10 Alumni Journal - SUNY Upstate Medical University

envisioned an interdisciplinary center that
would encourage collaboration between
researchers and local leaders to take a
public-health approach to gun violence,
similar to other multi-causal epidemics
such as smoking, drug addiction, alcoholism,
or auto crash deaths.
None of those issues, however, precipitate
the same political polarization
as guns. “If you use the word ‘gun’ in a
sentence, there is an immediate political
reaction. You’re either a gun advocate
or you’re a gun-control advocate,” says
Schwab. Framing firearm injury as a public
health problem allows FICAP to engage
in data-driven dialogue about decreasing
injury and death, he says, a very different
approach than the classic pro-gun versus
anti-gun debates.
Nonetheless, the politics surrounding
guns present significant challenges. Schwab
points to roadblocks, such as the Tiarht
Amendment, which prohibits the Bureau
of Alcohol, Tobacco, Firearms and Explosives
from sharing information from its
firearms trace database unless for a criminal
investigation. He also points to the national
dearth of funding for study of the issue, and
what he calls a “government gag” against
funding the necessary science to answer the
questions about gun violence and death.
Since 1996, Congress has restricted appropriations
to the Centers for Disease Control
(CDC) for any research that could affect
legislation to restrict the use or purchase
of firearms. Current efforts seek to put similar restrictions on
research supported by the National Institutes of Health.
firearm injury in
the United States*
An AmericAn problem
While it’s initial focus was on gun safety, FICAP now looks
beyond guns to understanding the root causes of and repercussions
from gun violence. The center collects data on the circumstances
leading to gun violence, the impact of exposure to violence, and
explores the incidence of long-term, rehabilitative care for surviving
victims. Researchers are studying the role of alcohol in
firearm injury and have identified the need to address firearm
suicide in rural areas.
n Over the last four decades, the U.S.
averaged 32,000 deaths a year from
firearm injury, the second leading
cause of death from injury after auto
crashes.
n More than half of these deaths
were from firearm suicide.
n The total number of U.S. firearm
injuries (fatal and nonfatal) is
estimated to be 100,000 per year.
n Firearm injury is a leading cause
of death for young Americans.
Homicide ranks second and suicide
third among the leading causes of
death for 15-24 year olds; the majority
of both causes are firearm related.
n Among wealthy nations, the U.S.
ranks near the bottom in terms of life
expectancy. Firearm deaths account
for about 27% of U.S. males’ excess
mortality when compared to other
peer nations.
n As of 2001, an estimated 35 percent
of U.S. households had a firearm.
* Data from FICAP’s website: www.
uphs.upenn.edu/ficap and from LDI
Issue Briefs: “Firearm Injury in America”
and “The Effect of Firearm Deaths
on Life Expectancy and Insurance
Premiums in the United States”: www.
upenn.edu/ldi/publications.html
A l U M n i J o U r n A l / s P r i n g 2 0 1 0 11
Interestingly, the risk for gun death
in rural areas is the same as in the inner
city. The difference is the victim and the
mechanism of wounding: older white
males dying by self-inflicted gunshot
wounds (rural suicide) versus young males
shot by others (urban homicide). Upstate
New York, says Schwab, has a bigger
problem with suicide from guns than
with either unintentional firearm death or
firearm homicide.
“We have worked diligently over the
years to distinguish risk factors for suicide,
so that primary care providers can
identify patients who may be at risk for
suicide, specifically, for suicide by a gun,”
says Schwab. Many of these risk factors
are correctable: a medical condition out of
control, untreated pain, depression, and
social isolation.
Despite FICAP’s efforts, the numbers
of gunshot wounds remain unacceptably
high. Twelve years of asking the question,
“Why?” has led to some answers, although
not enough solutions. “We, as a society,
have chosen to live with guns,” says
Schwab. “We are never going to reverse
that; it’s part of our history and culture.”
Nonetheless, he also believes that as a
society we should balance the right to be
armed with the public’s right to be safe.
“We need to continue to educate
people about gun carrying and ownership,”
he says. “We know from numerous
studies that people living in a home with
a gun have a four to five times increased risk of gun suicide or
homicide.” Another recent study found that, on average, guns
did not protect those who possessed them from being shot in
an assault, suggesting that the probability of successful defensive
gun use may be lower than the public perception, at least for
civilians in urban areas.
“FICAP continues to conduct evidence-based studies with a
goal to make the public safer,” Schwab says. “By understanding
the circumstances surrounding firearm injuries, a community is
more likely to develop policies that address the circumstances
around shootings, identify populations at risk, and intervene
before the trigger is pulled.” n