Dataset Information

Global Mortality From Firearms, 1990-2016.

ABSTRACT:

Importance

Understanding global variation in firearm mortality rates could guide prevention policies and interventions.

Objective

To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.

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.

Exposures

Firearm ownership and access.

Main outcomes and measures

Cause-specific deaths by age, sex, location, and year.

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).

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.

SUBMITTER: Global Burden of Disease 2016 Injury Collaborators

PROVIDER: S-EPMC6143020 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Global Mortality From Firearms, 1990-2016.

Naghavi Mohsen M Marczak Laurie B LB Kutz Michael M Shackelford Katya Anne KA Arora Megha M Miller-Petrie Molly M Aichour Miloud Taki Eddine MTE Akseer Nadia N Al-Raddadi Rajaa M RM Alam Khurshid K Alghnam Suliman A SA Antonio Carl Abelardo T CAT Aremu Olatunde O Arora Amit A Asadi-Lari Mohsen M Assadi Reza R Atey Tesfay Mehari TM Avila-Burgos Leticia L Awasthi Ashish A Ayala Quintanilla Beatriz Paulina BP Barker-Collo Suzanne Lyn SL Bärnighausen Till Winfried TW Bazargan-Hejazi Shahrzad S Behzadifar Masoud M Behzadifar Meysam M Bennett James R JR Bhalla Ashish A Bhutta Zulfiqar A ZA Bilal Arebu Issa AI Borges Guilherme G Borschmann Rohan R Brazinova Alexandra A Campuzano Rincon Julio Cesar JC Carvalho Félix F Castañeda-Orjuela Carlos A CA Dandona Lalit L Dandona Rakhi R Dargan Paul I PI De Leo Diego D Dharmaratne Samath Dhamminda SD Ding Eric L EL Phuc Do Huyen H Doku David Teye DT Doyle Kerrie E KE Driscoll Tim Robert TR Edessa Dumessa D El-Khatib Ziad Z Endries Aman Yesuf AY Esteghamati Alireza A Faro Andre A Farzadfar Farshad F Feigin Valery L VL Fischer Florian F Foreman Kyle J KJ Franklin Richard Charles RC Fullman Nancy N Futran Neal D ND Gebrehiwot Tsegaye Tewelde TT Gutiérrez Reyna Alma RA Hafezi-Nejad Nima N Haghparast Bidgoli Hassan H Hailu Gessessew Bugssa GB Haro Josep Maria JM Hassen Hamid Yimam HY Hawley Caitlin C Hendrie Delia D Híjar Martha M Hu Guoqing G Ilesanmi Olayinka Stephen OS Jakovljevic Mihajlo M James Spencer L SL Jayaraman Sudha S Jonas Jost B JB Kahsay Amaha A Kasaeian Amir A Keiyoro Peter Njenga PN Khader Yousef Y Khalil Ibrahim A IA Khang Young-Ho YH Khubchandani Jagdish J Ahmad Kiadaliri Aliasghar A Kieling Christian C Kim Yun Jin YJ Kosen Soewarta S Krohn Kristopher J KJ Kumar G Anil GA Lami Faris Hasan FH Lansingh Van C VC Larson Heidi Jane HJ Linn Shai S Lunevicius Raimundas R Magdy Abd El Razek Hassan H Magdy Abd El Razek Muhammed M Malekzadeh Reza R Carvalho Malta Deborah D Mason-Jones Amanda J AJ Matzopoulos Richard R Memiah Peter T N PTN Mendoza Walter W Meretoja Tuomo J TJ Mezgebe Haftay Berhane HB Miller Ted R TR Mohammed Shafiu S Moradi-Lakeh Maziar M Mori Rintaro R Nand Devina D Tat Nguyen Cuong C Le Nguyen Quyen Q Ningrum Dina Nur Anggraini DNA Akpojene Ogbo Felix F Olagunju Andrew T AT Patton George C GC Phillips Michael R MR Polinder Suzanne S Pourmalek Farshad F Qorbani Mostafa M Rahimi-Movaghar Afarin A Rahimi-Movaghar Vafa V Rahman Mahfuzar M Rai Rajesh Kumar RK Ranabhat Chhabi Lal CL Rawaf David Laith DL Rawaf Salman S Rowhani-Rahbar Ali A Safdarian Mahdi M Safiri Saeid S Sagar Rajesh R Salama Joseph S JS Sanabria Juan J Santric Milicevic Milena M MM Sarmiento-Suárez Rodrigo R Sartorius Benn B Satpathy Maheswar M Schwebel David C DC Seedat Soraya S Sepanlou Sadaf G SG Shaikh Masood Ali MA Sharew Nigussie Tadesse NT Shiue Ivy I Singh Jasvinder A JA Sisay Mekonnen M Skirbekk Vegard V Soares Filho Adauto Martins AM Stein Dan J DJ Stokes Mark Andrew MA Sufiyan Mu'awiyyah Babale MB Swaroop Mamta M Sykes Bryan L BL Tabarés-Seisdedos Rafael R Tadese Fentaw F Tran Bach Xuan BX Thanh Tran Tung T Ukwaja Kingsley Nnanna KN Vasankari Tommi Juhani TJ Vlassov Vasily V Werdecker Andrea A Ye Pengpeng P Yip Paul P Yonemoto Naohiro N Younis Mustafa Z MZ Zaidi Zoubida Z El Sayed Zaki Maysaa M Hay Simon I SI Lim Stephen S SS Lopez Alan D AD Mokdad Ali H AH Vos Theo T Murray Christopher J L CJL

JAMA 20180801 8

<h4>Importance</h4>Understanding global variation in firearm mortality rates could guide prevention policies and interventions.<h4>Objective</h4>To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.<h4>Design, setting, and participants</h4>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 ...[more]

PMID: 30167700

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Project description:ObjectivesTo use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016.DesignSystematic analysis.Main outcome measuresCrude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education).ResultsThe total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%).ConclusionsAge standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.

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Project description:BackgroundMultiple sclerosis is the most common inflammatory neurological disease in young adults. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic method of quantifying various effects of a given condition by demographic variables and geography. In this systematic analysis, we quantified the global burden of multiple sclerosis and its relationship with country development level.MethodsWe assessed the epidemiology of multiple sclerosis from 1990 to 2016. Epidemiological outcomes for multiple sclerosis were modelled with DisMod-MR version 2.1, a Bayesian meta-regression framework widely used in GBD epidemiological modelling. Assessment of multiple sclerosis as the cause of death was based on 13 110 site-years of vital registration data analysed in the GBD's cause of death ensemble modelling module, which is designed to choose the optimum combination of mathematical models and predictive covariates based on out-of-sample predictive validity testing. Data on prevalence and deaths are summarised in the indicator, disability-adjusted life-years (DALYs), which was calculated as the sum of years of life lost (YLLs) and years of life lived with a disability. We used the Socio-demographic Index, a composite indicator of income per person, years of education, and fertility, to assess relations with development level.FindingsIn 2016, there were 2 221 188 prevalent cases of multiple sclerosis (95% uncertainty interval [UI] 2 033 866-2 436 858) globally, which corresponded to a 10·4% (9·1 to 11·8) increase in the age-standardised prevalence since 1990. The highest age-standardised multiple sclerosis prevalence estimates per 100 000 population were in high-income North America (164·6, 95% UI, 153·2 to 177·1), western Europe (127·0, 115·4 to 139·6), and Australasia (91·1, 81·5 to 101·7), and the lowest were in eastern sub-Saharan Africa (3·3, 2·9-3·8), central sub-Saharan African (2·8, 2·4 to 3·1), and Oceania (2·0, 1·71 to 2·29). There were 18 932 deaths due to multiple sclerosis (95% UI 16 577 to 21 033) and 1 151 478 DALYs (968 605 to 1 345 776) due to multiple sclerosis in 2016. Globally, age-standardised death rates decreased significantly (change -11·5%, 95% UI -35·4 to -4·7), whereas the change in age-standardised DALYs was not significant (-4·2%, -16·4 to 0·8). YLLs due to premature death were greatest in the sixth decade of life (22·05, 95% UI 19·08 to 25·34). Changes in age-standardised DALYs assessed with the Socio-demographic Index between 1990 and 2016 were variable.InterpretationMultiple sclerosis is not common but is a potentially severe cause of neurological disability throughout adult life. Prevalence has increased substantially in many regions since 1990. These findings will be useful for resource allocation and planning in health services. Many regions worldwide have few or no epidemiological data on multiple sclerosis, and more studies are needed to make more accurate estimates.FundingBill & Melinda Gates Foundation.

Dataset Information

Global Mortality From Firearms, 1990-2016.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Global Mortality From Firearms, 1990-2016.

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