GunsGunshot Injuries in California Drop, but Percentage of Firearm Death Goes Up

Gun-violence research experts at UC Davis Health say that despite a significant drop in firearm injuries in recent years in California, there has been a substantial increase in the state’s overall death rate among those wounded by firearms.

“We found that the number of nonfatal firearm injuries in California decreased over an 11-year period, primarily due to a drop in firearm assaults,” said Sarabeth Spitzer, lead author and a UC Davis research intern at the time of the study. “However, the lethality of those and other firearm injuries did not go down. In fact, it went up.”

The new study is online in JAMA Network Open.

Nonfatal firearm injuries pose a significant health burden with great social and economic costs. For individuals who survive firearm injuries, the long-term physical and psychological effects can be devastating, requiring years of healthcare attention and rehabilitation. Until now, there has been relatively little knowledge about the distribution and types of nonfatal firearm injuries in the U.S.

The study used data from California’s Office of Statewide Health Planning and Development (OSHPD) for individuals treated in Emergency Departments (ED) or discharged from hospitals and data from the Centers for Disease Control and Prevention (CDC) WISQARS for fatal firearm injuries. Data were for the period between Jan. 1, 2005 and Dec. 31, 2015.

The study found that over the 11-year study period, there were approximately 81,000 ED visits and hospitalizations due to nonfatal firearm injuries. It also found that the overall rate of nonfatal firearm injuries decreased by 38%. While this decrease was driven primarily by a substantial decrease in firearm assaults, self-inflicted and unintentional injuries remained stable. The study identified around 70% of the nonfatal injuries were from an assault, 24% were unintentional injuries, 2% self-inflicted and 5% undetermined.

To capture the lethality of firearm injuries, the researchers calculated two versions of the case fatality ratio (CFR), the proportion of injuries that are fatal. The overall CFR is for all people who sustain a firearm injury, whether or not those people receive medical care (most people who die from gunshot wounds do so at the scene of the shooting). The clinical CFR is for people who survive to reach the hospital and receive medical care. California’s overall CFR for firearm injuries increased from 27.6% in 2005 to 32.2% in 2015, while the clinical CFR remained stable, at about 8%.