The cost of gun vi­o­lence A la une

A public health cri­sis?

Vocable (All English) - - Édito | Sommaire - JES­SICA GLENZA

More than 100,000 peo­ple are shot each year in the US at a to­tal cost of $2.8bn in hospi­tal charges, a study from John Hop­kins Univer­sity has found. If lost wages and hospi­tal charges are con­sid­ered to­gether, the au­thors said, the an­nual cost of shoot­ings in the US could be as high as $45bn.The study was pub­lished in the jour­nal Health Af­fairs, hours af­ter the dead­li­est mass shoot­ing in Amer­i­can his­tory, at a mu­sic fes­ti­val in Las Vegas on Oc­to­ber 1. At least 58 peo­ple were killed and 546 wounded.

2. Al­though mass shoot­ings rep­re­sent the most high-pro­file gun vi­o­lence in the US, homicide, sui­cide and ev­ery­day vi­o­lence kill many more. The study, which looked at more than 150,000 pa­tients in a na­tional data­base of emergency depart­ment vis­its be­tween 2006 and 2014, is one of just a hand­ful on Amer­i­can gun vi­o­lence pub­lished each year, be­cause of a lack of con­gres­sional fund­ing.

3.“The num­bers are re­ally, re­ally star­tling,” said Faiz Gani, one of the au­thors of the study and a post­doc­toral re­search fel­low at Johns Hop­kins School of Medicine depart­ment of surgery. “Pre­vi­ous stud­ies just fo­cused on the mor­tal­ity, but ig­nored the larger chunk of peo­ple who don’t die but are af­fected by this is­sue… That re­ally struck me as some- thing that was re­ally alarm­ing. There are 100,000 peo­ple who are af­fected and we’re not re­ally do­ing any­thing.”

4. In 2015, about 36,500 peo­ple died of firearms-re­lated in­juries. When that to­tal was added to those in­jured, Gani and his coau­thors found more than 100,000 peo­ple each year were shot, ei­ther as part of an as­sault, ac­ci­den­tally or while at­tempt­ing to kill them­selves.


5. Dr Thomas Weiser, a trauma sur­geon and as­so­ci­ate pro­fes­sor at Stan­ford Medicine, called the mass shoot­ing in Las Vegas “to­tally shock­ing, in­cred­i­bly tragic and to­tally ex­pected”. Re­cent re­search by Weiser es­ti­mated that vic­tims of firearms in­juries cost $700m in hos­pi­tal­iza­tions be­tween 2006 and 2014.

6.“It’s just a mat­ter of time be­fore this hap­pens again,” said Weiser. “The truth is these tragedies – these mass shoot­ings – at­tract tremen­dous head­lines. The other truth is there is daily car­nage through­out the United States in ones, twos and threes that don’t make head­lines.”

7. Pa­tients pay a high price for be­ing shot. On av­er­age, those treated in emergency de­part­ments in­curred $5,254 in charges. If they stayed in hospi­tal overnight, charges were far higher – $95,887 on av­er­age.

8. Pa­tients who stayed overnight in hospi­tal were more likely to be dis­charged to ex­pen­sive re­ha­bil­i­ta­tion fa­cil­i­ties. About a third of in­pa­tient gun­shot vic­tims were dis­charged to an­other med­i­cal fa­cil­ity and in­curred costs of $179,565 on av­er­age.

9. Over the course of the study, 2006 to 2014, the US Cen­ters for Dis­ease Con­trol and Pre­ven­tion (CDC) es­ti­mated 970,622 peo­ple in the US were wounded or killed by a firearm. “A lot of these in­di­vid­u­als tend to be from a lower so­cioe­co­nomic back­ground and tend to be unin­sured,” Gani said. “They’re pay­ing that out of pocket di­rectly.”


10. Firearms in­juries are the third-lead­ing in­jury-re­lated cause of death in the US, be­hind drug over­doses and car crashes. Nev­er­the­less, re­search on the causes and con­se­quences of gun vi­o­lence re­mains se­verely un­der­funded be­cause of the “politi­cized en­vi­ron­ment” around guns and gun sales.

11. One of the co-au­thors of the new re­search, Dr Joseph Sakran, is a pro­fes­sor and trauma sur­geon at Johns Hop­kins, and was a shoot­ing vic­tim. When Sakran was 17, he was shot in the throat af­ter a high school foot­ball game

and nearly died, he said, an ex­pe­ri­ence that in­spired him to pur­sue medicine as a ca­reer. “I love what I do, and I love be­ing able to take care of pa­tients, but what I would love more is to not ever have to take care of such un­nec­es­sary vi­o­lent crimes,” said Sakran. “This is a public health cri­sis we’re fac­ing here in the US.”

12. As many peo­ple die from gun­shots ev­ery year as from sep­sis. How­ever, gun vi­o­lence re­search re­ceives only 0.7% of the fund­ing given to re­search into sep­sis. For ev­ery 100 stud­ies pub­lished on sep­sis, four are pub­lished on gun vi­o­lence.


13. The study was con­ducted by re­searchers based at Johns Hop­kins in Bal­ti­more, a city that is ex­pe­ri­enc­ing one of the worst waves of gun-re­lated homicide in its his­tory. In late spring, the city’s mayor said “mur­der is out of con­trol” and that there were “too many guns on the streets”.

14. The study re­flected that re­al­ity. Nearly half of the pa­tients who ar­rived at the emergency depart­ment af­ter be­ing shot were vic­tims of as­sault, ac­count­ing for 348,000 pa­tients. Men be­tween 15 and 24 had the high­est in­ci­dences of gun wounds and were nine times more likely to be in­jured by guns than women. “There’s a lot of vi­o­lent crime,” Gani said, “and I think re­ally just be­ing a cit­i­zen of the city it’s some­thing that is pretty dis­con­cert­ing, and you want to find a so­lu­tion, and do some­thing.”

15. In the US, for ev­ery 100,000 peo­ple, 25.3 will visit an emergency depart­ment with a gun­shot wound each year – a rate “dis­pro­por­tion­ately higher” than in other de­vel­oped coun­tries such as Ger­many, Ja­pan and the UK. Some of the best in­ter-

na­tional data com­pares homicide rates be­tween coun­tries. In the US, 27 peo­ple are killed by firearms for ev­ery 1 mil­lion peo­ple. In the UK, that rate is one per 1 mil­lion, ac­cord­ing to the Geneva-based Small Arms Sur­vey.

16.“Al­though nu­mer­ous stud­ies have iden­ti­fied and pro­posed ef­fec­tive in­ter­ven­tions to limit firearm-re­lated vi­o­lence, ef­forts to re­duce firearm-re­lated in­juries have been lim­ited as a re­sult of the politi­cized en­vi­ron­ment sur­round­ing gun vi­o­lence and a lack of will to con­sis­tently im­ple­ment pro­posed poli­cies,” the Johns Hop­kins re­searchers wrote. The au­thors sug­gested that “fu­ture poli­cies must pro­mote more ef­fec­tive ways of lim­it­ing firearms ac­cess” for the men­tally ill and peo­ple with crim­i­nal records.


Firearms in­juries are the third-lead­ing in­jury-re­lated cause of death in the US.

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