Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System

C Barber; D Hemenway; J Hochstadt; D Azrael

doi:10.1136/ip.8.3.252

Responses

METHODOLOGIC ISSUES

Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System

Compose a Response to This Article

Compose Response

Title *

Author Information

Contributors
First Name and Middle Initial * First or given name, e.g. 'Peter'. Last Name * Your last, or family, name, e.g. 'MacMoody'. Email Address * Your email address, e.g. higgs-boson@gmail.com Occupation * Your role and/or occupation, e.g. 'Orthopedic Surgeon'. Affiliation * Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.

Statement of Competing Interests

Competing interests? *

Yes

Please describe the competing interests

PLEASE NOTE:

A rapid response is a moderated but not peer reviewed online response to a published article in a BMJ journal; it will not receive a DOI and will not be indexed unless it is also republished as a Letter, Correspondence or as other content. Find out more about rapid responses.
We intend to post all responses which are approved by the Editor, within 14 days (BMJ Journals) or 24 hours (The BMJ), however timeframes cannot be guaranteed. Responses must comply with our requirements and should contribute substantially to the topic, but it is at our absolute discretion whether we publish a response, and we reserve the right to edit or remove responses before and after publication and also republish some or all in other BMJ publications, including third party local editions in other countries and languages
Our requirements are stated in our rapid response terms and conditions and must be read. These include ensuring that: i) you do not include any illustrative content including tables and graphs, ii) you do not include any information that includes specifics about any patients,iii) you do not include any original data, unless it has already been published in a peer reviewed journal and you have included a reference, iv) your response is lawful, not defamatory, original and accurate, v) you declare any competing interests, vi) you understand that your name and other personal details set out in our rapid response terms and conditions will be published with any responses we publish and vii) you understand that once a response is published, we may continue to publish your response and/or edit or remove it in the future.
By submitting this rapid response you are agreeing to our terms and conditions for rapid responses and understand that your personal data will be processed in accordance with those terms and our privacy notice.

I agree to and have read the terms and conditions for rapid responses and BMJ Privacy Notice *

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Other responses

Jump to comment:

Authors' response
Catherine W. Barber
Published on: 13 May 2016
Doubts about undercounts of gun accident deaths
Gary D. Kleck
Published on: 13 May 2016

Published on: 13 May 2016
Authors' response
- Catherine W. Barber, Co-director, NVISS
- Other Contributors:
  Deborah Azrael, David Hemenway, and Jenny Hochstadt
Dear Editor
Kleck states that the misclassification of some unintentional shootings as homicides is likely to be counterbalanced by the misclassification of some suicides as unintentional, citing a study of unintentional gun deaths in North Carolina in the 1970s as evidence.[1] However, the investigators in that study reviewed only self-inflicted shootings that were noted as "accidents" or "undetermined" for ma...
Show More

Dear Editor
Kleck states that the misclassification of some unintentional shootings as homicides is likely to be counterbalanced by the misclassification of some suicides as unintentional, citing a study of unintentional gun deaths in North Carolina in the 1970s as evidence.[1] However, the investigators in that study reviewed only self-inflicted shootings that were noted as "accidents" or "undetermined" for manner of death to check for misclassifications. As such, they could detect suicides that were coded incorrectly as accidents, but they could not detect accidents that were coded incorrectly as suicides or as homicides. An investigation that tests only for false positives and not for false negatives and that is specific to one state (when medical examiner policies on coding manner of death vary widely across jurisdictions) sheds limited light on the issue.
Our paper [2] provides evidence that the National Vital Statistics System substantially undercounts the number of unintentional gun deaths that are inflicted at the hands of another person. We do not make any conclusion about whether self-inflicted gun accidents or gun accidents overall are accurately counted because the data against which we compared Vital Statistics--police Supplementary Homicide Reports--do not include self-inflicted gun accidents. There is no national source of data on self-inflicted gun accidents against which to substantiate Vital Statistics, nor is there a national source of data on the proportion of unintentional gun deaths that are self-inflicted versus other-inflicted.
A promising new source of data that could settle this issue at a national level is the National Violent Death Reporting System, currently being launched by the Centers for Disease Control and Prevention. That system will collect consistent, comparable data on all homicides and suicides, on gun-related deaths, and on injury deaths of unknown intent. A uniform protocol could be used for assigning gun-related deaths to the homicide, suicide, and unintentional injury categories for those cases in which the facts of the case are known and are not in dispute.
Why is this important? We should know the true burden of gunshot wounds in lives lost--whether higher than, lower than, or on par with current Vital Statistics figures. But to work more effectively to prevent these deaths, we should also know their true distribution by demographic features of the victim and by the specific precipitating circumstances and weapon types involved.
References
(1) Morrow PL. Response from Morrow. Am J Public Health 1987;77(4):153-154.
(2) Barber C, Hemenway D, Hochstadt J, and Azrael D. Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System. Inj Prev 2002;8:252-256.
Show Less

Conflict of Interest:
None declared.
- Back to top
Published on: 13 May 2016
Doubts about undercounts of gun accident deaths
- Gary D. Kleck, criminologist
Dear Editor
Barber et al.[1] note that some fatal gun accidents (FGAs) may be missclassified as homicides, and conclude that the nation "may be undercounting the burden of unintentional firearm deaths". They report 168 gun deaths labelled negligent (and thus accidental) manslaughters by police, and estimate that 75 % were misclassified as intentional homicides on death certificates, implying an undercount of...
Show More

Dear Editor
Barber et al.[1] note that some fatal gun accidents (FGAs) may be missclassified as homicides, and conclude that the nation "may be undercounting the burden of unintentional firearm deaths". They report 168 gun deaths labelled negligent (and thus accidental) manslaughters by police, and estimate that 75 % were misclassified as intentional homicides on death certificates, implying an undercount of perhaps 126 FGAs.
The authors mention misclassification of gun suicides as accidents, but as if it were merely a possible source of errors in the opposite direction. Morrow carefully reexamined a statewide sample of deaths officially labelled self-inflicted gun accidents and concluded that 11-28 % were actually suicides.[2] Since about half of the nation's 981 official FGAs in 1997 were self-inflicted, these figures imply 54-137 suicides wrongly counted as FGAs. If we accept a midrange figure of 96 "overcounts" v the authors' undercount of 126, there was a net undercount of 30, just 3.1 % of the national FGA total. Using the 137 upper limit figure would of course imply there was a net overcount of FGAs.
In sum, a more balanced appraisal of the evidence suggests that at present there is little foundation for concluding that there is any significant undercount of unintentional firearm deaths.
References
(1) Barber C, Hemenway D, Hochstadt J, and Azrael D. Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System. Inj Prev 2002;8:252-256.
(2) Morrow PL. Response from Morrow [Response to Kleck G., Accidental firearm fatalities] Am J Public Health 1987;77(4):153-154.
Show Less

Conflict of Interest:
None declared.
- Back to top

Main menu

Plain text

PLEASE NOTE:

Vertical Tabs

Other responses

Jump to comment:

Log in using your username and password

Main menu

Log in using your username and password

You are here

Plain text

PLEASE NOTE:

Vertical Tabs

Other responses

Jump to comment:

Read the full text or download the PDF:

Log in using your username and password