Forging New Frontiers 2025: Injury Prevention in Evolving Environments

Presenter Profile

Lauren Bozarth, BS

UAB Marnix E Heersink School Of Medicine
Second Year Medical Student
Lb47@uab.edu

Lauren Bozarth is a second-year medical student at the Heersink School of Medicine at the University of Alabama at Birmingham, dedicated to advancing health equity and community-based care. Originally from Boaz, Alabama, she earned her undergraduate degree from Troy University and spent nearly three years working in the UAB Emergency Department, where she discovered her passion for improving access to care. As Community Health Director for Equal Access Birmingham Clinic, Lauren leads targeted outreach, education, and the operation of two monthly free clinics at sites across Birmingham serving the city’s unhoused populations. She is especially passionate about building partnerships that connect individuals and families to high-quality, accessible healthcare, and about developing programs that reduce preventable injuries and support underserved communities.

Presentations

Utilization of the Emergency Department for Mental Health by Pediatric Survivors of Firearm Injuries

Kendall Snellgrove, MD
Lauren Bozarth, BS
Claire Johnson, MD
Zain Hashmi, MD
Megan Schultz, MD
Jennifer McCain, MD

Part of session:
Lightning Round Presentations
Sunday Lightning Round
Sunday, December 7, 2025, 10:30 AM to 12:00 PM
Background:

In 2020, firearm injuries became the leading cause of death among U.S. children and adolescents. For Black youth, this has been true since 2006. While 14–25% of pediatric survivors of firearm injuries develop new mental health conditions, little is known about their use of emergency departments (EDs) for mental health care post-injury. This study aims to describe the epidemiology of pediatric firearm injuries in one region and investigate the prevalence of mental health-related ED visits within one year after injury.

Methods:

This retrospective cohort study includes all firearm-injured pediatric patients (ages 0–18) presenting to a Level 1 Pediatric Emergency Department (PED) and a Level 1 Adult Trauma Center in the same city January 2018 - December 2023. Comprehensive chart reviews across both hospital systems are conducted to capture all patients and visits without omission.

Data collected includes: (1) demographics (age, sex, race, ZIP code, insurance), (2) firearm details (type, shooter, location, intent), (3) injury characteristics (injured body area, Abbreviated Injury Score [AIS], disposition, length of stay, diagnoses), (4) mental health history (pre-existing conditions, prior PED crisis visits, new mental health diagnoses, new crisis visits post-injury), and (5) somatic health comparisons (non-mental health PED visits post-injury).

Descriptive statistics will characterize the cohort. Chi-square and Mann-Whitney U tests will compare key variables. Kaplan-Meier curves will estimate time from injury to new mental health diagnosis or crisis event.

Results:

Chart review is ongoing. Preliminary analysis of 2023 patients seen at the PED show most were male (80.8%), Black (92.3%), and publicly insured (80.8%), with a mean age of 11.7 years. The largest subgroup was ages 13–16 (53.8%). Injuries involved extremities (46.2%), trunk (30.8%), and head (23.1%). About one-third had an AIS of 2 (34.6%).

Shooters were unknown in 50.9% of cases. Assault was the most common intent (37.3%), followed by unknown (35.3%) and unintentional (27.5%). Shooting locations included street (35.3%), home (35.3%), community (13.7%), vehicle (5.9%), or unknown (9.8%). Most patients (73.1%) were admitted.

Pre-existing mental health conditions were present in 23.1%. No new mental health diagnoses requiring a PED visit were identified within one year post-injury. However, 11.5% presented for somatic complaints.

Conclusions:

Preliminary findings show a disproportionate burden of firearm injury among Black, male, and publicly insured youth. Despite notable pre-existing mental health needs, no new mental health-related PED visits were recorded within one year, suggesting potential gaps in recognition, access, or care utilization. These results highlight the urgent need for improved mental health screening, structured follow-up protocols, and community-level support to address the full impact of firearm trauma in youth.

Objectives:

1. Describe the demographics of pediatric firearm injuries.
2. Identify the prevalence of pre-existing and new mental health conditions within one year post-injury.
3. Discuss gaps in post-injury mental health care utilization and implications for ED/community interventions.