The impact of secondary exposure to gun violence fatality on mental health outcomes in four urban United States settings
Given the widespread availability of firearms, high prevalence of gun violence in the U.S., and the intersection of race, cumulative violence and adverse mental health outcomes, it is important to understand the mental health consequences of exposure to gun violence fatality on racially/ethnically diverse secondary victims. The aims of this study were to examine 1) the prevalence and demographic differences in secondary exposure to gun violence fatality; 2) the associations between secondary exposure and depression, psychological distress, suicidal ideation and psychotic experiences; and 3) the interaction between race and secondary exposure in relation to depression, psychological distress, suicidal ideation and psychotic experiences. Participants (n=1615) were adult community residents from Baltimore, New York, Philadelphia, and Washington, D.C, who participated in the online Survey of Police-Public Encounters. Chi-square, linear, and logistic regression were used to test study aims. Results indicated that 24% of respondents reported secondary exposure to gun violence fatality. Black, Latino, younger, and those of lower income and education were disproportionately exposed. Exposed respondents had significantly higher levels of psychological distress, depression, suicidal ideation and/or psychotic experiences compared to those not exposed. There was a significantly stronger association between exposure and depression among Latinos and "other" races relative to Whites. Findings suggest that vicarious exposure to gun violence fatality is widespread, disproportionately experienced by racial/ethnic minorities, and related to a higher prevalence of mental health symptoms.