123 lines
4.1 KiB
YAML
123 lines
4.1 KiB
YAML
abstract: 'Objective: We aimed to determine whether gentrification predicts the
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movement of shooting victims over time and if this process has decreased
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access to care. Background: Trauma centers remain fixed in space, but
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the populations they serve do not. Nationally, gentrification has
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displaced disadvantaged communities most at risk for violent injury,
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potentially decreasing access to care. This process has not been
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studied, but an increase of only 1 mile from a trauma center increases
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shooting mortality up to 22\%. Methods: We performed a cross-sectional
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study utilizing Philadelphia Police Department (PPD) and Pennsylvania
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trauma systems outcome (PTOS) data 2006-2018. Shootings were mapped and
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grouped into census tracts. They were then cross-mapped with
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gentrification data and hospital location. PPD and PTOS shooting data
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were compared to ensure patients requiring trauma care were captured.
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Census tracts with >= 500 residents with income and median home values
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in the bottom 40th percentile of the metropolitan area were eligible to
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gentrify. Tracts were gentrified if residents >= 25 with a bachelor''s
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degree increased and home price increased to the top third in the
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metropolitan area. Change in distribution of shootings and its relation
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to gentrification was our primary outcome while proximity of shootings
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to a trauma center was our secondary outcome. Results: Thirty-two
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percent (123/379) of eligible tracts gentrified and 31,165 shootings
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were captured in the PPD database. 9090 (29.2\%) patients meeting trauma
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criteria were captured in PTOS with an increasing proportion over time.
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The proportion of shootings within gentrifying tracts significantly
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dropped 2006-2018 (40\%-35\%, P < 0.001) and increased in
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non-gentrifying tracts (52\%-57\%, P < 0.001). In evaluation of shooting
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densities, a predictable redistribution occurred 2006-2018 with incident
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density decreasing in gentrified areas and increasing in non-gentrified
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areas. Shootings within 1 mile of a trauma center increased overall, but
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proportional access decreased in gentrified areas. Conclusions:
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Shootings in Philadelphia predictably moved out of gentrified areas and
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concentrated in non-gentrified ones. In this case study of a national
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crisis, the pattern of change paradoxically resulted in an increased
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clustering of shootings around trauma centers in non-gentrified areas.
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Repetition of this work in other cities can guide future resource
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allocation and be used to improve access to trauma care.'
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affiliation: 'Scantling, D (Corresponding Author), Univ Penn, Dept Surg, Div Traumatol
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Surg Crit Care \& Emergency Surg, Philadelphia, PA 19104 USA.
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Scantling, Dane; Hatchimonji, Justin; Kaufman, Elinore; Holena, Daniel, Univ Penn,
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Dept Surg, Div Traumatol Surg Crit Care \& Emergency Surg, Philadelphia, PA 19104
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USA.
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Orji, Whitney, Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA.'
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author: Scantling, Dane and Orji, Whitney and Hatchimonji, Justin and Kaufman, Elinore
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and Holena, Daniel
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author-email: Dane.Scantling@PennMedicine.UPenn.edu
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author_list:
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- family: Scantling
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given: Dane
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- family: Orji
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given: Whitney
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- family: Hatchimonji
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given: Justin
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- family: Kaufman
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given: Elinore
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- family: Holena
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given: Daniel
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da: '2023-09-28'
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doi: 10.1097/SLA.0000000000004771
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eissn: 1528-1140
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files: []
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issn: 0003-4932
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journal: ANNALS OF SURGERY
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keywords: access to care; firearm violence; gentrification; trauma centers
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keywords-plus: 'EMERGENCY MEDICAL-SERVICES; SELF-RATED HEALTH; RESIDENTIAL-MOBILITY;
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INJURED PATIENTS; TRANSPORT TIMES; UNITED-STATES; NEIGHBORHOOD;
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ASSOCIATION; MORTALITY; OUTCOMES'
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language: English
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month: AUG
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number: '2'
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number-of-cited-references: '45'
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orcid-numbers: Scantling, Dane/0000-0002-0744-9930
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pages: 209-217
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papis_id: 96dea591c2fcd32691833704bbdbc54e
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ref: Scantling2021firearmviolence
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times-cited: '4'
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title: Firearm Violence, Access to Care, and Gentrification A Moving Target for American
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Trauma Systems
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type: article
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unique-id: WOS:000670889700022
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usage-count-last-180-days: '1'
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usage-count-since-2013: '6'
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volume: '274'
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web-of-science-categories: Surgery
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year: '2021'
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