Tuesday, August 7, 2012

Gun Mathematics

James Holmes went to the movies and shot 142 people. Wade Page entered a Sikh temple and gunned down 9 citizens. 31,513 people were killed by firearms in 2010 in the United States. (1) It remains remarkably easy to obtain firearms in most states.

One man, Richard Reid, boarded flight 63 from Paris to Miami on December 22, 2001 with plastic explosives in his shoe. The fuse failed to ignite. Reid is serving a life sentence in a supermax prison that houses the most dangerous prisoners in the federal system. All airline passengers since Reid’s attempt must remove their shoes so they can be scanned for bombs.  

How do we make sense of the different responses?
To put the question another way, how do we compare the association of shoes with bombs vs. the association of firearms with mortality? What would the equivalent of the new transportation safety regulations be for guns?

Is this simply a matter of the relative impotence of the shoe lobby compared to the gun lobby?

A brief review of the statistics lends some clarity to this uniquely American situation.

Firearms are one of the top 10 causes of death in the US. (1) In a 2003 World Health Organization study, the US was compared to 20 other high-income countries (Australia, Austria, Canada, Czech Republic, Finland, France, Germany, Hungary, Iceland, Japan, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Slovenia, Spain, Sweden, Scotland, and the United Kingdom). The US population at that time was 290.8 million and the combined population of the other countries was 563.5 million. There were 29,791 firearm deaths in the US that year and a total of 7,653 firearm deaths in the other 20 countries. (2)

We Americans are not more violent. But American violence is often lethal violence. And there is one reason for this fact; access to guns. We humans are an emotional lot, prone to impulsive behavior. Most violence is impulsive and the consequences limited by what’s at hand.

Another set of statistics helps frame a rational approach to gun legislation. Firearm deaths fall into three categories, suicides, homicides, and accidents. Most people are unaware of the fact that suicides represent the largest category, followed by homicides. (1)

It is fair to say that the majority of individuals who commit suicide are mentally ill or temporarily out of their minds. Most suicide deaths are accomplished with firearms. Between 2003 and 2007, an average of 46 Americans committed suicide with guns each day. (3)

Studies attempting to explain why some regions have higher suicide rates repeatedly find a strong significant positive association between gun ownership and rates of suicide. (4) Simply put, states with more guns have more suicides.

Public health concerns legitimately include gun control.

Similarly, preventable accidents fall under the purview of public health. Many fatal firearm accidents occur in children. In the U.S., children between the ages of 5 and 14 are 11 times more likely to be killed accidentally by a gun compared with the same aged children in other developed countries. (5) If we can perfect the child-proof medicine bottle, we should be able to protect children from guns.

It took one shoe to change the way Americans travel.
What will it take to change our way with guns?  


1.     U.S. Department of Health and Human Services, CDC, National Center for Health Statistics, National Vital Statistics Reports Jan 11 2012 Vol.60, 4
2.     Richardson EG, Hemenway D, J Trauma 2011 Jan; 70 (1):283-43
3.     Hemenway D. Amer J Lifestyle Med 2011 5:502
4.     Miller M, Lippman S, Azrael D, Hemenway D. Household firearm ownership and rates of suicide across the 50 U.S. states J Trauma. 2007;62:1029-1035
5.     Richardson EG, Hemenway D. Homicide, suicide, and unintentional firearm fatality: comparing the United States with other high-income countries, 2003 J Trauma. Doi: 10.1097/TA.


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