State-specific, racial and ethnic heterogeneity in trends of firearm-related fatality rates in the USA from 2000 to 2010

Bindu Kalesan; Sowmya Vasan; Matthew E Mobily; Marcos D Villarreal; Patrick Hlavacek; Sheldon Teperman; Jeffrey A Fagan; Sandro Galea

doi:10.1136/bmjopen-2014-005628

State-specific, racial and ethnic heterogeneity in trends of firearm-related fatality rates in the USA from 2000 to 2010

BMJ Open. 2014 Aug 14;4(9):e005628. doi: 10.1136/bmjopen-2014-005628.

Authors

Bindu Kalesan¹, Sowmya Vasan², Matthew E Mobily³, Marcos D Villarreal³, Patrick Hlavacek³, Sheldon Teperman⁴, Jeffrey A Fagan⁵, Sandro Galea³

Affiliations

¹ Department of Surgery, Columbia University, New York, New York, USA Department of Epidemiology, Columbia University, New York, New York, USA.
² Department of Surgery, Columbia University, New York, New York, USA.
³ Department of Epidemiology, Columbia University, New York, New York, USA.
⁴ Trauma and Critical Care Services, Jacobi Medical Center, Bronx, New York, USA.
⁵ Department of Epidemiology, Columbia University, New York, New York, USA Department of Law, Columbia University, New York, New York, USA.

Abstract

Objectives: To document overall, racial, ethnic and intent-specific spatiotemporal trends of firearm-related fatality rates (FRF rates) in the USA.

Design: Cross-sectional study per year from 2000 to 2010.

Setting usa participants: Aggregate count of all people in the USA from 2000 to 2010.

Outcome measures: Data from the Web-based Injury Statistics Query and Reporting System from 2000 to 2010 was used to determine annual FRF rates per 100,000 and by states, race, ethnicity and intent.

Results: The average national 11-year FRF rate was 10.21/100,000, from 3.02 in Hawaii to 18.62 in Louisiana: 60% of states had higher than national rates and 41 states showed no temporal change. The average national FRF rates among African-Americans and Caucasians were 18.51 and 9.05/100,000 and among Hispanics and non-Hispanics were 7.13 and 10.13/100,000; Hispanics had a decreasing change of -0.18, p trend<0.0001. In states with increasing trends (Florida and Massachusetts), Caucasians and non-Hispanics drove the rise; while in states with decreasing trends (California, North Carolina, Arizona, Nevada, New York, Illinois, Maryland), Hispanics and African-Americans drove the fall. The average national FRF rates due to homicides (4.1/100,000) and suicides (5.8/100,000) remained constant, but varied between states.

Conclusions: Endemic national FRF rates mask a wide variation in time trends between states. FRF rates were twice as high in African-Americans than Caucasians but decreased among Hispanics. Efforts to identify state-specific best practices can contribute to changes in national FRF rates that remain high.

Keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH; STATISTICS & RESEARCH METHODS.

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Publication types

Comparative Study

MeSH terms

Black or African American*
Cross-Sectional Studies
Firearms*
Hispanic or Latino*
Humans
Time Factors
United States / epidemiology
White People*
Wounds, Gunshot / mortality*