Medical Professionals as Advocates Program (MPAP)
Michael Grossman, MD
St. Luke's Adult Level 1 Trauma Center |
Andrea Nesfeder, MPH
St. Luke's Adult Level 1 Trauma Center |
Background
- MPAP began in 1997 through the Firearm Injury Center at Penn (FICAP) at the University of Pennsylvania
- FICAP was funded by the Joyce Foundation in a three-year grant to establish MPAP
- MPAP uses data to develop community strategies through an additional three-year Center Grant awarded in 2001
Purpose of MPAP
- Support local efforts to reduce firearm injury in small and medium-sized cities
- Develop a trauma center - community partnership to address firearm injury
- Collect and analyze local data to develop community intervention strategies
MPAP Model
- Trauma center - community partnership
- Site director (trauma surgeon) and site coordinator
- Two sites:
Data Collection
- Firearm fatality data collected in two counties
- Lehigh County
- Northampton County
Results: 1994 - 1998 Data Analysis & Intervention Strategies for the Lehigh Valley
Firearm Homicides
Incidence:
- 22 percent of all firearm-related deaths (1994 - 1998 = 54)
Risk populations:
- Black males younger than 25 years of age
- No college education
Firearm: handgun Neighborhoods
- Heavily trafficked
- Low income, working class
- One-half of firearm homicides occurred in 8 percent of neighborhoods
Firearm homicides occur:
- More often on the weekend in the predominantly black neighborhoods
- More often during the week in predominantly white neighborhoods
Intervention Strategies for Homicide
MPAP Advisory Board (physicians, coroners, local political leaders, law enforcement representatives, judges, social security agency representatives), established in 1999, focuses on neighborhoods.
Partnered with Mayor, City Council and Police in developing and applying for the Weed and Seed Program:
- Policing strategy - targeted patrols
- Housing strategy - restructuring housing policy
- Youth development strategy - expand opportunities for inner-city youth (police leagues, etc.)
MPAP homicide intervention strategies have been:
- Endorsed by the Mayor of Allentown and the Allentown City Council
- Adapted and utilized within the City of Allentown's State Weed and Seed application
MPAP neighborhood strategies will continue through Allentown's Weed and Seed program
Firearm Suicides
Incidence:
77 percent of all firearm-related deaths (1994 - 1998 = 189)
Risk populations:
- White males older than 65
- Youth between 18 and 24
- Individuals with no college education
Firearms:
- More than 80 percent committed at home
- More than 90 percent had a gun in the home
Neighborhoods:
- Less trafficked, more isolated
- One-half of firearm suicides occurred in 20 percent of neighborhoods
Youth-at-Risk Strategies
- Advisory Board focuses on Health Care Advocacy in 2002
- Identify the role health care professionals can play in reducing violence
- Intervention strategies to target the adolescent population and utilize "best practices"
Conclusions
- MPAP has developed a data profile for firearm-related deaths in the Lehigh Valley
- Determined "hot spot" areas within the two county region (areas with the most significant firearm injury)
- The firearm homicide rate in the Lehigh Valley is 2 per 100,000 for the period 1994 - 1998. This is low compared to the Youngstown, Ohio hospital participating in the study, which is 12.5 per 100,000, or for the United States as a whole, which is 5.6 per 100,000.
- MPAP Advisory Board develops and guides potential community intervention strategies
- Community intervention strategies are data-driven
- Ongoing activities: homicide and suicide strategies are still being developed; data collection and analysis
Future
- Continue data collection and analysis for firearm fatalities in Lehigh and Northampton counties for 1999 - 2002
- Expand data collection to include all violent deaths, not just those by firearm
- Utilize the MPAP Advisory Board for future guidance of the project, based on the new data
- Continue MPAP health care advocacy within the community
- Educate physicians and other health care professionals regarding the information contained in the data
- Educate and train primary care and ED physicians to screen adolescents for risk of firearm injury
- Provide firearm safety education and prevention to adolescents and school-aged children
- Develop specific community intervention strategies targeted to the adolescent population
Acknowledgements
- C. William Schwab, MD
- Therese Richmond, PhD, FAAN, CRNP
- Charles Branas, PhD
- Rose Cheney, PhD
- Melissa Sitter, MSW, LSW
- Maura Dunfey