American Journal o Liestyle MedicineXXX • XXX XXXX
others having guns imposes risks andprovides benefits to you. For exam-ple, your gun may be stolen and usedto commit crimes, your child may shoota friend accidentally, or you may scarea burglar away from your neighbor’shouse. This article does not focus onsuch issues.Finally, it is important to recognize thatthe scientific literature typically deals withaverages, whereas each individual family and each individual situation is unique.
The main risks of having a gun in thehome stem from the fact that someoneinappropriate can be shot or intimidated with the gun. There can be (
) suicides, (
) assaults and homicides,and (
According to death certificate data, from2003 to 2007, more than 680 Americansper year were killed unintentionally withfirearms. Data from the National ViolentDeath Reporting System (which has morecomprehensive data on each shoot-ing but currently is operating only in 18states) show that two thirds of the acci-dental shooting deaths occurred in some-one’s home, about half of the victims were younger than 25 years, and half of all deaths were other inflicted—the vic-tim was typically shot accidentally by afriend or family member (eg, brother.)
It appears that the large majority of acci-dental shooting deaths in the home arefrom guns that were kept in the home.Children aged 5 to 14 years in theUnited States have 11 times the likelihoodof being killed accidentally with a guncompared with similarly aged children inother developed countries (Table 1).
The United States has been in this unen- viable position for at least the pastdecade.
From 2003 to 2007, the yearly averages of unintentional firearm fatalities were as follows: 62 children aged 0 to14, 89 youth aged 15 to 19, and 95 youngadults aged 20 to 24 years.
Not surprisingly, there are more acci-dental gun deaths in areas with moreguns.
The differences are substan-tial. To illustrate, we compare acciden-tal firearm deaths among the states mostextreme in terms of firearm ownershiplevels. States are grouped so that the pop-ulations of the high and low gun statesare equal. According to the Centers forDisease Control (CDC) data, between 2003and 2007, the typical resident from the 15states with the most guns (WY, MT, AK,SD, AR, WV, AL, ID, MS, ND, KY, TN, LA,MO, and VT) was 6 times more likely todie in a gun accident than a typical res-ident from the 6 states with the fewestguns (HI, NJ, MA, RI, CT, and NY). Forexample, although there were virtually the same number of children aged 5 to 14 years in both groups of states, 82 had diedfrom accidental gunshot wounds in thesehigh gun states, compared with 8 in thelow gun states (Table 2).Fatal injuries are only the tip of the ice-berg. For every fatality from an accidentalshooting, there are more than 10 peopleinjured seriously enough in gun acci-dents to be treated in hospital emergency departments.
In other words, almost 20people a day are shot unintentionally butdo not die. This number does not includeany of the more than 45 people per day who are treated in emergency rooms forBB/pellet gun wounds (2003-2007) or themany others injured by firearms in other ways (eg, powder burns, struck with afirearm, injured by the recoil of a fire-arm), many unintentionally.One study of nonfatal accidental shoot-ings found that the majority were self-inflicted, most involved handguns, andmore than one third of the injuries requiredhospitalization. Injuries often occurredduring fairly routine gun handling— cleaning a gun, loading and unloading,target shooting, and so on.
It is impor-tant to recognize that although somepeople are at higher risk for uninten-tional shootings than others, accidentscan happen to anyone. No one is com-pletely immune, as shown anecdotally by scores of stories of police, firearms safety instructors, firearms advocates, and otherexperts who have accidentally shot them-selves or others.
Overall, the evidence indicates that agun in the home is a risk factor for seri-ous accidental injury. When 34 injury prevention experts were asked to priori-tize home injury hazards for young chil-dren, based on frequency, severity, andpreventability of the injury, the expertsrated access to firearms in the home asthe most significant hazard.
From 2003 to 2007, an average of 46 Americans committed suicide with gunseach day. This includes 2 teenagers(aged 15-19) and 3.5 young adults (aged20-24) per day. Even though suicideattempts with guns are infrequent, more Americans kill themselves with guns than with all other methods combined. That isbecause among methods commonly usedin suicide attempts, firearms are the mostlethal.Many suicides appear to be impulsiveacts. Individuals who take their own livesoften do so when confronting a severe buttemporary crisis. In a study of self-inflicted
Violent Deaths Among 5- to 14-Year-Olds: United States Versus OtherHigh-Income OECD Countries, 2003
HomicidesGun homicides13.4Nongunhomicides1.8Total 3.6SuicidesGun suicides 8.0Nongun suicides 1.2Total 1.6Unintentional gundeaths10.6Total gun deaths10.6
Richardson and Hemenway.