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BACKGROUND: U.S. firearm sales surged during the COVID-19 pandemic, with many purchases by first-time firearm owners. The 2023 National Survey of Gun Policy sought to understand the public health implications of this surge by comparing the purchasing motivations and firearm policy views of pandemic-era first-time purchasers to prior gun owners. METHODS: We fielded a nationally representative public opinion survey of U.S. adults (n = 3096) from 1/4/23 to 2/6/23. We oversampled for gun owners and Black, Hispanic, and Asian Americans. Survey weights were applied to generate representative estimates. New gun owners were identified through affirmative responses to: "Have you bought any guns since January 1, 2020?" and "Did you buy your first gun after January 1, 2020?" Recent purchasers were additionally asked whether concerns of 1) political or 2) racial violence motivated their purchase. Purchase motivations and gun policy support were examined among new and prior gun owners (n = 1002) and compared using logistic regression and predictive probabilities. RESULTS: Overall, 11% of respondents reported purchasing a gun since 1/1/20, 35% for the first time. Among recent purchasers, larger proportions of Democrat, Black, Asian, and Hispanic respondents were new gun owners than Republican or white respondents. Compared to prior owners, odds were 4.5-times higher that new gun owners' recent purchase was motivated by racial violence and 3.2-times higher for political violence. Majority support was found for protective gun policies, with few differences by purchase recency or motivations. The only policy for which support by new and prior gun owners differed significantly was the permit-to-purchase policy (76% v. 63%, respectively). Similarly, few significant differences in support were observed when stratifying by purchase motivation. Notably, both those who reported recent purchase motivations of racial violence and of political violence expressed significantly higher support for a "stand-your-ground" policy compared to those who did not report such motivations. CONCLUSIONS: Racial and political violence appear to be larger concerns among new gun owners, motivating purchasing among demographic groups with traditionally lower gun ownership rates. These findings suggest a need for safety assurances amid racial and political tensions and growing gun ownership. Gun owners' support for such policies remains strong.

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Working with data about homicide victims and perpetrators from 50 of America's largest cities, we investigate the explanatory power of some familiar explanations for why murder in those cities rose sharply in 2020. The analysis reveals that the distribution of risk by race was essentially the same in 2020 as in 2019. That empirical finding challenges some theories of how racial tensions after the death of George Floyd may have driven homicide increases. Similarly, homicide growth was not concentrated in those cities with the greatest availability in 2020 of new and older guns, or among the cities that suffered the most from the COVID-19 pandemic. At a minimum, the cross-city outcomes should reduce confidence that some combination of "race, guns, and COVID-19" explains all of the most important aspects of what happened in 2020.

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BACKGROUND: In March 2020, the novel 2019 coronavirus disease (COVID-19) was declared a pandemic. In May 2020, George Floyd was murdered, catalyzing a national racial reckoning. In the Southern United States, these events occurred in the context of a history of racism and high rates of poverty and discrimination, especially among racially and ethnically minoritized populations. OBJECTIVES: In this study, we examine social vulnerabilities, the perceived impacts of COVID-19 and the national racial reckoning, and how these are associated with depression symptoms in the South. METHODS: Data were collected from 961 adults between June and November 2020 as part of an online survey study on family well-being during COVID-19. The sample was majority female (87.2%) and consisted of 661 White participants, 143 Black participants, and 157 other racial and ethnic minoritized participants. Existing social vulnerability, perceived impact of COVID-19 and racial violence and protests on families, and depressive symptoms were assessed. Hierarchical regression analysis was used to predict variance in depressive symptoms. RESULTS: Half of the sample (52%) reported a negative impact of COVID-19, and 66% reported a negative impact of national racial violence/protests. Depressive symptoms were common with 49.8% meeting the cutoff for significant depressive symptoms; Black participants had lower levels of depressive symptoms. Results from the hierarchical regression analysis indicate social vulnerabilities and the perceived negative impact of COVID-19 and racial violence/protests each contribute to variance in depressive symptoms. Race-specific sensitivity analysis clarified distinct patterns in predictors of depressive symptoms. CONCLUSION: People in the South report being negatively impacted by the confluence of the COVID-19 pandemic and the emergence of racial violence/protests in 2020, though patterns differ by racial group. These events, on top of pre-existing social vulnerabilities, help explain depressive symptoms in the South during 2020.

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INTRODUCTION: The impact of racism on patient outcomes in Emergency Medicine has been examined but there have been few studies exploring the experiences of racism in health care workers. This survey aims to explore the experience of racism by interdisciplinary staff in a tertiary ED. By characterizing the staff experience of racism in the ED, we hope to inform the design of strategies to disrupt racism and ultimately improve the health and wellness of both staff and patients. METHODS: We conducted a self-administered, cross-sectional survey to explore the reported experience of racism by healthcare workers in a single urban ED in an academic trauma centre. We employed classification and regression tree analyses to evaluate predictors of racism through an intersectional lens. RESULTS: A majority (n = 200, 75%) of all ED staff reported experiencing interpersonal racism (including physical violence, direct verbal violence, mistreatment and/or microaggressions) in the workplace. Respondents who identified as racialized self-reported significantly more racism at work than white respondents (86% vs. 63%, p < 0.001). Occupation, race, migrant status and age were identified through intersectional machine-learning models to be significantly predictive of the experience of racism. Nearly all respondents felt that the disruption of racism in Emergency medicine is important to them (90%, n = 207) and (93%, n = 214) were willing to participate in further training in anti-racism. CONCLUSIONS: Racism against interdisciplinary staff working in EDs is common and the burden on healthcare workers is high. Intersections of occupation, race, age and migrant status are uniquely predictive of the experience of racism for EM staff. Interventions to disrupt racism should be informed by intersectional considerations to create a safe working environment and target populations most at risk. ED healthcare workers are willing to take steps to disrupt racism in their workplace and need institutional support to do so.

ABSTRAIT: INTRODUCTION: L'impact du racisme sur les résultats des patients en médecine d'urgence a été examiné, mais peu d'études ont exploré les expériences de racisme chez les travailleurs de la santé. Cette enquête vise à explorer l'expérience du racisme par le personnel interdisciplinaire dans un ED tertiaire. En caractérisant l'expérience de racisme du personnel à l'urgence, nous espérons éclairer la conception de stratégies visant à perturber le racisme et, ultimement, à améliorer la santé et le bien-être du personnel et des patients. MéTHODES: Nous avons mené une enquête transversale auto-administrée pour explorer l'expérience signalée de racisme par les travailleurs de la santé dans un seul service d'urgence urbain dans un centre de traumatologie universitaire. Nous avons utilisé des analyses d'arbres de classification et de régression pour évaluer les prédicteurs du racisme dans une optique intersectionnelle. RéSULTATS: La majorité (n = 200, 75 %) de tous les employés de l'urgence ont déclaré avoir été victimes de racisme interpersonnel (y compris de violence physique, de violence verbale directe, de mauvais traitements ou de microagressions) en milieu de travail. Les répondants qui se sont identifiés comme racialisés ont déclaré beaucoup plus de racisme au travail que les répondants blancs (86 % c. 63 %, p < 0,001). La profession, la race, le statut de migrant et l'âge ont été identifiés par des modèles d'apprentissage automatique intersectionnels pour être significativement prédictifs de l'expérience du racisme. Presque tous les répondants étaient d'avis que la perturbation du racisme en médecine d'urgence était importante pour eux (90 %, n = 207) et (93 %, n = 214) étaient disposés à suivre une formation plus poussée en matière de lutte contre le racisme. CONCLUSIONS: Le racisme à l'égard du personnel interdisciplinaire travaillant dans les DEA est courant et le fardeau imposé aux travailleurs de la santé est élevé. Les intersections de la profession, de la race, de l'âge et du statut de migrant sont des prédictions uniques de l'expérience du racisme pour le personnel EM. Les interventions visant à perturber le racisme devraient être fondées sur des considérations intersectionnelles afin de créer un environnement de travail sécuritaire et de cibler les populations les plus à risque. Les travailleurs de la santé ED sont prêts à prendre des mesures pour perturber le racisme dans leur milieu de travail et ont besoin du soutien institutionnel pour le faire.

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Places marred by a legacy of racial violence have contemporary implications for racial and ethnic minorities. However, there is limited work examining how racial and ethnic minorities perceive and navigate these spaces and how they may affect their health. We examine the daily lives of Black residents of St. Louis County, living in what we refer to as a hyperracialized space, or areas characterized by multiple forms of violence, to understand how navigating a hyperracialized space impacts how Black residents negotiate space and make meaning of their health. Qualitative interviews (n = 20) revealed three themes: (1) Whiteness and the maintenance of a hyperracialized space, (2) unspoken rules of police encounters and the embodiment of self-regulation, (3) and hypervigilance. Narratives reveal how individuals and institutions concretize a hyperracialized space through social control. Moreover, participants discussed how their environment influenced how they interacted with and navigated space, the toll of which elicited hypervigilance.

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Scholars have begun to address how exposure to vicarious racial violence influences stress and coping processes among Black families in the U.S. Yet, fewer scholars have considered the importance of racial grief as a component of the coping process. The current study drew upon semi-structured interview data from 31 Black mothers in the U.S. (25-52 years; M age = 35 years) to explore how mothers processed and responded to vicarious anti-Black racial violence. We used consensual qualitative research methods and identified the following themes: (a) recognizing the endemic nature of racial violence, (b) feeling frozen in fear after a new case of racial violence, and (c) transforming grief into grievance as a route to racial justice. The findings contextualize Black mothers' concerns about the racial violence that they and their children might experience during their lifetime, and how they channel this grief into actionable change against racial injustice. Authors discuss strengths-based ways to frame the role of grief and loss in the context of racism.

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In the US, American Indian and Alaskan Native people experience higher rates of violence than all other ethnicities. The purpose of the present research has been to investigate the MMIW crisis, determine the cities with the highest rates of MMIW, and to begin an initial investigation into the root causes for this national crisis. In the present study, missing persons data was analyzed from the National Missing and Unidentified Persons System (NamUs), the National Crime Information Center (NCIC), and from data collected and published in a report produced by the Urban Indian Health Institute (UIHI). Additionally, unidentified persons data was analyzed from NamUs, and data regarding murder cases of indigenous women was analyzed from the UIHI report. Locations with the highest rates of MMIW cases in the country were identified as potential "hot spots". Following the analysis, a total of 23 locations were determined to be "hot spots" for MMIW cases. Of these 23 locations, five were identified as being of the highest priority for intervention due to their disproportionately high rates of MMIW cases. Furthermore, hydraulic fracking across the US seems to be a likely contributing factor in the rate of MMIW cases in nine to 16 of the identified "hot spots". Currently in the US, despite a national movement to raise awareness to the MMIW crisis, there has yet to be any direct actions taken by the federal government to address this issue. The present study has served to identify the primary "hot spots" for MMIW cases and has isolated some key contributing factors to this national problem. In order to most holistically address this issue, actions need to be taken at both the local and federal levels.

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Cross-racial violence is a high-profile issue in the United States; however, there is little empirical research on the epidemiology of cross-racial homicides. The objective of this work was to use national-level data to evaluate the characteristics of homicides in which the victim and suspect are of the same or different race or Hispanic ethnicity. Victims and suspects from National Violent Death Reporting System data (2005-2015) were classified into seven-categories on the basis of race/ethnicity (six non-Hispanic races or Hispanic ethnicity), and 51,454 homicide events were classified as concordant (same race or ethnicity), discordant (different race or ethnicity), or unknown (missing race or ethnicity or no suspect information). While discordancy was observed to be similar across all race and ethnicity groups, it was less likely with relatives, romantic partners, and relatives of romantic partners; less likely to occur at home; less likely to occur in intimate partner violence-related homicides; less likely when the homicide was preceded by an argument over money or property; less likely when the homicide was associated with a family problem; more likely among rival gangs and strangers than other known person relationships; and more likely with drug-involved homicides. There were differences for victims of non-Hispanic Black race. Notably, discordance was more likely for justifiable self-defense and more likely with victim having used a weapon. These results suggest that discordant homicides may follow patterns of peer groups and close relationships in society regardless of victim race/ethnicity, that is, individuals may form closer relationships with individuals of the same race/ethnicity.

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Introdução: O racismo e a intolerância religiosa, configuram-se atualmente como problema de saúde pública em todo o mundo. Constitui-se em um problema social que impacta de maneira significativa o modo de viver, adoecer e morrer de grupos em situação de vulnerabilidade. Objetivo: Analisar as notificações das violências racial e intolerância religiosa no Brasil. Metodologia: Estudo ecológico, tipo série temporal de caráter exploratório com recurso a métodos quantitativos de dados de violência por racismo e intolerância religiosa no Brasil entre 2015 e 2018. Análises foram conduzidas segundo a motivação da violência, as variáveis independentes foram compostas pelas características da vítima, do agressor e da agressão. Para análise multivariada, foi utilizada a regressão de Poisson com variância robusta. Resultados: No período do estudo houve o registro de 1.267 casos de violência interpessoal, sendo 50,3% por racismo e 49,7% por intolerância religiosa. A violência física foi mais prevalente nos casos de intolerância religiosa (58,1%) e a violência psicológica foi prevalente nos casos descritos como racismo (70,3%), com idade compreendida de entre 25 e 59 anos (52,9%), de cor negra, vivendo com companheiro(a). As mulheres com baixo nível de escolaridade, vivendo sozinhas constituem as principais vítimas de violência racial e intolerância. Considerações finais: O racismo e a intolerância desafiam as sociedades marcadas fortemente por exclusão social, comprometendo os indicadores sociais, econômicos da população negra e grupos abandonados, enfrentando maiores obstáculos para conseguir posições de prestígio e de autonomia na sociedade. Os níveis baixos de escolaridade e a pobreza, fragilizam todo o tecido de atenção e proteção no atendimento e compreensão das desigualdades sociais e raciais.

Introduction: Racism and religious intolerance are now a public health problem around the world. It is a social problem that significantly impacts the way of living, getting sick and dying of vulnerable groups. Objective: To analyze the notifications of racial violence and religious intolerance in Brazil. Methodology: Ecological study, type of time series of exploratory character using quantitative methods of data on violence by racism and religious intolerance in Brazil between 2015 and 2018. Analyses were conducted according to the motivation of the violence, the independent variables were composed by the characteristics of the victim, the aggressor and the aggression. For multivariate analysis, Poisson regression with robust variance was used. Results: In the period of the study there were 1,267 cases of interpersonal violence, 50.3% due to racism and 49.7% due to religious intolerance. Physical violence was more prevalent in cases of religious intolerance (58.1%) and psychological violence was more prevalent in cases described as racism (70.3%), with ages ranging from 25 to 59 years (52.9%), black, living with a partner. Women with a low level of education, living alone, are the main victims of racial violence and intolerance. Final considerations: Racism and intolerance challenge societies strongly marked by social exclusion, compromising the social and economic indicators of the black population and abandoned groups, facing greater obstacles to achieve positions of prestige and autonomy in society. Low levels of education and poverty weaken the entire fabric of attention and protection in addressing and understanding social and racial inequalities.

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The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others.

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