Structural drivers of firearm violence in Baltimore City: An intersectional and spatial analysis of structural racism

Firearm violence is a major public health issue throughout the United States and particularly in Baltimore City. Over 7,000 people have been shot since the Baltimore Uprising following the death of Freddie Gray in 2015. There has been renewed interest in examining the relationship between structural racism and firearm violence. Existing research has established that single dimensions of structural racism are associated with higher levels of firearm violence. However, there are gaps in this emerging research area related to the lack of multidimensional models, lack of a diversity of racism-related constructs examined, and lack of a strong theoretical framework guiding this research. In this dissertation, I addressed these gaps by 1) using an intersectional approach to investigate the role of multiple dimensions of structural racism in shaping spatial firearm violence inequities; 2) developing a novel indicator of racism based on subprime mortgage lending; and 3) formulating a theoretical framework that is undergirded by the concept racial capitalism. To assess the relationship between structural racism and firearm violence, I used two analytic methods: additive interaction measure calculations (descriptive epidemiology) and spatial regression (inferential spatial analysis). In this analysis, two intersectional relationships are examined: 1) historical redlining and racialized economic segregation and 2) historical redlining and subprime mortgage lending. Our findings revealed that Baltimore’s most disadvantaged neighborhoods (i.e., neighborhoods that experienced high historical redlining coupled with high subprime mortgage lending or segregation) had the highest burden of firearm violence. Moreover, our findings showed that the intersectional nature of structural racism contributed to a significant proportion of firearm violence in disadvantaged neighborhoods. Overall, our findings suggest that structural racism is a fundamental cause of firearm violence inequities in Baltimore City. Future research should engage with academic scholarship from urban sociology, Black geographies, and Black criminology to 1) extend theoretical frameworks and 2) delineate the pathways between structural racism and firearm violence. To ensure a safer and healthier Baltimore, researchers should collaborate with advocates and policymakers to develop, implement, and evaluate transformational policies in addition to place-based and community-oriented violence prevention approaches that prioritize health equity and racial justice