Elsevier

Preventive Medicine

Volume 79, October 2015, Pages 5-14
Preventive Medicine

Firearm injuries in the United States

https://doi.org/10.1016/j.ypmed.2015.06.002Get rights and content

Highlights

  • We examined the epidemiology of fatal and nonfatal firearm injuries in the United States.

  • The majority of firearm deaths were suicides (over 60%).

  • Males, racial/ethnic minorities and young Americans are disproportionately affected.

  • Firearm injuries declined in the 1990s, but firearm suicides and assaults recently increased.

  • Nonfatal firearm assaults have increased in recent years to a level not seen since 1995.

Abstract

Objective

This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact.

Method

Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries.

Results

More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995.

Conclusion

Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence.

Introduction

The tragedy in Newtown, Connecticut on December 14, 2012 cast a spotlight on firearm violence in the United States. Twenty-seven people, mostly schoolchildren and their teachers, lost their lives that day. It was the deadliest school shooting in an elementary or high-school in U.S. history. In an average week, 645 people lose their lives to firearm violence and 1565 more are treated in an emergency department for a firearm-related injury (Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2005). Most of these events do not make headlines, yet reflect part of the human toll of firearm violence in the United States.

The nature and frequency of firearm violence, combined with its substantial impact on the health and safety of Americans, make it an important public health problem. Many Americans are non-fatally injured or die in acts involving a firearm each year in the United States. These include acts of interpersonal violence, self-directed violence, legal intervention (i.e., injuries inflicted by law enforcement during the course of duty), unintentional injuries involving a firearm, and acts where the intent cannot be determined. Firearm-related injuries are highly lethal and account for 7.1% of premature death or years of potential life lost before the age of 65 (Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2005). Firearm homicide is the second leading cause of injury death among youth 10–24 years of age. Firearm suicide, on the other hand, is the third leading cause of injury death for persons aged 35 years and older, after drug overdoses and motor vehicle crashes. Overall, firearm injuries are among the 5 leading causes of death for people ages 1–64 in the United States.

Firearm violence is preventable. The first step in preventing it is to understand the nature and extent of the problem—what it is, whom it affects, where it occurs, how patterns have changed over time and the factors contributing to these changes. An examination of the factors contributing to firearm violence and changes over time is covered elsewhere in this special issue. Here we provide an overview of fatal and nonfatal firearm violence in the United States—examining patterns of interpersonal, self-directed and unintentional firearm injuries and deaths, including the demographic characteristics of victimization, trends over time, and health impact.

Section snippets

Methods

A firearm-related injury is defined as a gunshot wound or penetrating injury from a weapon that uses a powder charge to fire a projectile. This definition includes gunshot injuries sustained from handguns, rifles, and shotguns but excludes gunshot wounds from air-powered, gas-powered, BB and pellet guns, as well as non-penetrating injuries associated with firearms (e.g., “pistol whipping”).

Fatal firearm injuries were derived from death certificate data from the National Vital Statistics System

The extent of firearm injuries and deaths in the U.S.

On average, from 2010 to 2012, more than 32,000 people (n = 32,529) died each year in the U.S. from a firearm-related injury, for an annual age-adjusted rate of 10.2 per 100,000 (Table 1). Sixty-two percent of these were suicides (n = 20,012), 35% were homicides (n = 11,256), and 2% were unintentional firearm deaths (n = 582). The annual rate of firearm suicide was about twice as high as the annual rate of firearm homicide (7.2 vs 3.7) and about 38 times the annual rate of unintentional deaths from

Discussion

The findings in this paper highlight the magnitude and impact of firearm violence in the United States. For every 100,000 people in the U.S. who die in an act of firearm violence, about the same number die in motor vehicle crashes (about 10 per 100,000). Apart from being a common problem, many Americans may not realize that over 60% of all firearm deaths in the U.S. are suicides—almost double the number of firearm homicides. This reflects, in part, the lethality of firearms particularly when

Conclusion

Firearm injuries are an important public health problem in the United States contributing substantially each year to premature death, illness, and disability. The human toll is only part of their devastating impact. The economic impact of firearm-related deaths and injuries costs the United States nearly $50 billion each year in medical and lost productivity costs alone. Understanding the nature, magnitude and health impact of firearm violence is only the first step in preventing firearm

Conflict of interest

The authors declare that there are no conflicts of interests.

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