This study investigating the case fatality rates (CFR) of gun assaults in California to assess whether the total number of gun homicide incidents is higher than expected given the overall volume of gun violence found that the number of nonfatal gun assaults in California decreased more quickly than the number of gun homicides.
This study investigating the case fatality rates (CFR) of gun assaults in California to evaluate whether the total number of gun homicide incidents is higher than expected given the overall volume of gun violence found that the number of nonfatal gun assaults in California decreased more quickly than the number of gun homicides. The trend is consistent with patterns observed in trauma center data. The ultimate cause of the trend requires further investigation but may be related to gradual changes in the caliber of guns in circulation. In this case series, the authors compiled data on gun violence incidents (firearm assaults and homicides) spanning 2005 to 2019 from emergency department and inpatient hospitalization discharge records from the California Department of Health Care Access and Information, and death records from the California Department of Public Health Vital Records. The number of nonfatal gun assaults (6787 in 2005 vs 3803 in 2019), number of gun homicides (1932 in 2005 vs 1282 in 2019), and gun injury rate per 100,000 population (24.3 deaths in 2005 vs 12.9 deaths in 2019) all declined significantly between 2005 and 2019. The CFR increased significantly during the study period, from 22.2% in 2005 (1932 homicides out of 8719 gun crimes) to 25.2% in 2019 (1282 homicides of 5805 gun crimes). Holding the CFR steady at the 2005 rate estimated from the linear model (20.8%) and assuming that total volume of shootings remained as observed, the authors calculated an excess mortality of 1919 gun homicides in California over the subsequent 14 years associated with the increase in CFR alone. This study is limited by a lack of situational details about individual crimes; nevertheless, the shift in CFR is practically significant.
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