Global Mortality From Firearms, 1990-2016.
Journal: JAMA
Volume: 320
Issue: 8
Year of Publication: 2018
Affiliated Institutions: Institute for Health Metrics and Evaluation, University of Washington, Seattle. Higher National School of Veterinary Medicine, Algiers, Algeria. Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada. Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. School of Population and Global Health, University of Western Australia, Perth, WA, Australia. Department of Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines. Department of Public and Community Health, Birmingham City University, Birmingham, England. School of Science and Health, Western Sydney University, Penrith, NSW, Australia. Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran. Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Pharmacy, Mekelle University, Mekelle, Ethiopia. Center of Health System Research, The National Institute of Public Health, Cuernavaca, Mexico. Indian Institute of Public Health, Gandhinagar, India. The Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia. School of Psychology, University of Auckland, Auckland, New Zealand. Institute of Public Health, Heidelberg University, Heidelberg, Germany. Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, California. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorranmabad, Iran. Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorranmabad, Iran. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India. School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia. Department of Epidemiology, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico. Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia. Institute of Epidemiology, Comenius University, Bratislava, Slovakia. National Institute of Health, Cuernavaca, Mexico. Ucibio, Requimte, Faculty of Pharmacy, University of Porto, Porto, Portugal. Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia. Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom. Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, QLD, Australia. Harvard School of Public Health, Department of Nutrition, Harvard University, Boston, Massachusetts. Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam. Department of Population and Health, University of Cape Coast, Cape Coast, Ghana. School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University (RMIT), Bundoora, VIC, Australia. Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia. School of Pharmacy, Haramaya University, Harar, Ethiopia. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Department of Public Health, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil. Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. Department of Public Health Medicine, Bielefeld University, Bielefeld, Germany. College of Public Health Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia. School of Medicine Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle. Department of Epidemiology and Biostatistics, Jimma University, Jimma, Ethiopia. Epidemiological and Psychosocial Investigations, National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Institute for Global Health, University College London, London, United Kingdom. Biomedical Science Division, School of Medicine, Mekelle University, Mekelle, Ethiopia. Research Unit, Parc Sanitari Sant Joan de Déu (CIBERSAM), Sant Boi de Llobregat, Spain. Department of Public Health, Mizan-Tepi University, Mizan Teferi, Ethiopia. School of Public Health, Curtin University, Bentley, Perth, WA, Australia. Research Coordination, Fundación Entornos AC, Cuernavaca, Mexico. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China. Department of Public Health and Community Medicine, University of Liberia, Monrovia, Liberia. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. Department of Surgery, Virginia Commonwealth University, Richmond. Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. School of Continuing and Distance Education, University of Nairobi, Nairobi, Kenya. Public Health and Community Medicine, Jordan University of Science and Technology, Alramtha, Jordan. Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, South Korea. Department of Nutrition and Health Science, Ball State University, Muncie, Indiana. Clinical Epidemiology Unit, Lund University, Lund, Sweden. Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. School of Medicine, Xiamen University Malaysia, Sepang, Malaysia. Independent Consultant, Jakarta, Indonesia. Public Health Foundation of India, Gurugram, India. Department of Community and Family Medicine, Academy of Medical Science, Baghdad, Iraq. Helpmesee, New York, New York. School of Public Health, University of Haifa, Haifa, Israel. General Surgery Department, Aintree University Hospital National Health Service Foundation Trust (NHS), Liverpool, United Kingdom. Department of Cardiology, Damietta University, Damietta, Egypt. Ophthalmology Department, Aswan Faculty of Medicine, Aswan, Egypt. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran. Departamento Materno Infantil e Saúde Publica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Department of Health Sciences, University of York, York, United Kingdom. Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa. Department of Public Health, University of West Florida, Pensacola. Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru. Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland. School of Pharmacy, Academy of Medical Science, Baghdad, Iraq. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran. Department of Health Policy, National Center for Child Health and Development, Setagaya, Japan. Health Information Unit, Ministry of Health, Suva, Fiji. Public Health Department, Semarang State University, Kota Semarang, Indonesia. Western Sydney University, Penrith, NSW, Australia. School of Medicine, University of Adelaide, Adelaide, SA, Australia. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia. Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China. Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. Research and Evaluation Division, BRAC (Bangladesh Rehabilitation Assistance Committee), Dhaka, Bangladesh. Society for Health and Demographic Surveillance, Suri, India. Institute for Poverty Alleviation and International Development, Yonsei University, South Korea. WHO Collaborating Centre for Public Health Education & Training, Imperial College London, London, United Kingdom. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom. Department of Epidemiology, University of Washington, Seattle. Sina Trauma and Surgery Center, Iran University of Medical Sciences, Tehran, Iran. Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran. Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India. Department of Surgery, Marshall University, Huntington, West Virginia. Faculty of Medicine, Institute of Social Medicine, Centre School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia. Department of Health and Society, Faculty of Medicine, Universidad Ciencias Aplicadas y Ambientales, Bogotá, Colombia. Department of Public Health Medicine, University of Kwazulu-Natal, Durban, South Africa. UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India. Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama. Department of Psychiatry, Stellenbosch University, Cape Town, South Africa. Independent Consultant, Karachi, Pakistan. College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia. Instituts Für Medizinische Epidemiologie, Biometrie Und Informatik, Martin Luther University Halle-Wittenberg, Haale, Germany. School of Medicine, University of Alabama at Birmingham. Norwegian Institute of Public Health, Oslo, Norway. Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil. South African Medical Research Council, Cape Town, South Africa. School of Psychology, Deakin University, Burwood, VIC, Australia. Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria. Department of Surgery, Northwestern University, Chicago, Illinois. Department of Criminology, Law, & Society, University of California Irvine. Department of Medicine, University of Valencia, Valencia, Spain. Department of Public Health, Wollo University, Dessie, Ethiopia. Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam. Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria. UKK Institute for Health Promotion Research, Tampere, Finland. Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow, Russia. Demographic Change and Ageing, Federal Institute for Population Research, Wiesbaden, Germany. Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, China. Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong SAR, China. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan. Healthcare Management-Health Economics & Finance/Global Health, Jackson State University, Jackson, Missouri. Department of Epidemiology, University Hospital of Setif, Setif, Algeria. Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Abstract summary
Understanding global variation in firearm mortality rates could guide prevention policies and interventions.To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.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.Firearm ownership and access.Cause-specific deaths by age, sex, location, and year.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).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.Authors & Co-authors: Naghavi Marczak Kutz Shackelford Arora Miller-Petrie Aichour Akseer Al-Raddadi Alam Alghnam Antonio Aremu Arora Asadi-Lari Assadi Atey Avila-Burgos Awasthi Ayala Quintanilla Barker-Collo Bärnighausen Bazargan-Hejazi Behzadifar Behzadifar Bennett Bhalla Bhutta Bilal Borges Borschmann Brazinova Campuzano Rincon Carvalho Castañeda-Orjuela Dandona Dandona Dargan De Leo Dharmaratne Ding Phuc Do Doku Doyle Driscoll Edessa El-Khatib Endries Esteghamati Faro Farzadfar Feigin Fischer Foreman Franklin Fullman Futran Gebrehiwot Gutiérrez Hafezi-Nejad Haghparast Bidgoli Hailu Haro Hassen Hawley Hendrie Híjar Hu Ilesanmi Jakovljevic James Jayaraman Jonas Kahsay Kasaeian Keiyoro Khader Khalil Khang Khubchandani Ahmad Kiadaliri Kieling Kim Kosen Krohn Kumar Lami Lansingh Larson Linn Lunevicius Magdy Abd El Razek Magdy Abd El Razek Malekzadeh Carvalho Malta Mason-Jones Matzopoulos Memiah Mendoza Meretoja Mezgebe Miller Mohammed Moradi-Lakeh Mori Nand Tat Nguyen Le Nguyen Ningrum Akpojene Ogbo Olagunju Patton Phillips Polinder Pourmalek Qorbani Rahimi-Movaghar Rahimi-Movaghar Rahman Rai Ranabhat Rawaf Rawaf Rowhani-Rahbar Safdarian Safiri Sagar Salama Sanabria Santric Milicevic Sarmiento-Suárez Sartorius Satpathy Schwebel Seedat Sepanlou Shaikh Sharew Shiue Singh Sisay Skirbekk Soares Filho Stein Stokes Sufiyan Swaroop Sykes Tabarés-Seisdedos Tadese Tran Thanh Tran Ukwaja Vasankari Vlassov Werdecker Ye Yip Yonemoto Younis Zaidi El Sayed Zaki Hay Lim Lopez Mokdad Vos Murray
Study Outcome
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Statistics
Citations : The Geneva Declaration on Armed Violence and Development (2006) . http://www.genevadeclaration.org/home.html. Accessed August 22, 2017.Authors : 169
Identifiers
Doi : 10.1001/jama.2018.10060SSN : 1538-3598