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Epidemiology
State of Alaska Epidemiology Bulletin

Bulletin No. 20
June 13, 1996
Firearm Injury: The Leading Cause of Injury Death in Alaska
Firearm Injuries Reportable to Health Department

During 1993-1994 firearm injury deaths overtook motor vehicle injury deaths as the leading cause of injury mortality among Alaska residents. In fact, firearm injuries were the leading cause of injury deaths from 1980 to 1994 (Figure 1). Because of the need to better understand the medical burden of firearm injuries in Alaska, firearm injuries are now reportable to the Section of Epidemiology. Firearm injuries must also continue to be reported to the Department of Public Safety, a local law enforcement agency or a village public safety officer.

Figure 1. Mortality Rates by Injury Category
Alaska, 1980-1994

Mortality
Vital statistics data provide some information about firearm injury deaths.1 Victims are most likely in the 15-24 year age group with a mortality rate in Alaska of 56/100,000 persons in 1994 (Figure 2). While the number of firearm injury deaths was lower than among other age groups, 71 deaths occurred in children 0-14 years and 76 deaths occurred in those over 64 years from 1980-1994.

Figure 2. Age-Specific Firearm Mortality Rates
Alaska, 1980-1994

The death rate from firearm injuries among Alaska Natives was 2.3 times that of non-Natives in 1994, despite a significant decrease in the Alaska Native firearm injury mortality rate from 80/100,000 in 1980 to 47/100,000 in 1994.

Suicide accounted for the majority (74%) of firearm injury deaths in Alaska during 1994 (Figure 3). Homicide accounted for 19% and unintentional firearm injury deaths accounted for 5% of total firearm injury deaths in Alaska in 1994.

Figure 3. Types of Firearm Injury Death (n=151)
Alaska, 1994

Morbidity
The number of nonfatal firearm injuries in Alaska can be estimated by applying national estimates of nonfatal firearm injuries. The U.S. Centers for Disease Control and Prevention reviewed a sample of emergency room visits and determined the ratio of nonfatal to fatal firearm injuries for various types of firearm injuries.2 Using 1994 Alaska firearm injury deaths, an estimate can be made of Alaska nonfatal firearm injuries (Table 1).

Table 1. Estimated Nonfatal Firearm Injuries
Alaska, 1994

Type of
Injury
Ratio
nonfatal:fatal
 
Deaths
Estimated
nonfatal
Assault/Legal
intervention
3.3 31 102
Unintentional 12.8 8 102
Suicide attempt 0.3 112 34
Total 1.6 151 238

Based on 1994 firearm fatalities in Alaska, there were an estimated 238 nonfatal firearm injuries in Alaska in 1994 for a nonfatal:fatal ratio of 1.6, which was less than the national nonfatal:fatal ratio of 2.6. The lower Alaska ratio is attributable to the greater percentage of suicide among firearm injuries in Alaska.

Firearm Injury Surveillance
In order to better understand the medical burden of firearm injuries in Alaska, firearm injury reporting is essential. Health care providers can either fax or phone reports within 24 hours to the Section of Epidemiology. An answering machine is available 24 hours a day for reporting firearm injuries and other reportable conditions.

Firearm Injury Reporting
Phone (1-800-478-1700) or Fax (562-7802)

The following information should be reported on all firearm injuries:
Patient name Community of residence
Date of birth Date of injury
Sex Health care facility name
Race  

References:
1. Mortality data for Alaska residents provided by the Section of Vital Statistics, Alaska Division of Public Health. ICD-9 codes: Firearm injury E922, E955.0-955.4, E965.0-965.4, E970, E985.0-985.4; Motor vehicle injury E810-825; Drowning E830, E832, E910.
2. Annest JL, Mercy JA, Gibson DR and Ryan GW. National estimates of nonfatal firearm related injuries. JAMA 1995:273(22);1749-54.

(Contributed by Michael G. Landen, MD, MPH, Section of Epidemiology.)

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