Facts of Life:
Issue Briefings for Health Reporters
Vol. 8, No. 8
August 2003

Gunning for Attention:
Firearm Health Hazards

The Issue

The Facts

In Need of Medical Attention

Expert Sources

References

Nearly 30,000 people in the United States die from gunshot wounds each year, a number that rivals annual deaths from pancreatic and prostate cancer. (1,2) These lost lives are often considered in the context of crime and gun control laws, but researchers and advocates are beginning to claim them as an issue of public health. This new focus examines the link between firearms and mental and social health problems such as suicide and intimate partner violence and views firearms as one of many environmental factors that may affect health.

• One in three U.S. households contains a firearm, adding up to almost 200 million personal firearms nationwide. (4)
  
• People who keep a gun in their home are almost twice as likely to die in a gun-related homicide and 16 times more likely to use a gun to commit suicide than people without a gun in their home. (1)
  
• Women who are physically abused by an intimate partner have a fivefold increase in their risk of being murdered if that partner owns a handgun. (5)
  
• In 1997, the average length of a hospital stay for gunshot injuries was six days, compared with an average stay of 4.9 days for all other medical conditions. Hospitalization costs for firearm-related injuries totaled more than $800 million that year. (6)
  
• A 2001 study found that 44 percent of law enforcement officers in the South stored an unlocked and loaded weapon in their home. (7)
  
• U.S. geographic regions with higher rates of household firearms also have higher rates of homicide and unintentional firearm deaths. Between 1988 and 1997, Louisiana, Alabama, Mississippi, Wyoming, West Virginia and Arkansas had the highest average rate of firearm ownership. Hawaii, Massachusetts, Rhode Island and New Jersey had the lowest rate. (8)
  
• Compared with urban areas, rural areas have a higher percentage of gun deaths from shotguns and rifles and a higher percentage from suicides and accidents, according to a 2001 study. However, handguns were involved in more than 50 percent of all gun deaths across the two areas. (9)
  
• A small study of unintentional firearm injuries suggests that 32 percent of those injuries resulted from “deficiencies” in design such as the lack of a safety mechanism or a loaded chamber indicator. (10)
  
• Children who are treated for firearm injuries are at high risk for repeat injuries, including other firearm, motor vehicle and assault injuries. (11)
  
• Three-quarters of gun-owning parents believe that children ages 4 to 12 can distinguish a toy gun from a real one. Nearly one-fourth of these parents also think that their children can be trusted with a loaded gun. (12)
  

Most doctors’ offices these days are full of pamphlets on how to reduce the risk of lung cancer, how to recognize the warning signs of a stroke or how to protect against sexually transmitted diseases. Douglas Wiebe would like to see one more bit of required reading in the waiting room: a pamphlet with a handgun on the cover.

“It would say upfront that firearms have been linked to an increased risk of death in the home and go on to options for reducing the likelihood of this outcome,” he explains. “I think that physicians should be discussing guns in the home as a general rule. But the challenge for physicians is the limited time they have with their patients.”

Wiebe, a professor at the Centers for Clinical Epidemiology and Statistics and the Firearm Injury Center at the University of Pennsylvania, is not alone in identifying firearm injury and death as a public health problem. The American College of Emergency Physicians, for example, supports efforts to make guns safer and to limit their availability. But while physicians are apt to tell their patients to use condoms, avoid fatty foods and practice other healthy behaviors, they seem to have a harder time talking about guns.

A 1998 survey of California health care practitioners found that 80 percent said they should counsel families on firearm safety, but only 38 percent do so. (13)

A Danger in the Chambers

Douglas Wiebe’s latest research suggests that people who keep a gun in their home are more likely to die in gun-related homicides and suicides. But he acknowledges that more research needs to be done to find out whether guns in the home contribute to an injury or disease-like effect.

To do that, researchers “need better measurements of the relevant time period, the time between when you are exposed, or when you come into contact with a gun, and when an injury occurs,” Wiebe says.

Although previous studies have linked some behavioral factors such as domestic violence and drug use to the risk of gun deaths, Wiebe suggests that it may be more useful to focus on guns in the home as an environmental health hazard.

“In terms of prevention,” he says, “behavior is difficult to modify. That is one reason to focus on environmental risk factors, because they offer real promise to reduce the incidence of gun-related injury.”