1932

Abstract

This brief review summarizes the basic epidemiology of firearm violence, a large and costly public health problem in the United States for which the mortality rate has remained unchanged for more than a decade. It presents findings for the present in light of recent trends. Risk for firearm violence varies substantially across demographic subsets of the population and between states in patterns that are quite different for suicide and homicide. Suicide is far more common than homicide and its rate is increasing; the homicide rate is decreasing. As with other important health problems, most cases of fatal firearm violence arise from large but low-risk subsets of the population; risk and burden of illness are not distributed symmetrically. Compared with other industrialized nations, the United States has uniquely high mortality rates from firearm violence.

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2015-03-18
2024-03-29
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Literature Cited

  1. 1.  2013. Consensus recommendations for reforms to federal gun policies. See Ref. 59, pp 259–62
  2. Adelson L. 2.  1980. The gun and the sanctity of human life; or the bullet as pathogen. Pharos Alpha Omega Alpha Honor Med. Soc. 43:15–25 [Google Scholar]
  3. Afifi TO, Henriksen CA, Asmundson GJG, Sareen J. 3.  2012. Victimization and perpetration of intimate partner violence and substance use disorders in a nationally representative sample. J. Nerv. Ment. Dis. 200:684–91 [Google Scholar]
  4. Alexander GR, Massey RM, Gibbs T, Altekruse JM. 4.  1985. Firearm-related fatalities: an epidemiologic assessment of violent death. Am. J. Public Health 75:165–68 [Google Scholar]
  5. 5. Am. Med. Assoc. Counc. Sci. Aff 1989. Firearms injuries and deaths: a critical public health issue. Public Health Rep. 104:111–20 [Google Scholar]
  6. Anglemeyer A, Horvath T, Rutherford G. 6.  2014. The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Ann. Intern. Med. 160:101–10 [Google Scholar]
  7. Applebome P. 7.  1993. Conversations/David Satcher: CDC's new chief worries as much about bullets as about bacteria. New York Times Sept. 26
  8. Bagge CL, Lee H-J, Schumacher JA, Gratz KL, Krull JL. 8.  et al. 2013. Alcohol as an acute risk factor for recent suicide attempts: a case-crossover analysis. J. Stud. Alcohol Drugs 74:552–58 [Google Scholar]
  9. Baker SP. 9.  1985. Without guns, do people kill people?. Am. J. Public Health 75:587–88 [Google Scholar]
  10. Baker SP, Teret SP, Dietz PE. 10.  1980. Firearms and the public health. J. Public Health Policy 1:224–29 [Google Scholar]
  11. Barry CL, McGinty EE, Vernick JS, Webster DW. 11.  2013. After Newtown—public opinion on gun policy and mental illness. N. Engl. J. Med. 368:1077–81 [Google Scholar]
  12. Beck A, Shipley B. 12.  1989. Recidivism of prisoners released in 1983 Rep. NCJ 116261, Bur. Justice Stat., Washington, DC
  13. Blaire JP, Schweit K. 13.  2014. A study of active shooter incidents, 2000–2013 Tex. State Univ., Fed. Bur. Investig., U.S. Dep. Justice, Washington, DC
  14. Borges G, Loera CR. 14.  2010. Alcohol and drug use in suicidal behaviour. Curr. Opin. Psychiatry 23:195–204 [Google Scholar]
  15. Branas CC, Nance ML, Elliott MR, Richmond TS, Schwab CW. 15.  2004. Urban-rural shifts in intentional firearm death: different causes, same results. Am. J. Public Health 94:1750–55 [Google Scholar]
  16. Branas CC, Richmond TS, Ten Have TR, Wiebe DJ. 16.  2011. Acute alcohol consumption, alcohol outlets and gun suicide. Subst. Use Misuse 46:1592–603 [Google Scholar]
  17. Briggs JT, Tabarrok A. 17.  2013. Firearms and suicides in US states. Int. Rev. Law Econ. 37:180–88 [Google Scholar]
  18. 18. Bur. Justice Stat 2012. NCVS Victimization Analysis Tool (NVAT). Washington, DC: Bur. Justice Stat http://www.bjs.gov/index.cfm?ty=nvat [Google Scholar]
  19. Butkus R, Doherty R, Daniel H. 19.  2014. Reducing firearm-related injuries and deaths in the United States: executive summary of a policy position paper from the American College of Physicians. Ann. Intern. Med. 160:858–60 [Google Scholar]
  20. 20. CDC (Cent. Dis. Control Prev.) 2014. Web-based Injury Statistics Query and Reporting System (WISQARS) Natl. Cent. Injury Prev. Control, CDC, Atlanta. http://www.cdc.gov/injury/wisqars/index.html [Google Scholar]
  21. Conner KR, Cox C, Duberstein PR, Tian L, Nisbet PA, Conwell Y. 21.  2001. Violence, alcohol, and completed suicide: a case-control study. Am. J. Psychiatry 158:1701–5 [Google Scholar]
  22. 22. Consort. Risk-Based Firearm Policy 2013. Guns, public health and mental illness: an evidence-based approach for federal policy Dec. 11. Consort. Risk-Based Firearm Policy. http://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-gun-policy-and-research/publications/GPHMI-Federal.pdf
  23. Cook PJ, Ludwig J, Braga AA. 23.  2005. Criminal records of homicide offenders. JAMA 294:598–601 [Google Scholar]
  24. Cummings P, Koepsell TD, Grossman DC, Savarino J, Thompson RS. 24.  1997. The association between the purchase of a handgun and homicide or suicide. Am. J. Public Health 87:974–78 [Google Scholar]
  25. Darke S. 25.  2010. The toxicology of homicide offenders and victims: a review. Drug Alcohol Rev. 29:202–15 [Google Scholar]
  26. Elbogen EB, Johnson SC. 26.  2009. The intricate link between violence and mental disorder. Arch. Gen. Psychiatry 66:152–61 [Google Scholar]
  27. Fatteh A, Troxler D. 27.  1971. The gun and its victims. A study of 1024 firearm fatalities in North Carolina during 1970. N. C. Med. J. 32:489–95 [Google Scholar]
  28. 28. Gen. Soc. Survey 2014. Data analysis using SDA (1972–2010). Natl. Opin. Res. Cent., Univ. Chicago. http://www3.norc.org/GSS+website/ [Google Scholar]
  29. Harford TC, Yi H-Y, Grant BF. 29.  2013. Other- and self-directed forms of violence and their relationships to DSM-IV substance use and other psychiatric disorders in a national survey of adults. Compr. Psychiatry 54:731–39 [Google Scholar]
  30. Hoffmire CA, Bossarte RM. 30.  2014. A reconsideration of the correlation between veteran status and firearm suicide in the general population. Inj. Prev. 20:317–21 [Google Scholar]
  31. Jagger J, Dietz PE. 31.  1986. Death and injury by firearms: Who cares?. JAMA 255:3143–44 [Google Scholar]
  32. Kaplan MS, McFarland BH, Huguet N, Conner K, Caetano R. 32.  et al. 2013. Acute alcohol intoxication and suicide: a gender-stratified analysis of the National Violent Death Reporting System. Inj. Prev. 19:38–43 [Google Scholar]
  33. Karch DL, Logan J, McDaniel D, Parks S, Patel N. 33.  2012. Surveillance for violent deaths—National Violent Death Reporting System, 16 states, 2009. MMWR 61:1–43 [Google Scholar]
  34. Kelleher K, Chaffin M, Hollenberg J, Fischer E. 34.  1994. Alcohol and drug disorders among physically abusive and neglectful parents in a community-based sample. Am. J. Public Health 84:1586–90 [Google Scholar]
  35. Kellermann AL, Reay DT. 35.  1986. Protection or pearl? An analysis of firearm-related deaths in the home. N. Engl. J. Med. 314:1557–60 [Google Scholar]
  36. Kellermann AL, Rivara FP, Rushforth NB, Banton JG, Reay DT. 36.  et al. 1993. Gun ownership as a risk factor for homicide in the home. N. Engl. J. Med. 329:1084–91 [Google Scholar]
  37. Kellermann AL, Rivara FP, Somes G, Reay DT, Francisco J. 37.  et al. 1992. Suicide in the home in relation to gun ownership. N. Engl. J. Med. 327:467–72 [Google Scholar]
  38. Kuhns JB, Exum ML, Clodfelter TA, Bottia MC. 38.  2014. The prevalence of alcohol-involved homicide offending: a meta-analytic review. Homicide Stud. 18:251–70 [Google Scholar]
  39. Langan PA, Levin DJ. 39.  2002. Recidivism of prisoners released in 1994 Rep. NCJ 193427, U.S. Dep. Justice, Bur. Justice Stat., Washington, DC
  40. LeardMann CA, Powell TM, Smith TC, Bell MR, Smith B. 40.  et al. 2013. Risk factors associated with suicide in current and former US military personnel. JAMA 310:496–506 [Google Scholar]
  41. Leland A, Oboroceanu M-J. 41.  2010. American war and military operations casualties: lists and statistics Rep. RL32492, U.S. Congr. Res. Serv., Washington, DC
  42. Mahler A, Fielding J. 42.  1977. Firearms and gun control: a public health concern. N. Engl. J. Med. 297:556–58 [Google Scholar]
  43. Maltz M. 43.  1984. Recidivism Orlando, FL: Academic Press
  44. Miller M, Azrael D, Hemenway D. 44.  2002. Firearm availability and suicide, homicide, and unintentional firearm deaths among women. J. Urban Health 79:26–38 [Google Scholar]
  45. Miller M, Azrael D, Hemenway D. 45.  2002. Firearm availability and unintentional firearm deaths, suicide, and homicide among 5–14 year olds. J. Trauma 52:267–74 [Google Scholar]
  46. Miller M, Azrael D, Hemenway D. 46.  2002. Rates of household firearm ownership and homicide across US regions and states, 1988–1997. Am. J. Public Health 92:1988–93 [Google Scholar]
  47. Miller T. 47.  2013. The cost of firearm violence Children's Safety Network Econ. and Data Anal. Resour. Cent., Pac. Inst. Res. Eval., Calverton, MD. http://www.childrenssafetynetwork.org/sites/childrenssafetynetwork.org/files/CostofFirearmViolence_Print.pdf
  48. Newton G Jr, Zimring FE. 48.  1969. Firearms and violence in American life. A staff report submitted to the National Commission on the Causes and Prevention of Violence. Natl. Comm. Causes Prev. Violence, Washington, DC
  49. Pinals DA, Cabaj RP, Appelbaum PS, Recupero PR. 49.  2013. Position statement on firearm access, acts of violence and the relationship to mental illness and mental health services APA Off. Actions, July. Am. Psychiatr. Assoc., Arlington, VA. http://www.psychiatry.org/advocacy–newsroom
  50. Rose G. 50.  1985. Sick individuals and sick populations. Int. J. Epidemiol. 14:32–38 [Google Scholar]
  51. Siegel M, Negussie Y, Vanture S, Pleskunas J, Ross CS, King C III. 51.  2014. The relationship between gun ownership and stranger and nonstranger firearm homicide rates in the United States, 1981–2010. Am. J. Public Health 104:1912–19 [Google Scholar]
  52. Siegel M, Ross CS, King C III. 52.  2013. The relationship between gun ownership and firearm homicide rates in the United States, 1981–2010. Am. J. Public Health 103:2098–105 [Google Scholar]
  53. Swanson JW, McGinty EE, Fazel S, Mays VM. 53.  2014. Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Ann. Epidemiol. http://dx.doi.org/10.1016/j.annepidem.2014.03.004. Online publ. April 29
  54. Swanson JW, Robertson AG, Frisman LK, Norko MA, Lin H-J. 54.  et al. 2013. Preventing gun violence involving people with serious mental illness. See Ref. 59 33–52
  55. Teret SP, Wintemute GJ. 55.  1983. Handgun injuries: the epidemiologic evidence for assessing legal responsibility. Hamline Law Rev. 6:341–50 [Google Scholar]
  56. Tillman R. 56.  1987. The size of the “criminal population”: the prevalence and incidence of adult arrest. Criminology 25:561–79 [Google Scholar]
  57. Vittes KA, Vernick JS, Webster DW. 57.  2012. Legal status and source of offenders' firearms in states with the least stringent criteria for gun ownership. Inj. Prev. 19:26–31 [Google Scholar]
  58. Webster DW, Crifasi CK, Vernick JS. 58.  2014. Effects of the repeal of Missouri's handgun purchaser licensing law on homicides. J. Urban Health 91:293–302 [Google Scholar]
  59. Webster DW, Vernick JS. 59.  2013. Reducing Gun Violence in America: Informing Policy with Evidence and Analysis Baltimore, MD: Johns Hopkins Univ. Press
  60. Webster DW, Vernick JS, Bulzacchelli MT. 60.  2009. Effects of state-level firearm seller accountability policies on firearm trafficking. J. Urban Health 86:525–37 [Google Scholar]
  61. 61. White House 2013. Now Is the Time: The President's Plan to Protect Our Children and Our Communities By Reducing Gun Violence Washington, DC: White House. http://www.whitehouse.gov/sites/default/files/docs/wh_now_is_the_time_full.pdf
  62. Wintemute GJ. 62.  1987. Firearms as a cause of death in the United States, 1920–1982. J. Trauma 27:532–36 [Google Scholar]
  63. Wintemute GJ. 63.  2007. Gun shows across a multistate American gun market: observational evidence of the effects of regulatory policies. Inj. Prev. 13:150–56 [Google Scholar]
  64. Wintemute GJ. 64.  2013. Comprehensive background checks for firearm sales: evidence from gun shows. See Ref. 59 95–107
  65. Wintemute GJ. 65.  2013. Responding to the crisis of firearm violence in the United States. JAMA Intern. Med. 173:740–42 [Google Scholar]
  66. Wintemute GJ. 66.  2013. Tragedy's legacy. N. Engl. J. Med. 368:397–99 [Google Scholar]
  67. Wintemute GJ. 67.  2014. Support for a comprehensive background check requirement and expanded denial criteria for firearm transfers: findings from the Firearms Licensee Survey. J. Urban Health 91:303–19 [Google Scholar]
  68. Wintemute GJ, Drake CM, Beaumont JJ, Wright MA, Parham CA. 68.  1998. Prior misdemeanor convictions as a risk factor for later violent and firearm-related criminal activity among authorized purchasers of handguns. JAMA 280:2083–87 [Google Scholar]
  69. Wintemute GJ, Parham CA, Beaumont JJ, Wright MA, Drake CM. 69.  1999. The mortality experience of recent purchasers of handguns. N. Engl. J. Med. 341:1583–89 [Google Scholar]
  70. Wintemute GJ, Teret SP, Kraus JF. 70.  1987. The epidemiology of firearm deaths among residents of California. West. J. Med. 146:374–77 [Google Scholar]
  71. Wintemute GJ, Wright MA, Drake CM, Beaumont JJ. 71.  2001. Subsequent criminal activity among violent misdemeanants who seek to purchase handguns: risk factors and effectiveness of denying handgun purchase. JAMA 285:1019–26 [Google Scholar]
  72. Wright MA, Wintemute GJ. 72.  2010. Felonious or violent criminal activity that prohibits gun ownership among prior purchasers of handguns: incidence and risk factors. J. Trauma 69:948–55 [Google Scholar]
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