EpiResearchReport

1 FirearmDeathsandInjuriesinNewYorkCityBac kgroundFirearm deaths and injuries havesevere and far-reaching effects costs of firearmdeaths and injuries per person havebeen estimated to be the highest ofany deaths andinjuries impose health care, judicial,and incarceration-related costs, aswell as a host of social andeconomic costs on the communitiesin which they violence underlies thesecosts. Firearm violence drivespeople and businesses away fromcommunities, placing some goodsand services beyond the reach affected byviolence also struggle with poverty,unemployment, disease and mentalhealth problems among youthexposed to firearm ,4 While the past two decades haveshown dramatic declines in firearminjuries in NewYork City, firearmsNewYorkCityDepartmentofHealthand MentalHygieneApril2013 KeyFindings: FirearmdeathsinNewYorkCitydeclinedfrom52 4in2000to366in2011. newyorkcity s2011firearmdeathrate( ,000)islessthanhalfthenationalrate( ,000).

2 newyorkcity sfirearmsuiciderateisthelowestamongthem. Despitesignificantdeclines, ,CrownHeights,CentralHarlemandtheSouthBr onx. ,NewYorkCitypublichighschoolstudentsrepo rtalowerprevalenceofcarryingagunduringth epast30daysthanstudentsnationwide(2% ).1 Cook PJ, Lawrence BA, Ludwig J, Miller medical costs of gunshot injuries in the United of the American Medical ; 282(5) R, Cook PJ, Ludwig J, Pollack H. Gun Violence Among School-age Youth in Chicago. Chicago, IL:University of Chicago Crime Lab; 2009. Accessed November 18, DP, Loeber R. Epidemiology of juvenile and Adolescent Psychiatric Clinics of NorthAmerica. 2000;9(4) PJ,Tompsett CJ, Braciszewski JM, Jacques-Tiura AJ, Baltes BB. Community violence: a meta-analysis onthe effect of exposure and mental health outcomes of children and ; 21(1) (firearmhomicidesandfirearmsuicides) (firearmassaultsandfirearmself-inflicted injuries) (alsoreferredtoasviolence)oragainstonese lf, |April2013emergency department visits per100,000 population.

3 In 2011,the overall firearmfatality rate for NewYork City isless than half the US rate ( deaths per 100,000);thefirearm suicide rate for newyorkcity is approximately one ninth ofthe US rate ( vs. deathsper 100,000). In NewYork City in 2011,84%of firearm deaths were homicidesand 16% were suicides (Table1).There were no unintentionalfirearm deaths. Nationwide in 2010 (the mostcurrent year for which data areavailable) suicides accounted forover half (62%) of all firearmdeaths,while homicidesaccounted for 35% (Table 1). In NewYork City in 2010,mostfirearm injury hospitalizationswere due to assaults (83%).Unintentional injuries (13%),injuries of undetermined intent(3%) and self-inflicted injuries(1%) accounted for thepersist as a leading cause ofpremature death among young menof public health data sourcesto describe those injured by firearms,this report examines trends andpatterns in firearm deaths andinjuries in NewYork City.

4 It highlightsfirearm violence, since most firearmdeaths and injuries in NewYork Cityresult from to 2011 and 2010 localpublic health data, the annual countof firearm deaths and injuries in NewYork City exceeded 2000; there were366 firearm fatalities, 999 firearmhospitalizations, and 691 firearminjury emergency department corresponding rates were per 100,000, per 100,000 and firearm comparable national data areavailable for nonfatal ,countyandcitycomparisonThe Centers for Disease Controland Prevention (CDC) publishesfatality data at the county New York City firearmhomicides and suicides to countiescontaining the 25 most populouscities in the US. For firearm homicides, the highestrate was deaths per 100, City s firearm homiciderate of deaths per 100,000was among the lowest, ranking 19out of the 25 counties with themost populous cities (Figure 1). For firearm suicides, the highestrate was deaths per 100, City s firearm suiciderate of deaths per 100,000was the lowest among the 25counties (Figure 2).

5 5 Jasek J, Immerwahr S, Stayton C, Maduro G, Olson C. Men s health in New York City: Premature death due to homicide and heart Vital ;9(4) Accessed December 1, for Disease Control and Prevention (CDC), National Center for Health Statistics Wide-ranging OnLine Data for Epidemiologic Research (WONDER) OnlineDatabase ( ). Accessed April 1, : NYC DOHMH Bureau of Vital Statistics, 2011 CDC WISQARST able1 SuicidebyfirearmismuchlesscommoninNewYor kCitywhencomparedwiththeUSOverallfirearm FirearmhomicideFirearmsuicide%offirearmd eaths%offirearmdeathsfatalityratefatalit yratefatalityratehomicidessuicidesper100 ,000per100,000per100, (n=366)US(n=31,328) rate per 100,0000123456789 Maricopa (Phoenix)Duval (Jacksonville)Marion (Indianapolis)Shelby (Memphis)Davidson (Nashville)Tarrant (Fort Worth)Harris (Houston)Franklin (Columbus)Dallas (Dallas)Bexar (San Antonio)Wayne (Detroit)Travis (Austin)Mecklenburg (Charlotte)King (Seattle)San Diego (San Diego)Philadelphia (Philadelphia)El Paso (El Paso)Los Angeles (Los Angeles)Baltimore CitySanta Clara (San Jose)Cook (Chicago)San Francisco (San Francisco)Washington DCSuffolk (Boston)New York City, 5 countiesFigure2 Rates(per100,000)

6 Offirearmsuicidesbycounty,basedontop25mo stpopulousUScities,2008 20103 EpiResearchReport |FirearmDeathsandInjuri esinNewYorkCity0510152025 Age-adjusted rate per 100,000 Baltimore CityWayne (Detroit)Philadelphia (Philadelphia)Washington DCShelby (Memphis)Duval (Jacksonville)Marion (Indianapolis)Cook (Chicago)Davidson (Nashville)Harris (Houston)Franklin (Columbus)Dallas (Dallas)Mecklenburg (Charlotte)Los Angeles (Los Angeles)Suffolk (Boston)Bexar (San Antonio)Maricopa (Phoenix)San Francisco (San Francisco)New York City, 5 countiesTarrant (Fort Worth)Travis (Austin)King (Seattle)Santa Clara (San Jose)El Paso (El Paso)San Diego (San Diego)Sources: CDC WONDER2010 US CensusFigure1 Rates(per100,000)offirearmhomicidesbycou nty,basedontop25mostpopulousUScities,200 8 2010 Sources: CDC WONDER2010 US Census4 NewYorkCityDepartmentofHealthandMentalHy giene|April2013 FirearmdeathandinjurytrendsFrom 2000 to 2011 in New YorkCity, firearm fatalities havedeclined 32%, from per100,000 to per 100, this decline in firearmdeaths was a 33% decline infirearm homicides, from per100,000 in 2000 to per100,000 in 2011.

7 In contrast,national rates of firearm fatalitiesoverall and firearm homicidesremained relatively New York City and nationaltrends in firearm suicides havedeclined slightly, New York City sfirearm suicide rate has beenconsistently and markedly lowerthan the national rate (Figure 3).Figure4 Firearmhospitalizationrateshavedeclinedi nNewYorkCitysince2000 New York City firearm hospitalizationrates per 100,000 : NYS DOH SPARCS2000 New York City firearm fatality ratesper 100,000 York City200920102011 Source: NYC DOHMH Bureau of Vital StatisticsSource: CDC WISQARSUS firearm fatality ratesper 100,000 with fatalities, firearm injuryhospitalizations declined in NewYork City; this decline is largelyattributed to a drop in firearmassault rate ofall firearm injury hospitalizationsdeclined 21% in the past 11 years,from per 100,000 in 2000 per 100,000 in 2010. Firearmassault hospitalizations alsoFigure3 newyorkcity sfirearmfatalityrateisdeclining,andislow erthantheUSrate5declined 21%, from per 100,000in 2000 to per 100,000 in 2010(Figure 4).

8 Rates of other types offirearm injuries that is,unintentional injuries, self-inflictedinjuries, and injuries of undeterminedintent are lower than firearmassaults, and have been relativelystable during the past no comparable data for the , young men aged 15 to 24years bear the greatest burden ofviolence-related firearm death andinjury. Men aged 45 years and olderbear the greatest burden of suicide(Table 2). NewYork City men wereapproximately 10 times more likelythan women to die from a firearmhomicide ( vs. deaths per100,000,respectively) andapproximately 12 times more likelyto be hospitalized for a firearmassault injury ( vs. per 100,000,respectively). NewYorkers aged 15 to24 and 25 to 34 years had thehighest rates of firearm homicide( and deaths per 100,000,respectively) and firearm assaulthospitalizations ( and per 100,000,respectively) compared with otherage groups. Bronx and Brooklyn residents hadhigh rates of firearm homicide( and deaths per 100,000,respectively) and firearm assaultTable2 Firearmhomicide,assaultandsuicideFirearm FirearmassaultFirearmhomiciderates hospitalizationsuicideratesper100,000 ratesper100,000per100,000(n=308) (n=827)(n=58) + : All rates are age-adjusted, except the age-specific rates.

9 Firearm assaulthospitalization rates by race/ethnicity were not computed because of data see Discussion for : NYC DOHMH Bureau of Vital Statistics, 2011 NYS DOH SPARCS, 2010hospitalization ( and per 100,000,respectively). Non-Hispanic blacks had the highestfirearm homicide rate ( deathsper 100,000);this rate was overfour times higher than that forHispanics,who had the next highestrate ( deaths per 100,000). EpiResearchReport |FirearmDeaths andInjuriesinNewYorkCity6 NewYorkCityDepartmentofHealthandMentalHy giene|April2013 Figure5 NewYorkCityneighborhoodswiththehighestfi rearmhomicideandassaulthospitalizationra tesamongyouthhaveratesatleasttwicetheCit y saverage01020304050 East New YorkCrown HeightsFlatbushFordham-Bronx ParkHigh Bridge-MorrisaniaHomicide rate per 100,000 youthCitywide averageamong youth( deaths per100,000) homicide rate among 15 24 year oldsSource: NYC DOHMH Bureau of Vital Statistics, 2010 Source: NYS DOH SPARCS, 2010020406080100120140 East New YorkCrown HeightsCentral HarlemHunts Point-Mott HavenEast HarlemAssault hospitalization rate per 100,000 youthCitywide averageamong youth( hospitalizationsper 100,000) assault hospitalization rate among 15 24 year oldsYouthandFirearmViolenceNeighborhoodd isparitiesinyouthgunviolenceRates of firearm violence amongyouth vary greatly by NewYork top five of 42 NewYork City neighborhoods wherefirearm violence among youth wasmost concentrated included CrownHeights, Central Harlem, East NewYork and other areas of Brooklynand the Bronx (Figures 5 and 6).

10 Rates in these neighborhoods wereat least twice the City s with research that showsneighborhoods of high violence alsoface economic stresses,3theseneighborhoods have some of thehighest poverty rates in the City(Figure 6).Firearmcarryingbehaviorandhealthriska mongyouthThe NewYork CityYouth RiskBehavior Survey (YRBS), which isadministered biennially to newyorkcity public high school students,was used to examine trends infirearm carrying and other riskbehaviors. Between 1997 and2011, the proportion of newyorkcity public high school students whoreported carryinganyweapon ( ,gun, knife, or club) anywhere during7 EpiResearchReport |FirearmDeathsandInjuri esinNewYorkCityFigure6 NewYorkCityneighborhoodswiththehighestfi rearmhomicideandassaulthospitalizationra tesamongyouthareamongtheCity shighestpovertyneighborhoodsFirearm Death RatesEast New YorkCrown HeightsLowest 20%(by quintile)High Bridge-MorrisaniaHighest 20%Poverty LevelHunts Point-Mott HavenHigh Bridge-MorrisaniaCrown HeightsEast New YorkLowest 20%(by quintile)Highest 20%NNeeiigghhbboorrhhoooodd ppoovveerrttyy iinn NNeeww YYoorrkk CCiittyySources: NYC DOHMH Bureau of Vital Statistics, 2010 and NYS DOH SPARCS, 2010 Source.