Guns, cars and potent toxins

In another post we pointed out that the number one cause of death in people aged 1 to 44 is unintentional injury. But some injuries are intentional, about half directed to other people and half self directed. Among people aged 15 to 44 intentional injury represents the second leading cause of death, about half homicides and half suicides (CDC). Guns figure prominently in both.

A recent study by Harvard School of Public Health researchers published in the Journal of Trauma shows that in states with higher rates of guns in households there is a significantly higher rate of suicide:

In the 15 states with the highest rates of household gun ownership, twice as many people committed suicide than in the six states with the lowest levels of household gun ownership. All the states had similar populations.

Although guns are involved in only five percent of all fatal and non-fatal suicide attempts, more than 90 percent of all suicidal attempts using guns are fatal, the study said. By comparison, drugs are used in 75 percent of all suicide attempts but are fatal only three percent of the time. (HealthDay News)

I wouldn't be a very good epidemiologist if I said this study shows that guns cause high suicide rates. It is well known that these kinds of ecological designs, where one tries to infer individual level risks from risks at the group level (here, the risk of a household with gun ownership versus suicide rate), can be in error. On the other hand, it is also well known that if someone makes a suicide attempt, they are much more likely to succeed if they use a gun, and often whether a gun is used is a question of access. This becomes a matter of concern for teens, where self directed violence is often impulsive and transitory. When a gun is used it becomes permanent.

Of the suicides, over half (by a bit) are gun suicides. In 2004 there were about 30,000 suicides a year in the US (CDC) and about half as many homicides (all ages). Risk of homicide is higher in the younger age groups where the ratio is half and half.

Whatever your view of guns, reducing gun violence (suicides and homicides) is an important public health problem. Guns kill about 27,000 people a year while cars kill some 43,000. But "exposure" to cars is much larger than "exposure" to guns.

In my world, that means guns are a much more potent and dangerous toxin.


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A gun certainly simplifies telling a suicide attempt from an accident. Wonder how many teen auto/drug/falling deaths are really suicides, and how we could tell if they were. I did some seriously risky things as a teen and in retrospect...

In Australia, restriction on gun ownership installed circa 1996 caused suicide by a gun to reduce by 50%, however overall rates of suicide were largely unchanged.

See report by Australian Bureau of statistics graph of "suicide by method"

I am just the teensiest bit suspicious of those sweeping statistical summaries.

bar: As you should be. Revere points out that this is an ecological study. (I wonder why those hoity-toity John Hopkins people even wasted their time to do an ecological study in the first place.) As such, those 'sweeping statistical summaries' are good general fodder, but drilling down deeper is spurious.

Interesting that you cited the suicide by gun data as I also remember that data as well as some UK data that charted suicide by type. The published research - though the authors and title are long since gone from my memory - had some data that suggested that the more violent the less willing that people would be to come suicide, to a point. At that point, would be suiciders used other means that may have had less efficiency.

Guns are dangerous. Locked up as they should be there is a lot less chance of a suicide. "I wouldn't be a very good epidemiologist if I said this study shows that guns cause high suicide rates" There has never been a suicide committed by a gun, its from someone using it on someone else or themselves. Suicide really should have a new designation...Self-murder. Thats like saying though that if they cut their wrists that knives caused it, or jumping from a bridge.

Nope. The people involved do themselves and not the guns. I wont argue that if you let an unstable person have a weapon of this nature that they will very likely succeed but only because they caused it.

The Australians outlawed guns and the murder rate went up with...guns. Illegally owned weapons...hmm. Its an agenda to ensure that the masses have no way to take their government out if they become too oppressive... Whats that guys name that said that? Tall, funny looking with a beard...Lincoln? Yeah thats the guy. Suicides are just that. If they want to off themselves they'll take poison, jump off bridges, put a rope around a tree limb, or my favorite...crossing the street in Memphis during five o'clock traffic. They can ensure a clean kill there.

Its like saying pencils make people write funny and food makes Rosie O'Donnell fat. Maybe she will go from self inflicted Twinkie ingestion. Outlaw Twinkie's.

In my world, they are a simple matter of defense.

By M. Randolph Kruger (not verified) on 13 Apr 2007 #permalink

It is currently being proposed to retrofit the Golden Gate Bridge with an antisuicide barrier suspended below the pedestrian walkways. (Not a single one of the dozens of proposed designs would do anything other than permanently disfigure the aesthetics of the structure.)

I wrote a letter to the bridge board in which I pointed out that a potential suicide who walks to midspan, looks down, and sees netting between them and the water, will if they simply turn 180 degrees then see a constant stream of 120kph traffic an arm's length away, much of it heavy vehicles which would be quite unable to stop in time.

I don't doubt that a barrier will eventually go in place. And I don't doubt that the overall regional suicide rate will be entirely unaffected by this.

Human lives are fragile. Human minds, even despairing ones, possess remarkable ingenuity. If it's not the bridge, or the .38, or the pill bottle, they'll find something.

Let us agree that from the standpoint of public health, suicide is a problem. But would it not be a more productive use of time to contemplate ways in which to alter intent rather than to prohibit an endless variety of potential means?


Oops-Have to post the latest here too. 4/14/07

Man Jumps to Death From Empire State Building; 911 Caller Reported Finding Leg on the Street

NEW YORK (AP) -- A man jumped to his death Friday out the window of a 69th-floor law office in the Empire State Building.

Police responded to the New York City landmark shortly before 3 p.m. after a 911 caller reported seeing a severed leg - covered in a gray sock - on the street below. The rest of the body was recovered from a setback on the 30th floor. The tragedy in the 102-story building closed portions of the busy Midtown Manhattan street while the investigation continued. Police identified the man as Moshe Kanovsky, a lawyer in his 30s. More than 30 people have committed suicide at the Empire State Building since it opened in 1931, including a 21-year-old man in February 2006.

Damn, now we have to outlaw buildings or put in thicker glass. Harvard is going to have to do a study now that shows that having a building in your life that is higher than one story is hazardous to your health if you are Jewish, and an attorney. Incidence rate between 15 and 44 year old attorneys are going to have to be reviewed to see if there is some relationship between open windows on the 69th floor and not making it all the way to the ground. I definitely want to know if Michael Jackson was up there getting his taxes done by this guy.

Well it had to have been the fact that Tuesday is tax day, I know that makes ME suicidal.

By M. Randolph Kruger (not verified) on 13 Apr 2007 #permalink

I don't doubt that individual gun ownership impacts rates of suicide, homocide, and other inappropriate uses of the firearms. However the Chezchs where unarmed while the Afghans, initially with ancient weapons, held off the Red army. While no one is about to invade the United States, individual ownership is still the last best defense against tyrany. They also provide some measure of protection against normal criminal activity. A mom and pop grocery store down the street from me was robbed about a year ago and the owner managed to get about four rounds off aginst the robber (not hitting him unfortunately). Anyway that particular robber is unlikely to return. Our local police were happy he at least got some rounds off. If we lived in an area where liberals rule the police likely would have arrested the store owner. All in all I really do prefer living in an area where all of my neighbors have firearms (most of them several) and our kids play safely in the street without fear of local gang bangers. Anyway, I know a lot of folks disagree (including people I otherwise admire greatly like trauma surgens). But I prefer the dangers living with available firearms to the dangers of living without them. Let me add that I understand a lot of people simply do not like firearms and don't want them around for well thought out reasons. It is helpful if you also understand that most of us in rural areas with multiple firearms are not raving lunitics who shoot family members in arguments or people who cut us off in traffic. Nor do we go around shooting at unidentified noises in the night. Their actually is such a thing as responsible owners of firearms.

Carl writes:

I prefer the dangers living with available firearms to the dangers of living without them.

As a Canadian, I can offer a perspective of someone living unarmed and without fear. You may wish to consider that both the prevalence of guns in the US and the fear mongering of the NRA may be the source of your fear.

individual ownership is still the last best defense against tyrany.

If things get so bad with your government that you are resorting to armed rebellion, then you've got way more to worry about than gun control laws.

individual ownership is still the last best defense against tyrany.

Would this be a good place to point out that nearly every family in Iraq owned a gun of some sort, many owned Kalashnikovs, but Saddam was still able to oppress the country? (Note: this is not an invitation to debate the rightness/wrongness of the Iraq war, only a counterexample to the thought that a modern dictatorship could be brought down by armed citizens)

decrepit: Yes, perfectly appropriate. I think all Cubans and all Swedes have rifles, too, as a requirement. There are many of us who don't think a gun is a defense against tyranny. So shoot me.

Yep, the Iraqi's all had rifles by requirement. But no ammo. Saddam held onto that. Sweden? What have they got to complain about? Everything is provided for them.

By M. Randolph Kruger (not verified) on 14 Apr 2007 #permalink

Randy: Well, I've lived there and it was pretty good. They also have a good economy, or at least as good as everyone else's. What do we have to cmplain about? Lots and lots. Which would I prefer? Having a lot or a little? (NB: The Swedes complain just like everyone else).

I wonder how long they would have lasted if NATO wasnt around Revere? Their King has been around for a bunch of years, and their biggest threat is Norway-Pop. of Idaho. I also never heard of any abuses by the Swedish government or King Gustav either.

By M. Randolph Kruger (not verified) on 14 Apr 2007 #permalink

I wonder how long they would have lasted if NATO wasnt around

The sound you just heard was the moving of the goalposts. The favorite tactic of those who cannot win an argument or face that fact.

The goal post NJ would have been moved if I had said that they wouldnt have been there if NATO wasnt around. They spend less on their own defense than most third world nations. They have gun crimes and bad people too. The difference isnt so much economics or health care there. Its the fact that people give a shit. We dont so much here.

By M. Randolph Kruger (not verified) on 16 Apr 2007 #permalink

Read recently that domestic violence is the leading cause of injury for women aged 18-44, (before car accidents).

I suppose there is no particular reason I should say that here, but your statistics brought it to mind... and I'm pretty convinced it isn't said nearly often enough.

The Virginia Tech gundown would have been prevented by a.) not having weapons at all in the nation? b.) If even two people had weapons on their person today one or both would have gotten shots off to take the shooter down? Please indicate a or b.....

Then we go to conjecture < = >. This guy was six kinds of pissed about something and the question was whether he was out to kill girlfriends, suitors to the girlfriend, professors or was just an asshole trying to make a political statement. Either way a lot of people died because he felt he was owed something in some manner.

May Deus servo quod servo vos totus

So now do we the gun toting public say he would have used a micro-wmd, such as a propane tank with a black powder charge on it, or would it have never happened? I dont know. I do know that he walked into a classroom with a weapon and that unless the number one guy carrying hadnt gotten him, the second one probably would have. They would have dealt with what was in front of them. Obviously you dont shoot at someone carrying a propane tank, but he brought a gun to a gun fight. I am just glad he didnt bring the barbeque machine with him.

Tragic, but this is the reason that I want everyone to pack. It keeps everyone very, very honest. He would have died of lead poisoning on the spot. He would have certainly gotten one of the students and maybe a shooter and maybe as many as three students and a shooter before they would have capped him, but down he would have gone. Anyone packing knows to dive and cover, and then open fire when they have a clear shot.

I am interested to see who knew what and when. If there was any discussion of it before it happened with any friend or family they are going down under Virginia's conspiracy laws and could face capital murder charges. I doubt if they will get a fair trial.

Sounds to me like he wanted some sort of payback for being treated poorly somewhere in his opinion. Hell's gates are waiting you sorry sack of shit. Good riddance, too bad you didnt use that bridge that Revere was talking about the other day. I would have helped you up on the rail yesterday afternoon if I had known about it. Assisted suicide? Now I guarantee I would have been acquitted.

The students are in my thoughts and the nations prayers. There is never any justice in these kinds of things, just tragedy. I wont even say that having a gun in a classroom would have been a good idea, only that it might have changed the outcome.

By M. Randolph Kruger (not verified) on 16 Apr 2007 #permalink