Separating Truth from Alternative Facts: 37 Years of Guns, Murder, and Violence Across the US

BACKGROUND: Gun violence remains a significant public health problem that is both understudied and underfunded, and plagued by inadequate or inaccessible data sources. Over the years, numerous trauma centers have attempted to use local registries to study single-institutional trends, however, this approach limits generalizability to our national epidemic. In fact, even easily accessible, health-centered data from the CDC lack national relevance because they are limited to those enrolled states only. We sought to examine how publicly available law enforcement data from all 50 states might complement our understanding of circumstances and demographics surrounding national firearm death and help forge the first step in partnering law enforcement with trauma centers. METHODS: All homicide that occurred in the US during a 37-year period ending in 2016 was analyzed. Primary data files were obtained from the Federal Bureau of Investigation and comprised the database. Data analyzed included homicide type, situation, circumstance, firearm type, and demographic characteristics of victims and offenders. The proportion of firearm-related homicide was stratified by year and compared over time using simple linear regression. RESULTS: There were 485,288 incidents of firearm homicide analyzed (64% of 752,935 total homicides). Most victims were male (85%), black (53%), and a mean age of 33 years; offenders were predominantly male (67%), black (39%), and a mean age of 30 years. Fifty-four percent of all homicide involved a single victim and single offender, followed by a single victim and unknown offender(s) (31%); 4% of firearm homicide had multiple victims. Overall, handguns, shotguns, and rifles accounted for 76%, 7%, and 5% of all firearm homicide, respectively; 11% had no firearm type listed and <1% were other gun or unknown. Linear regression analysis identified a significant increase in the proportion of firearm-related homicide from 61% in 1980 to 71% in 2016 (beta = 0.25; p < 0.0001). CONCLUSIONS: Gun violence represents an ongoing public health concern, with the proportion of firearm homicide steadily and significantly increasing from 1980 to 2016. Homicide data from the Federal Bureau of Investigation can serve to supplement trauma registry data by helping to define gun violence patterns. However, stronger partnerships between local law enforcement agencies and trauma centers are necessary to better characterize firearmtype and resultant injury patterns, direct prevention efforts and firearm policy, and reduce gun-related deaths. ((C) 2020 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.)