Social determinants of health are linked to gun homicide rates

December 17, 2019

Gun homicide rates in the US are associated with several social determinants of health, including income inequality, government welfare spending, trust in institutions, and social mobility, according to a new study published December 17 in the open-access journal PLOS Medicine by Daniel Kim from Northeastern University in Boston, Massachussetts.

Gun violence is a major contributor to the life expectancy of Americans, and better knowledge about its root causes is crucial for prevention. Yet no previous studies have comprehensively investigated and compared major area-level social determinants of health as possible drivers of firearm homicides and mass shootings. To address this knowledge gap, Kim used the latest location-linked gun homicide incident data from the US in 2015 to explore and compare the independent associations of key state-, county-, and neighborhood-level social determinants of health with neighborhood gun homicides and mass shootings in the United States. State firearm laws and other state, county, and neighborhood (census tract [CT]) characteristics were also taken into account. The study population consisted of all 74,134 CTs as defined for the 2010 Census in the 48 states of the contiguous US. The analyses were based on 13,060 firearm-related deaths reported in 2015.

Higher levels of trust in institutions (including the government, media, and corporations) by citizens at the county level were linked to a 19% reduction in the gun homicide rate and a 17% decrease in the total number of gun homicide incidents at the neighborhood level. County levels of social mobility, the ability to climb the socioeconomic ladder, were related to a 25% reduction in the gun homicide rate and a 24% decrease in the total number of gun homicide incidents. Increases in the neighborhood percentages of residents in poverty and males living alone were associated with 26-27% and 12% higher neighborhood gun homicide rates, respectively. One limitation of the study was the lack of disaggregation of gun homicide data by factors such as race and gender.

Taken together, this study shows that the rich-poor gap, levels of citizens' trust in institutions, social mobility, and welfare spending may be related to neighborhood firearm homicide rates in the US. According to Kim, further establishing the cause-and-effect nature of these associations and modifying these social determinants may help to address the growing gun violence epidemic and reverse recent downward trends in life expectancy among Americans.
Research Article


The author received no specific funding for this work.

Competing Interests:

The author has declared that no competing interests exist.


Kim D (2019) Social determinants of health in relation to firearm-related homicides in the United States: A nationwide multilevel cross-sectional study. PLoS Med 16(12): e1002978.

Image Credit: Botana, Pixabay

Image Credit: Daniel Kim, pmed.1002978

Author Affiliations:

Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, United States of America

In your coverage please use this URL to provide access to the freely available paper:


Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to