Firearm Violence in America: Is There a Solution?

Rachel L. Choron, MD
, Sarabeth Spitzer
Joseph V. Sakran, MPH, MD, MPA

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INTRODUCTION

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 [8]. 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 [8].

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