Beyond the Index: Family Fragility as a Geographic Risk Factor for Pediatric Firearm Injuries

Pediatric firearm injuries are associated with geographic social determinants of health (SDOH), but SDOH metrics may have limited explanatory power and actionability. “Family fragility,” defined as the degree of disruption of family structures in a geographic area, may be an underrecognized driver of firearm injury disparity. This study evaluated the impact of family fragility on population-adjusted pediatric firearm hospitalizations in the context of other geographic SDOH.