Trends in Nonfatal and Fatal Firearm-Related Injury Rates in the United States, 1985–1995,☆☆,

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Abstract

See related editorials, p 77 and p 79.

Study objective: To characterize trends in annual estimates of nonfatal firearm-related injuries treated in US hospital emergency departments and to compare trends in quarterly rates of such injuries with those of firearm-related fatalities in the US population.

Methods: Data on nonfatal firearm-related injuries were obtained from the National Electronic Injury Surveillance System (NEISS) by review of medical records for June 1, 1992, through May 31, 1995. Data on firearm-related fatalities were obtained from the National Vital Statistics System for January 1, 1985, through December 31, 1995. NEISS comprises 91 hospitals that represent a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and provide 24-hour emergency service. The main outcome measures were numbers, percentages, and quarterly population rates for nonfatal and fatal firearm-related injuries.

Results: An estimated 288,538 nonfatal firearm-related injuries (95% confidence interval [CI], 169,776 to 407,300) were treated in EDs during the 3-year study period. The annual number of nonfatal firearm-related injuries increased from 99,025 for June 1992 through May 1993 (95% CI, 58,266 to 139,784) to 101,669 for June 1993 through May 1994 (95% CI, 59,822 to 143,516), then decreased to 87,844 for June 1994 through May 1995 (95% CI, 51,687 to 124,001). Before the third quarter of 1993, quarterly nonfatal and fatal firearm-related injury rates in the total US population and quarterly nonfatal firearm assaultive injury and firearm homicide rates for males aged 15 to 24 years were observed to be on the rise. Since then, these rates have significantly declined.

Conclusion: Analysis of national trends indicates that nonfatal and fatal firearm-related injuries are declining in the United States, although the rate of firearm-related deaths remains high, especially among males aged 15 to 24 years, in relation to other leading causes of injury death. An assessment of factors responsible for the decline in firearm-related injuries is needed to design further prevention efforts.

[Cherry D, Annest JL, Mercy JA, Kresnow M-J, Pollock DA: Trends in nonfatal and fatal firearm-related injury rates in the United States, 1985–1995. Ann Emerg Med July 1998;32:51-59.]

Section snippets

INTRODUCTION

In 1993, firearm-related injuries ranked second to motor vehicle-related injuries as the leading cause of injury death in the United States, taking 39,595 lives.1, 2 From 1968 to 1993, the number of motor vehicle-related deaths steadily declined, whereas the number of firearm-related deaths increased.1, 3 If those trends continue, firearm-related injuries are predicted to replace motor-vehicle crashes as the leading cause of injury death in the United States by the year 2001 (based on an

METHODS

Data were collected for all gun-related injuries treated in NEISS hospital EDs during the 3-year study period (June 1, 1992, through May 31, 1995). Study data were obtained through an ongoing agreement between the Centers for Disease Control and Prevention (CDC) and CPSC.

NEISS comprises 91 hospitals selected as a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and provide 24-hour emergency care. Hospital size, specified by the

RESULTS

A total of 9,401 cases of nonfatal firearm-related injury were recorded in the NEISS system from June 1, 1992, through May 31, 1995. Summing of the sample weights of these cases produced a national estimate of 288,538 (95% CI, 169,776 to 407,300) nonfatal firearm-related injuries treated in US hospital EDs during the 3-year study period. The overall annual rate of nonfatal firearm-related injury increased slightly between the period from June 1992 through May 1993 (38.8/100,000 [95% CI, 22.8 to

DISCUSSION

In this report, we present annual estimates of nonfatal firearm-related injuries treated in US EDs for the 3-year study period, June 1992 through May 1995. We also examine and compare trends in the quarterly rates of nonfatal and fatal firearm-related injury in the total US population and in the US male population aged 15 to 24 years.

Our data provide further evidence that firearm-related injuries and deaths are beginning to decline in the United States.6, 22 The annual number of nonfatal

Acknowledgements

We would like to express our thanks and appreciation to Art McDonald, director, and Eileen Kessler, statistician and project officer, Division of Hazard and Injury Data Systems, and other staff of the US Consumer Product Safety Commission for their diligence in providing high-quality surveillance data on nonfatal firearm-related injuries using the NEISS. We also thank Mr Steve James for his assistance in data preparation and Dr George Ryan for statistical consultation at the National Center for

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    From the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.

    ☆☆

    Reprint no. 47/1/90751

    Address for reprints: Joseph L Annest, PhD, Director, Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS/K59, Atlanta, GA 30341-3724, 770-488-4804, Fax 770-488-1665

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