Background: We collected detailed activity paths of urban youth to investigate the dynamic interplay between their lived experiences, time spent in different environments, and risk of violent assault.
Methods: We mapped activity paths of 10- to 24-year-olds, including 143 assault patients shot with a firearm, 206 assault patients injured with other types of weapons, and 283 community controls, creating a step-by-step mapped record of how, when, where, and with whom they spent time over a full day from waking up until going to bed or being assaulted. Case–control analyses compared cases with time-matched controls to identify risk factors for assault. Case-crossover analyses compared cases at the time of assault with themselves earlier in the day to investigate whether exposure increases acted to the trigger assault.
Results: Gunshot assault risks included being alone (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.3, 1.9) and were lower in areas with high neighbor connectedness (OR = 0.7, 95% CI = 0.6, 0.8). Acquiring a gun (OR = 1.4, 95% CI = 1.1, 1.6) and entering areas with more vacancy, violence, and vandalism (OR = 1.7, 95% CI = 1.1, 2.7) appeared to trigger the risk of getting shot shortly thereafter. Nongunshot assault risks included being in areas with recreation centers (OR = 1.2, 95% CI = 1.1, 1.4). Entering an area with higher truancy (OR = 1.6, 95% CI = 1.1, 2.5) and more vacancy, violence, and vandalism appeared to trigger the risk of nongunshot assault. Risks varied by age group.
Conclusions: We achieved a large-scale study of the activities of many boys, adolescents, and young men that systematically documented their experiences and empirically quantified risks for violence. Working at a temporal and spatial scale that is relevant to the dynamics of this phenomenon gave novel insights into triggers for violent assault.
From the aDepartment of Biostatistics and Epidemiology, Perelman School of Medicine, bDepartment of Biobehavioral and Health Sciences, School of Nursing, cDepartment of Sociology, School of Arts and Sciences, dDepartment of Emergency Medicine, Perelman School of Medicine, e Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA; and fDepartment of Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA.
Editor's Note: A Commentary on this article appears on page 29.
Submitted 18 January 2015; accepted 16 September 2015.
Supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; R01AA014944, K02AA017974).
The authors report no conflicts of interest.
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Correspondence: Douglas J. Wiebe, Department of Biostatistics and Epidemiology, Perelman School of Medicine, 423 Guardian Drive, Blockley Hall Room 902, Philadelphia, PA 19104. E-mail: dwiebe@upenn.edu.
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