Firearm Violence in America: Is There a Solution?
Rachel L. Choron, MD
, Sarabeth Spitzer
Joseph V. Sakran, MPH, MD, MPA
Firearm injury is a public health crisis in the United States. Every day, anaverage of 109 individuals are killed, and more than 240 people suffer injuriessecondary to ﬁrearm violence [1,2]. Although the United States is a worldleader in many arenas, we are failing when it comes to ﬁrearm injury preven-tion. Firearm-related injury and death is a public health problem creating a vastburden of disease across the spectrum of ages and socioeconomic groups in thiscountry. In addition, ﬁrearm-related violence has a substantial economicburden of more than 229 billion dollars per year to the United States healthcare system [3,4]. Most concerning, despite advances in trauma systems andhealth care capabilities, the fatality rate secondary to ﬁrearms has not signiﬁ-cantly changed or improved [5,6].
EPIDEMIOLOGY OF FIREARM VIOLENCE
In 2017, the Centers for Disease Control and Prevention (CDC) reported 39,773deaths from ﬁrearm injury. This ﬁgure accounts for 58% of all intentional in-juries in the United States. Of these ﬁrearm-related deaths, 23,854 (60%) weresuicides and 15,919 (40%) were homicides [1,6]. These numbers are the highestthat have been seen in the past 40 years. Since 1999, there has been a 17% in-crease in ﬁrearm-related intentional injury mortalities, with 7000 more suicidedeaths secondary to ﬁrearms in 2017 compared with 1999 [1,7].In the United States, we have nearly the same number of deaths from ﬁre-arms as compared with motor vehicle collisions (MVC). MVCs account for10.6 deaths/100,000, whereas ﬁrearms account for 10.5 deaths/100,000, fol-lowed by falls at 10.4 deaths/100,000 . Interestingly, although there is nearlythe same number of deaths from MVCs as ﬁrearms, only 5% of patients caredfor by trauma centers are from ﬁrearm-related injuries; this emphasizes the highseverity of injury and associated ﬁrearm mortality .