Injuries/Violence
Racial differences in the association of physical disability and healthcare access with firearm violence at the neighborhood level in Chicago, 2011-2023 Bennett Allen* Bennett Allen Allen Allen Allen Allen Department of Population Health, NYU Grossman School of Medicine
Background: Firearm violence remains a public health crisis in the United States, disproportionately affecting racially minoritized and historically disinvested neighborhoods. The relationship between neighborhood-level disability prevalence and healthcare access with firearm violence risk remains poorly understood.
Methods: We conducted an ecological, spatiotemporal analysis of 77 community areas in Chicago from 2011 to 2023. Using Bayesian negative binomial models adjusted for neighborhood economic and demographic covariates, we estimated associations between community-level disability prevalence and healthcare underservice—defined as proportion of land designated as a Medically Underserved Area (MUA)—with annual rates of nonfatal firearm victimizations and firearm homicides. Models were adjusted for income, poverty, and racial/ethnic composition and stratified by neighborhood racial/ethnic plurality.
Results: A 5–percentage point increase in disability prevalence was associated with a 10% higher rate of firearm victimization (95% credible interval [CrI], 3%–18%) and an 11% higher rate of firearm homicide (95% CrI, 2%–22%). A 5–percentage point increase in MUA coverage was associated with a 4% increase in firearm victimization (95% CrI, 2%–6%) and 3% increase in firearm homicide (95% CrI, 2%–5%). In stratified models, disability was most strongly associated with firearm violence in plurality non-Hispanic Black neighborhoods. Associations between MUA coverage and firearm violence were largest in plurality non-Hispanic white and Hispanic neighborhoods.
Conclusions: Neighborhood-level disability and healthcare underservice are significantly associated with firearm violence in Chicago, with differences by racial/ethnic composition. Findings illustrate how disability intersects with racialized social and geographic structures and underscore the need to integrate disability and healthcare access into public health violence prevention frameworks.