Firearm Mortality

Firearms are a leading contributor to mortality in men aged 15-34 years in the USA, Mexico, Brazil, and Colombia, according to an observational study using national data for 106.3 million deaths, including 2.5 million firearm deaths in these 4 countries, published in The Lancet Public Health journal.

Although the number of firearm deaths has report at the national level for countries in the Americas previously; so the variations in firearm mortality at the state level, by race or ethnicity; so by education level have not been examined before. In addition, the impact of these deaths on life expectancy among sub populations has not been assessed.

Firearm mortality

In the study, the authors collected national data on individual deaths between 1990-2015 in the USA, Mexico, Brazil, and Colombia and, using information from death certificates; so they compare overall and firearm mortality at the country and state levels. In addition, the authors analyse these deaths by intent; also they also stratified cause of death data by age, gender, and education level.

Place of residence, education, and race were important factors in firearm mortality risk. There was more than ten-fold variation in the risk of firearm mortality; so in men age 15-34 across states in each of the 4 countries during 2010-15; also ranging between levels of 1.1% in Louisiana and 0.1% in Hawaii in the USA; so 4.7% in Chihuahua and 0.05% in Yucatán in Mexico, 4.4% in Alagoas and 0.5% in Roraima in Brazil, and 4.8% in Valle del Cauca and 0.2% in Guainía in Colombia.

The authors analysed firearm homicide rates between 2000-15 in men; so aged 25-34 years and how education and race affected this. They find that men with low educational attainment (high school or lower level of education); so were at greater risk of firearm homicide than those with higher educational attainment (post-secondary education) across all 4 countries.

In particular, in the USA, black men with lower educational attainment were 14 times; so more likely to die due to firearm homicide than comparably educated white men (1.52% vs 0.11% firearm mortality risk), and, in these groups, firearm homicides account for three quarters of the difference; so in overall mortality risk between black and white men (there was a 2% overall mortality difference between US black and white men).

The firearm homicide

Comparing these rates with comparably educate men of different races, and in different countries; so the authors find that black US men with low educational attainment were 2-4 times; hence more likely to die by firearm homicide than Brazilian black, brown or white men; also Mexican men (1.52% homicide mortality risk rate for black men in the USA compared with, respectively, 0.53%, 0.67%, 0.38%, and 0.39%).

The effect of race on firearm homicide was much greater in the USA than in Brazil; hence where differences in men’s risk of firearm mortality were mostly due to differences in education; also where a higher education reduced the relative risk of firearm homicide among men of all races by similar amounts.

The authors note that their state-level data may mask differences in smaller areas; so including cities and other localities. They also note that their homicide estimates in Brazil; which may be less reliable as they were based on national level race and education data; also because the underlying state level data on homicides in Brazil is less complete.

Further, in a linked Comment, Dr. Sandro Galea, Boston University, USA, states; so that the time has come for a world without civilian owned guns. He says: A world without most handguns and military style assault weapons might be unimaginable now; but data such as these from Dare and colleagues support the argument against civilian owned firearms; also prepare for a time when the question is not whether there should be a world without most guns; but simply how can this be achieved.