# Race/ethnicity on firearm & self-injuries during COVID-19 using TQIP data

## TL;DR

The study found that during the COVID-19 pandemic, certain racial and ethnic groups in the U.S. faced higher rates of assaults and firearm injuries.

## Contribution

The study provides novel insights into how specific racial and ethnic groups were disproportionately affected by trauma-related injuries during the pandemic.

## Key findings

- Assaults and firearm-related injuries increased during the pandemic, especially among Black, American Indian, and Hispanic populations.
- Asian American Pacific Islanders had higher odds of self-inflicted injuries during the pandemic.
- Self-inflicted injury rates modestly declined during the pandemic overall.

## Abstract

The COVID-19 pandemic led to increased assaults, self-inflicted injuries, and firearm-related injuries across the nation, along with increased reports of depression and anxiety worldwide. Our study examines trends in these types of injuries among diverse racial and ethnic groups in the United States during this time.

Data was extracted from the ACS-TQIP database, including patients with assaults, self-inflicted injuries and firearm-related injuries from 2018 to 2021. Pre-COVID period was defined as 2018–2019, and COVID period as 2020–2021. We performed univariable and multivariable logistic regressions to identify associations between injury rates and COVID period, sex, race, and ethnicity.

We identified 417,797 assaults (9.3% of traumas), 57,853 self-inflicted injuries (1.3%) and 208,882 firearm-related injuries (4.7%). Multivariable analysis revealed significant increase in assaults (OR: 1.02, 95% CI: [1.01, 1.03]; p < 0.001) and firearm-related injuries (1.28 [1.27, 1.29]; p < 0.001) and a significant decrease in self-inflicted injuries (0.98 [0.97, 0.99]; p = 0.039) during the COVID period.

Asian American Pacific Islanders (1.06 [1.02–1.10]; p < 0.005), American Indians (3.47 [3.35–3.60]; p < 0.001), Black or African American (5.32 [5.26–5.38]; p < 0.001, other races (1.23 [1.20–1.25]; p < 0.001) and Hispanics (1.71[1.65–1.74]; p < 0.001) had higher odds of assaults during COVID.

Asian American Pacific Islanders (1.12 [1.04–1.20]; p = 0.001) and American Indians (1.23 [1.12–1.35]; p < 0.001 had higher odds of self-inflicted injuries and Hispanic patients had lower odds (0.73 [0.70–0.76]; p < 0.001) during COVID.

American Indians (1.45 [1.36–1.55]; p < 0.001), Black or African Americans (6.42 [6.33–6.52]; p < 0.001), Hispanics (1.46 [1.43–1.50]; p < 0.001) and other races (1.11 [1.08–1.15]; p < 0.001) had higher odds of firearm related injuries during COVID.

The COVID period saw higher odds of assaults, self-inflicted injuries, and firearm-related injuries in certain racial/ethnic minorities. These findings highlight the need for targeted interventions to address the disproportionate impact on racial/ethnic minorities.

•The COVID-19 pandemic was associated with increased assaults and firearm injuries.•Self-inflicted injury rates showed a modest decline during the COVID period.•Black and American Indian patients experienced the greatest injury disparities.•Asian American Pacific Islanders demonstrated elevated self-inflicted injury risk.•Findings underscore the need for targeted, equity-focused trauma interventions.

The COVID-19 pandemic was associated with increased assaults and firearm injuries.

Self-inflicted injury rates showed a modest decline during the COVID period.

Black and American Indian patients experienced the greatest injury disparities.

Asian American Pacific Islanders demonstrated elevated self-inflicted injury risk.

Findings underscore the need for targeted, equity-focused trauma interventions.