restricted access Chapter 3. Gun-Related Injury and Death
In lieu of an abstract, here is a brief excerpt of the content:

Chapter 3   Gun-Related Injury and Death Environmental modifications are premised on the assumption that humans can alter and control their surroundings to make them less hazardous. This is hardly a startling insight, although it is too frequently ignored (as, for example, in the case of firearm design and accessibility). —T. Christoffel and S. S. Gallagher The Centers for Disease Control and Prevention divides injury deaths into accidents (unintentional injuries), suicides, and homicides. This chapter discusses the extent to which firearms contribute to deaths in each of these categories , including scientific evidence regarding the problem, and examines gun use in robberies, assaults, and other crimes. The chapter also briefly describes some specific policies that could prevent many of these incidents. Gun Accidents Between 1965 and 2000, more than sixty thousand Americans died from unintentional firearm shootings. That is more Americans than were killed in our wars or from coal mine injuries during the same period. In the 1990s, an average of twelve hundred Americans died each year from gun “accidents”— an average of more than three people per day (table 3.1). In addition, about four hundred people each year (one person a day) were killed in situations where the intent was undetermined. Young people are the primary victims. More than half of all unintentional firearm fatalities are individuals under twenty-eight years of age. Although relatively few adolescents own guns, the fifteen- to-nineteen-year-old age group has by far the highest rate of unintentional firearm fatalities; second 27 is the twenty-to-twenty-four age group, followed by the ten-to-fourteen age group. Children under age fifteen in the United States are nine times as likely to die as a result of a fatal gun accident as similarly aged children in the rest of the developed world (CDC 1997b). Between 1991 and 2000, unintentional firearm fatalities per year averaged 23 for children aged zero to four, 31 for children aged five to nine, and 105 for children between ages ten and fourteen. As with almost all injuries, males are at highest risk (CDC 2003b). According to criminologist Gary Kleck, “Most surprisingly, general gun ownership levels . . . appear to be unrelated to rates of fatal gun accidents” (1997b, 384). This claim is indeed surprising, and it is incorrect. Where there are more guns, there are more accidental gun deaths. One study examined data from 1979 to 1997 and found that for every age group, for men and for women, for blacks and for whites, people living in states with more guns were far more likely to die in gun accidents. Even after accounting for poverty, urbanization, and region, the differences were enormous (Miller, Azrael, and Hemenway 2001). To help illustrate the size of these differences, table 3.2 contrasts the number of accidental gun deaths in states at the extremes in terms of gun prevalence . The five lowest gun states were selected, as determined by the percentage of the population living in households with firearms, with the data coming from the CDC’s 2001 Behavioral Risk Factor Surveys conducted in all fifty states. These five low gun states were Hawaii, Massachusetts, Rhode Island, New Jersey, and Connecticut. Since many of the high gun states have small 28 PRIVATE GUNS, PUBLIC HEALTH Table 3.1.  Unintentional Firearm Deaths in the United States, 1965–2000 Year Number of Deaths Rate per 100,000a 1965 2,344 1.3 1970 2,406 1.2 1975 2,380 1.1 1980 1,955 0.9 1985 1,649 0.7 1990 1,416 0.6 1995 1,225 0.5 2000 776 0.3 1965–2000 62,213 0.8   Source: Data from CDC 1997a, 2000, 2003c (accessed January 23, 2003).   aAge-adjusted. populations, to get an equivalent population at risk among high gun states required taking the eleven states with the most people living in households with firearms (Wyoming, Montana, Alaska, South Dakota, Arkansas, West Virginia, Alabama, Idaho, Mississippi, North Dakota, and Kentucky). Between 1991 and 2000, a typical resident from a high gun state was over ten times more likely to die in a gun accident than someone from a low gun state. For example, although there were virtually the same number of children aged zero to four in both groups of states, 38 died from accidental gunshot wounds in the high gun states, compared to none in the low gun states (table 3.2). Two studies of adults created by pooling two national surveys also found that a gun...