Global mortality from firearms, 1990-2016

Naghavi, Moshen, and GBD 2016 Injury Collaborators, (2018) Global mortality from firearms, 1990-2016. Journal of the American Medical Association, 320 (8). pp. 792-814.

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View at Publisher Website: http://doi.org/10.1001/jama.2018.10060
 
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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 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; R-2 = 0.21) and homicide (P<.001; R-2 = 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.

Item ID: 55564
Item Type: Article (Research - C1)
ISSN: 1538-3598
Related URLs:
Additional Information:

Richard Franklin is part of the Global Burden of Disease 2016 Injury Collaborators group. All collaborators are listed at the end of the article.

Funders: Bill and Melinda Gates Foundation (BMGF)
Projects and Grants: BMGF OPP1152504
Date Deposited: 12 Sep 2018 08:41
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111711 Health Information Systems (incl Surveillance) @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 100%
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