Megan Ranney MD MPH 🗽 Profile picture
Oct 7, 2018 19 tweets 15 min read Twitter logo Read on Twitter
A lot of brouhaha in the #gunviolence world about this well-reported article showing that @CDCgov data on the number of NON-FATAL gun injuries is not accurate.…

I want to highlight a few things about this article.
1. First, kudos to the writers for highlighting an issue that all of us #gunviolence researchers bemoan: that there are NO GOOD SOURCES OF DATA on non-fatal gun injuries. As the article reports, even the CDC admits that its data on #gunviolence injuries are unreliable.
2. Please note that this issue is not unique to #gunviolence non-fatal injuries. It’s also observed for other types of injuries (like drownings).

It’s because of the way that the CDC is forced to collect non-fatal-injury data.
3. Although the reliability of the CDC data on #gunviolence is low, overall the numbers for CDC estimates are “tighter” than the numbers from other sources of #gunviolence injury data, which range tremendously.
4.And – the estimates for #s of injuries from CDC are pretty darn similar to the estimates from other data sources. (For all we know, prior years’ CDC numbers were *under*estimates? Who knows!)
5 BUT!!!!! BUT!!!! BUT!!!!

Lost in the article is this important fact: regardless of the debate about number of #gunviolence INJURIES, gun DEATHS are INDISBUTABLY high in the US. There is zero debate about this fact.

Here is some data to support that assertion:
6. To quote from a recent article on youth mortality in the US: "The firearm-homicide rate among individuals aged 15 to 29 years was 82x higher in the US than 19 other high-income countries and increased by about 25% between 2012 to 2014."
7. #gunviolence homicide is mostly affecting young minority males. But according to the same JAMA article, the US youth firearm #suicide rate is 8x higher than in similar high-income countries. This rate is also increasing, especially for white kids.
8. Another recent article in JAMA reports (using global death data) that rates of firearm injury and death in the US is similar to that of Venezuela or Colombia.
9. According to the analyses presented in this article, the rate of #gunviolence deaths decreased in the late 90s (due to the end of the crack epidemic), but is now rising again.
10.Yet another article in JAMA reports that the fatality **RATE** from #gunviolence injuries is increasing in Denver -- in other words, people who are shot are MORE LIKELY to die.
11. (This same article reports a DECREASING fatality rate for every other type of injury. So: something is different about gun injuries. It's not the fault of the trauma system, it's the fault of the injury itself.)
12. Of course, none of these studies report on the very real #mentalhealth effects of #gunviolence exposure. (That’s a whole different thread… stay tuned.)
13. In sum: I’m super super happy that @teamtrace and @FiveThirtyEight are calling out the very real issue of unreliability of #gunviolence injury data.

But I don’t want this critique to lead to us throwing the baby out with the bathwater.
14. What they are ultimately proving is that “We have a lost generation of firearms research" (per the ever-eloquent @sandrogalea) --- due to restrictions on @CDCgov (& NIH) data collection, analysis, and extramural funding.
15. TL/DR? --> The takeaways:

a.#gunviolence is a #publichealth problem.

b.WE NEED BETTER DATA - which is the basis of the #publichealth approach.

c. We need FUNDING to make this happen.
Kudos @researchaffirm @strohcunningham @wycdinitiative & many others for being part of the solution.

Because if others won’t do it, we will. #docs4gunsense

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More from @meganranney

Mar 24, 2018
My take on the new #omnibus bill, as it relates to #gunviolence:
1) The fixes to NICS (the background check system) are long overdue. I hope that they will be implemented well.…
2) I am glad that Congress clarified what CDC, NIH, and NIJ have long known: the "Dickey amendment" doesn't ban research per se. (Cf this article I wrote with @EmmyBetz & Wintemute 2 years ago:…)
3) HOWEVER: this clarification does **nothing** to fix the lack of research. We need appropriations. Want to know more about why this clarification is meaningless (and may even be harmful)? Read here:…
Read 9 tweets
Feb 27, 2018
Over the past 2 days, hundreds of doctors have shared heartbreaking accounts of how #gunviolence is a #publichealth issue. These are the stories of #docs4gunsense ... May their words make a difference.

@choo_ek @physicianwomen @darakass @gitapensa
The result of a bullet ricocheting inside the skull and destroying the brain on CT scan. The worst trauma I have seen. GUNS ARE A PUBLIC HEALTH ISSUE – Gen Geller MD, NY #docs4gunsense @drgenngeller
The damage a bullet does to a 1 year old brain as it ricochets back and for. The guilt the family feels. The sadness we all feel.
Melissa Miller MD, Missouri
Peds EM #docs4gunsense
Read 121 tweets

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