FIREARM-RELATED VIOLENCE
In 1994, there were 39,720 firearm-related deaths in the United States, nearly twice the total
number of deaths (19,945) among residents of the state of West Virginia in that same year.
In this country firearms, especially handguns, dominate as the weapon of choice in
intentional violence, a phenomenon that shows no signs of decreasing in magnitude. The
statistics on firearm violence in our nation are staggering, revealing a burden on society
heavy in both human and financial terms. In 1985 an estimated $911 million was spent on
direct health care expenses alone incurred from firearm-related injuries; over 80% of
these costs were paid for with public funds (1). As part of a national strategy
to address the issue, the Healthy People 2000 initiatives have targeted overall injury
control and prevention, with special attention to the problem of intentional,
unintentional, and self-inflicted firearm injury.
Considerable variation in firearm-related mortality exists among the states. The latest
year for which state data were available at the time of this study was 1991. The U.S.
Centers for Disease Control and Prevention (CDC) recently released a report that included
crude rates of total firearm-related mortality (including unintentional, suicide,
homicide, and legal intervention deaths) for all 50 states and the District of Columbia in
that year (2) (Table 1). The data provide a state-by-state snapshot of
firearm-related mortality across the country. The rates ranged from a low of 5.0
(firearm-related deaths per 100,000 population) in Hawai'i to a high of 57.5 in the
District of Columbia, with a U.S. average of 15.2. West Virginia's crude rate of
firearm-related mortality in 1991 was 16.2.
Lethality and Impulsiveness. Firearms are different from other
weapons: they possess a far greater lethality. It is firmly established that assaults,
robberies, and suicide attempts are less likely to be fatal if a weapon other than a
firearm is used (3). Impulsive behavior (particularly among youth) is an
additional factor in assessing the problem of firearm violence; if a firearm were not
readily available, the use of another, less lethal, weapon might change the outcome of a
violent event, whether interpersonal or self-directed (3). Two recent studies
conducted in Massachusetts and Oregon support the evidence that firearms pose a greater
risk of serious injury or fatality than other weapons.
In 1989, the Massachusetts Department of Public Health began a pilot project to develop
the first statewide emergency-department-based Weapons-Related Injury Surveillance System
(WRISS) in the country (4). From November 1993-April 1994, the first six months
of reporting, 1,345 weapon-related injuries were reported to WRISS, 451 of which were
gunshot wounds (GSWs) and 894 sharp instrument wounds (SIWs). When the severity of the
injuries was compared between the two types of wounds, persons with GSWs were more likely
to be hospitalized (53%) than persons with SIWs (29%).
The State Health Division of the Oregon Department of Human Resources conducted a study of
fatal and nonfatal suicide attempts among adolescents in Oregon from 1988-93 (5).
Over the six-year period, there were 3,783 suicide attempts among persons aged 17 and
under; 124 attempts resulted in death. The most common method of attempted suicide among
this age group was the ingestion of drugs (75.5%), followed by cutting/piercing (11.1%),
other poisonings (4.8%), suffocation/hanging (2.4%), and firearms (0.6%). The more common
methods used were the least likely to result in death; for example, only 0.4% of all
attempts by drug overdose were fatal. In contrast, 78.2% of attempts involving firearms
resulted in the death of the adolescent. Sixty-four percent (63.7%) of all suicide
deaths among adolescents in Oregon from 1988-93 were the result of firearm use.
At-Risk Populations. Firearm violence strikes harder at certain
segments of our society, in particular youth and young adults. Among all persons aged
10-34, firearm injuries were second only to motor vehicle accidents as the leading cause
of death in the U.S. in 1990 (1). Among black males aged 15-34, firearm injuries
are now the number one cause of death (1). A 1994 CDC study revealed that the
rate of homicide among all 15-to-19-year-old males in the nation increased by 154% (from
13.0 to 33.0 deaths per 100,000 15-to-19-year-old males) between 1985 and 1991;
firearm-related homicides accounted for 97% of this increase (6).
Older persons (aged 65+) are more at risk from firearm suicide than others, and the
percentage of firearm-related suicides among that age group is growing (7).
According to a CDC study released in 1996, from 1980 through 1992 firearms were the most
common method of suicide used by both men and women aged 65 and older. Over that time
period, the percentage of firearm-related suicides among men increased from 69% to 77%;
the percentage among women increased from 24% to 35%. The overall rate of firearm-related
suicide increased from 10.6 (deaths per 100,000 population aged 65+) to 13.1 deaths.
The poor are also at higher risk of firearm-related mortality, according to Baker et al
in The Injury Fact Book (8). Statistics show that firearm suicide is
twice as common in low income areas. Homicides due to firearms are three times more likely
among low-income populations; unintentional firearm deaths are seven times more common.
Purpose of this Study. West Virginia is a rural state, and
firearms have always been part of our culture. Hunting is a prominent activity, both as a
sport and a means of supplementing the diet of rural families, and many homes in the state
have rifles and shotguns for that purpose. Handguns traditionally have not been a favorite
weapon of state gun owners, but the times are changing in West Virginia as well as in the
rest of the country, and crime and the fear of crime are increasing. The primary focus of
this study entails a detailed examination of the role played by firearms in mortality in
West Virginia, with comparisons to the U.S. as a whole to determine if the state is
following the nation's trends in firearm violence.
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Health Statistics Center
Office of Epidemiology and Health Promotion
West Virginia Bureau for Public Health
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Last updated 02/07/06