Private Guns, Public Health

6. Demography

CHAPTER 6 DEMOGRAPHY Firearm problems strike different groups differently. For example, suicide is more of a rural problem, while homicide disproportionately affects city dwellers. Black Americans have about half the risk of suicide of white Americans but more than ‹ve times the risk of becoming homicide victims. This chapter describes the risk of ‹rearm injury to four vulnerable populations— young children, adolescents and young adults, women, and African Americans . YOUNG CHILDREN There has been a growing recognition that the developmental factors that limit a child’s ability to deal with the injury environment are a reason for modifying that environment rather than a cause for blaming the child’s (or the parents’) injuryavoiding inadequacies. —T. Christoffel and S. S. Gallagher One criterion by which a country may be judged is how it protects its children . By that criterion, the United States is doing very badly with regard to ‹rearms. Each day during the 1990s, ‹rearms killed an average of two children between ages zero and fourteen in the United States. Firearm injuries are not a major killer of children zero to four but rank as the ‹fth-leading cause of death for ‹ve- to nine-year-olds and the second-leading cause of death for ten- to fourteen-year-olds (National Center for Injury Prevention and Control 1995). And many children who do not die from bullet wounds are permanently disabled, either physically or psychologically. On an average day in the United States, one child aged between zero and fourteen is murdered with a gun. Indeed, between 1990 and 2000, almost four hundred children per year were ‹rearm homicide victims (table 6.1). Our ‹rearm homicide rate for children between zero and fourteen is sixteen times  higher than the average of other developed nations. Our overall homicide rate for this age group is ‹ve times higher (Krug et al. 1998) (see table 1.3). Firearms are used in about 70 percent of murders of children aged ‹ve to fourteen (but in only 10 percent of murders of children aged zero to four) (CDC 1997b). Between 1990 and 2000, an annual average of 320 children aged zero to fourteen either committed suicide with guns or were accidentally killed by guns. Our ‹rearm suicide rate for children between zero and fourteen is eleven times higher than that of other high-income countries, while our non‹rearm suicide rate is roughly similar. Our overall suicide rate for zeroto fourteen-year-olds is twice as high as that of other developed countries. Our unintentional ‹rearm death rate for zero- to fourteen-year-olds is nine times higher than that of other developed nations (CDC 1997b). An international study of twelve industrialized countries for which there were comparable data on gun ownership levels from telephone surveys found that, for children aged zero to fourteen, the percentage of households with guns was strongly and signi‹cantly associated with homicide rates, suicide  PRIVATE GUNS, PUBLIC HEALTH TABLE 6.1. Number of Firearm Deaths of Children between Zero and Fourteen (1990–2000) 1990 1995 2000 Average Firearm Homicide 390 462 227 392 0–4 69 82 40 69 5–9 63 70 50 66 10–14 258 310 137 257 Firearm Suicide 144 184 110 154 0–4 0 0 0 0 5–9 2 1 0 1 10–14 142 183 110 153 Unintentional Firearm Death 236 181 86 166 0–4 34 20 19 24 5–9 56 32 18 33 10–14 146 129 49 109 Total Firearm Deathsa 784 853 436 730 0–4 103 105 59 95 5–9 121 107 70 102 10–14 560 641 307 533 Source: Data from CDC 2003b. aIncludes undetermined and legal intervention firearm deaths. rates, and accidental gun deaths (Lester 1999). Children in countries with lots of guns (e.g., Finland, Norway, the United States) were at far greater risk of these types of violent death than children in countries with few guns (e.g., the United Kingdom, Germany, the Netherlands). The U.S. regions and states with the most guns have the highest rates of homicide, suicide, and accidental gun deaths of children. One study of children aged ‹ve to fourteen found that in states where more households had guns, signi‹cantly more children were dying violent deaths. Children in these states were substantially more likely to be murdered and to commit suicide (and to be killed unintentionally with ‹rearms) (Miller, Azrael, and...