Residential Racial Segregation and Youth Firearm Aggression: Neighborhood disadvantage and exposure to violence as mediators.

Youth interpersonal firearm violence (e.g., homicides) disproportionately affects Black youth and contributes to racial health disparities. Institutional racial discrimination - in particular, residential racial segregation - is a determinant of racial disparities in firearm violence. Residential racial segregation, which is enforced to limit racially minoritized members to undesirable residential areas (e.g., fewer educational and employment opportunities), is associated with the socioecological risk factors of youth firearm violence (e.g., exposure to violence [ETV], neighborhood disadvantage). The socioecological mechanisms underlying the link between, however, remains unclear. Therefore, we tested the mediating role of neighborhood disadvantage (mediator 1) and ETV (mediator 2) in the association between residential racial segregation and youth firearm violence. Participants consisted of 338 Black youth who used illicit drugs in the past year and sought care in an urban emergency department. Using serial mediation analysis, residential racial segregation was indirectly associated with youth firearm violence via neighborhood disadvantage and then exposure to violence. Identifying the downstream socioecological consequences of residential segregation can inform the development of firearm violence prevention programs that address the socioecological consequences of racism.