Firearms and population health

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1 Firearms and population health Sandro Galea Boston University School of Public Health 1

2 Population health requires us, as a society, to collectively assure the social, economic, cultural conditions for people to be healthy Modified from Institute of Medicine. The Future of Public Health. National Academy Press; Washington, D.C.: 1988

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7 Nass D. Here s How Quickly Cable News Lost Interest in the Las Vegas Mass Shooting. The Trace. October 27, Accessed October 30, 2017.

8 Nass D. Here s How Quickly Cable News Lost Interest in the Las Vegas Mass Shooting. The Trace. October 27, Accessed October 30, 2017.

9 1. Descriptive epidemiology 9

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11 The Trace. 15 Statistics That Tell the Story of Gun Violence This Year. < Accessed June 10, 2016

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14 National Firearm Deaths, Rate per 100, Firearm Data source: CDC, WISQARS. NCHS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. 14

15 State-specific fatal firearm injury Decreasing trend: New York, Illinois, Maryland, North Carolina, California, Arizona, Nevada and DC Increasing trend: Massachusetts and Florida Data source: CDC, WISQARS. NCHS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. 15

16 Fatal firearm- Temporal trends by Race White Black Other race Whites: Annual rate change= per 100,000, P-trend=0.71 Blacks: Annual rate change= per 100,000, P-trend=0.22 Other race: Annual rate change= per 100,000, P-trend< Data source: CDC, WISQARS. NCHS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. 16

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18 2. Guns 18

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21 3. Guns=gun death and injury 21

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24 4. Suicide and lethality 24

25 Firearm suicides versus homicides, Rate per 100, suicide homicide Data source: CDC, WISQARS. NCHS Vital Statistics System for numbers of deaths. Bureau of Census for population estimates. 25

26 The Trace. 10 Essential Facts About Guns and Suicide. < Accessed September 11, 2016

27 The Trace. 10 Essential Facts About Guns and Suicide. < Accessed September 11, 2016

28 5. What we often forget 28

29 29

30 Total Burden of Firearm injuries Unknown,, 22,948, 2% Non-fatal transferred or hospitalized, 547,689, 38% treated and released, 432,010, 30% fatal, 440,095, 30% 30

31 Kalesan B, Adhikarla C, Pressley JC, Fagan JA, Xuan Z, Siegel M, Galea S. The hidden firearm epidemic: Increasing firearm injury rates, American Journal of Epidemiology. In press. 31

32 6. The mental health myth 32

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34 Lifetime prevalence of psychiatric disorders are comparable in Canada and the U.S. 50 Weighted survey prevalence United States Canada Bipolar disorder Major depression Any anxiety disorder Bipolar disorder Major depression Any anxiety disorder Schaffer A et al. Community survey of bipolar disorder in Canada: lifetime prevalence and illness characteristics. Can J Psychiatry 2006; 51(1): Patten SB et al. Descriptive Epidemiology of Major Depression in Canada. The Canadian Journal of Psychiatry February Kessler RC et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. JAMA 2005; 62 (6). Mental Health and Mental Illness. Anxiety Disorders Association of Canada. < Accessed November 21, 2014.

35 Firearm homicide rate per 100,000 in Rate per 100,000 population Canada United States Beatty, Sarah, Cotter, Adam. (2010) Homicide in Canada, 2009, Juristat 30 via An Overview of Gun Control in US, Canada and Globally. Coalition for Gun Control. < Accessed November 14, 2014.

36 7. On research 36

37 Stark DE, Shah NH. Funding and Publication of Research on Gun Violence and Other Leading Causes of Death. JAMA: The Journal of the American Medical Association. 2017; 317(1):

38 8. On potential solutions 38

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43 Bui Q, Sanger-Katz M. How to Prevent Gun Deaths? Where Experts and the Public Agree. The New York Times. January 10, Public.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region ion=top-news&wt.nav=top-news&_r=1 Accessed January 10, 2017.

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