We Know That Guns Are A Risk. But Does Anyone Really Care?

Two noted clinical gun researchers, ER physicians Garen Wintemute and Megan Ranney, have just published an important commentary about gun violence. The article follows from the decision of the American College of Emergency Physicians to join the seven other major medical organizations in calling for a more aggressive and comprehensive medical approach to gun violence, and the authors raise some important issues both in terms of the data on gun violence, as well as the particular challenges facing ER physicians who often face this problem on a daily basis.

The article points out that while vehicular and gun death rates were relatively stable beginning in 2000 and continuing for the next six or seven years, motor vehicle deaths then plunged again while the rate of gun mortality is beginning to creep back up.  The decline in car deaths is due to a successful public health campaign, but there has been no such campaign in the case of guns. This is even more disconcerting when one realizes that the United States is, in fact, one of the least violent countries in the OECD.  The percentage of American adults reporting being the victims of an assault is less than one third the number in Belgium, less than half of what is reported in Switzerland or Spain.

emt                What sets America apart from these other countries is that our violence is so much more deadly, and this is due to the existence of so many guns.  Only one OECD country, Israel, has a homicide rate one-third as high as ours; for the remaining OECD community our rate is ten to thirty times higher than anywhere else.  The authors tie these disparities to the enormous number of guns floating around, the U.S. counts only 5% of the world’s population but more than 40% of all guns in civilian hands.  I want to inject a cautionary note here, however, because our gun violence is overwhelmingly a function of the presence and use of handguns and, if anything, the U.S. probably has even a greater proportion of the world’s privately-owned pistols and revolvers, certainly this is the case when we confine our comparison to the rest of the OECD.

I mention the issue of handguns because the authors call for comprehensive background checks as the primary mechanism for reducing the possibility that guns will get into the wrong hands.  But I have never understood why background check advocates always promote checks both on handguns and long guns when gun violence as a criminal behavior overwhelmingly involves handguns, and while long guns are often used in suicides, it is arguably the case that long gun suicides are usually committed by the legal owner of the gun.  Given the firestorm that erupts every time an attempt is made to expand background checks, would we lose much ground by only using NICS to control the transfer of guns that cause the most harm?

My other concern is the article’s reliance on a public health approach that has worked for many other products but does not, in my view, address the central issue involved in regulating guns.  I cannot think of another consumer product whose regulation was opposed by the energized, mobilized and well-financed grass-roots effort which is the case with guns.  Of course car manufacturers fought seat belts, of course cigarette companies tried to deny that smoking made people sick, but when public policies were being debated you didn’t see the galleries packed by drivers or smokers demanding that the government stay off their backs.

Public opinion polls now show that, pace the valid research referenced by Wintemute and Ranney, a majority of Americans believe that a home containing guns is safer than a home which is gewehr-rein.  Consider such people deluded, stupid or worse, but the NRA has done a helluva job making us feel that the benefits of gun ownership outweigh the risks.  And I’m not sure the other side has a message that plays as well in Peoria or anywhere else.


Homicide And Gun Ownership: Update, Comparisons and Strategies

Last week I submitted this article to The Journal of Criminology and they rejected it immediately without comment.  But I thought you would like to read it anyway so here it is.    

In 2011 Erin Richardson and David Hemenway published a painstakingly-researched article based on 2003 data comparing gun violence in OECD countries.1  One of their findings was that the U.S. gun homicide rate was nearly 20 times higher than the overall rate for other high-income countries.   While they did not explicitly link elevated gun homicides in the U.S. to the prevalence of firearms in the civilian population, their findings have been utilized by virtually every gun control advocate to justify additional gun ownership restrictions, particularly in the wake of the Sandy Hook massacre in December, 2012.The purpose of this article is to update their data with more current information, as well as to determine whether the policy strategies being advanced to diminish gun harm aligns with the relevant data on gun violence.

The chart which follows contains updated (2010) data on national population, the number of guns in civilian hands, per capita civilian gun ownership and the gun homicide rate per 100,000.

Country Population (000’s) Civilian guns (000’s) Per capita % Hom. Rate
Australia 22,065 3,250 14.7 0.11
Austria 8,389 2,500 29.8 0.18
Canada 34,126 9,950 29.1 0.5
Czech Repub. 10,519 136 1.2 0.12
Finland 5,363 2,400 44.7 0.26
France 65,031 19,000 29.2 0.22
Germany 81,776 25,000 30.5 0.2
Hungary 10,000 560 0.05 0.13
Iceland 315 90 28.5 0
Italy 60,463 7,000 11.5 0.36
Japan 127,450 710 0.005 0
Luxembourg 506 70 13.8 0.6
Netherlands 16,615 510 3 0.2
New Zealand 4,367 1,000 22.8 0.26
Norway 4,889 1,320 26.9 0.04
Portugal 10,637 2,600 24.4 0.48
Slovakia 5,430 450 8.2 0.18
Spain 46,070 4,500 9.7 0.15
Sweden 9,378 2,800 29.8 0.19
UK 62,271 4,060 6.5 0.05
TOTAL OECD 585,660 87,906 15 0.17
USA 309,326 270,000 87.2 3.58


Notwithstanding changes in some specific values, the 2010 data shows a very similar profile to what Richardson and Hemenway discovered for 2003, namely, a correlation between gun ownership and gun homicide rates on the one hand, and a continued and significant disparity between the United States and other economically-advanced countries on the other.  Gun homicide rates per 100,000 range between null for Japan and Iceland up to .48 for Portugal, with the mean of .24 or above only being experienced by countries with a per capita gun ownership of at least 1 in 5.  There were other countries (Sweden, Norway, Iceland, France) whose per capita ownership also exceeded 1 in 5, but they were still below the mean for gun homicides.  The correlation for gun homicide and median per capita gun ownership, on the other hand, does not appear to be as strong.

Both the OECD and the U.S. gun homicide rate slipped between 2003 and 2010 (15 and 13 percent respectively) but the significant gap in gun homicide between the United States and other OECD countries remained basically unchanged.  To put this differential in a somewhat more graphic context, in the 22 countries above there were 12,070 homicide victims in 2010, of whom 11,078, or 92%, lived in the United States.  This is a remarkable statistic and there is no other form of violent death in which the disparity between the United States and its OECD cohorts displays even a fraction of this difference.3

The consistency of the data from 2003 and 2010 makes it difficult to ignore the connection between gun prevalence and gun homicide in the United States.  But the data, suggestive and comprehensive as it is, does not yield the kind of information that would allow us to align it properly with strategies designed to diminish the harm caused by guns. In particular, the evidence both for the U.S. and elsewhere is either silent or unreliable on defining the type of guns that are used in felony assaults.4  We can estimate this data from FBI-Uniform Crime Reports as well as other sources, and it appears to be the case that handguns (pistols, revolvers), as opposed to long guns (shotguns, rifles) are used in perhaps 90% of gun felony crimes.

If we deduct estimates of long gun ownership from the overall total of guns circulating amongst civilians in the United States, the per capita number for U.S. gun ownership would drop from its current 87 to somewhere below 40, placing us within the “normal” boundaries of gun ownership within the OECD.  What this simple exercise affirms is that we are not the only advanced country to allow its citizens access to small arms, but we are the only country that gives equal opportunity to acquiring both long guns and hand guns. The discussion about guns and homicide should focus on the prevalence of handguns, and not on small arms in general. Strategies to curb gun violence in the U.S. by controlling access to all types of small arms do not really catch the issue which needs to be addressed.



  1.  Erin G. Richardson & David Hemenway, “Homicide, Suicide and Unintentional Firearm Fatality: Comparing the United States with other High-Income Countries, 2003,” The Journal of Trauma, Injury, Infection, and Critical Care, Volume 70, No. 1 (January 2011), 238-243.
  2. See, for example, http://www.bradycampaign.org/about-gun-violence and  http://www.vpc.org/studies/moreguns.pdf.
  3. The U.S. auto fatality rate per 100,000 is lower than rates recorded for many OECD countries; cf. http://www.internationaltransportforum.org/irtadpublic/pdf/risk.pdf.
  4. Of the OECD countries compared in this study, less than 20% provide breakdown between long guns and hand gun ownership.  According to the ATF, 2010 was the first year since records have been kept (mid-80’s) when handguns constituted more than 50% of all guns manufactured or imported into the U.S. Cf. Firearms Commerce in the United States, Exhibits 1 and 3.
  5. Reliable estimates for 2010 in: http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2010/crime-in-the-u.s.-2010/tables/10shrtbl08.xls. See Table 6.