Journal of the Louisiana State Medical Society
Firearm-Related Mortality, Louisiana 1999-2010
Susanne Straif-Bourgeois, PhD, MPH; Raoult Ratard, MD, MS, MPH&TM
This report is a purely descriptive study of firearm-related deaths occurring in Louisiana from 1999 to 2010. Mortality data were collected from death certificates from this 12-year period to describe firearm fatalities by year, race, gender, age group, and manner of death (accident, homicide, suicide). Louisiana data were also compared to national data. Race, sex, and age were important factors influencing mortality rates and the death manner. Rates were higher in males than in females and higher in African-Americans than in Whites. The highest rates were observed for homicides among African-American males. The ratio of Louisiana age/race-adjusted firearm mortality rates over the US rates were 1.8. Both Louisiana and the US mortality rates remained fairly constant over the 12-year period. Parish level data showed a wide variation in firearmmortality rates with some urban and some rural parishes having the highest rates. Data obtained from death certificates have limitations due to the limited number of variables available.
INTRODUCTION Firearm-related deaths are a significant public health problem. They are the second leading cause of injury deaths after deaths due to motor vehicle accidents in the United States (US). The Center for Disease Control and Prevention (CDC) estimates that about 33,000 Americans die each year from firearms. Younger age groups are affected dispropor- tionately. 1 One of the goals of “Healthy People 2010,” an initiative from the Department of Health and Human Ser- vices to improve the health of Americans, is to reduce the current firearm annual mortality rate from 10.3 per 100,000 to 4.9 per 100,000. The goal of this study is to describe the basic epidemiologic features of firearmdeaths in Louisiana, understand the pattern by age, sex, and race, evaluate the trend over a 12-year period, compare the situation of Loui- siana and that of the United States as a whole, and provide a basis to future studies. POPULATION AND METHODS Mortality data were collected from Louisiana death certificates for the 12-year period from 1999 to 2010. The International Classification of Diseases (ICD) 10 Codes listed in Table 1 were used for data extraction. One of these codes had to be present among the first eight causes of death to be included in this study. All of the firearm deaths were listed as the first cause of death except for 18 of the 9,722 deaths included. For further analysis, the causes of death were grouped in three categories (with the descriptive “Manner of death” used on the death certificate) shown on Table 1: Accident, Suicide, andHomicide. Eachmanner of deathwas
divided in three subgroups according to the type of firearm: Handgun (H); rifle, shotgun, and larger firearm discharge (L); and other or unspecified firearm (O). Data on the type of firearm (“handgun” or “rifle, shotgun, and larger firearm discharge” were not analyzed since most were categorized as “other or unspecified firearm”). The age groups selected were increments of five-year age groups, except for the first group (ages less than nine years old), and in all, there were 17 age groups. In order to make the description of the manners of deaths (accident, homicide, and suicide) more simple, five age groups were used for that section. The trend analysis comparing Louisiana, the United States, and the parish level rates included all races. Since the large majority of cases were among Whites (W) and African-Americans (AA), any detailed analysis by race was limited to these two race groups. The data were extracted to a database and tabulated us- ing SQL queries. Average age-group-specific mortality rates (per 100,000) were calculated for the entire 12-year period weighted for the population of each age group in each year. To depict the trends of mortality rates over the 12-year span between Louisiana and the United States, an age-adjusted mortality rate was calculated (US 2000 standard population, all races, both sexes). The basic statistical tests were performed using Win- PEpi downloaded in 2013. • For comparison of each race, sex, and age group stratum, a crude rate ratio and an Upton x 2 were used, and for all strata a Mantel-Haenszel x 2 esti-
168 J La State Med Soc VOL 166 July/August 2014
Made with FlippingBook - Online catalogs