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Abstract
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Gun violence in the US remains a persistent public health challenge.1 The US gun homicide rate is nearly 25 times higher than that of any other high-income country,2 amounting to 13 938 deaths in 2019 alone. Although much has been made of a spike in gun violence since the onset of the global COVID-19 pandemic, it is important to note that, at least through 2019, crime and violence declined steadily for the past 3 decades. There were around 8275 fewer homicides nationally in 2019 compared with the historical peak in 1991, a 33.5% decrease.
While this decline is remarkable, it masks other concerning trends. Here we investigate the case fatality rates (CFR) of gun assaults in California, seeking to evaluate whether the total number of gun homicide incidents is higher than expected given the overall volume of gun violence.
Methods
In this case series, we compiled data on gun violence incidents (firearm assaults and homicides) spanning 2005 to 2019 from 2 sources: emergency department and inpatient hospitalization discharge records from the California Department of Health Care Access and Information, and death records from the California Department of Public Health Vital Records. Records included all hospital visits and deaths in California, with the exception of active-duty military hospitals, and captured the external cause of death or injury. People who went to the emergency department before being admitted to a hospital only had a hospitalization record. People who died without seeking care or after being released from care at an emergency department or hospital were only included from the death records. Thus, there were no duplicates of incidents incorporated in the measures.
We identified gun assaults from the emergency department and inpatient hospitalization data using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.3 We identified gun homicides from the death records using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes.4 We compiled annual counts of gun assaults and...
Language: en |