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Comment & Response
November 25, 2013

Firearm Legislation and Gun-Related Fatalities

Author Affiliations
  • 1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
  • 2Department of Anesthesia, Stanford University Hospitals, Stanford, California
  • 3Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
JAMA Intern Med. 2013;173(21):2011. doi:10.1001/jamainternmed.2013.9958

To the Editor With regard to the study by Fleegler et al,1 critics of stronger gun control policies argue that there is no rational impetus to strengthen the laws. They note that gun-related deaths have remained constant over the last 10 years; 10.4 gun-related deaths per 100 000 in the United States in 2002 and 10.3 per 100 000 in 2011.2

Focusing on trends in gun-related deaths rather than total gunshot injuries misrepresents the situation. In 2002, the incidence of nonfatal gunshot injuries in the United States was 20.5 per 100 000; in 2011 it was 23.7 per 100 000.2 The likely explanation is improvements in the management of trauma, such as prompt field stabilization and improved endovascular repair. The improvements have reduced the lethality of gunshot injuries, despite the proliferation of assault-style weapons.

The declining lethality of gunshot injuries has been offset by increases in the rate of shootings, leaving the rate of gun-related deaths relatively stable. In fact, gun violence in the United States has increased.

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Article Information

Corresponding Author: Anupam B. Jena, MD, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave, Boston, MA 02115 (jena@hcp.med.harvard.edu).

Conflict of Interest Disclosures: None reported.

Fleegler  EW, Lee  LK, Monuteaux  MC, Hemenway  D, Mannix  R.  Firearm legislation and firearm-related fatalities in the United States.  JAMA Intern Med. 2013;173(9):732-740.PubMedGoogle ScholarCrossref
Centers for Disease Control and Prevention (CDC). Injury Prevention & Control: Data & Statistics (WISQARS). www.cdc.gov/injury/wisqars/index.html. Accessed May 24, 201.