siana parishes. There seems to be two patterns for high firearmmortality rates. The first pattern includes urban areas with a concentration of poor living con- ditions such as in Orleans, East Baton Rouge, and Caddo parishes. Orleans Parish firearm-related death rate is the highest in Louisiana, more than twice as high as in East Baton Rouge and Caddo Parishes. According to census data, more than 25%of Orleans Parish residents live below the poverty level compared to 18.4% in Louisiana as a whole. 6 The sec- ond pattern includes rural areas which have been much less studied than urban areas. Firearm mortality rates observed in Louisiana are consistently higher than those observed in the United States, even after adjusting for race, sex, and age distribution. Mortality data are easily acces- sible and very useful for the purpose of describing the magnitude of a public health problem in specified popula- tions and trends over time. However, firearm-related mortality data have some serious limitations. Data on homi- cides might be underreported since at time of filling out the death certificate, the criminal investigation often is still ongoing. Data on suicide deathmight be underreported because of stigma of this manner of death. 7 Another limitation is that mortality data only describe the tip of the iceberg. Data based on emergency department visits estimate that about two-thirds of firearm-related injuries are non-fatal and makeup the majority of firearm violence. 8 The likelihood of dy- ing from a gunshot wound also depends on the intent of the person using the weapon; case fatality rates for firearm injuries range from 20% for homicides and to 80% for suicides. 2 REFERENCES Center for Disease Control and Prevention WISQARS database. Available at: http://www.cdc.gov/ncipc/wisqars. Accessed April 2013. 2. Firearm injury in the U.S. (2009). 1. Firearm & Injury Center at Penn. Available at: http://www.uphs.upenn.edu/ficap. Last accessed April, 2013. 3. Bj er regaard, B; Li zot te A. Gun Ownership and Gang Membership. Journal of Criminal Law and Criminology. 1995;86:37–58.
Figure 5B: Mortality rates for homicidal firearm deaths by race, sex, and age group in Louisiana, 1999-2010, logarithmic scale.
Key: AAM=African-American Male; WM=White Male; AAF=African-American Female; WF= White Female
Figure 6: Mortality rates for suicidal firearm deaths by race, sex, and age group in Louisiana, 1999-2010. Key: AAM=African-American Male; WM=White Male; AAF=African-American Female; WF= White Female
J La State Med Soc VOL 166 July/August 2014 173
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