Victims in the Shadows
The Pain and Cost of Non-fatal Gun Violence
by Henry B. Ryan
With stunning frequency we learn of a gun massacre somewhere in the United States, often in a school. We hear that there are 12 dead, 14 dead, 17 dead, and in the worst so far, this time at an outdoor concert, 58 dead. For a while, the media identifies these horrors using the number killed—“58 shot dead in Las Vegas,” or “14 dead in California Mass Shooting.”
Those headlines are understandable, but, unfortunately, they mask one of the worst effects of American gun violence. They sideline and often overlook the enormous number of wounded. According to news reports, the Las Vegas shooter, for example, besides murdering 58 people, injured at least 500 others. Despite that huge number, however, those victims have tended to fade in the public’s awareness. Still, in terms of human suffering and societal cost, they comprise an enormous part of the story. Many will be crippled for life, confined to wheel chairs, dependent on oxygen tanks and crutches, forced to remake or leave their homes, give up their jobs, abandon their careers, rely heavily upon relatives, and give up sports and recreational activities in which they can no longer participate. The list of life-diminishing, life-complicating
adjustments they will need to make every day for the rest of their lives is nearly endless, and the overall number of non-fatal victims is massive. It amounted to almost exactly 85,000 in 2015, according to the Centers for Disease Control and Prevention (CDC), the last year it made figures available.
But just as the non-fatal victims of gunfire are often overlooked, so is the enormous economic impact of their new circumstances. It includes the costs not only to them and their families but also to public and private institutions that are required to accommodate their many special needs. These include, especially, emergency and long-term medical care backed by financial assistance, much of it provided by state governments. Ted Miller is an economist at the Pacific Institute for Research and Evaluation (PIRE), a non-profit organization that studies public health, education and safety issues. An expert on the costs of violence, he estimates that the overall total of medical bills, follow-up care, and life adjustments for victims of the Las Vegas shooting alone will come to at least $600 million. And that is only one event, albeit the worst. The CDC, in one of the few studies it has made of the subject, estimates that between 2001 and 2015 more than 1 million Americans were wounded in shooting incidents.
Stanford School of Medicine researchers, looking at the problem from a purely medical viewpoint, estimate that initial hospital care alone for gun shot victims in the United States comes to approximately $735 million per year. Looking at the issue in terms of individual cases, the University of Iowa estimates the average hospital admission cost per shooting victim is $20,989. Corinne Peek-Asa, a member of the Iowa Study, which was published in July 2017 in the journal Injury Epidemiology, said, “being admitted for a firearm injury is very expensive.” The study showed that it amounts to more than double the cost of the average hospital stay and pointed out that government insurance provides reimbursement for some
33% of victims of gunshot wounds, and that about an equal percentage are uninsured. Consequently, in some two-thirds of the cases either government or various medical institutions pick up the tab. Private insurance pays very little. As Peek-Asa pointed out, the expense of treating gunshot victims “is a public cost.”
Ted Miller concluded in a study in 2012 that the total cost of caring for victims of shootings came to $229 billion per year. That includes $8.6 billion in direct costs–for example, emergency care, other medical expenses, and also for court and prison costs, items rarely considered as part of this problem. The remaining $221 billion represents indirect costs such as productivity loss and expenses incurred by victims and their communities as the injured adjust to their new circumstances. That research is now six years old, but both overall costs and the annual number of victims have only increased so there is little reason to believe that those numbers are lower today. According to CDC, deaths alone have gone from more than 33,500 in 2012 to more than 38,600 in 2016, the last year in which federal data was available.
Data gathering on gun violence, including economic statistics, has been beset by a piece of legislation called the Dickey Amendment. It is an amendment added to an omnibus spending bill in 1996 by Republican Congressman Jay Dickey of Arkansas, which stated that no funds provided to the CDC “for injury prevention and control” could be used “to advocate or promote gun control.” While it does not prohibit the Center from studying gun control issues, it has seriously inhibited it from doing so. But by far the principal inhibitor has been simply the denial of funding for such studies. In 2018, for example, no funds for gun violence studies have been made available to CDC. Although, in the new atmosphere of gun reform following the school shooting in Parkland, Florida, and the nationwide student protests, the National Institutes of Health in April 2018 made $5 million available to study ways to prevent children from being shot, the second largest cause of child death in the country. This is its first grant to study gun issues in 20 years.
In fact, lack of data is no longer an excuse to avoid legislative action. The web is awash with statistics and data of all sorts regarding gun violence. Furthermore, the information comes from reliable sources, many of them medical faculties of major universities. In addition, the field got a boost in April 2018 when the giant health organization, Kaiser Permanente, announced that it would make $2 million available to study ways to reduce the nation’s gun violence. It was motivated, it said, by the large number of gun injuries treated in its facilities nationwide—some 11,000 in a two year period, 2016/ 2017. The company hopes to spur similar investments by other health-care organizations, helping close the research gap, which it says CDC created by walking away from the subject more than 20 years ago.
The Trace is probably the best place to start a search for data on gun violence. It is an online publication that describes itself as “an independent, non-profit news organization dedicated to expanding coverage of guns in the United States.” Besides providing large amounts of data, it gives links to numerous other sites and publications that look at the topic from many difference angles. Certainly, it would be an enormous public benefit to have more private organizations like Kaiser Permanente focus on this subject, just as it would be to have CDC return to the table. There is, however, no longer any reason for anyone to maintain that meaningful legislation on gun violence in America is hindered by the absence of essential data. If America’s political class has the courage and the will to control this problem, the data to back necessary legislation is readily available.