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Gun violence is a major problem in contemporary American society. However,relatively little is known about the effects of firearm injuries on survivorsand their family members and how these effects vary across subpopulations. Tostudy these questions and, more generally, to address a gap in the causalinference literature, we present a framework for the study of effectmodification or heterogeneous treatment effects in difference-in-differencesdesigns. We implement a new matching technique, which combines profile matchingand risk set matching, to (i) preserve the time alignment of covariates,exposure, and outcomes, avoiding pitfalls of other common approaches fordifference-in-differences, and (ii) explicitly control biases due to imbalancesin observed covariates in subgroups discovered from the data. Our case studyshows significant and persistent effects of nonfatal firearm injuries onseveral health outcomes for those injured and on the mental health of theirfamily members. Sensitivity analyses reveal that these results are moderatelyrobust to unmeasured confounding bias. Finally, while the effects for thoseinjured are modified largely by the severity of the injury and its documentedintent, for families, effects are strongest for those whose relative's injuryis documented as resulting from an assault, self-harm, or law enforcementintervention.

Risk Set Matched Difference-in-Differences for the Analysis of Effect  Modification in an Observational Study on the Impact of Gun Violence on  Health Outcomes