The burden of firearm violence in the United States: stricter laws result in safer states

Abstract: Background: Increasing firearm violence has resulted in a strong drive for stricter firearm legislations. Aim of this study was to determine the relationship between firearm legislations and firearm-related injuries across states in the United States. Methods: We performed a retrospective analysis of all patients with trauma related hospitalization using the 2011 Nationwide Inpatient Sample database. Patients with firearm-related injury were identified using E-codes. States were dichotomized into strict firearm laws [SFL] or non-strict firearm laws [Non-SFL] states based on Brady Center score. Outcome measures were the rate of firearm injury and firearm mortality. Linear Regression and correlation analysis were used to assess outcomes among states. Results: 1,277,250 patients with trauma related hospitalization across 44 states were included of which, 2,583 patients had firearm-related injuries. Ten states were categorized as SFL and 34 states as Non-SFL. Mean rate of firearm related injury per 1000 trauma patients was lower in SFL states (1.3±0.5 vs. 2.1±1.4; p=0.006) and negatively correlated with Brady score (R2 linear=-0.07; p=0.04). SFL states had a 28% lower incidence of firearm related injuries compared to Non-SFL states (Beta coefficient, -0.28; 95% CI, -1.7- -0.06; p=0.04). Firearm related mortalities resulted in overall 9,722 potential life years lost and more so in the non-SFL states (p=0.001). Conclusions: States without SFL have higher firearm related injury rates, higher firearm related mortality rate, and significant potential years of life lost compared to SFL states. Further analysis of differences in the legislation between SFL and non-SFL states may help reduce firearm related injury rate.

[1]  D. Grossman,et al.  Gun storage practices and risk of youth suicide and unintentional firearm injuries. , 2005, JAMA.

[2]  P Cummings,et al.  An evaluation of state firearm regulations and homicide and suicide death rates , 2005, Injury Prevention.

[3]  P. Rhee,et al.  Children are safer in states with strict firearm laws: A National Inpatient Sample study , 2014, The journal of trauma and acute care surgery.

[4]  M. Lambert,et al.  An Update on the Impact of Gun Control Legislation on Suicide , 2004, Psychiatric Quarterly.

[5]  D. Hosmer,et al.  Gunshot wounds resulting in hospitalization in the United States: 2004-2013. , 2017, Injury.

[6]  Richard Rosenfeld,et al.  Gun Violence: The Real Costs , 2001 .

[7]  D. Hemenway,et al.  Household firearm ownership and rates of suicide across the 50 United States. , 2007, The Journal of trauma.

[8]  M. Monuteaux,et al.  Firearm legislation and firearm-related fatalities in the United States. , 2013, JAMA internal medicine.

[9]  T R Miller,et al.  The medical costs of gunshot injuries in the United States. , 1999, Journal of the American Medical Association (JAMA).

[10]  Jon S Vernick,et al.  Association between youth-focused firearm laws and youth suicides. , 2004, JAMA.

[11]  E. Eriksson,et al.  Cervical spine injuries and helmet laws: A population-based study , 2012, The journal of trauma and acute care surgery.

[12]  D. Tashjian,et al.  Guns and states: Pediatric firearm injury , 2013, The journal of trauma and acute care surgery.

[13]  K. Conner,et al.  State firearm laws and rates of suicide in men and women. , 2003, American journal of preventive medicine.

[14]  P. Cook,et al.  Homicide and suicide rates associated with implementation of the Brady Handgun Violence Prevention Act. , 2000, JAMA.

[15]  P. Layde,et al.  Firearm death rates and association with level of firearm purchase background check. , 2008, American journal of preventive medicine.