Accid. Anal. & Prey., Vol. 9, pp. 177-182. Pergamon Press 1977. Printed in Great Britain

S O M E S O C I A L C H A R A C T E R I S T I C S O F

Y O U N G G U N S H O T F A T A L I T I E S ?

DAVID KLEIN

Department of Social Science, Bessey Hall, Michigan State University, East Lansing, MI 48824, U.S.A.

and

MAURICE S. REIZEN, GEORGE H. VAN AMaURG and S c o y r A. WALKER

Michigan Department of Public Health, Lansing, Michigan, U.S.A.

(Received 29 October 1976)

Al~tract--The demographic characteristics of young gunshot fatalities, the type of gun involved, and the social situation surrounding the death were investigated through an analysis of all death certificates and 77% of the birth certificates for Michigan victims under the age of 16 from 1970 through 1975.

Blacks are heavily overrepresented in the mortality data, and information on the education, occupation and age-parity status of the victims' parents suggest that gunshot mortality rates are directly related to low socioeconomic status. Police reports indicate that the guns involved seem to have been acquired preponderantly for self-protection rather than for hunting, target-shooting or criminal purposes. All the victims of hand-gun accidents were urban residents.

Mthough several studies have demonstrated that the gunshot mortality rate is directly related to 1:he number of guns privately owned--that is, that mortality and morbidity have increased as gun ownership has increased--there are no reliable data on the distribution of gun ownership within 1he United States population, and hence it is impossible to identify the demographic characteristics of the population at greatest risk. Some studies suggest that both homicides I Hirsch et al., 1973] and accidental firearms deaths [Heins et al., 1974; Rushforth et al., 1975] tend lo be concentrated in the lower socioeconomic levels and that blacks are more likely to be involved than whites, but these findings are not sufficiently precise to permit identification of the population at risk.

If countermeasures against firearms mortality and morbidity are to be effective, it is essential Ihat we know not only the demographic characteristics of the victims but also the social situation in which the episodes occur and the type of firearm involved. Gun-control legislation, for example, will be effective only to the extent that handguns are involved in accidental deaths and only if enforcement efforts would reduce illegal gun ownership. The effectiveness of community safety programs, courses in gun safety, or restrictions on hunting would depend heavily on the characteristics of population at risk and on the social environment in which most episodes occur. 7:?he present paper attempts, therefore, to identify some of the social characteristics of gunshot tatalities, the type of gun involved, and the social situation surrounding the shooting.

Heins et al. [1974] attempted to identify the social characteristics of the population at risk and the situations surrounding gun accidents to children brought to medical attention at Detroit General Hospital over a nine-year period. These investigators found that blacks were significantly overrepresented in the victim population, that many of the victims came from families broken by divorce or desertion and beset with numerous other problems (non-gun- related accidents, chronic illness, school failure, unemployment, etc.), and that the guns were acquired for self-protection rather than recreation or criminal activities.

The major limitations of the Heins study are that it dealt only with an urban population (in a city with a high crime rate and a large population of poor blacks) and that it omitted the substantial proportion of cases that were treated in other hospitals or that were dead at the scene of the accident or on arrival at the hospital. The present study constitutes a preliminary attempt to determine whether the Heins findings hold true for the state of Michigan as a whole--a state

CPresented at the annual meeting of the American Public Health Association, Miami, Florida, 17 October 1976.

177

178 D. KLEIN et al.

which includes cities and suburbs of varying degrees of affluence, rural areas and areas in which hunting is an important seasonal activity. Like Heins et al., we use an age range of 0-15 years.

METHODS

In order to collect comprehensive data for the state as a whole, we examined all death certificates for a six-year period (1970-75) for gunshot victims under the age of 16, since the death certificate is the only document that is available for every case and that is centrally filed. Nonfatal gun injuries are not routinely reported to the public health authorities and, although all gun injuries are reportable to the police, these reports are filed locally and their quality depends on the professionalism of the investigating officer as well as his current work load. Nonfatal-injury records are filed in local hospital emergency rooms, and their quality, too, is highly variable.

The information available from death certificates ranges from a bare minimum (age, address and race of the victim, with unspecified "gunshot wound" indicated as the cause of death) to somewhat richer information on caliber of bullet, gun type, some situational details and culpability. Autopsy records, which were submitted by some county medical examiners along with the death certificates, were almost uniformly useless as sources of information on social characteristics of the victim, culpability, or even on weapon type, although they were often very rich in legally required medical details that were almost entirely irrelevant not only for our purposes but for determining the cause of death.

In order to determine whether gunshot fatalities were related to population density, we used the addresses on the death certificates to classify each death as "rural" or "urban." All counties containing at least one city of more than 35,000 (1970 census) were classified as urban; the balance were classified as rural.

Because the present stage of this study did not include interviews with the victims' parents, the socioeconomic status of the victim's family was assessed from data available from the victim's birth certificate, which we were able to obtain for 77% of both the whites and the blacks in our sample. For births prior to 1968, the birth certificates provided a description of the father's occupation; in 1968, the form of the birth certificate changed, and each parent's level of education was substituted for father's occupation. We used the mother's educational level rather than the father's because our sample included a number of illegitimate births. In addition, birth certificates provided information on the mother's age-parity status at the time of the victim's birth.

Using father's occupation, we arbitrarily classified all white-collar and professional occupations as "high," and all manual occupations as "low." Using the mother's educational level, we classified mothers who had not completed high school as "low," and those with 12 years or more of schooling as "high." Using 1970 statewide data for age-parity for whites and for blacks as a standard, we were able to assess the age-parity status of each victim's mother. If she was younger than the median age for that parity, she was classified as "low" (that is, low in social status because she was high in terms of parity).

Given these data, our method of assessing socioeconomic status was necessarily somewhat crude. Our use of father's occupation (on the pre-1968 birth certificates) probably underestimated socioeconomic level, since the Michigan labor force includes some relatively well-paid and regularly employed blue-collar workers as well as some low-salaried white-collar workers. On the other hand, our use of mother's educational level (on the post-1968 birth certificates) probably overestimated socioeconomic level, since in Michigan, according to the 1970 U.S. Census, 54% of whites and 37% of blacks were high school graduates. Our parity data are probably reliable, because most studies indicate a high level of correspondence between parity and socioeconomic status--and, in fact, our parity data correlate satisfactorily with our other measures of socioeconomic status.

RESULTS

Perhaps because every death certificate specified the race and age of the victims, these two characteristics present the most striking findings. As Table 1 indicates, blacks are disproportionately represented in over-all fatalities. The black victim tends also to be younger--for reasons to be discussed later--and hand guns are far more frequently involved in black than in white deaths.

The type of firearm involved in the fatalities was specified in only 59% of the cases, but there

Some social characteristics of young gunshot fatalities

Table 1. Accidental gunshot deaths 0-15 by race and type of gun involved. Michigan residents, 1970-75

179

Total White Black

Deaths 100% 70% I 30%

Michigan Population 100% 87.2% 12.8%

Median Age of Victims (0-15) 132 lO

o Type of Gun Involved Total

Hand Gun

Rifle

Shot Gun

Unrecorded

100%

11%

22%

22%

44%

100%

41%

18%

10%

30%

~-highiy s ign i f i can t (p<O.O05) e-highly s ign i f i can t (p<0.005)

is no reason to believe that this low level of reporting provides biased information, since the quality of the reporting varied both in rural counties, where long guns might be expected to predominate, and in urban counties, where hand guns are presumably more prevalent.

Because we are concerned with fatalities rather than nonfatal injuries the overrepresentation of black victims might be attributable to differences in the promptness of response by police or medical emergency units or differences in the level of medical care available to each racial group, or both. Table 2 reveals some actual difference in the outcome of each episode for blacks and for whites. It may be true that black victims receive less prompt response and less adequate medical attention, but this would be masked or possibly outweighed by the fact that blacks, who live preponderantly in urban areas, are in closer reach of medical care than whites living in sparsely populated rural areas. In fact, the higher death rate for rural whites than for urban whites suggests (Table 3) that emergency medical care may be inferior in rural areas, although a study of iajuries as well as deaths would be necessary to to document this point.

The substantial overrepresentation of black victims raises a question as to whether vulnerability to gunshot death is related to racial subcultural factors (e.g. a higher proportion of female-headed families, feelings of victimization and of exclusion from the opportunity structure, residence in high-crime areas), to residence in areas of high population density (because 38 of the 39 black victims died in urban areas), or to low socioeconomic status (since rlost blacks tend to be poorer than most whites).

We therefore classified our sample into three groups--urban whites, rural whites and urban

Table 2. Accidental gunshot deaths by race and time of death. Michigan residents age 0-15, 1970-75

Time of Death

Total Deaths

Dead at Scene

Dead on Arrival

Died in Hospital

All Fatal i t ies White

100% (N:133)

38%

30%

31%

100%

43%

29%

28%

Black

100%

29%

32%

38%

180 D. KLEIN et al.

Table 3. Accidental gunshot deaths and death rates by socioeconomic status, race and characteristic of residence. Michigan residents age 0-15, 1970-75

Urban Rural Urban Socioeconomic Status Whites Whites Blacks

Socioeconomic Status Measured by Occupational- Educational Cr i te r ia

T o t a l

High

Low

Socioeconomic Status Measured by Mother's Parity Criteria

Total

High

Low

41(1oo%)

12(29%)

29(71%)

41(100%)

21(51%)

70(49%)

32(I00%)

6(19%)

26(81~)

32(100%)

II(34%)

21(66%)

30(100%)

3(10%)

27(90%)

3o(1oo%)

7(2,3%)

23(77%)

Death Rate* .5 1.0 [ 1.8

*Rate - Deaths per 100,000 persons (1970 Census) per year (1970-1975 average) for each race and residence category

blacksiapplied our measures of socioeconomic status, and calculated the gunshot death for each group. As Table 3 indicates, the gunshot death rate relates clearly to socioeconomic level, regardless of population density. The urban whites, the only group that is not preponderantly of lower socioeconomic status according to our two measures, have the lowest death rate. The rural whites, who have lower socioeconomic status than the urban whites, have a death rate higher than that of the urban whites but lower than that of the urban blacks, who have the lowest socioeconomic status of the three groups. These findings suggest that poverty rather than racial factors or population density is the strongest predictor of gunshot death in children.

The question of why hand guns were disproportionately involved in black deaths was resolved when we tabulated all recorded gun types according to the area in which the death occurred. All but one of the blacks in our sample were urban and, as Table 4 indicates, 100% of the hand guns in the sample of recorded guns were involved in urban areas, whether the victim was black or white. In brief, a hand gun is more likely to be acquired by urban than by rural residents, regardless of their race or their socioeconomic status.

The concentration of hand guns in urban areas becomes logical in the light of our very strong impression that almost all of the guns involved in the fatalities, regardless of type, were used for self-protection rather than for hunting or for criminal purposes. Although in many cases the information available to us was sketchy, only 2 of our 133 cases involved a hunting-related

Table 4. Type of gun by rural or urban residence. Michigan accidental gunshot deaths--ages 0-15, 1970--75

Type of Gun Rural Urban

All Deaths 100% (N=43) 100% (N=90)

Hand Gun 0%

Ri f le 2]%

Shot Gun 21%

' 58:~ Unrecorded

30%

20%

17%

33%

Some social characteristics of young gunshot fatalities 181

situation, and only 1 of our cases involved a child's death with a hand gun that may have been concealed for criminal purposes. According to the police reports available for some of the cases, most of the guns, whether hand guns or long guns, were kept loaded for use against prowlers, and in several cases parents had instructed the eventual child victim or the child shooter to use the gun against prowlers or burglars. Obviously, guns used for self-protection are more likely to be involved in accidental shootings because hunting or target guns are much less likely to be stored loaded or to be kept where they are readily accessible for use against an intruder. In many of the cases on which we have information, the victim found the gun in the parent's bedroom, where he was playing unsupervised.

DISCUSSION

The study is limited by the fact that it deals only with fatalities and excludes the much larger number of nonfatal injuries produced by guns. But whether this exclusion of nonfatal injuries biases our sample and hence our findings is questionable. In highway crashes, there are conspicuous differences in social characteristics between victims who are injured and those who a:~,e killed [Klein and Waller, 1970], because differences between injury and death may be due to speed, impairment by alcohol, time and location of exposure, vehicle type and other factors that are to some extent socially determined. In the case of gunshot, by contrast, it is our very strong inpression that the difference between death and injury is largely determined by the trajectory of the bullet--that any one of our fatalities might have been an injury had the bullet passed an inch o:, two to one side or the other of its actual trajectory. Hence we do not believe that there are social differences between fatality and injury cases.

We have no data on the distribution of guns in the population as a whole but, whether or not they are distributed uniformly throughout the socioeconomic spectrum, our findings suggest that f~talities (and presumably nonfatal injuries) are concentrated among the poor. Since the guns appear to be used almost exclusively for self-protection, this finding is in accord with what n Jmerous other investigators have noted as two prominent characteristics of the "culture of poverty": (1) a strong fear of crime, acquired through first-hand experience with the numerous crimes against property and person that occur in their own neighborhoods and (2) lack of confidence that the police are willing or able to provide protection against this threat of crime.

If our findings prove to be valid, they provide several implications for the formulation of countermeasures. Gun-control legislation, for example, is not likely to be highly effective in the short run, for two reasons. First, although hand guns play a substantial part in these deaths, more than half of the deaths are caused by long guns. Secondly, even the strongest enforcement measures are unlikely to eliminate these hand guns since, from the point of view of their owners, compliance with the law would deprive them of their only protection against what they see as a real and immediate threat.

Programs of gun safety are unlikely to be effective because, in their present form, they are intended for an essentially middle-class audience of hunters and target-shooters. (Ironically, one ot the white victims was killed by her 12-year-old sister who had been given a rifle as a gift by her father and who had just completed a course in gun safety). The gun owner who uses his gun for self-protection is unlikely to follow any advice against keeping a loaded gun in the house.

In the long run, any reduction of mortality or morbidity would seem to require improvement in the quality of police protection sufficient to reduce the need that the poor perceive for guns as a m,~ans of self-protection. And the reduction of poverty would promise to change the disorganized lifestyle and the child-rearing patterns that contribute so heavily to the problem.

These are, of course, long-range solutions that require the expenditure of substantial resources. But a number of studies indicate that both the mortality rate and the morbidity rate are increasing. And these rates severely underrepresent the magnitude of the problem, because they include only the victims who are injured or killed. They ignore completely the severe, and in many cases permanent, damage done to four or five other people in each case--the shooter and the parents of both victim and shooter.

It has become almost ritually obligatory to close a paper of this kind with a plea for more re~;earch. We would like to violate this tradition and plead, instead, for better data on which to base further research.

Although we recognize that the death certificate is primarily a legal document, it is also the

182 D. KLEIN et al.

fundamental data source for studies of gunshot mortality. And the information provided for research investigators by the death certificate in its present form is inadequate, both quantitatively and qualitatively. If gunshot mortality is regarded as a public health problem, there is no reason why its etiology should not be as clearly specified on the death certificate as it is for deaths due to respiratory conditions. An improvement in the certificate information would require (1) changing the coding protocol so that it provides more detail and (2) motivating the medical examiner or attending physician to include on the death certificate not merely the medical details but also situational information available from the police report. The findings of this study are necessarily ten ta t ive- -not only because the death certificate is inadequate but also because comprehensive information on morbidity is virtually impossible to obtain. If police reports and hospital records on gunshot incidents were filed centrally, research would be more feasible and of better quality by virtue of being based on better data.

REFERENCES Heins M., Kahn R. and Bjordnal J., Gunshot wounds in children. Am. J. Pub. Health 64, 326-330, 1974. Hirsch C. S., Rushforth N. B., Ford A. B. and Adelson L., Homicide and suicide in a metropolitan county--I: Long-term

trends. J. Amer. Med. Assoc. 2223, 9(10-905, 19 Feb. 1973. Klein D. and Waller J. S., Causation, culpability and deterrence in highway crashes, pp. 59-102. U.S. Dept. of Transportation,

1970. Rushforth N., Hirsch C. S., Ford A. B. and Adelson L., Accidental firearms death in a metropolitan country (1958-1973). Am.

J. Epidemiol. 100(6), 499-505, Dec. 1975.