The cost of gun vio­lence

La vio­lence des armes en chiffres.

Vocable (Anglais) - - Édito Sommaire -

Comme à chaque fu­sillade de masse aux États-Unis, la tra­gé­die de Las Ve­gas a re­lan­cé le dé­bat sur le contrôle des armes à feu. Pour faire bou­ger les lignes, des mé­de­cins ont dé­ci­dé d’éva­luer pré­ci­sé­ment le coût hu­main et ma­té­riel des armes pour la so­cié­té amé­ri­caine. Ils parlent d’une vé­ri­table crise de santé pu­blique.

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 in­ter­na­tio­nal

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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