Journal article
Global Mortality From Firearms, 1990-2016
JAMA : the journal of the American Medical Association, Vol.320(8), pp.792-814
2018
PMCID: PMC6143020
PMID: 30167700
Abstract
Importance: Understanding global variation in firearm mortality rates could guide prevention policies and interventions.
Objective: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.
Design, Setting, and Participants: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths.
Exposures: Firearm ownership and access.
Main Outcomes and Measures: Cause-specific deaths by age, sex, location, and year.
Results: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (−0.2% [95% UI, −0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P < .001; R2 = 0.21) and homicide (P < .001; R2 = 0.35).
Conclusions and Relevance: This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.
Details
- Title
- Global Mortality From Firearms, 1990-2016
- Authors/Creators
- Mohsen Naghavi - University of Washington, SeattleLaurie B Marczak - University of Washington, SeattleMichael Kutz - University of Washington, SeattleKatya Anne Shackelford - University of Washington, SeattleMegha Arora - University of Washington, SeattleMolly Miller-Petrie - University of Washington, SeattleMiloud Taki Eddine Aichour - Higher National School of Veterinary Medicine, Algiers, AlgeriaNadia Akseer - University of TorontoRajaa M Al-Raddadi - King Abdulaziz UniversityKhurshid Alam - School of Population and Global Health, University of Western Australia, Perth, WA, AustraliaSuliman A Alghnam - King Abdullah International Medical Research CenterCarl Abelardo T Antonio - University of the Philippines ManilaOlatunde Aremu - Birmingham City UniversityAmit Arora - Sydney Local Health DistrictMohsen Asadi-Lari - International Relations Department, Iranian Ministry of Health and Medical Education, Tehran, IranReza Assadi - Mashhad University of Medical SciencesTesfay Mehari Atey - Mekelle UniversityLeticia Avila-Burgos - Center of Health System Research, The National Institute of Public Health, Cuernavaca, MexicoAshish Awasthi - Public Health Foundation of IndiaBeatriz Paulina Ayala Quintanilla - General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, PeruSuzanne Lyn Barker-Collo - University of AucklandTill Winfried Bärnighausen - Harvard UniversityShahrzad Bazargan-Hejazi - University of California, Los AngelesMasoud Behzadifar - Lorestan University of Medical SciencesMeysam Behzadifar - Lorestan University of Medical SciencesJames R Bennett - University of Washington, SeattleAshish Bhalla - Post Graduate Institute of Medical Education and ResearchZulfiqar A Bhutta - Aga Khan UniversityArebu Issa Bilal - Addis Ababa UniversityGuilherme Borges - Department of Epidemiology, National Institute of Psychiatry Ramón de la Fuente, Mexico City, MexicoRohan Borschmann - The University of MelbourneAlexandra Brazinova - Comenius University BratislavaJulio Cesar Campuzano Rincon - MedicinaFélix Carvalho - Universidade do PortoCarlos A Castañeda-Orjuela - Universidad Nacional de ColombiaLalit Dandona - Public Health Foundation of IndiaRakhi Dandona - Public Health Foundation of IndiaPaul I Dargan - King's College LondonDiego De Leo - Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, QLD, AustraliaSamath Dhamminda Dharmaratne - University of PeradeniyaEric L Ding - Harvard UniversityHuyen Phuc Do - Duy Tan UniversityDavid Teye Doku - University of TampereKerrie E Doyle - School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University (RMIT), Bundoora, VIC, AustraliaTim Robert Driscoll - The University of SydneyDumessa Edessa - Haramaya UniversityZiad El-Khatib - Karolinska InstitutetAman Yesuf Endries - Millennium Engineering and Integration (United States)Alireza Esteghamati - Tehran University of Medical SciencesAndre Faro - Department of Psychology, Federal University of Sergipe, Sao Cristovao, BrazilFarshad Farzadfar - Tehran University of Medical SciencesValery L Feigin - Auckland University of TechnologyFlorian Fischer - Bielefeld UniversityKyle J Foreman - University of Washington, SeattleRichard Charles Franklin - James Cook UniversityNancy Fullman - University of Washington, SeattleNeal D Futran - University of Washington, SeattleTsegaye Tewelde Gebrehiwot - Jimma UniversityReyna Alma Gutiérrez - Epidemiological and Psychosocial Investigations, National Institute of Psychiatry Ramon de la Fuente, Mexico City, MexicoNima Hafezi-Nejad - Johns Hopkins UniversityHassan Haghparast Bidgoli - Institute for Global Health, University College London, London, United KingdomGessessew Bugssa Hailu - Mekelle UniversityJosep Maria Haro - Universitat de BarcelonaHamid Yimam Hassen - Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, BelgiumCaitlin Hawley - University of Washington, SeattleDelia Hendrie - Curtin UniversityMartha Híjar - CISS, National Institute of Public Health, Cuernavaca, MexicoGuoqing Hu - Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, ChinaOlayinka Stephen Ilesanmi - University of LiberiaMihajlo Jakovljevic - University of KragujevacSpencer L James - University of Washington, SeattleSudha Jayaraman - Virginia Commonwealth UniversityJost B Jonas - Capital Medical UniversityAmaha Kahsay - Mekelle UniversityAmir Kasaeian - Tehran University of Medical SciencesPeter Njenga Keiyoro - University of NairobiYousef Khader - Jordan University of Science and TechnologyIbrahim A Khalil - University of Washington, SeattleYoung-Ho Khang - Seoul National UniversityJagdish Khubchandani - Ball State UniversityAliasghar Ahmad Kiadaliri - Lund UniversityChristian Kieling - Child & Adolescent Psychiatry Division, Hospital of Clinics of Porto Alegre, Porto Alegre, BrazilYun Jin Kim - Xiamen University MalaysiaSoewarta Kosen - Independent Consultant, Jakarta, IndonesiaKristopher J Krohn - University of Washington, SeattleG Anil Kumar - Public Health Foundation of IndiaFaris Hasan Lami - Department of Community and Family Medicine, Academy of Medical Science, Baghdad, IraqVan C Lansingh - Institute of OphthalmologyHeidi Jane Larson - London School of Hygiene & Tropical MedicineShai Linn - University of HaifaRaimundas Lunevicius - University of LiverpoolHassan Magdy Abd El Razek - Damietta UniversityMuhammed Magdy Abd El Razek - Faculty (United Kingdom)Reza Malekzadeh - Shiraz University of Medical SciencesDeborah Carvalho Malta - Universidade Federal de Minas GeraisAmanda J Mason-Jones - Department of Health Sciences, University of York, York, United KingdomRichard Matzopoulos - University of Cape TownPeter T N Memiah - Department of Public Health, University of West Florida, PensacolaWalter Mendoza - United Nations Population FundTuomo J Meretoja - University of HelsinkiHaftay Berhane Mezgebe - School of Pharmacy, Academy of Medical Science, Baghdad, IraqTed R Miller - Pacific Institute for Research & Evaluation, Calverton, MarylandShafiu Mohammed - Ahmadu Bello UniversityMaziar Moradi-Lakeh - Iran University of Medical SciencesRintaro Mori - National Center For Child Health and DevelopmentDevina Nand - Accamargo Cancer Center, São Paulo, BrazilCuong Tat Nguyen - Duy Tan UniversityQuyen Le Nguyen - Duy Tan UniversityDina Nur Anggraini Ningrum - Taipei Medical UniversityFelix Akpojene Ogbo - Western Sydney UniversityAndrew T Olagunju - University of LagosGeorge C Patton - Murdoch Children's Research InstituteMichael R Phillips - Shanghai Jiao Tong UniversitySuzanne Polinder - Department of Public Health, Erasmus University Medical Center, Rotterdam, the NetherlandsFarshad Pourmalek - University of British ColumbiaMostafa Qorbani - Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, IranAfarin Rahimi-Movaghar - Tehran University of Medical SciencesVafa Rahimi-Movaghar - Tehran University of Medical SciencesMahfuzar Rahman - BRACRajesh Kumar Rai - University of GöttingenChhabi Lal Ranabhat - Yonsei UniversityDavid Laith Rawaf - University College London Hospitals, London, United KingdomSalman Rawaf - Public Health EnglandAli Rowhani-Rahbar - University of Washington, SeattleMahdi Safdarian - Iran University of Medical SciencesSaeid Safiri - Iranshahr UniversityRajesh Sagar - All India Institute of Medical SciencesJoseph S Salama - University of Washington, SeattleJuan Sanabria - Case Western Reserve UniversityMilena M Santric Milicevic - University of BelgradeRodrigo Sarmiento-Suárez - Faculty (United Kingdom)Benn Sartorius - Department of Public Health Medicine, University of Kwazulu-Natal, Durban, South AfricaMaheswar Satpathy - Utkal UniversityDavid C Schwebel - University of Alabama at BirminghamSoraya Seedat - University of Cape TownSadaf G Sepanlou - Shiraz University of Medical SciencesMasood Ali Shaikh - Independent Consultant, Karachi, PakistanNigussie Tadesse Sharew - Debre Berhan UniversityIvy Shiue - Martin Luther University Halle-WittenbergJasvinder A Singh - University of Alabama at BirminghamMekonnen Sisay - Haramaya UniversityVegard Skirbekk - Norwegian Institute of Public HealthAdauto Martins Soares Filho - Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, BrazilDan J Stein - University of Cape TownMark Andrew Stokes - School of Psychology, Deakin University, Burwood, VIC, AustraliaMu'awiyyah Babale Sufiyan - Ahmadu Bello UniversityMamta Swaroop - Department of Surgery, Northwestern University, Chicago, IllinoisBryan L Sykes - University of California, IrvineRafael Tabarés-Seisdedos - Universitat de ValènciaFentaw Tadese - Wollo UniversityBach Xuan Tran - Hanoi Medical UniversityTung Thanh Tran - Duy Tan UniversityKingsley Nnanna Ukwaja - Federal Teaching Hospital AbakalikiTommi Juhani Vasankari - UKK InstituteVasily Vlassov - Department of Health Care Management and Economics, National Research University Higher School of Economics, Moscow, RussiaAndrea Werdecker - Federal Institute for Population ResearchPengpeng Ye - National Center for Chronic and Noncommunicable Disease Control and PreventionPaul Yip - University of Hong KongNaohiro Yonemoto - Kyoto UniversityMustafa Z Younis - Tsinghua UniversityZoubida Zaidi - Faculty (United Kingdom)Maysaa El Sayed Zaki - Mansoura UniversitySimon I Hay - University of Washington, SeattleStephen S Lim - University of Washington, SeattleAlan D Lopez - The University of MelbourneAli H Mokdad - University of Washington, SeattleTheo Vos - University of Washington, SeattleChristopher J L Murray - University of Washington, SeattleGlobal Burden of Disease 2016 Injury Collaborators
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.320(8), pp.792-814
- Identifiers
- 991005591579307891
- Copyright
- © 2018, American Medical Association
- Murdoch Affiliation
- Centre for Healthy Ageing
- Language
- English
- Resource Type
- Journal article
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- 1.21 Psychiatry
- 1.21.430 Suicide Prevention
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