TABLE. Rates of ED visits for firearm injuries* in medium and high social vulnerability areas compared with rates in low social vulnerability areas^† — FASTER program, 10 U.S. jurisdictions,^§ 2018–2021.

SVI themes	SVI tertile (vulnerability level), RR¶ (95% CI)
	1 (Low)**	2 (Medium)	3 (High)
Overall	Ref	1.34 (1.22–1.47)	1.80 (1.50–2.16)
Socioeconomic status	Ref	1.27 (1.15–1.39)	1.61 (1.33–1.94)
Percentage of persons living below poverty	Ref	1.40 (1.27–1.53)	1.95 (1.62–2.34)
Percentage of persons unemployed	Ref	1.18 (1.07–1.30)	1.39 (1.15–1.68)
Per capita income††	Ref	1.15 (1.04–1.26)	1.31 (1.09–1.59)
Percentage of persons aged ≥25 yrs with no HS diploma	Ref	1.20 (1.08–1.32)	1.43 (1.18–1.74)
Household composition and disability status	Ref	1.02 (0.93–1.12)	1.05 (0.86–1.26)
Percentage of persons aged ≥65 yrs	Ref	0.89 (0.81–0.98)	0.80 (0.66–0.97)
Percentage of persons aged <18 yrs	Ref	1.07 (0.97–1.18)	1.14 (0.94–1.39)
Percentage of persons living with a disability	Ref	1.10 (0.99–1.21)	1.20 (0.99–1.46)
Percentage of households with single parents and children	Ref	1.18 (1.07–1.29)	1.39 (1.15–1.67)
Racial and ethnic minority status and language proficiency	Ref	1.08 (0.97–1.20)	1.17 (0.94–1.44)
Percentage of racial and ethnic minority residents	Ref	1.25 (1.13–1.37)	1.55 (1.28–1.89)
Percentage of persons with limited English proficiency	Ref	0.97 (0.88–1.08)	0.94 (0.77–1.16)
Housing type and transportation	Ref	1.32 (1.21–1.45)	1.75 (1.45–2.11)
Percentage of housing structures with ≥10 units	Ref	1.00 (0.91–1.11)	1.00 (0.82–1.22)
Percentage of housing units that are mobile home units	Ref	0.92 (0.83–1.01)	0.84 (0.70–1.03)
Percentage of households with more persons than rooms	Ref	1.06 (0.96–1.17)	1.12 (0.92–1.37)
Percentage of households with no vehicle access	Ref	1.10 (1.01–1.20)	1.21 (1.01–1.45)
Percentage of persons living in group quarters	Ref	1.20 (1.09–1.32)	1.45 (1.20–1.75)

Abbreviations: ATSDR = Agency for Toxic Substances and Disease Registry; ED = emergency department; FASTER = Firearm Injury Surveillance Through Emergency Rooms; HS = high school; NSSP = National Syndromic Surveillance Program; Ref = referent group; RR = rate ratio; SVI = social vulnerability index.

* Defined using CDC’s syndrome definition based on a combination of discharge diagnosis codes and chief complaint terms identifying initial encounters for a firearm injury, including those classified as unintentional, intentional self-harm, assault, legal intervention, terrorism, and undetermined intent.

^† County-level social vulnerability data were obtained from the 2018 CDC/ATSDR SVI. Counties were categorized into groups (low, medium, high) of social vulnerability for the overall SVI, its four themes, and the individual indicators comprising each SVI theme based on tertile distributions across the counties. Higher values of the overall SVI, SVI themes, and SVI indicators represent greater levels of social vulnerability.

^§ The 10 FASTER-funded jurisdictions were District of Columbia, Florida, Georgia, New Mexico, North Carolina, Oregon, Utah, Virginia, Washington, and West Virginia. Data from these jurisdictions were shared with CDC’s NSSP (accessed March 16, 2022). Among 652 counties with facilities sharing data with NSSP in the 10 jurisdictions, 647 (99%) had data on the SVI and at least one ED visit and were included in rate calculations.

^¶ Rates of firearm injury ED visits (number of ED visits for firearm injuries per 100,000 ED visits) for each level of county social vulnerability were calculated. Negative binomial regression models including fixed effects for jurisdictions were fit to estimate RRs and associated 95% CIs comparing rates among high and medium social vulnerability counties with those in low social vulnerability counties across the overall SVI, separate SVI themes, and individual SVI indicators.

** Referent group was low social vulnerability areas.

^†† Per capita income was reverse-coded.