Context and Its Importance for Gun Injury Costs

Philip F. Lee, 12/26/05

There is a teaching lesson in the two year old article given below on the cost of gun injuries.  The lesson is about how to analyze articles from grabbers that frequently convey the message “here are some terrible facts about guns”.  In this particular instance, the message is “gunshots cost big bucks ($0.8 billon).  The unspoken subtext frequently is that guns are bad and should be restricted or banned.

There are two counters to these kinds of arguments – one is that guns help more than hurt and our side frequently makes that argument.  Another is that looking at the problem in the context of other problems shows this isn’t a big problem – certainly not worth worrying about.  So, a context for youth being killed with guns is to remind people that many more are killed drowning in pools or tubs. 

Examining context can illuminate the nature of the problem and allow defusing type arguments to be made rather than polarizing arguments.  It is with that intent, that we present some context concerning the costs for gun injuries.

Consider the cost of injuries in automobile accidents.

According to http://www.carinsuranceamerica.com/guide.html "a motor vehicle accident occurs every second. Auto accidents cause an injury every 14 seconds, and every 13 minutes a car accident results in a fatality. More than 31 million accidents occur per year, at an annual cost of almost $100 billion (125 times the costs associated with gun injuries)."

The article http://www.nhtsa.dot.gov/people/economic/ecomvc1994.html reports total economic cost of motor vehicle crashes in 1994 was $150.5 billion. This represents the present value of lifetime costs for 40,676 fatalities, 5.2 million nonfatal injuries, and 27 million damaged vehicles, in both police reported and unreported crashes. Property damage costs of $52.1 billion accounted for the largest share of costs, while lost market productivity accounted for $42.4 billion. Medical expenses totalled $17 billion. Each fatality resulted in an average discounted lifetime cost of $830,000. Alcohol-involved crashes caused $45 billion or 30 percent of all economic costs, and 78 percent of these costs occurred in crashes where a driver or pedestrian was legally intoxicated (>= .10% BAC). Crashes in which police indicate that at least one driver was exceeding the legal speed limit or driving too fast for conditions cost $27.7 billion in 1994. Public revenues paid for 24 percent of medical costs, and 9 percent of all costs resulting from motor vehicle crashes. These crashes cost taxpayers $13.8 billion in 1994, the equivalent of $144 in added taxes for each household in the United States."

Alcohol was involved in $45 billion of economic costs associated with automobile crashes.  So, alcohol involved injuries cost approximately 56 times firearm involved injuries (assuming the $0.8 billion was correct).  The total automobile injury cost is $100 billion to 150 billion according to these two sources producing between 125 and 188 times the cost of firearm injuries.

Consider the cost of injuries produced by medical treatments.

Preventable medical treatment errors  cause 98,000 to 195,000 deaths annually and additional errors (see Invasive Surgery or Silence About Medical Errors) resulting in injuries (removing the wrong leg for example or leaving instruments in patients requiring a new operation to fix).  Medical errors produce 3 to 7 times as many deaths as attributed to firearms and costs estimated as “$17 billion annual price tag for all preventable adverse events in hospitals”.  These costs are 21 times the estimated costs for gunshot injuries.

Consider the cost of the common cold.

The common cold is estimated to cost Americans $40 billion annually according to an article in the Feb. 24, 2003 Archives of Internal Medicine).  These estimated costs are 49.9 times the estimated costs for gunshot injuries.  The article identifies part of the costs ($1 billion) as being spent on antibiotics which are useless against the common cold.  The article points out that people waste money on drugs which don't have any effect on the cold but do increase antibiotic resistence in some cases.  So, it isn't just with gun control that we do the wrong thing to treat the problem and it isn't just with gun control that the wrong thing we do makes other problems worse.

PITTSBURGH - Injuries from gunshots result in $802 million a year in hospital charges nationwide, with nearly a third of victims uninsured, a new study indicates.

The study by Dr. Jeff Coben, director of Allegheny General Hospital's Center for Violence and Injury Control, and Dr. Claudia Steiner of the federal Agency for Healthcare Research and Quality, was published Wednesday in the American Journal of Preventive Medicine.

They analyzed injuries from 1997, the most recent year with complete data.

Coben said that gunshots were "the leading cause for uninsured hospital days in the country that year."

He added: "That was pretty concerning to us, and pretty astounding."

The $802 million figure represents hospital costs and does not include physician fees or follow-up care, Coben said.

Initial stays cost, on average, almost $24,000 for assault cases and $30,000 for accident cases.

Overall, 29 percent of patients did not have health insurance, the study found. Hospitals often have to absorb the costs of treating uninsured patients.

Gun violence "isn't just an issue that's isolated to poor people in inner cities," Coben said. "It's going to affect all of us because of the costs involved."

Previous estimates of gun violence used data from the Centers for Disease Control and Prevention from 100 emergency departments around the country, Coben said. While that gave some information about nonfatal shootings, it didn't offer details about what procedures victims underwent, their length of stay and whether victims were disabled or eventually died of their injuries.

For their study, Coben and Steiner analyzed admission information gathered in 1997 from more than 1,000 hospitals in 22 states, including Pennsylvania, New York and California.

They concluded that there were an estimated 35,800 firearm-related hospital admissions nationwide in 1997, similar to what the emergency room data predicted.

About 7 percent of people died from their injuries, 12 percent went to other health facilities for rehabilitation or other care, and 75 percent recovered and went home, according to the study.

More than half the shootings occurred during assaults, about 30 percent were accidental and 8 percent were self-inflicted. The cause of the others could not be determined.

Eighty-six percent of patients were male, and about 60 percent were younger than 30.

Updated by Phil Lee on 11/16/07.  Contact pflee at wdn dot com (sorry for being obscure, but web mail address scavenge programs make this practice necessary).