A detailed picture of firearm injuries suffered in three American cities appears in this week's New England Journal of Medicine . In addition to tabulating firearm deaths, study investigators evaluated the amount, nature and outcome of firearm injuries, says first author Arthur L. Kellermann, M.D., director, Center for Injury Control, Rollins School of Public Health, Emory University. The injury rate in Memphis was twice that in Galveston and four times the rate in Seattle, the authors report. Forty-two percent of assault victims were shot by strangers and 38 percent by nonintimate acquaintances. Firearm-related injuries are a major cause of morbidity and mortality in urban areas.
Fatality rates vary markedly according to the intent of the shooter.
The ratio of nonfatal injuries to deaths ranged from roughly 16 to 1 for unintentional injury to 0.16 to 1 for suicide attempts. Most of this difference appears to be due to different anatomical patterns of injury. Handguns are disproportionately involved. Although handguns account for roughly half the new guns sold in the United States, they were involved in almost 90 percent of the shootings in the three study communities. The ability of handguns to be concealed readily and their ease of use are the most likely explanations for this observation.