 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Michael L. Nance, MD1, Charles C. Branas, PhD2, Douglas J. Wiebe, PhD2, Michael R. Elliott, PhD2, and C. William Schwab, MD3. (1) Department of Surgery, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104, (215) 590-5932, nance@email.chop.edu, (2) Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Room 807 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, (3) Firearm Injury Center at Penn, University of Pennsylvania, 3440 Market Street, First Floor, Philadelphia, PA 19104-3335
Background: Firearm mortality in the United States is largely dominated by suicides and homicides, unintentional firearm deaths comprising a much smaller fraction. Regional variation has been demonstrated for homicide and suicide rates. The purpose of this study was to investigate potential regional variation of unintentional firearm mortality across the United States. Methods: A retrospective analysis of vital statistics data was performed for the years 1989 to 1999 for all unintentional injury deaths. Decedents were assigned to the 3,141 U.S. counties and analyzed using a modified rural-urban continuum code per county. This code distinguished counties into 11 categories by population size and proximity to metropolitan areas. Rates were adjusted for various sociodemographic factors using negative binomial time-series regressions. Separate analyses were conducted to examine the effect of “ruralization” on unintentional injury deaths (firearm and non-firearm) and unintentional firearm death (handgun and long gun). Results: During the 11-year period, 13,683 unintentional firearm deaths (3.6% of all firearm deaths) occurred in U.S. counties. The most rural counties experienced 1.74(95% CI, 1.18 to 2.56) times the average adjusted unintentional firearm mortality rate of the most urban counties (p<0.01). A similar but less pronounced trend was noted for unintentional non-firearm deaths across the rural-urban continuum. A pronounced trend in unintentional long-gun deaths, highest in rural counties, was also observed Conclusion: The rate and risk of unintentional firearm mortality is significantly greater in the rural counties than in the urban counties. Prevention strategies should be optimized to the specific region and should account for geographic variation.
Learning Objectives:
Keywords: Firearms, Mortality
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.