Canadian and international researchers have produced the most extensive assessment of global firearm mortality ever undertaken in a study recently published in JAMA.
The researchers, working as part of the Global Burden of Disease project, investigated global firearm mortality between 1990 and 2016 by analyzing several thousand data sources to identify trends in 195 countries. They measured cause-specific deaths in relation to age, sex, location, and year, and also explored the relationship between gun ownership and access and deaths.
Around 250,000 people worldwide died from gunshots outside of military contexts in 2016 alone – 64% were homicides, 27% were suicides, and 9% were accidental. A total of 87% of deaths were of males, and the 20-24 age group alone experienced 34,700 deaths.
In all but one year during the study period (1994, owing to the Rwandan genocide), firearm deaths were more common outside of military contexts than inside. Deaths from executions, terrorism, and law enforcement were not included in the assessment.
“When a quarter of a million people die per year by use of firearms, that is an enormous public health problem and crisis we should address… and, of course, acknowledge that the risks vary tremendously across nations,” says Daniel Webster, Director of the Johns Hopkins Center for Gun Policy and Research in an accompanying video presentation.
Most Firearm Deaths in 2016 Occurred in the Americas
Overall, there was an average annual decrease of 0.9% in deaths per 100,000, mainly because of a decelerating suicide rate. But trends from country to country were found to vary wildly, and arguably the most important trend was the disproportionate concentration of gun deaths in the Americas.
Six American countries encompassed 50.5% of all firearm deaths worldwide in 2016: Brazil, Colombia, Mexico, Venezuela, Guatemala, and the U.S.
Caribbean and other Latin American countries were similarly afflicted by gun violence, and the authors suggest that this extreme concentration of firearm homicides is because many of these countries are trafficking and production hotspots for the international drug trade.
As for Canada, 900 died by gunshots in 2016 – for comparison, the U.S. rate of deaths per 100,000 was five times higher. Regardless, “that’s 900 too many”, says Canadian co-author Nadia Akseer, PhD and Senior Research Associate of Biostatistics and Epidemiology at the Hospital for Sick Children.
“Canada must step up and tackle our domestic challenges to make any gain – tighter gun legislation, intervening with young adults, and prioritizing mental health in public health agendas are important steps to that end,” she adds.
Suicides Dominate the Data in Higher Income Countries
The other major takeaway from this study is the connection between higher income countries and the primacy of gun deaths by suicide. In 2016, the U.S. saw 35% of global suicides using firearms despite only 4% of the world’s population living there.
The authors believe that the ready availability of guns in the home is a significant factor in the number of gun-related suicides. Suicide by gun rarely fails (91% of attempts are fatal according to the paper), and inadequate uptake in safe storage practices leaves immediate access to a “means of harm that generally does not allow opportunity for second thoughts.”
But accessibility and ownership are not necessarily the tipping point for suicide rates. In the case of the US, the vast majority of homes in possession of a firearm will not experience a terrible outcome.
Webster explains that it is when access is coupled with other high-risk factors – which can be found in any country – that the real danger emerges. Impulsive personalities, the mentally ill, and those with substance abuse issues all have a much greater chance of harming themselves or others when in reach of a firearm.
Cultural norms regarding firearm suicide, especially as it relates to sex, are also believed to play a role, and the complex interaction between all of these factors will be crucial for future prevention strategies.
International Cooperation Will Be Essential
The data from this paper offer powerful indicators to legislators about how to direct their policies in future. Understanding trends – historical, cultural, economic, and legal, especially at the level of complex, international interaction – is key to mitigating this global issue.
“This landmark and timely study provides important data to support the relationship between firearm ownership and increased mortality from homicides and suicides,” says Akseer. “In a global climate that often contests such relationships, it’s critical for legislators to take action on these objective data – the facts are the facts.”
