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Research ArticleOriginal Research

Emergence of Gun Violence as a Patient Priority

E. Marshall Brooks, Sebastian T. Tong, Alex H. Krist and Anton J. Kuzel
The Journal of the American Board of Family Medicine August 2022, jabfm.2022.AP.210283; DOI: https://doi.org/10.3122/jabfm.2022.AP.210283
E. Marshall Brooks
From Virginia Commonwealth University (EMB, AHK, AJK); University of Washington (STT).
PhD
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Sebastian T. Tong
From Virginia Commonwealth University (EMB, AHK, AJK); University of Washington (STT).
MD, MPH
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Alex H. Krist
From Virginia Commonwealth University (EMB, AHK, AJK); University of Washington (STT).
MD, MPH
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Anton J. Kuzel
From Virginia Commonwealth University (EMB, AHK, AJK); University of Washington (STT).
MD, MHPE
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Article Figures & Data

Tables

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    Table 1.

    Demographic and Socioeconomic Characteristics of Patient Sample Interviewed on Experiences of Community-Level Factors Influencing Health, January–April 2018

    CharacteristicPatients (n = 19)
    Median age at time of study52.0
    Race and ethnicityN (%)
        Non-Hispanic Black or African American19 (100)
        Non-Hispanic White0 (0)
        Non-Hispanic Other0 (0)
        Hispanic/Latino, any race0 (0)
    Women9 (47)
    Insurance status
        Commercial0 (0)
        Medicaid14 (74)
        Medicare4 (21)
        Uninsured1 (5)
    Unemployed9 (47)
    Live in area with greater than average poverty rate19 (100)
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    Table 2.

    Findings About the Effect of Living in Areas with Gun Violence From Interviews on Experiences of Community-Level Factors Influencing Health January–April 2018

    ThemeKey FindingsIllustrative Quotes
    Chronic trauma experienceFeeling chronically unsafe in community“Basically, I don't feel safe where I'm living.” (Participant 3)
    General sense of insecurity and danger“Back in the day, you can walk down the street, you can sit on your porch and go to sleep. Now, you scared to even sit on your porch, scared you gonna get hit by a bullet or something.” (Participant 7)
    “I don't go outside at night. I mean, it ain't safe in daytime no more, neither. It's just crazy, all this crazy shooting going on. It's terrible.” (Participant 16)
    “You wanna at least feel safe where you live at. Where I used to live at, I was used to sitting outdoors on the porch or on the back or on the front. You know, I liked my neighbors and everything. It was very nice. And then when I moved here, it was completely different. I have to ask people to move from off my porch ‘cause they'll be on my porch doing things they shouldn't be doing, or there a crowd of people on the side of my house.” (Participant 10)
    “If I walk down the street, if my blood pressure up a little bit and I stagger, they think you drunk. You sit down, and that's the first thing out here in these projects: ‘Oh, he dropped…let's get him.’ And that's a miserable feeling.” (Participant 2)
    Acute trauma experienceWitnessing random acts of gun violence“We was cutting the grass and next thing you know, in front of us, they open fire on this vehicle. They shot a girl right next to where we was cutting. We stopped…hopped off the lawnmowers and we were trying to get away.” (Participant 16)
    Being targeted for gun violence“A little boy, no more than about ten or eleven years old, pulled up on me with a gun and robbed me. I ain't have nothing but some change. They said, ‘Give me what you got in your pockets.’ I had about three, four pennies.” (Participant 2)
    Physical response to traumaPrompts or exacerbates elevated heart rate and blood pressure“Where I live at, it's a whole lot of activity going on, illegal activity, enough to keep your blood pressure up.” (Participant 7)
    “You see somebody running around…you know, running with a gun. I guess they done shot someone or gonna shoot somebody. I mean, then you don't know if they gonna target you or you gonna get hit by accident. I mean, your heartbeat (thumps hand on chest to mimic a racing heartbeat)…” (Participant 13)
    Cognitive response to traumaHypervigilance of environment“You got to worry so much. If you come out and walk to the store, you got to worry about getting robbed or somebody beating you up for no reason ‘cause they prey on the older folks.” (Participant 8)
    Mistrust/paranoia“That's the feeling. Paranoid. You leave from one section, you all right…and you get in another section, you start getting paranoid, you start worrying, watching your back.” (Participant 12)
    Hyperaroused state“They can't shoot worth a damn. So, you know…it's all the innocent people get killed.” (Participant 13)
    “It's kinda eerie ‘cause you always gotta watch your back. Even riding on the bus… A few months ago, somebody got shot on the bus.” (Participant 8)
    “It's mostly young folks killing each other. I might say, ‘Oh, eff you, man.’ Next thing I know, I might get shot just for disrespecting him.” (Participant 2)
    Impact on heart health behaviorRestricts ability to exercise, access food and fill prescriptions“I hate going to the store during the daytime. ‘Cause you know, nowadays they shooting in the daytime. They don't care no more.” (Participant 8)
    Prompts or exacerbates unhealthy coping behaviors“If you're intimidated by what's going on outside, that means that you're reluctant to get out and exercise. And with the things happening out here, people are fearful of getting out to exercise or go to the store to buy something healthy. So, sometimes people just, you know, wanna stay in their homes.” (Participant 3)
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The Journal of the American Board of Family     Medicine: 38 (1)
The Journal of the American Board of Family Medicine
Vol. 38, Issue 1
January-February 2025
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Emergence of Gun Violence as a Patient Priority
E. Marshall Brooks, Sebastian T. Tong, Alex H. Krist, Anton J. Kuzel
The Journal of the American Board of Family Medicine Aug 2022, jabfm.2022.AP.210283; DOI: 10.3122/jabfm.2022.AP.210283

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Emergence of Gun Violence as a Patient Priority
E. Marshall Brooks, Sebastian T. Tong, Alex H. Krist, Anton J. Kuzel
The Journal of the American Board of Family Medicine Aug 2022, jabfm.2022.AP.210283; DOI: 10.3122/jabfm.2022.AP.210283
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Keywords

  • Cardiovascular Diseases
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  • Mental Health
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  • Public Health
  • Qualitative Research
  • Social Determinants of Health
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