Geo-demographic analysis revealed that both GSW incident locations and patient home addresses are spatially clustered in predominantly poor, black neighborhoods near downtown Miami, and that these patterns persisted throughout the study period. Using spatial regression, we observed that census tract-level GSW incidence rates (coded by home address) were associated with a census tract’s proportion of black residents (P < .001), single-parent households (P < .001), and median age (P < .001) (R 2 = .42).
As was true in Philadelphia, the neighborhoods with high proportions of blacks have significantly higher rates of morbidity and mortality from gunshot wounds. This has the effect, of course, of contributing to significantly higher rate of incarceration among young black men, as I discussed last month. But it more importantly speaks to deep structural issues within these communities that are not currently being addressed.
As previously mentioned, race and neighborhood are interconnected within MDC, and this racial segregation is due to a history of racially-charged policies that have exacerbated violence. The persistent clustering of firearm-injury over the study period shows an alarming lack of community and political engagement and gun control policies that might normally contribute to some geographical variation in gun violence patterns, and ultimately a reduction in mortality. Such inaction in the face of well-documented need arguably perpetuates a history of institutionalized racism in Miami. Our findings thus represent a call for urgent intervention that must address key risk factors in a very small area of MDC. Such interventions could have a significant public health impact on interrupting this epidemic of gun violence and serve as a model for other cities.