Download presentation
Presentation is loading. Please wait.
Published byKristian Paul Modified over 8 years ago
1
FIREARM VIOLENCE The physician’s perspective on the impact of firearm violence in our society.
2
Generously supported by: The John D. and Catherine T. MacArthur Foundation (for the 2003 and 1995 edition) and The Joyce Foundation The Chicago Community Trust (for the original 1995 edition)
3
FEAR OF VIOLENCE
4
CELEBRATING VIOLENCE We Celebrate Violence We Glamorize Violence We Promote Violence
5
REALITY OF VIOLENCE Source: Cook County Medical Examiner
6
VIOLENCE AS ENTERTAINMENT
7
REALITY OF VIOLENCE
9
EPIDEMIOLOGY
10
Source: National Center for Health Statistics, 2002 FIREARMS AS A PUBLIC HEALTH EPIDEMIC Number of U.S. Deaths Due to Firearms Each Year
11
FIREARM RELATED DEATHS IN THE UNITED STATES, 2000 (Total: 28,663) Source: National Center for Health Statistics, 2002
12
FIREARM AND MOTOR VEHICLE RELATED INJURY DEATHS Source: National Center for Health Statistics, 2002 Deaths
13
Source: National Center for Health Statistics, 2002 Firearm deaths of teenagers exceed the total from all natural causes of death combined.
14
Source: Annest JL, Mercy JA, Gibson DR, Ryan GW. National Estimates of Nonfatal Firearm-related Injuries. JAMA 1995 For every child killed by a gun, four are injured.
15
Source: National Center for Health Statistics, 2002 Age in Years U.S. FIREARM DEATH RATES BY AGE: HOMICIDE, SUICIDE AND UNINTENTIONAL, 2000 (Rate per 100,000 population)
16
U.S. FIREARM DEATH RATES BY AGE, RACE AND GENDER, 2000 (Rate per 100,000 population) Source: National Center for Health Statistics, 2002 Age in Years
17
FIREARM RELATED INJURIES Source: CDC. Data sources: for deaths, 2000 National Vital Statistics System, NCHC; for nonfatal injuries, 2000 National Electronic Injury Surveillance Systems, CPSC. Note: excludes 595 observed/unknown. Treated and Released 26,450 Hospitalized or Transferred 31,053 Deaths 28,663 Ratio: 0.9 1.1 1.0
18
Firearm injuries are all too common in the pediatric and adolescent population in the United States.
19
Source: National Center for Health Statistics, 2002 Gun violence is the Number 2 cause of death for young Americans between the ages of 10 and 19.
20
Source: National Center for Health Statistics, 2002 Gun violence is the number one cause of death for young African Americans between the ages of 10 and 19.
21
Source: National Center for Health Statistics, 2002 U.S. CHILD FIREARM FATALITIES 0-19 YEARS OF AGE 1986 – 2000
22
Deaths from polio (1952) 3,145 (all ages) Deaths from Firearms (2000) 3,042 (ages 0-19) Source: National Center for Health Statistics, 2002 COMPARING U.S. EPIDEMICS
23
Every day in America, eight children die from gun violence.
24
More than 30% of homes with children contain a gun. Source: Smith, T. 2001 National Gun Policy Survey of The National Opinion Research Center: Research Findings.
25
FIREARM STORAGE PRACTICES AMONG PARENTS 28% keep a gun hidden and unlocked 54% of parents would be very concerned about their child’s safety if they knew there was a gun in the home of their child’s friend However, 73% believe that it is “not at all likely” that their child would find and handle a gun without permission Source: Center to Prevent Handgun Violence, 1998
26
IN STUDY OF BOYS 8 – 12 YEARS: Source: Jackman GA, et al., Seeing Is Believing: What Do Boys Do When They Find a Real Gun?, Pediatrics, 2001. Found the hidden gun72% Handled the gun76% Pulled the trigger 48%
27
SAFETY PRECAUTIONS OF PARENTS OF YOUNG CHILDREN Source: Coyne-Beasley, Tamera, The Association of Handgun Ownership and Storage Practices with Safety Consciousness, Archives of Pediatric and Adolescent Medicine, Aug 2002 Use Smoke Detector99% Kept Poisons Out of Reach92% Store Guns Locked73% Cap Electrical Outlets72%
28
Nearly 40 % American teens know someone who has been shot. Source: Source: Teen Research Unlimited, Teen Gun Survey. Commissioned by Uhlich Children’s Advantage Network, 2003.
29
PROTECT CHILDREN NOT GUNS
30
HOMICIDE
31
GUN HOMICIDE RATES IN TEN DEVELOPED NATIONS (1999/2000*) Source: Alpers, Phillip. Update: Closing Illegal Markets, The Educational Fund to Stop Gun Violence, July 2002. *Most recent year available. Rate per 100,000 population
32
Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Rate per 100,000
33
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
34
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
35
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
36
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
37
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
38
INTERNATIONAL HOMICIDE RATES MALE, AGE 10-29 (1997-2000*) Source: World Health Organization, 2002 National Center for Health Statistics, 2002 * Most recent year available Rate per 100,000
39
1 Unintentional Injury 2 HOMICIDE 3 SUICIDE 4 Malignant Neoplasms Age 15 –24 LEADING CAUSES OF DEATH, YOUNG AMERICANS 2000 Source: CDC, National Center for Injury Prevention and Control, 2002 1 Unintentional Injury 2 Malignant Neoplasms 3 SUICIDE 4 HOMICIDE Age 10 –14
40
LEADING CAUSES OF DEATH, YOUNG AFRICAN AMERICAN MALES, 2000 Source: CDC, National Center for Injury Prevention and Control, 2002 1 HOMICIDE 2 Unintentional Injury 3 SUICIDE 4 Heart Disease Age 10 –14 1 HOMICIDE 2 Unintentional Injury 3 HIV 4 Heart Disease Age 15 –24
41
YEARS OF POTENTIAL LIFE LOST AT AGE 65 U.S. AFRICAN AMERICAN MALES, 2000 Source: CDC, National Center for Injury Prevention and Control, 2002
42
FIREARM & NON-FIREARM HOMICIDES, BY YEAR, FOR AFRICAN-AMERICAN MALES (12-24 YEARS OF AGE) Source: CDC, National Center for Injury Prevention and Control, 2002
43
PERCENT OF U.S. HOMICIDES DUE TO FIREARMS, 2000 Source: CDC, National Center for Injury Prevention and Control, 2002
44
HOMICIDE CHARACTERISTICS
45
RELATIONSHIP OF MURDER OFFENDER AND VICTIM, 2000 Source: U.S. Department of Justice, 2002
46
White VictimsBlack Victims RACE RELATIONSHIP OF MURDER OFFENDER AND VICTIM, 2000 Source: U.S. Department of Justice, 2002
47
HOMICIDE CIRCUMSTANCES, 2000 Source: U.S. Department of Justice, 2002 Romantic Triangle Brawl Argument
48
HOMICIDE TRENDS IN THE U.S., ALL AGES HOMICIDE CIRCUMSTANCES 1976-2000 Source: FBI, Supplementary Homicide Reports, 1976-2000. Deaths Year
49
WEAPONS USED IN HOMICIDES, 2000 (TOTAL: 12,943) Source: Bureau of Justice, 2002
50
RISKS OF HOMICIDE Summary Usually killed by someone known to victim Usually killed by someone of the same race Usually killed during an argument or fight Usually killed in an environment of drugs or alcohol Usually killed with a handgun
51
SUICIDE
52
Source: CDC, National Center for Injury Prevention and Control, 2002 SUICIDE is the third leading cause of death for young adults in the United States.
53
Source: Joe S, Kaplan M, Psychiatric Services, 2002 Suicide rates increased 14% among African American young men from 1979 to 1997.
54
Source: CDC, National Center for Health Statistics, 2002 Most suicides (over 57%) are committed with a firearm.
55
SUICIDE METHODS IN U.S. BY GENDER, 1998 Percentage of All Suicides Source: Romero, M and Wintemute, G. The Epidemiology of Firearm Suicide in the United States, Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2002 Totals Firearm 7,424 Hanging/Suffocation 5,726 Poisoning 5,072 Other 881 Fall 621 Cutting/Piercing 476 Drowning 375
56
Source: Kellerman AL and Waeckerle JF. Preventing Firearm Injuries. Ann Emergency Medicine, July 1998 85% of firearm suicide attempts result in death.
57
SUICIDE RATES, 2000: HIGH RISK GROUPS Source: CDC, Center for Health Statistics, 2002
58
Source: Kellerman AL, Rivara FP, Somes G, et al., NEJM 1992 Guns Kept in the Home: Increase risk of suicide 5 times
59
SUICIDE RISK AND GUN OWNERSHIP Source: Kellerman AL, Rivara FP, Somes G, et al., NEJM 1992 No Increased Risk Odds Ratio No Increased Risk
60
In 1 st year after gun purchase, suicide is leading cause of death. Source: Wintemute GJ, Parham CA, Beaumont JJ, Wright M, and Drake C. Mortality among recent purchasers of handguns. New England Journal of Medicine 1999, 341:1583-1589, November 18, 1999.
61
In 1 st week after handgun purchase, suicide risk increases 57 times. Source: Wintemute GJ, Parham CA, Beaumont JJ, Wright M, and Drake C. Mortality among recent purchasers of handguns. NEJM, 1999.
62
37% of American teens can get a gun if they want one. Source: Teen Research Unlimited, Teen Gun Survey. Commissioned by Uhlich Children’s Advantage Network, 2003.
63
Source: Kellerman AL, Rivara FP, Somes G, et al., NEJM 1992 In homes with firearms, a gun was the method chosen in 86% of the suicide cases. In homes where firearms were not usually kept, only 6% of the cases killed themselves with a gun.
65
Source: Smith, T. 2001 National Gun Policy Survey of The National Opinion Research Center: Research Findings. About 25% of American adults and 40% of American households own 192 million firearms.
66
American Citizens Own: 65 Million Handguns 70 Million Rifles 49 Million Shotguns 8 Million Other Long Guns Source: Smith, T. 2001 National Gun Policy Survey of The National Opinion Research Center: Research Findings.
67
HOMES WITH GUNS Homicide of Household Member – 3 times more likely Risk of Suicide – 5 times more likely Source: Kellerman AL et al. Gun ownership as a risk factor for homicide in the home. NEJM, 1993, and Suicide in the home in relation to gun ownership, NEJM, 1992.
68
A gun in the home increases a woman’s risk of intimate partner homicide 7 times. Source: Bailey, JE, et al., Archives of Internal Medicine, 1997
69
ARE GUNS PROTECTIVE? Gun Deaths
70
21% of law enforcement officers killed with a handgun were shot with their own weapon. Source: Wintemute GJ. American Journal of Public Health, 1994.
71
Potential for Morbidity or Lethality
72
Kinetic Energy
73
Caliber
74
Assault Weapons The term “assault weapon” refers to an entire category of military-style firearms that have the ability to hold a large capacity magazine, generate a rapid rate of fire, and operate in semi-automatic mode.
75
Semiautomatic Weapons
77
Armor Piercing Bullet
78
PERCENTAGE U.S. SPINAL CORD INJURIES CAUSED BY VIOLENCE Source: Spinal Cord Injury Information Network, 2003.
79
Source: CDC, Safe USA Fact Sheet: What You Should Know About Spinal Cord Injury Young Americans between 16 and 30 years of age account for over 50% of the spinal cord injuries from violence.
80
TRAUMATIC BRAIN INJURIES Source: CDC, Safe USA Fact Sheet: What You Should Know about Spinal Cord Injury
81
Annual U.S. Cost of Spinal Cord Injury due to Violence: $ 1.81 Billion Source: DeVivo MJ. Causes and costs of spinal cord injury in the United States. Spinal Cord, 1997.
83
Federal Gun Control Laws National Firearms Act of 1943 Federal Firearms Act of 1938 Gun Control Act of 1968 Brady Bill 1994
84
A Right to Bear Arms? “…the right of the people to keep and bear arms shall not be infringed.” Second Amendment The Constitution of the United States
85
A Right to Bear Arms? “A well–regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed.” Second Amendment The Constitution of the United States
86
Examples of Federal Protection Agencies National Highway Traffic Safety Administration Environmental Protection Agency Food and Drug Administration Consumer Product Safety Commission Bureau of Alcohol, Tobacco, and Firearms Source: Sugaman J, Rand K. Ceasefire, Violence Policy Center, 1994
87
Public Health and Individual Rights Smoke-free Environments Mandatory Seat Belts Motorcycle Helmets Childhood Immunizations Firearms
88
SURGEON GENERAL’S WARNING: Smoking By Pregnant Women May Result in Fetal Injury, Premature Birth, and Low Birth Weight. Public Health Approach to Injury Prevention Handguns Fatal
89
TRAUMA IS NO ACCIDENT
90
The Public Health Approach: Multidisciplinary Scientific Method Directed to Prevention Individual Behaviors and Attitudes Disease or Injury Social and Physical Environments
91
- AIDS Tested Methods: - Use condoms - Do not share needles - Multiple sex partners increase risk - Firearm Injuries Under Study: - Lock all guns - Store ammunition separately - Guns in home increase risk PUBLIC HEALTH ISSUES Health Problem Examples of Attitude and Behavior Changes
92
PUBLIC HEALTH ISSUES Tested Methods: - Improvement in sanitation, nutrition, housing - Attention to overcrowded areas Under Study: - Creation of youth activity programs - Developing suicide prevention networks - Common sense gun laws Health Problem Examples of Social Environment Modifications - Tuberculosis - Firearm Injuries
93
PUBLIC HEALTH ISSUES Health Problem Examples of Physical Environment Modifications - Shoulder harness - Airbags - Roadway construction and lighting - Integrated trigger locks - Chamber load indicators - Magazine disconnect devices - Motor vehicle crashes - Firearm Injuries
94
Primary Prevention Prevent injury or disease before it happens PUBLIC HEALTH ISSUES Primary PreventionFirearms - Vaccines - Smoking education - Diet and exercise Under Study: - Conflict resolution training - Prevent access (locks, background checks) - Develop alternative means of protection.
95
PUBLIC HEALTH ISSUES Secondary Prevention Minimizing the effects of disease or injury in progress - Treating hypertension - Registration of guns - Smoking cessation - Bulletproof vests - Reducing air pollution - Less destructive firearm power and ammunition Secondary PreventionFirearms
96
PUBLIC HEALTH ISSUES Tertiary Prevention Responding after the injury or disease has occurred Tertiary PreventionFirearms - Treating lung cancer - Coronary artery bypass - Chelation therapy for lead poisoning - Trauma network - Spinal cord injury rehabilitation - Counseling programs for victims
97
PRESCRIPTION TO REDUCE GUN VIOLENCE
98
Handguns, like cigarettes, can be deglamorized.
99
Rx: Public Messages Source: Chicago Project for Violence
100
“Which one is more regulated?” Source: Consumer Federation of America
101
Child proofing Chamber load indicators Less destructive ammunition Personalized handguns Rx: PRODUCT LIABILITY OPPORTUNITIES FOR SAFETY Ballistic fingerprinting Truth in advertising Control distribution Regulate manufacturers
102
Rx: Physician and Medical Student Advocacy
103
Rx: ADDRESS SOCIAL INEQUALITIES AND CONDITIONS THAT FUEL VIOLENCE
104
Rx: Reduced Gun Access to Suicidal Patients
105
Rx: Identify High Risks
106
PREVENTIVE MEDICINE TOPICS REMEMBERED BY PATIENTS (%) One study showed that young men recalled their doctor’s discussion of guns more than any other preventive medicine issue. Source: May JP, Martin KL, Journal of General Internal Medicine. 1993 Counseling Topic % patients
107
64% of teens are willing to discuss guns with their physicians Source: Kahn DJ, Kazimi MM, Mulvihill MN, Attitudes of New York City High School Students Regarding Firearm Violence, Pediatrics. May 2001
108
64% of adults made safe gun storage changes after counseling. 12% got rid of their guns altogether. Source: Albright TL, Burger SK. Improving Firearm Storage Habits: Impact of Brief Office Counseling by Family Physicians, Journal of the American Board of Family Practice. 2003
109
COUNSELING PATIENTS ABOUT GUNS
114
Talk to your patients about guns and violence.
115
Threats to children’s health require urgent and comprehensive action.
116
Adults must make environments safe, so kids can be safe.
117
WHAT WILL YOU DO?
118
Thank You
Similar presentations
© 2024 SlidePlayer.com Inc.
All rights reserved.