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Risks and Benefits of a Gun in the Home.full

Risks and Benefits of a Gun in the Home.full

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Published by Michael Reinke

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Published by: Michael Reinke on Dec 20, 2012
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American Journal of Lifestyle Medicine
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 
David Hemenway
Risks and Benefits of a Gun in the Home
- Nov 1, 2011version of this article was published onmore recentA Published by: 
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at DUKE UNIV on December 20, 2012ajl.sagepub.comDownloaded from 
 
 American Journal o Liestyle Medicine
 1
Risks and Beneftso a Gun in the Home
David Hemenway, PhD
DOI: 10.1177/1559827610396294. Manuscript received September 9, 2010; revised November 5, 2010; accepted November 8, 2010. From the Harvard Injury ControlResearch Center, Harvard School of Public Health, Boston, Massachusetts. Address correspondence to David Hemenway, PhD, Director, Harvard Injury Control ResearchCenter, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115; e-mail: hemenway@hsph.harvard.edu.For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.Copyright © 2011 The Author(s)
 vol. x • no. x
For example, your gun may bestolen and used to commit crimes, your child may shoot a friend accidentally,or you may scare a burglar away from your neighbors house.
 Abstract:
This article summarizes the scientific literature on the healthrisks and benefits of having a gun inthe home for the gun owner and his/ her family. For most contemporary  Americans, scientific studies indi-cate that the health risk of a gun in the home is greater than the benefit. The evidence is overwhelming for the fact that a gun in the home is a risk fac-tor for completed suicide and that gunaccidents are most likely to occur inhomes with guns. There is compelling evidence that a gun in the home is arisk factor for intimidation and for kill-ing women in their homes. On the ben-efit side, there are fewer studies, and there is no credible evidence of a deter-rent effect of firearms or that a gunin the home reduces the likelihood or  severity of injury during an altercationor break-in. Thus, groups such as the  American Academy of Pediatrics urge  parents not to have guns in the home.
Keywords:
guns; firearms; accidents;suicide; homicide; self-defense
Introduction
 Americans have more private guns percapita, and particularly more handguns,than citizens of other developed coun-tries. Currently, more than one third of households in the United States contain a working firearm; slightly fewer than half of American men and 10% of women arefirearm owners. Although most firearmsin the United States are rifles or shot-guns, handguns sales have recently beenhigher than long gun sales.Compared with other Americans, gunowners are disproportionately male, mar-ried, older than 40 years, and are morelikely to live in nonurban areas. Theirlong guns (rifles, shotguns) are ownedmainly for sport (hunting and targetshooting). Major predictors of sportinggun ownership include havingparents who owned guns and cur-rently having friends and neighbors withguns. Individuals surrounded by gunowners tend to want guns themselves.People who own only handguns typi-cally own the guns for protection againstcrime. As a group, gun owners tend tobe Conservatives, and they are less likely than nonowners to believe that publicofficials care about them or that policecan protect them and are somewhat morelikely to believe in private retribution foroffenses against them.
1,2
Gun issues are among the most conten-tious in America. This article summarizesthe scientific evidence on the health risksand benefits of having a gun in the homefor the gun owner and his/her family.The article does not examine some of thepossible benefits (eg, the fun of targetpractice) or costs (eg, loss of hearing) of gun use nor does it directly address theliterature on the effects of gun laws onpublic health. It focuses instead on therisks of firearm intimidation, injuries, anddeath and on the benefits of protectionThere are also risks and benefits to car-rying a gun outside the home. And, of course, your having a gun imposes risksand provides benefits to others, just as
at DUKE UNIV on December 20, 2012ajl.sagepub.comDownloaded from 
 
2
 American Journal o Liestyle 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.
Risks
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 (
a
) accidents,(
b
) suicides, (
c
) assaults and homicides,and (
) intimidation.
 Accidents
 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.)
3
 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).
4
 The United States has been in this unen- viable position for at least the pastdecade.
5
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.
6
Not surprisingly, there are more acci-dental gun deaths in areas with moreguns.
7-9
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.
10
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.
11
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.
12
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.
13
Self-Harm: Suicides
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
Table 1.
 Violent Deaths Among 5- to 14-Year-Olds: United States Versus OtherHigh-Income OECD Countries, 2003
a
MortalityRate Ratio
HomicidesGun homicides13.4Nongunhomicides1.8Total 3.6SuicidesGun suicides 8.0Nongun suicides 1.2Total 1.6Unintentional gundeaths10.6Total gun deaths10.6
a
Richardson and Hemenway.
4
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