Missouri Firearm-Related Injury Surveillance System

Am J Prev Med. 1998 Oct;15(3 Suppl):67-74. doi: 10.1016/s0749-3797(98)00064-6.


Context: The Missouri Department of Health collects hospital inpatient and emergency room records statewide. With mortality data, they make up a population-based surveillance system of firearm-related injuries. Much information is not captured by these data, however.

Objective: During a three-year project we attempted to develop a timely, representative, and sensitive surveillance system of firearms-related injuries and their circumstances.

Design: The surveillance system consisted of Missouri's hospital and mortality records linked to police records of firearm incidents.

Setting: Lack of standardization of police department data precluded a statewide surveillance system; therefore, we concentrated on the two largest urban areas, St. Louis and Kansas City.

Participants: Firearm-related injuries occurring during crimes in the surveillance area in 1994 were recorded. Wounds inflicted unintentionally or during suicide attempts were excluded.

Main outcome measures: We evaluated the system according to its simplicity, flexibility, acceptability, sensitivity, predictive value positive, representativeness, and timeliness.

Results: The surveillance system was neither timely nor simple. Though estimated to represent 95% of the desired cases, information about the firearms and the circumstances was relatively scant.

Conclusions: Police records as they now exist cannot be included in a statewide firearms surveillance system. The cost/benefit ratio does not justify even a regional surveillance system. Standardization of police records would be helpful, but some information will always be lacking unless the perpetrator is arrested.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Data Collection / methods
  • Female
  • Humans
  • Male
  • Medical Record Linkage
  • Middle Aged
  • Missouri / epidemiology
  • Population Surveillance / methods*
  • Program Development
  • Program Evaluation
  • Sensitivity and Specificity
  • Wounds, Gunshot / epidemiology*
  • Wounds, Gunshot / etiology