February 1997


Peter H. Proctor writes:

2) The main factor was apparently the substitution of handguns for long guns as home defense weapons. For penetrating trunchal wounds, the mortality rate for handguns is 15-20 %, roughly the same as for equivalent knife wounds. For (e.g) shotguns, the mortality rate is 70% or so. If memory serves, for high power rifles, about 30-40 %, BTW, the mortality rate from those wicked “assault weapons” is close to that for handguns, since they shoot a relatively low-powered round

Please provide a source for these claims.

This is what I was taught in my training as a pathologist and seem to be pretty standard figures. Also, I saw roughly these figures presented at a Path convention and see no reason to question them. But I suppose I could find the reference somewhere.

Please do so. I’ve appended about 20 studies that all contradict this.

I looked in Medline for studies on gun shot and stab wound mortality and turned up dozens. There was a consistent pattern across different countries and wound locations — gunshot wounds were far more lethal. For example a study in The Journal of Trauma (36:4 pp516-524) looked at all injury admissions to a Seattle hospital over a six year period. The mortality rate for gunshot wounds was 22% while that for stab wounds was 4%. Even among patients that survived, gunshot wounds were more serious — the mean cost of treatment for these patients was more than twice that for stab wounds.

Apples and Oranges. I suspect the difference is ” for equivalent trunchal wounds” which I carefully specified.. If you include superficial knife wounds and wounds that do not penetrate the peritoneum, your figures do sound about right. These are easy to treat and nobody ever dies from them.

Sorry, as I specifically stated those rates were for wounds serious enough to warrant hospital admission, not superficial ones. Further, the other studies mostly looked at equivalent wounds in equivalent locations. Without exception, gunshot wounds were more serious and more likely to lead to death. I’ve appended the abstracts of the studies from Medline.

But wait until you penetrate a viscous or ( especially ) cut a great vessel. The lesser energy involved in knife wounds is more than made up for by their larger size.

This does not seem to be the case. See the attached studies.

As for handgun vs long gun wound mortality, I suggest you look at table 5.10 of “Point Blank” which presents the results of a multivariate analysis based on NCS and SHR data and shows no significant difference.

Er, this just does not sound right. Long guns ( particularly shotguns) are much more destructive than handguns. Compare about 200 ft-lbs for 38 Special to 2000 ft lbs for a high-power military round.

The kinetic energy of the projectile is obviously not the only thing that matters.

One possibility—These figures are for people who actually make it to the hospital alive.

No. They are are based on the the NCS (victim survey) for the number and type of woundings and the FBI’s supplementary homicide reports for the number and type of deaths.

(more…)

HerrGlock writes:

Oh hell, now I’m going to have to dig up that study. There’s a study done that shows long guns are more likely to have an accidental/negligent shooting than are handguns. Something along the lines of 4 to 1.

Try 1 to 4. Handguns are four times as likely to be involved in an accidental shooting as long guns. Handguns comprise about 1/3 of the US gun stock and are involved in 2/3 of the accidental woundings (NEISS).

Peter H. Proctor writes:

Er, According to Kleck ( Point Blank, table 2, ) 90% or more of firearms kept loaded at any one time are handguns.

Er, there is no table 2 in “Point Blank”. Nor does Kleck make this claim anywhere in “Point Blank”. Nor is true. You can estimate the percentage of firearms kept loaded all the time from a survey of firearm storage practices (JAMA 92). 80% of those who said that they kept a gun loaded all or some of the time said they owned a handgun. From this we can conclude that AT MOST 80% of the guns kept loaded are handguns. It would only be 80% if every person who owns a handgun NEVER keeps a long gun loaded.

Presumably, you cannot get shot by an unloaded gun, so handgun “exposure’ ( in the sense we toxicologists use it) is very high relative to long guns, even though there are more long guns.

  1. You CAN get shot with an “unloaded” gun. In fact guns that are, in fact, loaded but are believed to be unloaded are particularly likely to be involved in accidents. Surveys measure whether people believe the gun to be unloaded, not whether it really is unloaded.

  2. Your measure of “exposure” is wrong. If hunting rifles were never stored loaded, do you think that this would magically stop all hunting accidents from occurring?

  3. The far greater handgun involvement in accidents may indeed be partly caused by the greater likelihood for a handgun being kept loaded. This still doesn’t change the fact that a handgun is four times as likely to be involved in a gun accident.

Yet handguns are involved in less than 14% of accidental gun fatalities.

ABSOLUTELY FALSE. You really should not rely on Kates for this stuff. He has deliberately misled you. Handguns are involved in about half of accidental gun fatalities.

A very interesting review of all of this is: Kates et al Guns and Public Health. Tennessee Law Review, vol 62, #3, p513 (1995).

A fiercely partisan pro-gun piece that manages to misstate or get wrong just about every relevant fact on this issue. See here for the discussion I had with Kates on this.

If you just want to look at accidental death, I would note that most of the decrease in fatal gun accidents in the US occured before there was an increase in handgun ownership

Table 2.1 of Kleck’s “Point Blank” shows that handgun sales jumped dramatically around 1965 — from around 0.5M per year to 1-2M per year afterwards. This is presumably the reason for the increase in the percentage of households owning handguns from 16% in the early sixties to 25% in the late eighties. (Table 2.2 of Kleck)

Table 7.1 of Kleck shows that the fatal gun accident rate declined from 2.4 per 100k population in 1933 to 1.21 in 1965 and then to 0.57 in 1987. That is a decrease of 1.19 before handgun ownership increased, and a decrease 0.64 afterwards. The rate of decrease was slower after 1965 than before.

Chris BeHanna wrote:

From 1967 to 1987, the U.S. accidental gun death rate declined by more than two thirds while the handgun stock simultaneously increased by 273%. (Kates et al, “Guns and Public Health: Epidemic of Violence or Pandemic of Propaganda?” Tenn. L. Rev., Spring, 1995 – I’d give you a page number but the article is at home).

Page 567: “Over the twenty year period 1967-1986, the number of handguns increased 173%, while the fatal gun accident rate decreased by almost two-thirds.” Dear me, you seem to have embellished Kates’ factoid by changing “almost two-thirds” to “more than two-thirds” and 173% to 273%. That wasn’t a very nice thing to do, Chris.

Mr Kates has also done some embellishing of his own, though with a bit more subtlety than Chris has. Firstly he has chosen to use 1967-1986 as his twenty year period. 1967 just so happened to be a year with an unusually large number of fatal accidents. Kleck’s tables actually go to 1987, and if he had used 1968-1987 he would only have been able to claim a decrease of one half instead of two thirds. Secondly, notice that he has compared the change in the gun accident rate (number of gun accidents divided by the size of the population) with the change in the absolute number of handguns (not divided by the size of the population). Once again this skews the comparison in the direction Kates prefers. A less misleading version would be: “Over the twenty year period 1968-1987, the number of handguns per person increased by 90%, while the fatal gun accident rate decreased by one half.”

Even this one has problems: most of the new handguns went to households that already had handguns — the percentage of households with handguns did not increase that much. A better version might be: “”Over the twenty year period 1968-1987, the fraction of households with handguns increased by 5 percentage points, while the fatal gun accident rate decreased by one half.”

This still shows that an increase in handgun ownership was associated with a decrease in gun accidents, but obviously this wasn’t dramatic for Kates.