Firearm possession among emergency department youth and young adults: A latent class analysis

Introduction: Firearm injuries are a leading cause of death for youth/young-adults. We utilized latent class analysis to identify distinct motivational/behavioral patterns of firearm possession in a youth/young-adult emergency department sample to inform prevention strategies. Methods: Cross-sectional data were obtained from surveys conducted among youth/young-adults (age = 16–29; n = 1311) seeking emergency department treatment (7/10/2017–6/25/2018). Latent class analysis was performed for individuals reporting firearm possession (n = 223) using five variables: carriage frequency, social carriage, risky firearm behaviors, ownership/carriage for protection, and recreational ownership/carriage. Descriptive statistics were examined. Results: In this sample, 17.0 % reported having firearms (age-22.7; 48.0 %-male; 49.3 %-Black; 52.5 %-public assistance). Latent class analysis identified four classes: 1-recreational possession (n = 51); 2-possession for protection with low carriage (n = 60); 3-carriage for protection with low risky firearm behaviors (n = 76); and 4-carriage for protection with high risky firearm behaviors (n = 36). Class-1 (recreational possession) had low firearm victimization, violence exposure, and community violence. This class primarily kept long-guns with secure storage patterns. Class-2 (protection with low carriage) were mostly female youth/young-adults with children and reported moderately high rates of violence exposure. Nearly 20 % stored their firearm unlocked. Class-3 and -4 endorsed firearm carriage for protection, with Class-4 also engaging in risky firearm behaviors. Both classes had high violence exposure; however, Class-4 had higher risk profiles including higher marijuana misuse, mental health symptoms, and firearm victimization. Conclusions: Among an emergency department sample, four distinct firearm possession classes emerged with different risk levels. Understanding firearm behaviors and risk/protective factors is critical to tailoring healthcare-focused interventions to address individual needs and reduce injury risk.