N = 4714; 95% CI: 55.15–57.56) indicates frequent exposure to media gun violence outside of their own communities on traditional media. Black adults are much more likely to indicate higher media GVE in their local communities on traditional (47% [N = 409]; 95% CI: 42.91–50.16) and social media (32% [N = 267]; 95% CI: 28.33–34.97) compared to White and Hispanic Americans. See the Supplementary Materials for bivariate analyses that assess disparities in exposure by household income for racial/ethnic group sub-samples (Supplementary Table S3), incident frequency of individual GVE types (Supplementary Table S4), and past-year individual exposures (Supplementary Table S5).
As illustrated in Table 3 and Table 4, significant racial/ethnic disparities are evident such that Black (odds ratio [OR] = 0.66, 95% CI: 0.52–0.82, p < 0.0001) and Hispanic respondents (OR = 0.68, 95% CI: 0.56–0.83, p < 0.0001) are less likely to experience firearm suicide exposure. However, Black adults are much more likely than their White counterparts to indicate being threatened (OR = 1.53, 95% CI: 1.19–1.97, p = 0.001), shot (OR = 3.17, 95% CI: 1.62–6.21, p = 0.001), knowing someone shot (OR = 3.05, 95% CI: 2.46–3.78, p < 0.0001), and witnessing a shooting (OR = 2.37, 95% CI: 1.67–3.35, p < 0.0001). Hispanic respondents also exhibit elevated risk for knowing someone who has been shot (OR = 1.73, 95% CI: 1.40–2.14, p < 0.0001) or witnessing a shooting (OR = 2.30, 95% CI: 1.68–3.16, p < 0.0001) relative to White respondents. Supplementary Table S3 demonstrates that Black GVE does not meaningfully differ by income level for most outcomes except witnessing a shooting (Chi2 = 0.037) and hearing shots (Chi2 = 0.043). Similarly, Hispanic GVE differs by income level only for being threatened (Chi2 = 0.013), witnessing a shooting (Chi2 = 0.026), and hearing shots in the neighborhood (Chi2 = <0.0001). On the other hand, GVE decreases consistently among Whites for all exposure types.
Table 3.
Individual and neighborhood-level predictors of lifetime gun violence exposures (N = 7615).
| Suicide |
Threatened |
Shot |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | SE | p | 95% CI | OR | SE | p | 95% CI | OR | SE | p | 95% CI | |
| Race/Ethnicity (ref = White) | ||||||||||||
| Black | 0.66 | 0.08 | <0.0001 | [0.52–0.82] | 1.53 | 0.20 | <0.0001 | [1.19–1.97] | 3.17 | 1.09 | <0.0001 | [1.62–6.21] |
| Hispanic | 0.68 | 0.07 | <0.0001 | [0.56–0.83] | 1.12 | 0.14 | 0.36 | [0.88–1.43] | 1.85 | 0.68 | 0.10 | [0.90–3.80] |
| Other | 0.56 | 0.07 | <0.0001 | [0.45–0.71] | 1.02 | 0.16 | 0.92 | [0.74–1.39] | 1.12 | 0.52 | 0.81 | [0.45–2.77] |
| Age | 1.01 | 0.00 | <0.0001 | [1.01–1.02] | 1.00 | 0.00 | 0.021 | [1.00–1.01] | 1.01 | 0.01 | 0.23 | [1.00–1.02] |
| Female (ref = male) | 0.97 | 0.06 | 0.64 | [0.87–1.09] | 0.55 | 0.04 | <0.0001 | [0.47–0.64] | 0.33 | 0.09 | <0.0001 | [0.20–0.56] |
| Sexual orientation (ref = heterosexual) | 0.89 | 0.09 | 0.23 | [0.73–1.08] | 1.31 | 0.16 | 0.021 | [1.04–1.66] | 1.11 | 0.38 | 0.75 | [0.58–2.16] |
| Household income (ref = <$25 K) | ||||||||||||
| $25 K–$74,999 | 0.95 | 0.10 | 0.59 | [0.77–1.16] | 0.63 | 0.08 | <0.0001 | [0.50–0.80] | 0.68 | 0.21 | 0.21 | [0.37–1.24] |
| $75 K–$149,999 | 0.93 | 0.10 | 0.49 | [0.76–1.14] | 0.51 | 0.06 | <0.0001 | [0.40–0.64] | 0.56 | 0.21 | 0.12 | [0.27–1.15] |
| $150 K+ | 0.93 | 0.10 | 0.51 | [0.75–1.16] | 0.56 | 0.07 | <0.0001 | [0.43–0.72] | 0.73 | 0.28 | 0.40 | [0.34–1.54] |
| Region (ref = Northeast) | ||||||||||||
| Midwest | 1.50 | 0.13 | <0.0001 | [1.26–1.78] | 1.19 | 0.14 | 0.15 | [0.94–1.50] | 0.73 | 0.24 | 0.35 | [0.38–1.40] |
| South | 1.60 | 0.14 | <0.0001 | [1.35–1.89] | 1.20 | 0.13 | 0.09 | [0.97–1.49] | 0.79 | 0.23 | 0.42 | [0.44–1.41] |
| West | 1.54 | 0.14 | <0.0001 | [1.28–1.85] | 1.21 | 0.15 | 0.12 | [0.95–1.54] | 0.65 | 0.23 | 0.22 | [0.32–1.29] |
| Firearm owner (ref = no) | 1.24 | 0.09 | <0.0001 | [1.08–1.42] | 0.92 | 0.09 | 0.43 | [0.75–1.13] | 0.92 | 0.28 | 0.80 | [0.51–1.67] |
| Firearm carry (ref = never/non-owner) | ||||||||||||
| Rarely/sometimes | 1.18 | 0.11 | 0.08 | [0.98–1.42] | 2.08 | 0.26 | <0.0001 | [1.63–2.65] | 2.04 | 0.67 | 0.030 | [1.07–3.88] |
| Frequently/almost always/always | 1.43 | 0.17 | <0.0001 | [1.14–1.79] | 3.69 | 0.50 | <0.0001 | [2.83–4.82] | 3.35 | 1.22 | <0.0001 | [1.64–6.86] |
| Current military/Veteran (ref = no) | 1.21 | 0.11 | 0.033 | [1.02–1.45] | 1.42 | 0.15 | <0.0001 | [1.16–1.74] | 3.23 | 0.78 | <0.0001 | [2.01–5.18] |
| Neighborhood factors | ||||||||||||
| Socioeconomic disadvantage | 1.19 | 0.05 | <0.0001 | [1.11–1.29] | 1.33 | 0.07 | <0.0001 | [1.21–1.46] | 1.56 | 0.24 | 0.004 | [1.15–2.12] |
| % Black | 0.99 | 0.00 | <0.0001 | [0.99–1.00] | 1.00 | 0.00 | 0.36 | [0.99–1.00] | 0.99 | 0.01 | 0.16 | [0.98–1.00] |
| % Hispanic | 0.99 | 0.00 | <0.0001 | [0.99–1.00] | 1.00 | 0.00 | 0.82 | [1.00–1.00] | 1.01 | 0.01 | 0.35 | [0.99–1.02] |
| M:F ratio | 0.73 | 0.12 | 0.06 | [0.53–1.01] | 0.97 | 0.20 | 0.88 | [0.65–1.45] | 0.87 | 0.67 | 0.86 | [0.20–3.90] |
| Constant | 0.26 | 0.06 | <0.0001 | [0.17–0.40] | 0.19 | 0.05 | <0.0001 | [0.11–0.33] | 0.01 | 0.01 | <0.0001 | [0.00–0.10] |
Table 4.
Individual and neighborhood-level predictors of lifetime gun violence exposures (N = 7615).
| Family/Friend |
Witnessed |
Heard Shots |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | SE | p | 95% CI | OR | SE | p | 95% CI | OR | SE | p | 95% CI | |
| Race/Ethnicity (ref = White) | ||||||||||||
| Black | 3.05 | 0.34 | <0.0001 | [2.46–3.78] | 2.37 | 0.42 | <0.0001 | [1.67–3.35] | 1.11 | 0.11 | 0.29 | [0.91–1.36] |
| Hispanic | 1.73 | 0.19 | <0.0001 | [1.40–2.14] | 2.30 | 0.37 | <0.0001 | [1.68–3.16] | 1.10 | 0.10 | 0.27 | [0.93–1.32] |
| Other | 1.03 | 0.14 | 0.86 | [0.78–1.35] | 1.49 | 0.31 | 0.06 | [0.99–2.25] | 0.68 | 0.07 | <0.0001 | [0.56–0.84] |
| Age | 1.00 | 0.00 | 0.09 | [1.00–1.01] | 0.99 | 0.00 | 0.021 | [0.99–1.00] | 1.00 | 0.00 | 0.37 | [1.00–1.00] |
| Female (ref = male) | 0.84 | 0.06 | 0.013 | [0.73–0.96] | 0.59 | 0.07 | <0.0001 | [0.48–0.74] | 0.87 | 0.05 | 0.02 | [0.78–0.97] |
| Sexual orientation (ref = heterosexual) | 0.97 | 0.11 | 0.79 | [0.78–1.21] | 1.29 | 0.20 | 0.10 | [0.95–1.76] | 1.23 | 0.11 | 0.03 | [1.03–1.48] |
| Household income (ref = <$25 K) | ||||||||||||
| $25 K–$74,999 | 0.78 | 0.09 | 0.033 | [0.63–0.98] | 0.80 | 0.13 | 0.15 | [0.58–1.09] | 0.96 | 0.10 | 0.71 | [0.79–1.17] |
| $75 K–$149,999 | 0.76 | 0.09 | 0.018 | [0.61–0.96] | 0.68 | 0.11 | 0.021 | [0.48–0.94] | 0.72 | 0.07 | <0.0001 | [0.59–0.87] |
| $150 K+ | 0.61 | 0.08 | <0.0001 | [0.48–0.79] | 0.68 | 0.13 | 0.043 | [0.47–0.99] | 0.73 | 0.08 | 0.003 | [0.59–0.90] |
| Region (ref = Northeast) | ||||||||||||
| Midwest | 1.43 | 0.16 | 0.002 | [1.15–1.79] | 1.05 | 0.17 | 0.76 | [0.76–1.45] | 1.21 | 0.10 | 0.02 | [1.03–1.43] |
| South | 1.57 | 0.16 | <0.0001 | [1.28–1.92] | 0.80 | 0.12 | 0.16 | [0.59–1.09] | 1.39 | 0.11 | <0.0001 | [1.19–1.62] |
| West | 1.65 | 0.19 | <0.0001 | [1.32–2.06] | 1.10 | 0.18 | 0.58 | [0.79–1.53] | 1.54 | 0.14 | <0.0001 | [1.29–1.83] |
| Firearm owner (ref = no) | 0.83 | 0.08 | 0.042 | [0.70–0.99] | 1.07 | 0.17 | 0.64 | [0.79–1.45] | 1.20 | 0.08 | 0.01 | [1.05–1.36] |
| Firearm carry (ref = never/non-owner) | ||||||||||||
| Rarely/sometimes | 1.77 | 0.20 | <0.0001 | [1.42–2.22] | 1.96 | 0.36 | <0.0001 | [1.37–2.79] | 1.29 | 0.12 | 0.01 | [1.07–1.55] |
| Frequently/almost always/always | 2.71 | 0.36 | <0.0001 | [2.09–3.51] | 2.25 | 0.47 | <0.0001 | [1.50–3.38] | 1.73 | 0.21 | <0.0001 | [1.36–2.19] |
| Current military/Veteran (ref = no) | 1.16 | 0.12 | 0.138 | [0.95–1.42] | 0.97 | 0.16 | 0.88 | [0.70–1.35] | 0.92 | 0.08 | 0.38 | [0.78–1.10] |
| Neighborhood factors | ||||||||||||
| Socioeconomic disadvantage | 1.18 | 0.05 | <0.0001 | [1.08–1.30] | 1.48 | 0.11 | <0.0001 | [1.28–1.70] | 1.40 | 0.05 | <0.0001 | [1.30–1.51] |
| % Black | 1.00 | 0.00 | 0.75 | [0.99–1.00] | 1.01 | 0.00 | 0.08 | [1.00–1.01] | 1.01 | 0.00 | <0.0001 | [1.01–1.02] |
| % Hispanic | 1.00 | 0.00 | 0.48 | [0.99–1.00] | 1.00 | 0.00 | 0.08 | [1.00–1.01] | 1.00 | 0.00 | 0.02 | [1.00–1.01] |
| M:F ratio | 0.80 | 0.14 | 0.22 | [0.56–1.14] | 0.86 | 0.27 | 0.63 | [0.47–1.58] | 0.62 | 0.10 | 0.003 | [0.46–0.85] |
| Constant | 0.18 | 0.05 | <0.0001 | [0.11–0.30] | 0.10 | 0.04 | <0.0001 | [0.04–0.22] | 1.11 | 0.24 | 0.64 | [0.73–1.69] |
Firearm ownership is associated with an increased risk of firearm suicide exposure (OR = 1.24, 95% CI: 1.08–1.42, p = 0.002) and hearing shots in one’s neighborhood (OR = 1.20, 95% CI: 1.05–1.36, p = 0.006) but decreased risk of knowing someone else who has been shot (OR = 0.83, 95% CI: 0.70–0.99, p = 0.042). High frequency of firearm carrying in public is associated with all types of GVE, particularly being threatened (OR = 3.69, 95% CI: 2.83–4.82, p < 0.0001) and shot (OR = 3.35, 95% CI: 1.64–6.86, p = 0.001). Those in the military/Veterans have a greater risk of firearm suicide exposure (OR = 1.21, 95% CI: 1.02–1.45, p = 0.032), being threatened (OR = 1.42, 95% CI: 1.16–1.74, p = 0.001), and having been shot (OR = 3.23, 95% CI: 2.01–5.18, p < 0.0001). Neighborhood socioeconomic disadvantage is consistently associated with all types of GVE with results ranging from OR = 1.18, 95% CI: 1.08–1.30, p < 0.0001 for knowing someone who has been shot to OR = 1.56, 95% CI: 1.15–2.12, p = 0.004 for being shot.
Table 5 depicts results related to in-person cumulative GVE, echoing the individual exposure findings. Being Black (beta [β] = 0.29, 95% CI: 0.17–0.41, p < 0.0001) and Hispanic (β = 0.13, 95% CI: 0.03–0.24, p = 0.018) is associated with greater cumulative exposure—these disparities are visualized as linear predicted margins in Supplementary Fig. S1. However, racial/ethnic group membership is not associated with greater risk of high exposure of three or more GVE types. Being female is associated with lower cumulative exposure (β = −0.17, 95% CI: −0.23 to −0.11) and risk of high exposure. Firearm ownership has a small association with cumulative exposure (β = 0.07, 95% CI: 0.01–0.14, p = 0.034) and risk for high exposure (OR = 1.25, 95% CI: 1.09–1.43, p = 0.001) while frequently or always carrying a firearm outside of the home is associated with greater cumulative exposure (β = 0.67, 95% CI: 0.53–0.82, p < 0.0001) and high exposure (OR = 2.33, 95% CI: 1.73–3.13, p < 0.0001). Neighborhood socioeconomic disadvantage is associated with both linear cumulative exposure (β = 0.20, 95% CI: 0.16–0.24, p < 0.0001) and risk for high cumulative exposure (OR = 1.41, 95% CI: 1.31–1.52, p < 0.0001).
Table 5.
Individual and neighborhood-level predictors of lifetime cumulative gun violence exposure (N = 7615).
| Cumulative (Linear) |
High Exposure (3+ types) |
|||||||
|---|---|---|---|---|---|---|---|---|
| β | SE | p | 95% CI | OR | SE | p | 95% CI | |
| Race/Ethnicity (ref = White) | ||||||||
| Black | 0.29 | 0.06 | <0.0001 | [0.17–0.41] | 1.15 | 0.12 | 0.20 | [0.93–1.41] |
| Hispanic | 0.13 | 0.05 | 0.018 | [0.03–0.24] | 1.05 | 0.10 | 0.62 | [0.87–1.26] |
| Other | −0.10 | 0.05 | 0.040 | [−0.19 to −0.00] | 0.60 | 0.06 | <0.0001 | [0.49–0.73] |
| Age | 0.00 | 0.00 | 0.015 | [0.00–0.00] | 1.01 | 0.00 | <0.0001 | [1.01–1.01] |
| Female (ref = male) | −0.17 | 0.03 | <0.0001 | [−0.23 to −0.11] | 0.86 | 0.05 | 0.01 | [0.77–0.97] |
| Sexual orientation (ref = heterosexual) | 0.09 | 0.05 | 0.08 | [−0.01 to 0.19] | 1.10 | 0.11 | 0.30 | [0.91–1.33] |
| Household income (ref = <$25 K) | ||||||||
| $25 K–$74,999 | −0.17 | 0.06 | 0.005 | [−0.29 to −0.05] | 0.93 | 0.10 | 0.52 | [0.75–1.15] |
| $75 K–$149,999 | −0.28 | 0.06 | <0.0001 | [−0.39 to −0.16] | 0.81 | 0.09 | 0.06 | [0.66–1.01] |
| $150 K+ | −0.29 | 0.06 | <0.0001 | [−0.41 to −0.17] | 0.80 | 0.09 | 0.048 | [0.64–1.00] |
| Region (ref = Northeast) | ||||||||
| Midwest | 0.17 | 0.04 | <0.0001 | [0.09–0.26] | 1.45 | 0.12 | <0.0001 | [1.22–1.71] |
| South | 0.19 | 0.04 | <0.0001 | [0.11–0.26] | 1.64 | 0.13 | <0.0001 | [1.41–1.92] |
| West | 0.25 | 0.04 | <0.0001 | [0.16–0.34] | 1.55 | 0.14 | <0.0001 | [1.31–1.84] |
| Firearm owner (ref = no) | 0.07 | 0.03 | 0.034 | [0.01–0.14] | 1.25 | 0.09 | 0.001 | [1.09–1.43] |
| Firearm carry (ref = never/non-owner) | ||||||||
| Rarely/sometimes | 0.34 | 0.05 | <0.0001 | [0.23–0.45] | 1.29 | 0.13 | 0.01 | [1.06–1.59] |
| Frequently/almost always/always | 0.67 | 0.07 | <0.0001 | [0.53–0.82] | 2.33 | 0.35 | <0.0001 | [1.73–3.13] |
| Current military/Veteran (ref = no) | 0.13 | 0.05 | 0.018 | [0.02–0.23] | 1.10 | 0.11 | 0.33 | [0.91–1.33] |
| Neighborhood factors | ||||||||
| Socioeconomic disadvantage | 0.20 | 0.02 | <0.0001 | [0.16–0.24] | 1.41 | 0.05 | <0.0001 | [1.31–1.52] |
| % Black | 0.00 | 0.00 | 0.044 | [0.00–0.00] | 1.00 | 0.00 | 0.17 | [1.00–1.01] |
| % Hispanic | −0.21 | 0.09 | 0.01 | [−0.38 to −0.04] | 1.00 | 0.00 | 0.82 | [1.00–1.00] |
| M:F ratio | 0.00 | 0.00 | 0.43 | [−0.00 to 0.00] | 0.63 | 0.10 | 0.004 | [0.46–0.87] |
| Constant | 1.25 | 0.12 | <0.0001 | [1.01–1.48] | 1.35 | 0.30 | 0.18 | [0.87–2.10] |
Table 6 and Table 7 depict the results for all media GVE outcomes. Black adults are more likely to experience higher exposure to local gun violence (OR = 1.46, 95% CI: 1.16–1.83, p = 0.001) and gun violence outside their communities (OR = 1.38, 95% CI: 1.14–1.68, p = 0.001) on social media. Relatedly, identifying as Black is associated with greater cumulative exposure to media GVE (β = 0.18, 95% CI: 0.05–0.31, p = 0.007) and consistently high media exposure across all contexts (OR = 1.57, 95% CI: 1.20–2.05, p = 0.001). See Supplementary Fig. S2 for a visual representation of these disparities as linear predicted margins. Being female is uniformly associated with greater media GVE, including cumulative exposure (β = 0.15, 95% CI: 0.08–0.21, p < 0.0001) and consistently high media exposure (OR = 1.35, 95% CI: 1.14–1.60, p < 0.0001). Frequently carrying a firearm outside of the home is associated with numerous outcomes including greater cumulative media GVE (β = 0.24, 95% CI: 0.09–0.38, p = 0.002) and risk of consistently high media exposure (OR = 1.79, 95% CI: 1.29–2.49, p < 0.0001).
Table 6.
Individual and neighborhood-level predictors of media gun violence exposure (N = 7588).
| Local: Traditional |
Local: Social |
Outside: Traditional |
Outside: Social |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | SE | p | 95% CI | OR | SE | p | 95% CI | OR | SE | p | 95% CI | OR | SE | p | 95% CI | |
| Race/Ethnicity (ref = White) | ||||||||||||||||
| Black | 1.19 | 0.12 | 0.09 | [0.97–1.45] | 1.46 | 0.17 | 0.001 | [1.16–1.83] | 1.07 | 0.11 | 0.51 | [0.88–1.30] | 1.38 | 0.14 | 0.001 | [1.14–1.68] |
| Hispanic | 1.03 | 0.10 | 0.71 | [0.86–1.24] | 1.15 | 0.13 | 0.20 | [0.93–1.42] | 0.84 | 0.07 | 0.05 | [0.70–1.00] | 1.19 | 0.11 | 0.06 | [1.00–1.43] |
| Other | 0.80 | 0.09 | 0.06 | [0.64–1.01] | 1.41 | 0.19 | 0.01 | [1.07–1.84] | 0.59 | 0.06 | <0.0001 | [0.48–0.72] | 1.13 | 0.12 | 0.26 | [0.91–1.39] |
| Age | 1.01 | 0.00 | <0.0001 | [1.01–1.01] | 0.99 | 0.00 | <0.0001 | [0.99–1.00] | 1.02 | 0.00 | <0.0001 | [1.01–1.02] | 0.99 | 0.00 | <0.0001 | [0.98–0.99] |
| Female (ref = male) | 1.17 | 0.07 | 0.006 | [1.04–1.30] | 1.37 | 0.10 | <0.0001 | [1.19–1.58] | 1.13 | 0.06 | 0.02 | [1.02–1.26] | 1.28 | 0.07 | <0.0001 | [1.14–1.43] |
| Sexual orientation (ref = heterosexual) | 1.16 | 0.10 | 0.094 | [0.97–1.39] | 1.23 | 0.13 | 0.053 | [1.00–1.51] | 1.18 | 0.10 | 0.06 | [1.00–1.40] | 1.16 | 0.10 | 0.10 | [0.97–1.38] |
| Household income (ref = <$25 K) | ||||||||||||||||
| $25 K–$74,999 | 0.85 | 0.08 | 0.09 | [0.69–1.03] | 0.80 | 0.09 | 0.05 | [0.65–1.00] | 1.07 | 0.10 | 0.51 | [0.88–1.29] | 0.90 | 0.09 | 0.31 | [0.74–1.10] |
| $75 K–$149,999 | 0.83 | 0.08 | 0.07 | [0.68–1.01] | 0.71 | 0.08 | 0.003 | [0.57–0.89] | 1.22 | 0.12 | 0.04 | [1.01–1.47] | 0.97 | 0.10 | 0.79 | [0.80–1.18] |
| $150 K+ | 0.90 | 0.10 | 0.33 | [0.73–1.11] | 0.70 | 0.09 | 0.004 | [0.54–0.89] | 1.34 | 0.14 | 0.005 | [1.09–1.64] | 1.03 | 0.11 | 0.75 | [0.84–1.27] |
| Region (ref = Northeast) | ||||||||||||||||
| Midwest | 1.65 | 0.15 | <0.0001 | [1.39–1.96] | 1.51 | 0.17 | <0.0001 | [1.21–1.89] | 1.17 | 0.10 | 0.06 | [1.00–1.38] | 0.94 | 0.08 | 0.49 | [0.80–1.12] |
| South | 1.32 | 0.11 | <0.0001 | [1.12–1.55] | 1.20 | 0.12 | 0.08 | [0.98–1.47] | 1.03 | 0.08 | 0.69 | [0.89–1.20] | 0.95 | 0.07 | 0.48 | [0.81–1.10] |
| West | 1.23 | 0.11 | 0.021 | [1.03–1.48] | 1.17 | 0.14 | 0.18 | [0.93–1.47] | 1.04 | 0.09 | 0.67 | [0.88–1.23] | 0.88 | 0.08 | 0.14 | [0.74–1.04] |
| Firearm owner (ref = no) | 0.91 | 0.06 | 0.19 | [0.80–1.05] | 0.92 | 0.08 | 0.38 | [0.77–1.10] | 0.89 | 0.06 | 0.09 | [0.78–1.02] | 0.99 | 0.07 | 0.85 | [0.86–1.13] |
| Firearm carry (ref = never/non-owner) | ||||||||||||||||
| Rarely/sometimes | 0.98 | 0.09 | 0.85 | [0.81–1.19] | 1.18 | 0.15 | 0.19 | [0.92–1.52] | 1.03 | 0.10 | 0.77 | [0.86–1.23] | 1.21 | 0.12 | 0.05 | [1.00–1.47] |
| Frequently/almost always/always | 1.13 | 0.14 | 0.30 | [0.90–1.43] | 1.63 | 0.23 | 0.001 | [1.23–2.16] | 1.27 | 0.15 | 0.05 | [1.00–1.59] | 1.49 | 0.17 | <0.0001 | [1.19–1.87] |
| Current military/Veteran (ref = no) | 1.08 | 0.10 | 0.37 | [0.91–1.29] | 1.08 | 0.13 | 0.52 | [0.86–1.36] | 1.13 | 0.10 | 0.19 | [0.94–1.34] | 0.98 | 0.09 | 0.86 | [0.82–1.18] |
| Neighborhood factors | ||||||||||||||||
| Socioeconomic disadvantage | 0.88 | 0.03 | <0.0001 | [0.81–0.94] | 1.02 | 0.05 | 0.66 | [0.93–1.12] | 0.92 | 0.03 | 0.03 | [0.86–0.99] | 1.08 | 0.04 | 0.03 | [1.01–1.16] |
| % Black | 1.02 | 0.00 | <0.0001 | [1.01–1.02] | 1.01 | 0.00 | <0.0001 | [1.01–1.02] | 1.00 | 0.00 | 0.14 | [1.00–1.01] | 1.00 | 0.00 | 0.63 | [1.00–1.00] |
| % Hispanic | 1.01 | 0.00 | <0.0001 | [1.01–1.01] | 1.01 | 0.00 | <0.0001 | [1.01–1.02] | 1.00 | 0.00 | 0.02 | [1.00–1.01] | 1.00 | 0.00 | 0.75 | [1.00–1.00] |
| M:F ratio | 1.19 | 0.19 | 0.27 | [0.87–1.62] | 0.88 | 0.17 | 0.51 | [0.60–1.28] | 0.86 | 0.13 | 0.31 | [0.63–1.16] | 0.83 | 0.13 | 0.22 | [0.61–1.12] |
| Constant | 0.14 | 0.03 | <0.0001 | [0.09–0.22] | 0.20 | 0.05 | <0.0001 | [0.12–0.34] | 0.50 | 0.11 | 0.001 | [0.33–0.76] | 0.94 | 0.20 | 0.78 | [0.62–1.44] |
Table 7.
Individual and neighborhood-level predictors of media gun violence exposure (N = 7588).
| Cumulative (Linear) |
Consistently High Media Exposure |
|||||||
|---|---|---|---|---|---|---|---|---|
| β | SE | p | 95% CI | OR | SE | p | 95% CI | |
| Race/Ethnicity (ref = White) | ||||||||
| Black | 0.18 | 0.07 | 0.007 | [0.05–0.31] | 1.57 | 0.21 | <0.0001 | [1.20–2.05] |
| Hispanic | 0.00 | 0.06 | 0.99 | [−0.11 to 0.11] | 1.19 | 0.16 | 0.18 | [0.92–1.55] |
| Other | −0.10 | 0.06 | 0.13 | [−0.22 to 0.03] | 1.16 | 0.21 | 0.42 | [0.81–1.65] |
| Age | 0.00 | 0.00 | 0.02 | [0.00–0.00] | 0.99 | 0.00 | 0.02 | [0.99–1.00] |
| Female (ref = male) | 0.15 | 0.03 | <0.0001 | [0.08–0.21] | 1.35 | 0.12 | <0.0001 | [1.14–1.60] |
| Sexual orientation (ref = heterosexual) | 0.16 | 0.06 | 0.004 | [0.05–0.27] | 1.13 | 0.15 | 0.33 | [0.88–1.46] |
| Household income (ref = <$25 K) | ||||||||
| $25 K–$74,999 | −0.08 | 0.06 | 0.18 | [−0.20 to 0.04] | 0.84 | 0.12 | 0.22 | [0.65–1.11] |
| $75 K–$149,999 | −0.05 | 0.06 | 0.40 | [−0.17 to 0.07] | 0.79 | 0.11 | 0.09 | [0.60–1.04] |
| $150 K+ | −0.02 | 0.06 | 0.80 | [−0.14 to 0.11] | 0.92 | 0.14 | 0.60 | [0.69–1.24] |
| Region (ref = Northeast) | ||||||||
| Midwest | 0.19 | 0.05 | <0.0001 | [0.10–0.29] | 1.48 | 0.21 | 0.006 | [1.12–1.95] |
| South | 0.06 | 0.05 | 0.19 | [−0.03 to 0.15] | 1.32 | 0.17 | 0.03 | [1.03–1.71] |
| West | 0.04 | 0.05 | 0.37 | [−0.05 to 0.14] | 1.26 | 0.18 | 0.11 | [0.95–1.68] |
| Firearm owner (ref = no) | −0.05 | 0.04 | 0.19 | [−0.13 to 0.03] | 0.95 | 0.11 | 0.65 | [0.77–1.18] |
| Firearm carry (ref = never/non-owner) | ||||||||
| Rarely/sometimes | 0.05 | 0.06 | 0.35 | [−0.06 to 0.16] | 1.22 | 0.19 | 0.20 | [0.90–1.65] |
| Frequently/almost always/always | 0.24 | 0.07 | 0.002 | [0.09–0.38] | 1.79 | 0.3 | <0.0001 | [1.29–2.49] |
| Current military/Veteran (ref = no) | 0.06 | 0.05 | 0.26 | [−0.04 to 0.16] | 0.81 | 0.12 | 0.15 | [0.60–1.08] |
| Neighborhood factors | ||||||||
| Socioeconomic disadvantage | −0.03 | 0.02 | 0.13 | [−0.08 to 0.01] | 1.00 | 0.06 | 0.96 | [0.90–1.12] |
| % Black | 0.01 | 0.00 | <0.0001 | [0.01–0.01] | 1.01 | 0.00 | <0.0001 | [1.01–1.02] |
| % Hispanic | 0.00 | 0.00 | <0.0001 | [0.00–0.01] | 1.01 | 0.00 | <0.0001 | [1.01–1.02] |
| M:F ratio | 0.00 | 0.09 | 0.97 | [−0.19 to 0.18] | 0.92 | 0.22 | 0.71 | [0.58–1.45] |
| Constant | 1.04 | 0.13 | <0.0001 | [0.79–1.29] | 0.08 | 0.03 | <0.0001 | [0.04–0.15] |
Discussion
In this study, we analyzed the prevalence of in-person and media GVE and associated disparities in a nationally representative US sample of adults. Our findings echo recent polling17 showing that exposure to gun violence is pervasive: in our study, over 60% of US adults have been exposed to at least one form of gun violence in person, nearly one-third have known someone who died by firearm suicide, one-fifth know a family member or friend who has been shot, and nearly one-half have heard gunshots in their neighborhood. Furthermore, the results highlight meaningful racial/ethnic disparities in all exposures, with White adults far more likely than their Black and Hispanic peers to have been exposed to firearm suicide and Black and Hispanic adults much more likely to have been exposed to all other forms of gun violence, including knowing individuals who have been shot and witnessing a shooting.
Our results considered both individual and neighborhood-level factors associated with diverse GVE types and several factors exhibited consistent, robust associations with exposure. Demographically, identifying as Black and Hispanic were associated with greater odds of exposure to all forms of gun violence than their White counterparts other than suicide. Individual household income and neighborhood economic deprivation were both associated with greater odds of GVE, highlighting that disparities in socioeconomic resources—within homes and across neighborhoods—may prompt and sustain violence, increasing the odds that specific communities encounter violence and are thus vulnerable to the physical and emotional costs of such experiences.4, 5, 6 The disproportionate burden of GVE upon Black and Hispanic communities facing individual and community-level economic deprivation is untenable and unjust. Marginalized communities are left to suffer traumatic experiences, bear the physical and emotional consequences of those experiences, and then see their children manage the intergenerational difficulty of rebounding from such inequities.
Frequent firearm carrying was also associated with individual and cumulative GVE. Given our cross-sectional data, it is not possible to determine the direction of this association and multiple possibilities exist. It may be that increased carrying of firearms heightens threat perception and provides greater opportunity for an individual to be involved with and exposed to gun violence.18,19 Alternatively, exposure to GVE might prompt individuals to carry firearms more frequently as a reactive form of self-protection. Recent cross-sectional research suggests that those who experience direct GVE and carry a firearm for protection store their firearms less securely.20 This provides initial evidence that GVE may influence certain firearm behaviors, but longitudinal data are needed to confirm the causal and directional nature of this relationship. Research has demonstrated that, when concealed carry limitations are relaxed, rates of gun violence increase,21 which lends credence to the initial interpretation; however, it remains possible that both interpretations are accurate.
A notable advance relative to prior research was our findings related to GVE via the media. Our results again highlighted substantial racial/ethnic disparities, with Black adults more likely to be exposed to gun violence via social media and cumulative media (traditional and social media), with particularly notable disparities in consistently high media exposure. This finding, alongside our result noting greater in-person GVE among Black adults, emphasizes that Black adults are inundated by experiences of gun violence in their daily lives. Consistent exposure, both in-person and via media, may heighten awareness of future incidents and generate greater vigilance. The impact this can have, not only on the mental and physical health of Black adults and their families, but also potentially on how they relate to, store, and carry firearms as a means of mitigating risk, are profound. Indeed, firearm carrying was also a correlate of GVE via media and, although the nature of our data preclude a clear understanding of why this is, it is possible that this association reflects more frequent firearm carrying among Black adults as a response to the risk for GVE within their neighborhood, especially if there is a sense that law enforcement is unwilling or unable to keep them safe.22
A somewhat surprising result was that female respondents reported far greater GVE via media across all contexts. This is in stark contrast to the higher prevalence of in-person exposure among men. It is unclear what specific media sources were typically consumed by female and male participants in this sample and, as such, it is difficult to know whether this finding reflects a simple difference in level of media consumption or if those who identify as female are more exposed to different media sources likely to include information on gun violence. Although men are much more likely to be direct victims of gun violence, women including mothers and intimate partners bear the greater brunt of indirect exposure,23 including via the news and online. It remains unclear to what extent the effects of media GVE on physical and mental health mirror those of in-person exposure,2, 3, 4, 5, 6, 7, 8 but this question is necessary to consider in future research aiming to help mitigate the downstream impacts of GVE.
This study was not without limitations. First, our cross-sectional data preclude determination of causality in the relationships between the variables in our models. Second, although we considered variations by racial/ethnic identity, data limitations restricted our analyses of disparities to White, Black, and Hispanic respondents. Future studies should assess GVE disparities among other racial and ethnic groups (e.g., Indigenous, Asian, mixed identity) where possible. We also encourage researchers to consider additional neighborhood-level measures to capture important aspects of residential segregation, discrimination threat, and racial inequality that may influence individual and collective GVE.24 Third, our results rely on survey responses with potential for self-report bias in the findings. Future research should consider integrating tract-level crime data with self-report indices of GVE to address potential bias and provide comparisons between victimization, offending, and firearm behaviors in local neighborhoods. Finally, although our sample leveraged probability-based sampling to optimize generalizability to all US adults, our ability to capture incarcerated and other difficult-to-reach populations was limited. Additional work is needed to understand GVE particularly among these vulnerable groups.
Despite these limitations, the findings from this study illustrate the pervasive nature of GVE and disparities across racial/ethnic and economic lines. Our study shows that racial/ethnic disparities are consistent across in-person and media GVE, particularly burdening Black and Hispanic Americans across a wide array of exposure outcomes. Research shows the broad mental, physical, and behavioral health impacts of GVE extend beyond primary victimization to secondary (family and friends), tertiary (community exposure), and peripheral exposure (media).2, 3, 4, 5, 6, 7, 8,13,25,26 Given the extent of our findings and the consistency of racial/ethnic and economic disparities across GVE outcomes, greater investment is necessary to reduce gun violence and provide resources to those exposed in order to fully address broader health disparities in the US that have persisted for generations.
In recent years, there has been a concerted effort to address the gun violence as a public health problem, evidenced by the 2024 Surgeon General’s advisory,1 the creation (and subsequent shuttering by the Trump administration) of a federal Office of Gun Violence Prevention at the White House, and enhanced federal funding to support community violence intervention and gun violence research.27 We must continue to build upon this progress with the knowledge that GVE and its associated disparities are extensive. Progress necessitates ongoing and structural investment in services for victims across types of exposure both within and adjacent to traditional healthcare systems through hospital-based violence intervention programs, trauma recovery centers, and community-based health resources.28, 29, 30 Our study underscores that a comprehensive and collaborative approach is vital to addressing significant disparities in gun violence exposure not only as a means of improving public safety, but also as an imperative for health equity and social justice.
Contributors
DS: conceptualization, formal analysis, investigation, methodology, project administration, supervision, writing–original draft, writing–reviewing and editing.
KB: conceptualization, writing–original draft, writing–reviewing and editing.
DZ: conceptualization, writing–original draft, writing–reviewing and editing.
BS: conceptualization, writing–original draft, writing–reviewing and editing.
MA: conceptualization, investigation, methodology, supervision, writing–original draft, writing–reviewing and editing.
RS: conceptualization, writing–reviewing and editing, supervision.
DS, KB, MA, and RS had full access to all the data in the study. DS is responsible for the decision to submit this manuscript for publication.
Data sharing statement
Deidentified participant data and a data dictionary from this study will be made available upon individual request to the authors with publication of this study. Additional documents including a statistical analysis plan, informed consent form, and analytic code can be made available upon individual request to the authors with publication of this study as well. Individual data requests can be made on a case-by-case basis to daniel.semenza@rutgers.edu and materials will be provided after approval of a proposal and signed data access agreement.
Declaration of interests
All authors (DS, KB, DZ, BS, MA, and RS) were supported by the New Jersey Gun Violence Research Center in this study. The New Jersey Gun Violence Research Center receives general funding from the Office of the Secretary of Higher Education in New Jersey to operate, but no funding was specifically received for this particular study. However, the general funding received was used to pay for data collection from the survey reported herein.
Acknowledgements
The New Jersey Gun Violence Research Center receives general funding from the Office of the Secretary of Higher Education in New Jersey to operate, but no funding was specifically received for this particular study. However, the general funding received was used to pay for data collection from the survey reported herein.
Footnotes
Supplementary data related to this article can be found at https://doi.org/10.1016/j.lana.2025.101101.
Appendix ASupplementary data
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