Guns, Drugs and Cars

This week’s JAMA released a comparison of major causes of injury death and how they contribute to the gap in life expectancy between the US and other high-income countries. Here are their findings:

Men in the comparison countries had a life expectancy advantage of 2.2 years over US men (78.6 years vs 76.4 years), as did women (83.4 years vs 81.2 years). The injury causes of death accounted for 48% (1.02 years) of the life expectancy gap among men. Firearm-related injuries accounted for 21% of the gap, drug poisonings 14%, and MVT [motor vehicle traffic] crashes 13%. Among women, these causes accounted for 19% (0.42 years) of the gap, with 4% from firearm-related injuries, 9% from drug poisonings, and 6% from MVT crashes. The 3 injury causes accounted for 6% of deaths among US men and 3% among US women.

These findings are also shown in tabular format here, in the paper’s Table 1:Screen Shot 2016-02-10 at 10.12.45 AM

What is simultaneously so hopeful and so frustrating about these findings is that all three causes of the mortality gap between the US and other high-income nations is that there are clear, proven public health answers to all three causes of injury (with thanks to Injury Epidemiologist Dr. Dawn Comstock for her scholarship and public health advocacy messages for all three).

  1. GUNS: I have written previously about prevention of gun violence deaths, including preventive technologies such as smart guns and required training for gun ownership (just as is required for vehicle licensure.
  2. OPIOIDS: I have also written about some local approaches to the opioid epidemic, including efforts to educate prescribers to prescribe carefully and efforts to improve prescription drug records as well as better packaging to prevent pill bottles and marijuana edibles from falling into the wrong hands and mouths.
  3. MOTOR VEHICLES: Finally, for motor vehicle related deaths, public health solutions include enforcing our existing laws (e.g., drunk driving laws, penalties for driving with suspended licenses) and improving technology (e.g., easier-installation car seats).

Findings of the JAMA study have also been covered in the media.


Published by Marion Sills

I am a Professor of Pediatrics and Emergency Medicine at the University of Colorado. I work as a physician in the emergency departments of the Children's Hospital of Colorado and as a health services researcher at the University's Adult and Child Consortium for Health Outcomes (ACCORDS).

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