Association between Markers of Structural Racism and Mass Shooting Events in Major US Cities

Abstract

Importance: The root cause of mass shooting events (MSEs) and the populations most affected by them are poorly understood. Objective: To examine the association between structural racism and mass shootings in major metropolitan cities in the United States. Design, Setting, and Participants: This cross-sectional study of MSEs in the 51 largest metropolitan statistical areas (MSAs) in the United States analyzes population-based data from 2015 to 2019 and the Gun Violence Archive. The data analysis was performed from February 2021 to January 2022. Exposure: Shooting event where 4 or more people not including the shooter were injured or killed. Main Outcome and Measures: MSE incidence and markers of structural racism from demographic data, Gini income coefficient, Black-White segregation index, and violent crime rate. Results: There were 865 MSEs across all 51 MSAs from 2015 to 2019 with a total of 3968 injuries and 828 fatalities. Higher segregation index (ρ = 0.46, P =.003) was associated with MSE incidence (adjusted per 100000 population) using Spearman ρ analysis. Percentage of the MSA population comprising Black individuals (ρ = 0.76, P