[Skip to Content]
[Skip to Content Landing]
May 5, 1993

Motor Vehicles or Firearms: Which Takes a Heavier Toll?

JAMA. 1993;269(17):2213. doi:10.1001/jama.1993.03500170043026

To the Editor.  —The leading causes of traumatic death in the United States are motor vehicles and firearms. In the former case, a major national effort to reduce the incidence and severity of injuries has had impressive results. From a high of 27.7 per 100 000 persons in 1969, the annual rate of motor vehicle-related deaths has declined 36% to an estimated 17.8 per 100 000 persons in 1991 (provisional data, National Center for Health Statistics)—lower than at any time since the early 1940s.1 No such injury prevention program has addressed firearm injuries, and the incidence of these has remained relatively stable at historically high levels.2For some years I have been suggesting that we may see firearms displace motor vehicles as the nation's leading cause of traumatic death. The news that this has already occurred in Texas and Louisiana3 prompted this attempt to predict when the