Browsing by Author "Corbin, Theodore J."

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    How combinations of state firearm laws link to low firearm suicide and homicide rates: A configurational analysis
    (Elsevier, 2022-12) Rich, John A.; Miech, Edward J.; Semenza, Daniel C.; Corbin, Theodore J.; Medicine, School of Medicine
    Firearm violence, including both homicide and suicide, is a major public health problem in the United States (US). To decrease firearm mortality, US states have implemented laws to restrict firearm availability. We evaluated ten state firearm laws using configurational comparative methods (CCMs) designed to uncover how multiple factors are linked to a given outcome. We applied coincidence analysis, a novel CCM, to ten firearm laws in US states in 2016, to assess how different combinations of firearm laws distinguished states with low firearm homicide or suicide rates from those states with higher rates. The suicide analysis included all 50 US states; the homicide analysis involved the 47 US states with homicide rates reported by the Centers for Disease Control and Prevention (CDC) in 2016. For low firearm suicide rates, we identified three solution pathways - the presence of universal background checks OR the presence of under 21 firearm possession restrictions OR the presence of junk gun bans - which were sufficient for low firearm suicide rates with high consistency (0.87) and coverage (0.76). For low firearm homicide rates, we identified three solution pathways - presence of under 21 firearm possession restrictions OR the presence of universal background checks together with the absence of trafficking prohibited laws OR membership in the Northern Great Plains -which were sufficient for low firearm homicide rates with high consistency (0.87) and coverage (0.81). We conclude that CCM analysis can add new insights to how multiple firearm laws work together to reduce firearm violence.
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    How education and racial segregation intersect in neighborhoods with persistently low COVID-19 vaccination rates in Philadelphia
    (BMC, 2022-05-25) Rich, John A.; Miech, Edward J.; Bilal, Usama; Corbin, Theodore J.; Emergency Medicine, School of Medicine
    Background: COVID-19 infection has disproportionately affected socially disadvantaged neighborhoods. Despite this disproportionate burden of infection, these neighborhoods have also lagged in COVID-19 vaccinations. To date, we have little understanding of the ways that various types of social conditions intersect to explain the complex causes of lower COVID-19 vaccination rates in neighborhoods. Methods: We used configurational comparative methods (CCMs) to study COVID-19 vaccination rates in Philadelphia by neighborhood (proxied by zip code tabulation areas). Specifically, we identified neighborhoods where COVID-19 vaccination rates (per 10,000) were persistently low from March 2021 - May 2021. We then assessed how different combinations of social conditions (pathways) uniquely distinguished neighborhoods with persistently low vaccination rates from the other neighborhoods in the city. Social conditions included measures of economic inequities, racial segregation, education, overcrowding, service employment, public transit use, health insurance and limited English proficiency. Results: Two factors consistently distinguished neighborhoods with persistently low COVID-19 vaccination rates from the others: college education and concentrated racial privilege. Two factor values together - low college education AND low/medium concentrated racial privilege - identified persistently low COVID-19 vaccination rates in neighborhoods, with high consistency (0.92) and high coverage (0.86). Different values for education and concentrated racial privilege - medium/high college education OR high concentrated racial privilege - were each sufficient by themselves to explain neighborhoods where COVID-19 vaccination rates were not persistently low, likewise with high consistency (0.93) and high coverage (0.97). Conclusions: Pairing CCMs with geospatial mapping can help identify complex relationships between social conditions linked to low COVID-19 vaccination rates. Understanding how neighborhood conditions combine to create inequities in communities could inform the design of interventions tailored to address COVID-19 vaccination disparities.