@article{ref1,
title="Global mortality from firearms, 1990-2016",
journal="JAMA journal of the American Medical Association",
year="2018",
author="Naghavi, Mohsen and Marczak, Laurie B. and Kutz, Michael and Shackelford, Katya Anne and Arora, Megha and Miller-Petrie, Molly and Aichour, Miloud Taki Eddine and Akseer, Nadia and Al-Raddadi, Rajaa M. and Alam, Khurshid and Alghnam, Suliman A. and Antonio, Carl Abelardo T. and Aremu, Olatunde and Arora, Amit and Asadi-Lari, Mohsen and Assadi, Reza and Atey, Tesfay Mehari and Avila-Burgos, Leticia and Awasthi, Ashish and Ayala Quintanilla, Beatriz Paulina and Barker-Collo, Suzanne Lyn and Bärnighausen, Till Winfried and Bazargan-Hejazi, Shahrzad and Behzadifar, Masoud and Behzadifar, Meysam and Bennett, James R. and Bhalla, Ashish and Bhutta, Zulfiqar A. and Bilal, Arebu Issa and Borges, Guilherme L. G. and Borschmann, Rohan and Brazinova, Alexandra and Campuzano Rincon, Julio Cesar and Carvalho, Felix and Castañeda-Orjuela, Carlos A. and Dandona, Lalit and Dandona, Rakhi and Dargan, Paul I. and De Leo, Diego and Dharmaratne, Samath Dhamminda and Ding, Eric L. and Phuc Do, Huyen and Doku, David Teye and Doyle, Kerrie E. and Driscoll, Tim Robert and Edessa, Dumessa and El-Khatib, Ziad and Endries, Aman Yesuf and Esteghamati, Alireza and Faro, Andre and Farzadfar, Farshad and Feigin, Valery L. and Fischer, Florian and Foreman, Kyle J. and Franklin, Richard Charles and Fullman, Nancy and Futran, Neal D. and Gebrehiwot, Tsegaye Tewelde and Gutiérrez, Reyna Alma and Hafezi-Nejad, Nima and Haghparast-Bidgoli, Hassan and Hailu, Gessessew Bugssa and Haro, Josep Maria and Hassen, Hamid Yimam and Hawley, Caitlin and Hendrie, Delia and Hijar, Martha and Hu, Guoqing and Ilesanmi, Olayinka Stephen and Jakovljevic, Mihajlo and James, Spencer L. and Jayaraman, Sudha and Jonas, Jost B. and Kahsay, Amaha and Kasaeian, Amir and Keiyoro, Peter Njenga and Khader, Yousef and Khalil, Ibrahim A. and Khang, Young-Ho and Khubchandani, Jagdish and Ahmad Kiadaliri, Aliasghar and Kieling, Christian and Kim, Yun Jin and Kosen, Soewarta and Krohn, Kristopher J. and Kumar, G. Anil and Lami, Faris Hasan and Lansingh, Van C. and Larson, Heidi Jane and Linn, Shai and Lunevicius, Raimundas and Magdy Abd El Razek, Hassan and Magdy Abd El Razek, Muhammed and Malekzadeh, Reza and Carvalho Malta, Deborah and Mason-Jones, Amanda J. and Matzopoulos, Richard and Memiah, Peter T. N. and Mendoza, Walter and Meretoja, Tuomo J. and Mezgebe, Haftay Berhane and Miller, Ted R. and Mohammed, Shafiu and Moradi-Lakeh, Maziar and Mori, Rintaro and Nand, Devina and Tat Nguyen, Cuong and Le Nguyen, Quyen and Ningrum, Dina Nur Anggraini and Akpojene Ogbo, Felix and Olagunju, Andrew T. and Patton, George C. and Phillips, Michael R. and Polinder, Suzanne and Pourmalek, Farshad and Qorbani, Mostafa and Rahimi-Movaghar, Afarin and Rahimi-Movaghar, Vafa and Rahman, Mahfuzar and Rai, Rajesh Kumar and Ranabhat, Chhabi Lal and Rawaf, David Laith and Rawaf, Salman and Rowhani-Rahbar, Ali and Safdarian, Mahdi and Safiri, Saeid and Sagar, Rajesh and Salama, Joseph S. and Sanabria, Juan and Santric Milicevic, Milena M. and Sarmiento-Suárez, Rodrigo and Sartorius, Benn and Satpathy, Maheswar and Schwebel, David C. and Seedat, Soraya and Sepanlou, Sadaf G. and Shaikh, Masood Ali and Sharew, Nigussie Tadesse and Shiue, Ivy and Singh, Jasvinder A. and Sisay, Mekonnen and Skirbekk, Vegard and Soares Filho, Adauto Martins and Stein, Dan J. and Stokes, Mark Andrew and Sufiyan, Mu'awiyyah Babale and Swaroop, Mamta and Sykes, Bryan L. and Tabarés-Seisdedos, Rafael and Tadese, Fentaw and Tran, Bach Xuan and Thanh Tran, Tung and Ukwaja, Kingsley Nnanna and Vasankari, Tommi Juhani and Vlassov, Vasily and Werdecker, Andrea and Ye, Pengpeng and Yip, Paul and Yonemoto, Naohiro and Younis, Mustafa Z. and Zaidi, Zoubida and El Sayed Zaki, Maysaa and Hay, Simon I. and Lim, Stephen S. and Lopez, Alan D. and Mokdad, Ali H. and Vos, Theo and Murray, Christopher J. L.",
volume="320",
number="8",
pages="792-814",
abstract="IMPORTANCE: Understanding global variation in firearm mortality rates could guide prevention policies and interventions. <br><br>OBJECTIVE: To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. <br><br>DESIGN, SETTING, AND PARTICIPANTS: This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. <br><br>EXPOSURES: Firearm ownership and access. <br><br>MAIN OUTCOMES AND MEASURES: Cause-specific deaths by age, sex, location, and year. <br><br>RESULTS: Worldwide, it was estimated that 251 000 (95% uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5% (95% UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95% UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95% UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95% UI, 107 000-182 000]); additionally, 27% were firearm suicide deaths (67 500 [95% UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95% UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2% [95% UI, -0.8% to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6% (95% UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95% UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95% UI, 24 900-39 700] and for women, an estimated 3580 deaths [95% UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P < .001; R2 = 0.21) and homicide (P < .001; R2 = 0.35). <br><br>CONCLUSIONS AND RELEVANCE: This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups.<p /> <p>Language: en</p>",
language="en",
issn="0098-7484",
doi="10.1001/jama.2018.10060",
url="http://dx.doi.org/10.1001/jama.2018.10060"
}