Banning open carry of unloaded handguns decreases firearm-related fatalities and hospital utilization.

BackgroundSince 1967, in California it has been illegal to openly carry a loaded firearm in public except when engaged in hunting or law enforcement. However, beginning January 1, 2012, public open carry of unloaded handguns also became illegal. Fatal and non-fatal (NF) firearm injuries were examined before and after adoption of the 2012 ban to quantify the effect of the new law on public health.MethodsState-level data were obtained directly from California and nine other US state inpatient and emergency department (ED) discharge databases, and the Centers for Disease Control Web-Based Injury Statistics Query and Reporting System. Case numbers of firearm fatalities, NF hospitalizations, NF ED visits, and state-level population estimates were extracted. Each incident was classified as unintentional, self-inflicted, or assault. Crude incidence rates were calculated. The strength of gun laws was quantified using the Brady grade. There were no changes to open carry in these nine states during the study. Using a difference-in-difference technique, the rate trends 3 years preban and postban were compared.ResultsThe 2012 open carry ban resulted in a significantly lower incident rate of both firearm-related fatalities and NF hospitalizations (p<0.001). The effect of the law remained significant when controlling for baseline state gun laws (p<0.001). Firearm incident rate drops in California were significant for male homicide (p=0.023), hospitalization for NF assault (p=0.021  male; p=0.025 female), and ED NF assault visits (p=0.04). No significant decreases were observed by sex for suicides or unintentional injury. Changing the law saved an estimated 337 lives (3.6% fewer deaths) and 1285 NF visits in California during the postban period.DiscussionOpen carry ban decreases fatalities and healthcare utilization even in a state with baseline strict gun laws. The most significant impact is from decreasing firearm-related fatal and NF assaults.Level of evidenceIII, epidemiology

Gun Deaths Outpace Motor Vehicle Deaths in the DMV in 2010

Firearm-related fatalities exceeded motor vehicle fatalities in the DMV (District of Columbia, Maryland, and Virginia) in 2010, the most recent year for which data is available for both products. Firearm-related deaths include homicide, suicide, and unintentional fatal injuries. Gun deaths outpaced motor vehicle deaths not only in the region as a whole, but in each of the three jurisdictions that comprise the DMV. In 2010, gun deaths in the DMV totaled 1,512 while motor vehicles deaths totaled 1,280.The statistics in the DMV offer a stark illustration of a public health emergency that often receives scant attention from policymakers. Firearms remain the only consumer product not regulated by a federal health and safety agency, while the National Highway Traffic Safety Administration (NHTSA) has overseen automobile safety since 1966. Nationally, firearm fatalities almost equal motor vehicle deaths despite the fact that roughly three times as many Americans own automobiles as own firearms. The tolerance for such a high level of gun death is even harder to comprehend when the relative utility of the two products is taken into account. Unlike guns, motor vehicles are essential to the functioning of the U.S. economy

The Epidemiology of Firearm Violence in the Twenty-First Century United States

This brief review summarizes the basic epidemiology of firearm violence, a large and costly public health problem in the United States for which the mortality rate has remained unchanged for more than a decade. It presents findings for the present in light of recent trends. Risk for firearm violence varies substantially across demographic subsets of the population and between states in patterns that are quite different for suicide and homicide. Suicide is far more common than homicide and its rate is increasing; the homicide rate is decreasing. As with other important health problems, most cases of fatal firearm violence arise from large but low-risk subsets of the population; risk and burden of illness are not distributed symmetrically. Compared with other industrialized nations, the United States has uniquely high mortality rates from firearm violence

The Persistent Southern Disadvantage in Us Early Life Mortality, 1965‒2014

Background: Recent studies of US adult mortality demonstrate a growing disadvantage among southern states. Few studies have examined long-term trends and geographic patterns in US early life (ages 1 to 24) mortality, ages at which key risk factors and causes of death are quite different than among adults. Objective: This article examines trends and variations in early life mortality rates across US states and census divisions. We assess whether those variations have changed over a 50-year time period and which causes of death contribute to contemporary geographic disparities. Methods: We calculate all-cause and cause-specific death rates using death certificate data from the Multiple Cause of Death files, combining public-use files from 1965‒2004 and restricted data with state geographic identifiers from 2005‒2014. State population (denominator) data come from US decennial censuses or intercensal estimates. Results: Results demonstrate a persistent mortality disadvantage for young people (ages 1 to 24) living in southern states over the last 50 years, particularly those located in the East South Central and West South Central divisions. Motor vehicle accidents and homicide by firearm account for most of the contemporary southern disadvantage in US early life mortality. Contribution: Our results illustrate that US children and youth living in the southern United States have long suffered from higher levels of mortality than children and youth living in other parts of the country. Our findings also suggest the contemporary southern disadvantage in US early life mortality could potentially be reduced with state-level policies designed to prevent deaths involving motor vehicles and firearms

Retrospective Autopsy Based Analysis of Nature and Prevalence of Fatal Injuries in Lahore

Bacckground: Autopsy is a medical examination conducted after death to ascertain the cause of death. For Clinical autopsies, the permission of the next of kin is required. In suspicious deaths, an autopsy is a legal requirement and is performed by the coroner ormedico-legal surgeon. Methodology: Retrospective analysis of records of forensic medicine from January 1st, 2016 to December 31st, 2016, was done to observe fatal injuries causing death, their nature, and prevalence. The deaths, in which cause of death was Fatal Injury were included in our study. These cases were analyzed with respect to age, gender, cause and manner of death, number and location of injuries and the approximate time lag between injury and death. All data were entered into SPSS. Results: A total of 785 autopsies were conducted at the Department of Forensic Medicine and Toxicology, King Edward Medical University, Lahore in 2016, 42.8% fulfilled our inclusion criteria and were included in the study. Cases of firearm injuries were maximum constituting 46.4%, followed by RTA (13.7%) and blunt trauma (11.9%). Most victims were in the age bracket of 21-40 (55.1%) with a male to female ratio of 4.09:1. Head was the predominant site involved. Conclusion: Fatal injury deaths are mostly due to firearm injuries. Victims are more commonly males and majority cases die immediately after sustaining the injury. Manner of death is predominantly homicidal. Efforts should be made to prevent and properly manage fatal injuries

Gun Deaths Outpace Motor Vehicle Deaths in 17 States and the District of Columbia in 2013

In this report we find that Seventeen states and the District of Columbia already experience gun death rates that exceed their motor vehicle-related death rates. If current trends continue, the number of states where gun deaths outpace motor vehicles deaths will only continue to increase. The historic drop in motor vehicle deaths illustrates how health and safety regulation can reduce deaths and injuries that were at one time thought to be unavoidable. Such an approach to injury prevention has been applied to every product Americans come into contact with every day except for one: guns. And as is the case with motor vehicles, health and safety regulation could reduce deaths and injuries associated with firearms.Comprehensive regulation of the firearms industry and its products could include: minimum safety standards (i.e., specific design standards and the requirement of safety devices); bans on certain types of firearms such as "junk guns" and military-style assault weapons; limits on firepower; restrictions on gun possession by those convicted of a violent misdemeanor; expanded prohibitions on possession by persons with a history of domestic violence and better enforcement of existing prohibitions; heightened restrictions on the carrying of loaded guns in public; more detailed and timely data collection on gun production, sales, use in crime, as well as involvement in injury and death; and, public education about the extreme risks associated with exposure to firearms.America is reaping the benefits of decades of successful injury prevention strategies on its highways, but continues to pay an unacceptable, yet equally preventable, cost in lives lost every year to gun violence

Gun Deaths Outpace Motor Vehicle Deaths in 12 States and the District of Columbia in 2010

While motor vehicle-related deaths are on the decline as the result of a successful decades-long public health-based injury prevention strategy, firearm deaths continue unabated - the direct result of the failure of policymakers to acknowledge and act on this ubiquitous and too often ignored public health problem

Women Under the Gun: How Gun Violence Affects Women and 4 Policy Solutions to Better Protect Them

Every day in the United States, five women are murdered with guns. Many of these fatal shootings occur in the context of a domestic or intimate partner relationship. However, women are not the only victims. Shooters have often made children, police officers, and their broader communities additional targets of what begins as an intimate partner shooting. In fact, one study found that more than half of the mass shootings in recent years have started with or involved the shooting of an intimate partner or a family member. Enacting a comprehensive set of laws and enforcement strategies to disarm domestic abusers and stalkers will reduce the number of women who are murdered by abusers with guns -- and it will make all Americans safer

Incidence of Gunshot Wounds: Before and After Implementation of a Shall Issue Conceal Carry Law

Introduction. This study examined the incidence of gunshot wounds before and after enacting a conceal carry (CC) law in a predominately rural state. Methods. A retrospective review was conducted of all patients who were admitted with a gunshot injury to a Level I trauma center. Patient data collected included demographics, injury details, hospital course, and discharge destination. Results. Among the 238 patients included, 44.6% (n = 107) were admitted during the pre-CC period and 55.4% (n = 131) in the post-CC period. No demographic differences were noted between the two periods except for an increase in uninsured patients from 43.0% vs 61.1% (p = 0.020). Compared to pre-CC patients, post-CC patients experienced a trend toward increased abdominal injury (11.2% vs 20.6%, p = 0.051) and increased vascular injuries (11.2% vs 22.1%, p = 0.026) while lower extremity injuries decreased significantly (38.3% vs 26.0%, p = 0.041). Positive focused assessment with sonography in trauma (FAST) exams (2.2% vs 16.8, p < 0.001), intensive care unit admission (26.2% vs 42.0%, p = 0.011) and need for ventilator support (11.2% vs 22.1%, p = 0.026) all increased during the post-CC period. In-hospital mortality more than doubled (8.4% vs 18.3%, p = 0.028) across the pre- and post-CC time periods. Conclusion. Implementation of a CC law was not associated with a decrease in the overall number of penetrating injuries or a decrease in mortality

Prevalence and Patterns of Injury-Related Mortality in Nevada

Too many lives are lost to injury in the United States and in Nevada. Nearly 200,000 people in our country die each year from injuries, which is equivalent to one death every three minutes (CDC 2017b). Each of these deaths not only extinguishes a life, but also affects the friends, family, and community of the deceased. And deaths from injury are costly: researchers estimate that costs from fatal injuries exceed $200 billion (CDC 2017b). Injury refers to damage to the body from some external force, such as from a car crash or a fall, including kinetic, chemical, electrical, thermal or other forces. There are multiple types of death from injury. Health researchers and policymakers classify injuries as unintentional or intentional, and if intentional, injury deaths are further classified as either suicide or homicide. Researchers and policymakers further categorize injuries by the mechanism or circumstances of the injury (such as motor vehicle crash, poisoning, or firearm)