Elsevier

Preventive Medicine

Volume 123, June 2019, Pages 20-26
Preventive Medicine

Violent death rates in the US compared to those of the other high-income countries, 2015

https://doi.org/10.1016/j.ypmed.2019.02.026Get rights and content

Highlights

  • The US firearm homicide rate is 24.9 times higher than in other high-income countries.

  • The US firearm suicide rate was 9.8 times higher than in other high-income countries.

  • 83.7% of all firearm deaths occurred in the US.

  • 91.7% of women and 98.1% of all children killed by firearms were in the US.

  • Firearm homicide rates in low-gun states were 13.5 times higher than other countries.

Abstract

Violence is a serious public health issue in the U.S. This research compares the US and other high-income countries in terms of violent death. We used data from the World Health Organization for populous, high-income countries. Data from CDC's WISQARS and WONDER systems were used to assess mortality data among US white and non-white populations and in low-, medium-, and high-gun states in 2015. Death rates per 100,000 populations were calculated overall, by age, and by sex. Poisson and negative binomial regression were used to test for significance. The homicide rate in the US was 7.5 times higher than the homicide rate in the other high-income countries combined, which was largely attributable to a firearm homicide rate that was 24.9 times higher. The overall firearm death rate was 11.4 times higher in the US than in other high-income countries. In this dataset, 83.7% of all firearm deaths, 91.6% of women killed by guns, and 96.7% of all children aged 0–4 years killed by guns were from the US. Firearm homicide rates were 36 times higher in high-gun US states and 13.5 times higher in low-gun US states than the firearm homicide rate in other high-income countries combined. The firearm homicide rate among the US white population was 12 times higher than the firearm homicide rate in other high-income countries. The US firearm death rate increased between 2003 and 2015 and decreased in other high-income countries. The US continues to be an outlier among high-income countries with respect to firearm deaths.

Introduction

Injuries are a major public health problem in the United States, accounting for more potential years of life lost before age 65 than cancer and heart disease combined. Intentional injuries (i.e., suicide and homicide) accounted for 27% of all US injury deaths in 2016. Among 15–34 year-olds, suicide and homicide were the second and third leading cause of death from all causes (National Center for Injury Prevention and Control, 2016).

Compared to other high-income countries, the US is an average country in terms of non-fatal crime and violence, but has much higher rates of gun homicide, overall homicide, gun suicide, and accidental gun deaths (Zimring and Hawkins, 1997) (Hemenway, 2017). A recent study that examined firearm-related mortality data from 195 countries found that in terms of total numbers, the US had the second largest number firearm-related deaths in 2016 and, when combined with the country that had the largest number of firearm-related deaths (Brazil), accounted for 32% of firearm deaths worldwide (The Global Burden of Disease 2016 Injury Collaborators, 2018). The United States has many more guns per capita than any other high-income country and the most permissive gun laws (Hemenway, 2017).

Previously, using data from 2003 and then from 2010, we compared violent death rates in the US—for all age groups stratified by sex—with rates in the other high-income countries (Richardson and Hemenway, 2011; Grinshteyn and Hemenway, 2016). The current article updates these previous studies with data from 2015, and expands upon the previous analyses by comparing the other high-income countries to subgroups within the US, both comparing violent death rates in low-, medium-, and high-gun US states with those of other high-income countries, and comparing violent death rates of US whites and non-whites to rates in these other countries. While studies have found that rates of firearm-related violence in low-gun states are lower than rates of firearm violence in high-gun states (Miller et al., 2002a, Miller et al., 2002b), we examine how safe residents of the low-gun US states do compared with residents of the other high-income countries. Research has also shown that firearm homicide rates among nonwhites in the US are much higher than rates of firearm homicides among whites (Riddell et al., 2018). This paper examines how rates for US Black and White populations compare with rates in other high-income countries. We are thus able to determine the extent to which firearm homicide victimization is also a relative problem for whites in the US compared with residents of other developed countries.

Section snippets

Data source

The World Health Organization's (WHO) Mortality Database compiles numbers of deaths by cause using data from each country's national vital registration systems. Cause of death is classified using International Classification of Diseases, 10th Revision (ICD-10).

Study population

We investigated data for all populous (i.e., greater than one million inhabitants) countries defined as high income by the Organisation for Economic Co-operation and Development (OECD) for 2015 (OECD, 2015). There were 31 countries

United States

In 2015, there were >17,000 homicides in the United States or 5.6 homicides per 100,000 US population (Table 1). Almost 73% of these homicides were firearm homicides. There were 9.4 firearm homicides and 9.1 firearm homicides per 100,000 population respectively for those aged 15–24 years and those aged 25–34 years. Results among the 15–24 years age category were also analyzed as two groups (15–20 years and 21–24 years) as those who are younger than 21 years of age are usually not allowed to

Discussion

The US continues to be an outlier among high-income countries in terms of firearm deaths. Indeed, it has become more of an outlier in the 21st century. Between 2003 and 2015, the US firearm death rate increased from 10.2 to 11.2 (Richardson and Hemenway, 2011). During the same period, the firearm death rate of the other high-income countries declined, so that the relative situation in the US has worsened. In 2003 the firearm death rate was 7.5 times higher, in 2010 it was 10.0 times higher, and

Conclusion

These results show that the United States suffers excessively from fatal firearm violence compared with other high-income countries—and that the US has become even more of an outlier since 2003. Even residents of the US low-gun states have far higher rates of firearm death than do residents of other high-income countries.

Acknowledgments/funding

David Hemenway was funded in part by The Joyce Foundation for this work.

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