Background: More than 71,000 people are non-fatally injured by firearms annually in the US and forced to deal with the aftermath and sequela of surviving a gunshot wound (GSW). The social determinants of health (SDOH) needs in this vulnerable population are poorly understood, particularly at the time of discharge. Following up with healthcare providers after discharge has also been notoriously difficult for these patients, contributing to this lack of knowledge. This study aims to assess the SDOH needs of GSW survivors to better understand the specific challenges these patients may face during their post-discharge rehabilitation.
Methods: GSW survivors admitted to a Level 1 trauma center were surveyed in-hospital regarding SDOH including insurance status, primary care utilization, cellular access, transportation, personal finances, safe housing, and mental health.
Results: One hundred patients were surveyed. The majority were male (81%), identified as Black or African American (83%), and were publicly insured (75%). Most patients had a cellphone (95%) and reliable Wi-Fi (91.1%). 39.6% of patients reported having a primary care provider, and of those, 25% had not seen their provider within the last year. 27% of patients reported they did not have access to mental health services post-discharge. Most patients (82%) had their own car. More than one-third (37%) of patients said they did not plan to return to their current living situation, with 13.9% of those reporting that they did not have a safe place to go. Half of the patients were unemployed and 46.5% stated that they did not have enough money to support themselves post-injury until they could return to work. Most patients did not know what assistance services they qualified for (80%) or how to access them (73%).
Conclusions: This study highlights the myriad of SDOH factors that can hinder the recovery of GSW survivors after discharge. Addressing these obstacles requires systemic change focused on providing extensive social support to these patients, a solution that comes with its own set of challenges. However, this study also showcases opportunities to improve health outcomes in this population through institutional interventions on a smaller, more accessible scale. Screening GSW survivors for SDOH needs and providing them with resources to access various social services could be a potential first step.