International comparison of civilian violent deaths: a public health approach to reduce gun-related deaths in US youth.

Abstract

OBJECTIVES: The political controversy surrounding firearm fatalities in US youths (aged 15-24 years) continues. This study examines whether a public health approach could reduce gun-related deaths in the US. METHODS: Based on the latest World Health Organization (WHO) data, current (2015) numbers and rates per million of US civilian violent deaths (CVDs) (including transport deaths, suicides and homicides) for both the general population and youths (aged 15-24 years) are examined. US CVD results are considered in a wider context by comparing the results with those of seven other major Western countries (MWCs). To demonstrate the effectiveness of a public health policy, transport deaths between 1979 and 2015 are analysed, which corresponds to a time period when government interventions based on technical improvements and behaviour change were implemented to improve road safety. The statistical significance of the comparison between road fatalities and suicide rates between 1979 and 2015 is determined by the chi-squared test. RESULTS: In 2015, the total number of US CVDs was 101,456, consisting of 44,193 suicides and 17,588 homicides (of which 30,891 were likely to be gun-related deaths). Youth deaths totalled 17,432; 5491 suicides and 4732 homicides, including approximately 5112 gun-related deaths. US CVDs are substantially higher than the other MWCs for both the general population and youths. In 1979, US transport deaths were 57,577, which decreased to 39,675 in 2015. Every country's public health approach to reduce road deaths, when compared with suicides, was highly statistically significant. CONCLUSIONS: Government interventions have reduced transport deaths; thus, new policies may also reduce gun-related violence. The evidence points towards a public health approach, such as that used to reduce road deaths, which could help reduce US firearm-related deaths to levels comparable with other MWCs.