Studies show lasting effects of gun violence, possible interventions

The researchers analyzed 10 years of health data on more than 6,000 survivors and more than 12,000 family members from IBM and Medicare databases.

They found that in the month after a nonfatal firearm injury, survivors had a 249% increase in the rate of pain diagnoses, a 200% increase in the diagnosis of a psychiatric disorder, and a 670% increase in substance use disorders compared to the control group.

One year later, psychiatric disorders increased 51%, substance use disorders increased 85%, and pain diagnoses increased 40% more in survivors than in the control group.

Families feel the effects

In relatives, psychiatric diagnoses increased 18% in the month and 12% in the year after a nonfatal injury.

In the year after an injury, health spending increased by $2,495 per person per month, an increase of more than 400% for survivors.

“Our findings demonstrate that the approximately 40,000 gun deaths in the US each year do not represent the total number of gun injuries,” the study authors wrote.

“Nonfatal firearms injuries are more than twice as common and have economic and clinical implications for survivors and their families, with direct costs largely borne by society through commercial insurers, self-insured employers, and public programs like Medicare.

Early intervention can work in rural areas

Early and targeted intervention may be needed to reduce gun carrying among adolescents and young adults in rural areas, according to a study published Monday in JAMA Network Open.

The researchers examined data from about 2,000 people who reported using firearms when they were between 12 and 26 years old between 2005 and 2019.

They identified six trajectories of adolescents carrying firearms. The most common, in which 79.4% of the subjects fell, was the zero or low probability of carrying. Three identified trajectories showed a higher probability of carrying a firearm.

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For those who carried handguns, “the initiation age was young, from 12 to 14 years old.”

The researchers compared data on rural carry with existing research on urban carry of firearms and found that the differences between the two communities “point to the need for prevention approaches tailored to rural contexts.”

Previous research on urban firearm carrying identified only four carrying trajectories. Trajectories in urban research have a “bell-shaped” curve and peak at age 21, but rural trajectories in this study did not peak until age 26, the earliest age the researchers examined .

“Firearm possession increased among young adults who grew up in rural areas to 8.9% at age 23 and 10.9% at age 26, while it remained between 4% and 6% between urban young adults up to 30 years of age. the study authors wrote.

This difference could point to the need for different ways to intervene in rural areas, the authors said.

“Given the early age of initiation into gun ownership in rural areas for most careers, programs established for youth-serving and educational organizational settings to educate teens about firearms, gun violence and how to resolve conflicts without guns may be appropriate for rural areas, especially if those programs connect with that community’s gun culture,” the authors wrote, noting that “nearly all” current intervention programs focus on crime, which may not apply in rural settings.

Other researchers say the app is the answer

In an editorial published alongside that study, researchers from Duke University and the University of Michigan rejected the conclusion that early intervention should come in the form of education, noting higher rates of suicide in rural teens.

“‘Promoting gun safety’ through education of rural children is of limited value, especially given that the predominant gun problem for rural adolescents is suicide,” wrote Philip Cook and Sue Parker.

Cook and Parker advocated enforcement of existing regulations, including those prohibiting the sale of firearms to those under 21, possession of firearms by those under 18, and targeting intervention efforts to parents.

The study authors “focus their recommendations on programs to teach youth gun safety, although there is little evidence that educational or training programs are effective in reducing risky behavior,” Cook and Parker wrote.

“Any comprehensive campaign to reduce youth suicide must include measures to persuade, facilitate or incentivize parents to maintain control over guns in the home.”

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