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Firearm Injury and Death

Firearm Injury and Death

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By Marianne W. Zawitzand Kevin J. StromBJS StatisticiansFirearm injuries from crime includethose caused by interpersonal violenceregardless of whether the injured partywas the intended target or even aperpetrator. Such injuries can be fatal(homicides) or nonfatal (assaults).Incidents resulting in firearm injury mayinvolve other crimes like robbery andburglary but are referred to as assaults.While injuries other than gunshotwounds can result from crimes involv-ing a firearm, this report focuses ongunshot wounds.No single source of data completelymeasures firearm injury and deathsfrom crime. Several sources cover onlyfatalities while others cover nonfatalinjury. For example, the National CrimeVictimization Survey (NCVS) does notinclude data about victims who died.In addition, while the NCVS providesa wealth of information about crimeand victims, it does not capture enoughcases involving gunshot wounds toprovide annual estimates of many ofthe characteristics of such events.Hospital emergency departmentsurveillance systems are able to collectadditional cases and details aboutvictims of nonfatal gunshot wounds butdo not collect information about victimswho do not seek treatment in hospitals(about 20% of all victims of nonfatalgunshot wounds, according to theNCVS).To describe firearm injury and deathfrom crime, this report uses data fromvictim surveys, hospital emergencydepartments, death certificates, andlaw enforcement reports on homicides.(See the box on page 5 and the
Methodology 
for additional discussionof sources of data concerning firearminjury.)
How much crime involves firearmsand gunshot wounds?
 The BJS National Crime VictimizationSurvey (NCVS) data for 1993-97 showthat of the 19.2 million incidents ofnonfatal violent crime, excluding simpleassault —
ù
28%were committed with a firearm
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4%were committed with a firearmand resulted in injury
ù
less than 1% resulted in gunshotwounds.
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Of serious nonfatal violent victimiza-tions, 28%were committed with afirearm,4%were committed with afirearmand resulted in injury, and lessthan 1% resulted in gunshot wounds.
ù
Of all nonfatal firearm-relatedinjuries treated in emergency depart-ments, 62% were known to haveresulted from an assault. For firearm-related fatalities, 44% were homicides.
ù
The number of gunshot woundsfrom assaults treated in hospitalemergency departments fell from64,100 in 1993 to 39,400 in 1997, a39% decline. Homicides committedwith a firearm fell from 18,300 in 1993to 13,300 in 1997, a 27% decline.
ù
Four out of five of the victims of bothfatal and nonfatal gunshot woundsfrom crime were male.
ù
Almost half of the victims of bothfatal and nonfatal gunshot woundsfrom crime were black males. Abouta quarter were black males ages15 to 24.
ù
Over half the victims of nonfatalgunshot wounds from crime wereyounger than 25. Older victims weremore frequent in the homicidestatistics.
ù
Over half of the victims of nonfatalfirearm injury from crime who wentto an emergency room were subse-quently hospitalized overnight.
Highlights
U.S. Department of Justice
Office of Justice Programs
Bureau of Justice Statistics
 
Selected Findings
Firearm Injury and Deathfrom Crime, 1993-97
October 2000, NCJ 182993
 
According to the FBI’s Uniform CrimeReports, 30% of the murders, robber-ies, and aggravated assaults reportedto police from 1993 to 1997 involvedfirearms. Of these violent crimes, 1%were murders. Of all murders from1993 to 1997, 69% were committedwith firearms.
How many people are injured byfirearms and how many of theseinjuries are the result of crime?
According to the National HospitalAmbulatory Medical Care Surveyconducted by the Centers for DiseaseControl and Prevention (CDC), 0.4% ofall injury visits to hospital emergencydepartments from 1992 to 1995 werecaused by firearms (4 of every 1,000visits.)
1
This estimate includes allcauses of firearm injury and mayinclude visits for patients seekingfollow-up care and patients who diedat the hospital.Estimates from the CDC Firearm InjurySurveillance Study show that from1993 through 1997, about 412,000nonfatal firearm-related injuries weretreated in U.S. hospital emergencydepartments.
-38%Percent change64,200199769,600199684,200199589,60019941042001993411,8001993-97 Total
Firearm injuryfromallcauses
Source: Centers for Disease Control andPrevention, Firearm Injury Surveillance Study,1993-97.
Of the total nonfatal firearm injuries —
ù
62% resulted from assaults
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17% were unintentional
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6% were suicide attempts
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1% were legal interventions
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13% were from unknown causes.While most nonfatal firearm-relatedinjuries are from crime, most firearm-related deaths are suicides. Accordingto the Vital Statistics, 180,533 firearmdeaths occurred from 1993 through1997: 51% were suicides, 44%homicides, 1% legal interventions, 3%unintentional incidents, and 1% were ofundetermined causes.
The number of nonfatal assaultsand homicides from firearmsdeclined from 1993 to 1997
From 1993 to 1997 nonfatal firearminjuries from crime declined 39% andfirearm-related homicides fell 27%.Firearm injury and deaths from othercauses also declined over the period.Firearm injuries resulting from suicideattempts declined 45%, and those fromunintentional causes declined 39%.Unintentional deaths from firearms fellby 36% and suicides fell by 7%. (Formore detailed data, see
Appendix 
.)
*95% confidence interval estimates thenumber to be between 160,300 to 353,700.See
Methodology 
.-27%-39%Percentchange13,25239,400199714,03739,200199615,55153,400199517,52761,200199418,25364,100199378,620*257,2001993-97 Total
HomicidesNonfatalassaultsNonfatal and fatalfirearminuries
Sources: Centers for Disease Control andPrevention, Firearm Injury Surveillance Study,1993-97 and the Vital Statistics of the UnitedStates, 1993-97.
The ratio of nonfatal to fatal gunshotinjuries varies by intent
 From 1993 through 1997 there were3.3 nonfatal gunshot injuries fromassault treated in hospital emergencydepartments for every firearm-relatedhomicide. For gunshot injuriessustained unintentionally, there were11.4 nonfatal injuries for every gunshotfatality. Firearm-related suicideattempts were the most likely to resultin a fatality, as there were 0.3 firearm-related attempted suicides for everycompleted suicide.
2
 
Most victims of gunshot injury anddeath from crime were male; almosthalf were black males
From 1993 to 1997 —
ù
Eighty-nine percent of the victims ofnonfatal gunshot wounds from crimewere male; 84% of firearm homicidevictims were male, according to theFBI’s Supplementary HomicideReports (SHR).
ù
Blacks made up 54% of the victimsof nonfatal gunshot wounds from crimeand 54% of the homicide victims.
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Almost 1 in 5 victims of nonfatalgunshot wounds from crime wereHispanic. Equivalent data for homicidevictims are not available in the SHR.According to the Vital Statistics, 18% ofthe homicide victims were Hispanic.
5Unknown**...Other female2Hispanic female3Other male3White female*6Black female15White male*17Hispanic male%49Black male
Percent of victimsof nonfatal gunshotwounds from crime
... Less than .05%.*Represents white, non-Hispanic.**Males of unknown race represented 4.2% ofthe victims, and females of unknown race were0.5%.Source: Centers for Disease Control andPrevention, Firearm Injury Surveillance Study,1993-97.
Black males ages 15 to 24 made up26% of all the victims of nonfatalgunshot wounds from crime and 22%of the homicide victims.While the majority of victims of nonfataland fatal gunshot wounds from crime2
Firearm Injury and Death from Crime, 1993-97 
 
2
V. Beaman, J.L. Annest, J.A. Mercy, M.Kresnow, and D.A. Pollock, “Lethality offirearm-related injuries in the United Statespopulation,”
Annals of Emergency Medicine 
,35:258-266, 2000.
1
C.W. Burt and L.A. Fingerhut. “Injury visits tohospital emergency departments: United States,1992-95,” National Center for Health Statistics,
Vital Health Statistics,
13:131, 1998.
 
were black, most victims of uninten-tional firearm injury and death andsuicides and suicide attempts withfirearms were white.
Many victims of nonfatal and fatalgunshot wounds from crime werejuveniles and young adults
40584525 andolder19171921-2424141918-201581315-172%2%3%14 andunder
HomicideNonfatalassaultAgeFirearmhomicideoffend-ersVictims of firearminjury
Note: May not total to 100%. Data on personsof unknown age are not presented.Sources: Centers for Disease Control andPrevention, Firearm Injury Surveillance Study,1993-97, andFBI, Uniform Crime Reports,Supplementary Homicide Reports, 1993-97.
Juveniles (persons under age 18)accounted for 16% of the victims ofnonfatal gunshot wounds from crimeand 10% of the firearm homicidevictims. Thirty-five percent of thevictims of nonfatal gunshot woundsfrom crime and 24% of the homicidevictims were under 21 years of age.Homicide offenders are also likely to beyoung. According to the Supplemen-tary Homicide Reports from 1993 to1997, 60% of the offenders who used afirearm to commit murder wereyounger than 25; 17% were juvenilesand 24% were between ages 18 and20. (The Youth Handgun Safety Act of1994 prohibits possession of handgunsby anyone under 18, and under theGun Control Act of 1968 it is unlawfulfor federally licensed firearms dealersto sell handguns to persons under 21.)
How did the victims of nonfatalfirearm assaults get to the hospital?
3Air transport3Unknown3Police6Walk-in19Private vehicle%66EMS/Rescue/Ambulance
Percent ofgunshot woundvictimsMode of transportto the hospital
Source: Centers for Disease Control andPrevention, Firearm Injury Surveillance Study,1993-97.
About two-thirds of the victims ofgunshot wounds from crime who weretreated in emergency departmentswere taken to the emergency depart-ment by an emergency medicalservice, ambulance, or rescue squad.Victims of unintentional firearm injurydiffer from gunshot victims from crimein that a higher percentage come tohospital by private vehicle than anyother means. 
Firearm Injury and Death from Crime, 1993-97 
3
 
Different sources of data on firearm injury from crime show consistent demographic patterns
A comparison of two sources offirearm homicide data to the CDC'sdata on nonfatal firearm injury fromcrime shows similar demographicpatterns among victims. Black malesare the most frequent victims offirearm homicide and nonfatal firearminjury from crime. Young people arealso more frequently victims in allthree sources. One explanation ofwhy older victims are more frequent inthe homicide statistics is that they areless able than younger victims torecover from gunshot wounds.Although these sources have differentpopulation coverage (see
Methodol- ogy 
), the homicide victims in the VitalStatistics and the FBI's Supplemen-tary Homicide Reports appear to bevery similar. Some of the differencesbetween these sources and thefirearm injury study are due to differ-ences in population coverage or to theestimation procedures used with thefirearm injury surveillance sample.
*Includes legal intervention homicides.**For comparison, Hispanics who were included in the other racial category in the original datawere included in the white racial category. Hispanic origin is not sufficiently reported in theSupplementary Homicide Reports to allow comparison.Sources: Vital Statistics of the United States, Centers for Disease Control and PreventionNational Center for Health Statistics, 1993-97; FBI, Uniform Crime Reports, SupplementaryHomicide Reports, 1993-97; and Centers for Disease Control and Prevention, National Centerfor Injury Prevention, Firearms Injury Surveillance Study, 1993-97.010Unknown 7131345 and older 12161735-44 26292925-34 25222220-24 26171715-19 %3%2%30-14
Age
423Other 676Black female 494746Black male **599White female %**33%34%36White male
Race and gender
Nonfatal firearminjury fromassaultFBI's Supplemen-tary HomicideReportsVital statistics*Firearm homicides, 1993-97

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