David Gomez1, Natasha Saunders2, Brittany Greene2, Robin Santiago2, Najma Ahmed2, Nancy N Baxter2. 1. Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia david.gomez@unityhealth.to. 2. Division of General Surgery (Gomez, Greene, Ahmed), Department of Surgery, University of Toronto; Division of General Surgery (Gomez, Ahmed), St. Michael's Hospital, Unity Health Toronto; Li Ka Shing Knowledge Institute (Gomez, Ahmed, Baxter), St. Michael's Hospital, Unity Health Toronto; ICES (Gomez, Saunders, Santiago, Baxter); Division of Pediatric Medicine (Saunders), The Hospital for Sick Children; Department of Pediatrics (Saunders), University of Toronto; Institute of Health Policy, Management and Evaluation (Saunders, Baxter), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Melbourne School of Population and Global Health (Baxter), University of Melbourne, Melbourne, Australia.
Abstract
BACKGROUND: Firearm-related injury is an important and preventable cause of death and disability. We describe the burden, baseline characteristics and regional rates of firearm-related injury and death in Ontario. METHODS: We conducted a population-based cross-sectional study using linked data from health administrative data sets held at ICES. We identified residents of Ontario of all ages who were injured or died as a result of a firearm discharge between Apr. 1, 2002, and Dec. 31, 2016. We included injuries classified as assault, unintentional, self-harm or undetermined intent secondary to handguns, rifles, shotguns and larger firearms. The primary outcome was the incidence of nonfatal and fatal injuries resulting in an emergency department visit, hospital admission or death. We also describe regional and temporal rates. RESULTS: We identified 6483 firearm-related injuries (annualized injury rate 3.54 per 100 000 population), of which 2723 (42.3%) were fatal. Assault accounted for 40.2% (1494/3715) of nonfatal injuries and 25.5% (694/2723) of deaths. Young men, predominantly in urban neighbourhoods, within the lowest income quintile were overrepresented in this group. Injuries secondary to self-harm accounted for 68.0% (1366/2009) of injuries and occurred predominantly in older men living in rural Ontario across all income quintiles. The case fatality rate of injuries secondary to self-harm was 91.7%. Self-harm accounted for 1842 deaths (67.6%). INTERPRETATION: We found that young urban men were most likely to be injured in firearm-related assaults and that more than two-thirds of self-harm-related injuries occurred in older rural-dwelling men, most of whom died from their injuries. This highlights a need for suicide-prevention strategies in rural areas targeted at men aged 45 or older.
BACKGROUND: Firearm-related injury is an important and preventable cause of death and disability. We describe the burden, baseline characteristics and regional rates of firearm-related injury and death in Ontario. METHODS: We conducted a population-based cross-sectional study using linked data from health administrative data sets held at ICES. We identified residents of Ontario of all ages who were injured or died as a result of a firearm discharge between Apr. 1, 2002, and Dec. 31, 2016. We included injuries classified as assault, unintentional, self-harm or undetermined intent secondary to handguns, rifles, shotguns and larger firearms. The primary outcome was the incidence of nonfatal and fatal injuries resulting in an emergency department visit, hospital admission or death. We also describe regional and temporal rates. RESULTS: We identified 6483 firearm-related injuries (annualized injury rate 3.54 per 100 000 population), of which 2723 (42.3%) were fatal. Assault accounted for 40.2% (1494/3715) of nonfatal injuries and 25.5% (694/2723) of deaths. Young men, predominantly in urban neighbourhoods, within the lowest income quintile were overrepresented in this group. Injuries secondary to self-harm accounted for 68.0% (1366/2009) of injuries and occurred predominantly in older men living in rural Ontario across all income quintiles. The case fatality rate of injuries secondary to self-harm was 91.7%. Self-harm accounted for 1842 deaths (67.6%). INTERPRETATION: We found that young urban men were most likely to be injured in firearm-related assaults and that more than two-thirds of self-harm-related injuries occurred in older rural-dwelling men, most of whom died from their injuries. This highlights a need for suicide-prevention strategies in rural areas targeted at men aged 45 or older.
Authors: Jahan Fahimi; Emily Larimer; Walid Hamud-Ahmed; Erik Anderson; C Daniel Schnorr; Irene Yen; Harrison J Alter Journal: Inj Prev Date: 2015-10-27 Impact factor: 2.399
Authors: Mohsen Naghavi; Laurie B Marczak; Michael Kutz; Katya Anne Shackelford; Megha Arora; Molly Miller-Petrie; Miloud Taki Eddine Aichour; Nadia Akseer; Rajaa M Al-Raddadi; Khurshid Alam; Suliman A Alghnam; Carl Abelardo T Antonio; Olatunde Aremu; Amit Arora; Mohsen Asadi-Lari; Reza Assadi; Tesfay Mehari Atey; Leticia Avila-Burgos; Ashish Awasthi; Beatriz Paulina Ayala Quintanilla; Suzanne Lyn Barker-Collo; Till Winfried Bärnighausen; Shahrzad Bazargan-Hejazi; Masoud Behzadifar; Meysam Behzadifar; James R Bennett; Ashish Bhalla; Zulfiqar A Bhutta; Arebu Issa Bilal; Guilherme Borges; Rohan Borschmann; Alexandra Brazinova; Julio Cesar Campuzano Rincon; Félix Carvalho; Carlos A Castañeda-Orjuela; Lalit Dandona; Rakhi Dandona; Paul I Dargan; Diego De Leo; Samath Dhamminda Dharmaratne; Eric L Ding; Huyen Phuc Do; David Teye Doku; Kerrie E Doyle; Tim Robert Driscoll; Dumessa Edessa; Ziad El-Khatib; Aman Yesuf Endries; Alireza Esteghamati; Andre Faro; Farshad Farzadfar; Valery L Feigin; Florian Fischer; Kyle J Foreman; Richard Charles Franklin; Nancy Fullman; Neal D Futran; Tsegaye Tewelde Gebrehiwot; Reyna Alma Gutiérrez; Nima Hafezi-Nejad; Hassan Haghparast Bidgoli; Gessessew Bugssa Hailu; Josep Maria Haro; Hamid Yimam Hassen; Caitlin Hawley; Delia Hendrie; Martha Híjar; Guoqing Hu; Olayinka Stephen Ilesanmi; Mihajlo Jakovljevic; Spencer L James; Sudha Jayaraman; Jost B Jonas; Amaha Kahsay; Amir Kasaeian; Peter Njenga Keiyoro; Yousef Khader; Ibrahim A Khalil; Young-Ho Khang; Jagdish Khubchandani; Aliasghar Ahmad Kiadaliri; Christian Kieling; Yun Jin Kim; Soewarta Kosen; Kristopher J Krohn; G Anil Kumar; Faris Hasan Lami; Van C Lansingh; Heidi Jane Larson; Shai Linn; Raimundas Lunevicius; Hassan Magdy Abd El Razek; Muhammed Magdy Abd El Razek; Reza Malekzadeh; Deborah Carvalho Malta; Amanda J Mason-Jones; Richard Matzopoulos; Peter T N Memiah; Walter Mendoza; Tuomo J Meretoja; Haftay Berhane Mezgebe; Ted R Miller; Shafiu Mohammed; Maziar Moradi-Lakeh; Rintaro Mori; Devina Nand; Cuong Tat Nguyen; Quyen Le Nguyen; Dina Nur Anggraini Ningrum; Felix Akpojene Ogbo; Andrew T Olagunju; George C Patton; Michael R Phillips; Suzanne Polinder; Farshad Pourmalek; Mostafa Qorbani; Afarin Rahimi-Movaghar; Vafa Rahimi-Movaghar; Mahfuzar Rahman; Rajesh Kumar Rai; Chhabi Lal Ranabhat; David Laith Rawaf; Salman Rawaf; Ali Rowhani-Rahbar; Mahdi Safdarian; Saeid Safiri; Rajesh Sagar; Joseph S Salama; Juan Sanabria; Milena M Santric Milicevic; Rodrigo Sarmiento-Suárez; Benn Sartorius; Maheswar Satpathy; David C Schwebel; Soraya Seedat; Sadaf G Sepanlou; Masood Ali Shaikh; Nigussie Tadesse Sharew; Ivy Shiue; Jasvinder A Singh; Mekonnen Sisay; Vegard Skirbekk; Adauto Martins Soares Filho; Dan J Stein; Mark Andrew Stokes; Mu'awiyyah Babale Sufiyan; Mamta Swaroop; Bryan L Sykes; Rafael Tabarés-Seisdedos; Fentaw Tadese; Bach Xuan Tran; Tung Thanh Tran; Kingsley Nnanna Ukwaja; Tommi Juhani Vasankari; Vasily Vlassov; Andrea Werdecker; Pengpeng Ye; Paul Yip; Naohiro Yonemoto; Mustafa Z Younis; Zoubida Zaidi; Maysaa El Sayed Zaki; Simon I Hay; Stephen S Lim; Alan D Lopez; Ali H Mokdad; Theo Vos; Christopher J L Murray Journal: JAMA Date: 2018-08-28 Impact factor: 56.272