By Brandon Vick, Robert Orth, Charles Gartside

Information on the prevalence and cost of firearm injury is difficult to find and typically lacks important details. Using a rich dataset from the Pennsylvania Health Care Cost Containment Council (PHC4), researchers from PCCD/IUP performed a statistical analysis of non-fatal firearm injuries from 2016 to 2021, finding the following: • Initial injury totals and costs: Over the five-year timeframe, an estimated 10,640 new, non-fatal firearm injuries occurred in Pennsylvania for which patients received treatment. The medical cost of initial treatment for these injuries was $308.4 million, or over $51 million per year. The average cost of treatment was $34,837 in 2020. • Rising medical costs and injuries: The number of total injuries increased by 20 percent and the medical cost for these injuries increased by 107 percent from 2016 to 2020. The number of accidental injuries increased by 46 percent (to over 1,000 per year in 2020), with a cost increase of 195%. Assault injuries increased by 5%, with the medical costs of these injuries increasing by 81%. • Rises with COVID: The number of firearm injuries rose dramatically immediately after the onset of the COVID-19 pandemic and resulting shutdowns. Both accidental and assault injuries rose to their highest levels over the timeframe studied. • Economic and Racial Disparities: The poorest one-fifth of zip codes incurred nearly 60 percent of the total medical costs of firearm injuries. Two-thirds of all patients of firearm injuries were Black, although Black people make up only 11 percent of the Pennsylvania population. • Long-term costs: 16 percent of new injuries require additional hospital visits and incur nearly four times the medical costs, averaging over $70,000 per patient. Over 3 percent of new firearm injuries result in paralysis, increasing costs over the first year to over $100,000. • Full Economic Losses: If values are placed on lost work and lower quality of life, the total economic losses of firearm injury increase by six-fold to an estimated $300 million per year and $1.5 billion. Estimates here should be considered conservative, as they do not consider full costs to society (i.e. disability and unemployment payments) and are limited to costs only incurred during the time of visits for treatment (i.e. not counting long-term rehabilitation). Additionally, they do not include fatal injuries or shootings – for instance, over 600 people are victims of homicide by firearm and at least double that number die by firearm suicide per year. The nonfatal injury findings here are in line with estimates for U.S. injuries made separately by the Government Accountability Office and the Center for Disease Control. 

Harrisburg:  Pennsylvania Commission on Crime and Delinquency , 2022.  48p.

By Terra Wiens

In 2001, the United States experienced a historic demographic change. For the first time, Hispanics became the largest minority group in the nation, exceeding the number of Black residents.2 With a population in 2020 of 62.1 million, Hispanics represent 18.7 percent of the total population of the United States.3 This study is intended to report on Hispanic homicide victimization and suicide in the United States, the role of firearms in homicide and suicide, and overall gun death figures. Recognizing this demographic landscape, the importance of documenting such victimization is clear. Indeed, studies have found that Hispanic individuals are more likely to die by firearm homicide compared to white, non-Hispanic individuals.  

Washington, DC: Violence Policy Center, 2023. 23p.

By Nanzi Zheng, Karen M. Abram,  Leah J. Welty; et alDavid A

Importance  Youths, especially Black and Hispanic males, are disproportionately affected by firearm violence. Yet, no epidemiologic studies have examined the incidence rates of nonfatal firearm injury and firearm mortality in those who may be at greatest risk—youths who have been involved with the juvenile justice system.

Objectives  To examine nonfatal firearm injury and firearm mortality in youths involved with the juvenile justice system and to compare incidence rates of firearm mortality with the general population.

Design, Setting, and Participants  The Northwestern Juvenile Project is a 25-year prospective longitudinal cohort study of 1829 youths after juvenile detention in Chicago, Illinois. Youths were randomly sampled by strata (sex, race and ethnicity, age, and legal status [juvenile or adult court]) at intake from the Cook County Juvenile Temporary Detention Center. Participants were interviewed at baseline (November 1995 to June 1998) and reinterviewed as many as 13 times over 16 years, through February 2015. Official records on mortality were collected through December 2020. Data analysis was conducted from November 2018 to August 2022.

Main Outcomes and Measures  Participants self-reported nonfatal firearm injuries. Firearm deaths were identified from county and state records and collateral reports. Data on firearm deaths in the general population were obtained from the Illinois Department of Public Health. Population counts were obtained from the US census.

Results  The baseline sample of 1829 participants included 1172 (64.1%) males and 657 (35.9%) females; 1005 (54.9%) Black, 524 (28.6%) Hispanic, 296 (16.2%) non-Hispanic White, and 4 (0.2%) from other racial and ethnic groups (mean [SD] age, 14.9 [1.4] years). Sixteen years after detention, more than one-quarter of Black (156 of 575 [27.1%]) and Hispanic (103 of 387 [26.6%]) males had been injured or killed by firearms. Males had 13.6 (95% CI, 8.6-21.6) times the rate of firearm injury or mortality than females. Twenty-five years after the study began, 88 participants (4.8%) had been killed by a firearm. Compared with the Cook County general population, most demographic groups in the sample had significantly higher rates of firearm mortality (eg, rate ratio for males, 2.8; 95% CI, 2.0-3.9; for females: 6.5; 95% CI, 3.0-14.1; for Black males, 2.5; 95% CI, 1.7-3.7; for Hispanic males, 9.6; 95% CI, 6.2-15.0; for non-Hispanic White males, 23.0; 95% CI, 11.7-45.5).

Conclusions and Relevance  This is the first study to examine the incidence of nonfatal firearm injury and firearm mortality in youths who have been involved with the juvenile justice system. Reducing firearm injury and mortality in high-risk youths and young adults requires a multidisciplinary approach involving legal professionals, health care professionals, educators, street outreach workers, and public health researchers.

JAMA Netw Open. 2023;6(4):e238902. doi:10.1001/jamanetworkopen.2023.8902