Firearm Injuries

Scope of the Problem

Firearms are responsible for over 38,500 deaths per year.1 Injuries resulting from firearms are estimated to be 5 fold higher than deaths.2 Motor vehicle crashes, in comparison, result in approximately 42,500 deaths per year in the US. In 6 states firearm deaths exceed motor vehicle deaths and by the year 2003 firearms are expected to be the leading cause of injury death.

The epidemiologic profile of firearm deaths varies by age, sex, race, region of the country and intent. National statistics for 1994 indicate that 52% of firearm deaths resulted from suicide, 43% from homicide and 5% were classified as unintentional. The majority of deaths are from handguns rather than rifles or automatic weapons. High risk groups for firearm homicide are young males between the ages of 15-34 with the 15-24 year age group at highest risk. The death rate for black males is over nine times that of white males. Suicide death rates are higher in white males with those over 85 years of age having the highest rates (60 per 100,000). Young males of both races between the ages of 15-24 have the second highest firearm suicide rate (18.8 per 100,000 for whites vs 17.0 per 100,000 for blacks). Unintentional fire arm deaths occur mainly in young children. About 500 children die each year in the U.S. from "accidental" shootings and at least 5 times as many are wounded.

US rates for firearm homicide and suicide are far higher than in other countries. A recent CDC study indicated that American children are 12 times more likely to die from a firearm injury than children in other industrialized countries.3

Cost of firearm injuries is estimated to be many billions of dollars. The direct cost of medical treatment and emergency services was $3 billion dollars in 1992. Much of this cost is paid by the public. The total increases dramatically if lost wages ($34 billion) and quality of life losses ($80 billion) are tallied.4

Results of the recent National Survey of Private Ownership of Firearms,(NSPOF), indicates that 35% households, and 25% of all adults own guns. (To view this report, go to the NIJ home page at www.ncjrs.org). This survey estimates that 44 million Americans own 192 million firearms; 65 million of these are handguns.

Gun violence is now considered a public health problem as well as a criminal justice problem. Firearm injuries should be addressed and dealt with in a similar fashion as the injury prevention community has addressed other types of injuries. The multifaceted approach to motor vehicle injuries has resulted in a decline in motor vehicle deaths in spite of ever increasing number of miles traveled. A similar approach is suggested for combating firearm injuries using education, product modification, environmental modification and legislation and regulation.

The following interventions were considered:

Education
  • Child/adolescent:
    1. Gun handling programs
    2. Counseling by physicians
    3. School based violence prevention programs
  • Parent:
    1. Physician counseling programs
    2. Community programs
    3. Safe storage of guns
    4. Use of guns for self-defense
Legislation
  1. Decreasing access to guns
  2. Restrict carrying in public places
  3. Increased punishment for felony use
  4. Increased enforcement against juvenile ownership
  5. Owner liability for harm to others caused by guns
  6. Licensing of owners
  7. Waiting periods (Brady Law)
  8. Restriction of sales to those at high risk
  9. Increased taxes
  10. Restriction of imports
  11. Restriction of certain types (assault)
  12. Changes in dealer licensing requirements
  13. Registry of firearm injuries
Product/environmental modification
  1. Barrel length
  2. Restrictions on ammunition
  3. Changes to prevent accidental discharge
  4. Metal detectors in school

In this review we examine the following interventions:

Prevention Interventions
Legislative interventions

Environmental interventions Educational interventions