A POPULATION-BASED STUDY OF FATAL AND NONFATAL FIREARM-RELATED INJURIES

Objective: To determine population-based firearm-related morbidity and mortality for Allegheny County, PA (population = 1.3 million), for th e year 1994. Methods: Fatalities were identified from a review of deat h certificates. To identify nonfatal cases, an active surveillance was conducted at all 24 acute care EDs in the county, The ED surveillance used 2 existing sources of case identification from each hospital to minimize undercount. Results: Firearms were the leading cause of injur y death to county residents, accounting for 155 deaths. The crude mort ality rate from firearms was 11.7/100,000. Black males aged 15-19 year s were most at risk for a firearm fatality (293/100,000). There were 5 14 nonfatal firearm injuries, producing a case fatality rate of 23%. T he highest age-specific rate for nonfatal firearm-related injuries tre ated in the county EDs was observed for black males aged 15-19 years ( 2,245/100,000), which is 58 times higher than the firearm-related inju ry rate for the entire county population (38.7/100,000). Conclusion: F irearm-related injury and death are a significant public health proble m in Allegheny County, Although the crude mortality rate from firearms in the county is lower than the reported national rate, the observed rate for nonfatal injuries in the black youth of this community is the highest firearm injury incidence rate ever reported, Local surveillan ce of firearm-related injuries, including nonfatal events, is needed t o more accurately demonstrate the magnitude of this problem.