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Global Mortality From Firearms, 1990-2016

, ; Naghavi, Mohsen; Marczak, Laurie B; Kutz, Michael; Shackelford, Katya Anne; Arora, Megha; Miller-Petrie, Molly; Aichour, Miloud Taki Eddine; Akseer, Nadia and Al-Raddadi, Rajaa M, et al. (2018) In JAMA - Journal of the American Medical Association 320(8). p.792-814
Abstract

Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions.

Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.

Design, Setting, and Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths.

Exposures: Firearm... (More)

Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions.

Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.

Design, Setting, and Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths.

Exposures: Firearm ownership and access.

Main Outcomes and Measures: Cause-specific deaths by age, sex, location, and year.

Results: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P < .001; R2 = 0.21) and homicide (P < .001; R2 = 0.35).

Conclusions and Relevance: This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.

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JAMA - Journal of the American Medical Association
volume
320
issue
8
pages
23 pages
publisher
American Medical Association
external identifiers
  • scopus:85052567667
ISSN
0002-9955
DOI
10.1001/jama.2018.10060
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English
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824d735a-076e-4b9c-8f84-118f28acc417
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2018-09-01 16:41:32
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2019-05-21 04:10:18
@article{824d735a-076e-4b9c-8f84-118f28acc417,
  abstract     = {<p>Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions.</p><p>Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.</p><p>Design, Setting, and Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths.</p><p>Exposures: Firearm ownership and access.</p><p>Main Outcomes and Measures: Cause-specific deaths by age, sex, location, and year.</p><p>Results: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P &lt; .001; R2 = 0.21) and homicide (P &lt; .001; R2 = 0.35).</p><p>Conclusions and Relevance: This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.</p>},
  author       = {,  and Naghavi, Mohsen and Marczak, Laurie B and Kutz, Michael and Shackelford, Katya Anne and Arora, Megha and Miller-Petrie, Molly and Aichour, Miloud Taki Eddine and Akseer, Nadia and Al-Raddadi, Rajaa M and Alam, Khurshid and Alghnam, Suliman A and Antonio, Carl Abelardo T and Aremu, Olatunde and Arora, Amit and Asadi-Lari, Mohsen and Assadi, Reza and Atey, Tesfay Mehari and Avila-Burgos, Leticia and Awasthi, Ashish and Ayala Quintanilla, Beatriz Paulina and Barker-Collo, Suzanne Lyn and Bärnighausen, Till Winfried and Bazargan-Hejazi, Shahrzad and Behzadifar, Masoud and Behzadifar, Meysam and Bennett, James R and Bhalla, Ashish and Bhutta, Zulfiqar A and Bilal, Arebu Issa and Borges, Guilherme and Borschmann, Rohan and Brazinova, Alexandra and Campuzano Rincon, Julio Cesar and Carvalho, Félix and Castañeda-Orjuela, Carlos A and Dandona, Lalit and Dandona, Rakhi and Dargan, Paul I and De Leo, Diego and Dharmaratne, Samath Dhamminda and Ding, Eric L and Phuc Do, Huyen and Doku, David Teye and Doyle, Kerrie E and Driscoll, Tim Robert and Edessa, Dumessa and El-Khatib, Ziad and Endries, Aman Yesuf},
  issn         = {0002-9955},
  language     = {eng},
  month        = {08},
  number       = {8},
  pages        = {792--814},
  publisher    = {American Medical Association},
  series       = {JAMA - Journal of the American Medical Association},
  title        = {Global Mortality From Firearms, 1990-2016},
  url          = {http://dx.doi.org/10.1001/jama.2018.10060},
  volume       = {320},
  year         = {2018},
}