20 Sep 84 Gun Deaths Per Day In US

MedicalResearch.com Interview with:
Bindu Kalesan PhD MPH
Department of Epidemiology
Mailman School of Public Health
Columbia University

Medical Research: What are the main findings of the study?

Dr. Kalesan: There were on average 84 gun deaths per day in the US between 2000 and 2010. The main message of the study is that the 11-year stable national firearm fatality rates mask the wide variation between states, racial and ethnic subgroups and intent of injury. Across 11 years, African-Americans had firearm fatality rates twice greater than Caucasians and 6-times greater than other minority races; the rates showing a decline only among other races. We found that the lowest rates are in HI while very high rates are observed in AK, LA and DC. Seven states (NY, IL, MD, NC, CA, AZ, NV) and DC showed declining rates while FL and MA had rising rates. The widely varying inter-state differences were driven by race specific differences within states.

Medical Research: What was most surprising about the results?

Dr. Kalesan: There were two surprising results. The first was that the stable gun death rates masked very large differences in fatality rates between states and racial/ethnic subgroups. The second one was that the state differences were driven by the racial/ethnic and intent differences. A reduction across all subgroups was observed only in CA. In CA, NY, NC and DC, the reduction was affected in all racial and ethnic sub groups. This reduction in CA was driven by reduction in suicides using guns; in NC, it was by reduction in gun-related homicides and suicides, while in DC it was solely by reduction in homicides. In AZ and NV, the overall reduction was propelled by lowering of rates among African-Americans and Hispanics and not among non-Hispanics. In MA, where the rate is low but rising, and in FL with high overall rates, the increase in gun deaths and homicides occurred mainly among Caucasians and non-Hispanics. Another very interesting observation is that gun death rates decreased among Hispanics and increased among non-Hispanics in PA and TX.

When we consider the state-specific gun laws to apply our findings, we find that our results to an extent, map on to the current lenient and restricted laws characteristic to each state. In FL, we could hypothesize that the lenient gun laws explain the increase, on the other hand, MA passed the most restrictive gun control laws and the observed increase maybe due to an influx of firearms from neighboring states. These findings imply the interaction of multiple factors (policy, social culture, technology, etc.) needs to be considered in reducing gun death and violence and that a public health approach should be adopted.

Medical Research: What should clinicians and patients take away from your report?

Dr. Kalesan: Our results are primarily intended for policy makers who could affect a change to reduce the uncharacteristically high gun death rate in this country. These results will mainly help remove the mask of apathy and acceptance towards gun violence to help understand the complexity and the multifactorial problem the nation faces as a whole, which is so vastly different in different states and groups. While basic common sense comprehensive background-check laws are an absolute necessity, the danger of dying and injury by guns is deeply rooted in varying ways in different places. Our study is intended to reveal the true magnitude and the complexity of the persisting menace to the clinicians, public, policy makers and researchers. Clinicians and patients should be acting together as advocates to push for gun control reform especially in states with high firearm fatality rates.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Kalesan: Given that the results of our study directs us to the possible effect of complex socio-political environment that drive the highly variable patterns in gun death rates in the US, future research to identify social, individual, state and political drivers firearm deaths and injury are required. We would recommend federal funding be directed towards the firearm violence research in the United States.

Citation:

Kalesan B. Vasan S, Mobily ME, et al. State-specific, racial and ethnic heterogeneity in trends of firearm-related fatality rates in the USA from 2000-2010. BMJ. 2014.

Last Updated on September 20, 2014 by Marie Benz MD FAAD