More USA death and injury stats

I was reading through an American article on pentrating abdominal trauma this afternoon (who says I don't know how to have a good time) and it started with this little nugget:

According to data published by the National Vital Statistics Reports, 11,406 homicide deaths occurred from firearm injuries in 2009 and 18,689 deaths from self-inflicted GSWs.[2] Forty percent of homicides and 14% of suicides by firearm involved injuries to the torso.
The 11.4K and 18.7K stats are slightly higher than the stats I saw recently, but let's work with that. The injury split is more or less what we'd expect: you would expect suicide by firearm to be almost universally targeted at the head, which means that 14% of firearm suicides either have very poor aim or something else is going on. Note that these are fatalities, not injuries; the remaining 60% of homicides would be mostly to the head, but there will be some fatal limb injuries (wrecking the femoral or brachial arteries and bleeding out), plus some multiple-site shootings where the fatal shot can't be nailed down.

Anyway, this led to a Medline article on race and insurance status as risk factors for trauma mortality (free registration required). This looked at the race of the victim rather than the offender, and from a reference group of white insured patients across a base of 400K USA victims. Now "insurance status" is a pretty good, if not 100%, signal for poverty; poor people don't tend to have medical insurance, they rely on Medicaid if anything. What this study determined was that poverty (lack of insurance) and African-American / Hispanic race status are independent predictors of poor trauma outcome, but poverty has a stronger association. So the number of trauma (vehicle accident, shooting, stabbing, suicide) deaths in the USA is at least partly because the people who live in areas where shootings occur most (poor, Hispanic + African-American communities) don't have good insurance and therefore don't get trauma care that's good enough to save them.

The CDC says that 180,000 Americans die of violence and injuries every year, and it's the dominant cause of death in the age range 1-44 years. They provide a data source called WISQARS which lets you query injury data including fatal injuries. Let's have a look at the stats for 2010.

  • Accidents (unintentional injury) is the leading cause of death from ages 1 thru 44, about 120K deaths overall
  • Suicide peaks in the 25-34 age group at number 2 and then tails off; about 38K deaths, 30% of accidents
  • Homicide peaks in the 15-24 age group and number 2 and is number 3 in age group 1-4; about 12K deaths, 10% of accidents
  • Flu kills 50K people per year, mostly in the 65+ age group
  • The ranking of death causes is about the same for men, but they are disproportionately likely to be victims of accidents (75K of 120K deaths) and suicide (30K of 38K deaths)
  • For black males, homicide leaps up to become the number 1 cause of death in ages 15-34, and nearly the same rate as accidents overall (8K accidental deaths vs 6.7K homicide deaths) but suicides are much lower-ranked overall (1.5K deaths)

So black men seem less likely to kill themselves, but more likely to be killed by others. And gun homicides are only 25% of the number of suicides overall. Yes, 50% of suicides are by gun - but then, given a 40% gun ownership rate, why wouldn't they be?

Perhaps not as many people would kill themselves if they didn't have a gun handy. Let's look ar the death stats in the UK where guns are very rare (though not non-existent). Data source is 2011 death registrations summary (final) which is 1 year off the 2010 USA figures, but I assert that no significant difference should be due to that time difference. UK population was ~65 million vs USA population of 311 million, so you can multiply UK figures by 5 to get roughly equivalent USA numbers

  • Accidents killed 6.5K men and 4.9K women (11.4K people corresponding to projected 55K and actual 120K in the USA - the USA is clearly a more dangerous place)
  • Transport accidents killed 1.4K men and 400 women - men are clearly much worse drivers
  • Falls killed about 3.9K men and women, equally divided.
  • Poisoning / exposure to poison killed 1.9K men, 900 women
  • "Accidental exposure to unspecified factor" killed 900 men and 1.5K women - WTF? Anyone any idea what this represents?
  • Intentional self-harm (basically, suicide) with deliberate intent killed 2900 men and 800 women for a total of 3.7K, and with undetermined intent killed 3.7K men and 1.2K women for a total of 8.6K (projected 43K and actual 38K people in the USA).
  • Assault and yet-to-be-determined-intent killed 480 men, 210 women for a total of 700 homicide-like instances (3500 projected vs 12K actual deaths).
So the USA has a suicide plague at similar rates to the UK, though the UK seems to have 1000 more suicides than it ought to if the USA is used as a baseline. The USA has about 3.5X the homicide rate of the UK. I note in passing and with reference to my post about US vs Canadian deaths and homicides by ethnicity that the UK has a black population fraction of less than 2% compared to the USA's 12%.

Overall, if anyone in the US political spectrum is serious at reducing unnecessary deaths of young people, they should be looking to reduce the rates of suicide and fatal (non-gun-related) accidents. Since they are not doing this, instead focusing on e.g. implementing a federal assault weapons ban similar to that which was so effective in Connecticut, I conclude that they are only interested in cheap political posturing and are hence below contempt. Perhaps "the war on poor mental health" and "the war on accidents" are not as vote-grabbing as "the war on guns", "the war on drugs".

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