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Biomedical subjects

J A Mercy

Publications and source records attributed to J A Mercy.

At least 37 records · Page 2Linked to original sources
PubMed1998

Trends in nonfatal and fatal firearm-related injury rates in the United States, 1985-1995.

STUDY OBJECTIVE: To characterize trends in annual estimates of nonfatal firearm-related injuries treated in US hospital emergency departments and to compare trends in quarterly rates of such injuries with those of firearm-related fatalities in the US population. METHODS: Data on nonfatal firearm-related injuries were obtained from the National Electronic Injury Surveillance System (NEISS) by review of medical records for June 1, 1992, through May 31, 1995. Data on firearm-related fatalities were obtained from the National Vital Statistics System for January 1, 1985, through December 31, 1995. NEISS comprises 91 hospitals that represent a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and provide 24-hour emergency service. The main outcome measures were numbers, percentages, and quarterly population rates for nonfatal and fatal firearm-related injuries. RESULTS: An estimated 288,538 nonfatal firearm-related injuries (95% confidence interval [CI], 169,776 to 407,300) were treated in EDs during the 3-year study period. The annual number of non-fatal firearm-related injuries increased from 99,025 for June 1992 through May 1993 (95% CI, 58,266 to 139,784) to 101,669 for June 1993 through May 1994 (95% CI, 59,822 to 143,516), then decreased to 87,844 for June 1994 through May 1995 (95% CI, 51,687 to 124,001). Before the third quarter of 1993, quarterly nonfatal and fatal firearm-related injury rates in the total US population and quarterly nonfatal firearm assaultive injury and firearm homicide rates for males aged 15 to 24 years were observed to be on the rise. Since then, these rates have significantly declined. CONCLUSION: Analysis of national trends indicates that non-fatal and fatal firearm-related injuries are declining in the United States, although the rate of firearm-related deaths remains high, especially among males aged 15 to 24 years, in relation to other leading causes of injury death. An assessment of factors responsible for the decline in firearm-related injuries is needed to design further prevention efforts.

Adolescent↗
PubMed1998

Use of national data systems for firearm-related injury surveillance.

INTRODUCTION: The purpose of this paper is to provide an overview of federal data systems that report national data on fatal and nonfatal firearm-related injuries and associated risk factors and behaviors. RESULTS: There are 13 federal data systems that provide useful information for national surveillance of firearm-related injuries in the United States. Each data system has useful features and limitations. Each provides a different methodologic approach to capture data for monitoring and characterizing firearm-related deaths or injuries, or behavioral risks associated with unintentional and violent events. CONCLUSION: Although much progress has been made over the past decade to improve national data on firearm-related injuries, many gaps still remain. A mechanism is needed to better coordinate and integrate federal efforts to collect, analyze, and disseminate data on firearm-related injury.

Censuses↗
PubMed1998

Firearm-related injury surveillance. An overview of progress and the challenges ahead.

Firearm-related injuries pose a serious public health problem in the United States and are increasingly the focus of public health concern. Despite the magnitude of this problem, ongoing and systematic collection of data on firearm-related injuries to help guide research and policy development has been lacking. The further development of firearm-related injury surveillance systems can provide an objective source of information for policy. Beginning in the mid-1980s, the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control began to support the development of firearm-related injury surveillance systems by augmenting existing national- and state-level data collection systems and establishing cooperative agreements with state and local health departments to identify optimal firearm-related injury surveillance practices. Some progress has been made in improving the capacity to undertake firearm injury surveillance at national, state, and local levels for mortality, morbidity (including disability), and risk/protective factors, but much work remains to be done. The development of state and local firearm-related injury surveillance systems provides the clearest potential for linking basic information on firearm-related injuries to action, given the critical role that states have in both public health surveillance and regulation of firearms. Broader application of external cause-of-injury codes, increased standardization and validation of definitions and data-collection instruments, improved methods for identifying firearm characteristics and types, and the identification of efficient techniques for linking health and criminal justice data sources are among the key challenges we face as we try to build a more uniform system for monitoring firearm-related injuries in the United States.

Centers for Disease Control and Prevention, U.S.↗
PubMed1997

Estimating intruder-related firearm retrievals in U.S. households, 1994.

To estimate the frequency of firearm retrieval because of a known or presumed intruder, the authors analyzed data from a 1994 national random digit dialing telephone survey (n = 5,238 interviews). Three mutually exclusive definitions of firearm retrieval were constructed: (1) retrieved a firearm because there might be an intruder, (2) retrieved a firearm and saw an intruder, and (3) retrieved a firearm, saw an intruder, and believed the intruder was frightened away by the gun. Of 1,678 (34%) households with firearms, 105 (6%) retrieved a firearm in the previous 12 months because of an intruder. National projections based on these self-reports reveal an estimated 1,896,842 (95% CI [confidence interval] = 1,480,647-2,313,035) incidents in which a firearm was retrieved, but no intruder was seen; 503,481 (95% CI = 305,093-701,870) incidents occurred in which an intruder was seen, and 497,646 (95% CI = 266,060-729,231) incidents occurred in which the intruder was seen and reportedly scared away by the firearm. Estimates of the protective use of firearms are sensitive to the definitions used. Researchers should carefully consider both how these events are defined and the study methods used.

Adult↗
PubMed1996

Unintentional, nonfatal firearm-related injuries. A preventable public health burden.

OBJECTIVE: To describe the magnitude and characteristics of unintentional, nonfatal firearm-related injuries treated in US hospital emergency departments. DESIGN: Data were obtained from medical records for all firearm-related injury cases identified using the National Electronic Injury Surveillance System (NEISS) from June 1, 1992, through May 31, 1994. We report on cases classified as unintentional gunshot wounds. SETTING: NEISS comprises 91 hospitals that are a stratified probability sample of all hospitals in the United States and its territories that have at least 6 beds and provide 24-hour emergency service. MAIN OUTCOME MEASURES: Number of and population rates for unintentional, nonfatal firearm-related injuries. RESULTS: An estimated 34 485 (95% confidence interval [CI], 25 225-43 745) persons (6.7 per 100 000 population; 95% CI, 4.9-8.5) were treated for unintentional, nonfatal firearm-related injuries in US emergency departments during the 2-year study period. The majority of patients were male (87%) and aged 15 to 34 years (61%); 38% required hospitalization. Injuries were most often to an extremity (73%), were self-inflicted (70%), involved a handgun (57%), and resulted during common gun-related activities. CONCLUSIONS: Further development of effective interventions are needed to reduce the risk of injury from unintentional discharge of a firearm during routine gun-handling practices by those who own and use firearms. These injuries often occur during common gun-related activities such as gun cleaning, loading/unloading, hunting, target shooting, and showing, handling, or carrying. Studies are needed to evaluate the efficacy of existing gun safety training courses and assess the potential role of various gun safety devices (eg, trigger locks and loading indicators) in future prevention strategies.

Accident Prevention↗
PubMed1995

National estimates of nonfatal firearm-related injuries. Beyond the tip of the iceberg.

OBJECTIVE: To describe the magnitude and characteristics of nonfatal firearm-related injuries treated in hospital emergency departments in the United States and to compare nonfatal injury rates with firearm-related fatality rates. DESIGN: Data were obtained from medical records for all firearm-related injury cases identified using the National Electronic Injury Surveillance System (NEISS) from June 1, 1992, through May 31, 1993. SETTING: NEISS comprises 91 hospitals that are a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and provide 24-hour emergency service. MAIN OUTCOME MEASURES: Numbers and population rates for nonfatal and fatal firearm-related injuries. RESULTS: An estimated 99,025 (95% confidence interval [CI], 56,325 to 141,725) persons (or 38.6 per 100,000 population; 95% CI, 22.0 to 55.2) were treated for nonfatal firearm-related injuries in US hospital emergency departments during the study period. The rate of nonfatal firearm-related injuries treated was 2.6 (95% CI, 1.5 to 3.7) times the national rate of fatal firearm-related injuries for 1992. CONCLUSIONS: Nonfatal firearm-related injuries contribute substantially to the overall public health burden of firearm-related injuries. NEISS can be useful to monitor the number of nonfatal firearm-related injuries in the United States. A national surveillance system is needed to provide uniform data on firearm-related injury morbidity and mortality for use in research and prevention efforts.

Adolescent↗
PubMed1995

Fighting as a marker for multiple problem behaviors in adolescents.

PURPOSE: Behaviors that put adolescents at risk frequently occur together. To help identify high-risk adolescents, we analyzed a national, self-reported behavior survey of high school students to assess the suitability of fighting as a marker for students with multiple problem behaviors. METHODS: A cross-sectional cluster survey of 11,631 U.S. high school students in 1990 was used to compare the prevalence of recent problem behaviors among all students and those who fight. RESULTS: One (8%) of every 12 students was in a fight during the 30 days before the survey. Reported problem behaviors were prevalent among fighters: during the previous 12 months, 24% attempted suicide; during the previous 30 days, 26% carried a firearm, 13% used cocaine, and 39% drove a motor vehicle while intoxicated; during the previous 3 months 41% had two or more sex partners; and 45% had sexual intercourse and did not use a condom the last time they had sex. Of all students, fighters accounted for 22% of those who reported attempting suicide, 49% carrying a firearm, 46% using cocaine, 18% driving while intoxicated, 25% having sex with multiple partners, and 11% not using condoms. Three or more of these six problem behaviors were reported by 26% of the fighters. The problem behaviors were all positively correlated, and the first principal component accounted for 35% of the total variation among the individual variables.

Adolescent↗
PubMed1994

Workplace-related homicide among health care workers in the United States, 1980 through 1990.

OBJECTIVE: To improve understanding of the epidemiology of fatal violence directed toward physicians and other health care workers (HCWs) in health care settings. DESIGN: Analyses of data for 1980 through 1990 from the National Traumatic Occupational Fatalities surveillance system. MAIN OUTCOME MEASURES: Overall occurrence of occupational injury deaths and occurrence of workplace-related homicides among HCWs. RESULTS: From 1980 through 1990, a total of 522 HCWs died from injuries sustained while working. The most common causes of death were motor vehicle crashes (122 [23.4%]), homicide (106 [20.3%]), and suicide (88 [16.9%]). Firearms were used in the greatest number (78 [73.6%]) of workplace-related homicides among HCWs. CONCLUSIONS: These findings highlight the need for strengthened surveillance and more accurate estimates of the risks of workplace-related violent injury for HCWs in the United States.

Accidents, Occupational↗
PubMed1994

Programs for the prevention of suicide among adolescents and young adults.

Incidence rates of suicide and attempted suicide among adolescents and young adults aged 15-24 years continue to remain at high levels. In 1992, to aid communities in developing new or augmenting existing suicide prevention programs directed toward this age group, CDC's National Center for Injury Prevention and Control published Youth Suicide Prevention Programs: A Resource Guide. The Resource Guide describes the rationale and evidence for the effectiveness of various suicide prevention strategies, and it identifies model programs that incorporate these strategies. This summary of the Resource Guide describes eight suicide prevention strategies and provides general recommendations for the development, implementation, and evaluation of suicide prevention programs targeted toward this age group.

Adolescent↗
PubMed1994

Geographic patterns of fatal abuse or neglect in children younger than 5 years old, United States, 1979 to 1988.

OBJECTIVE: To examine geographic patterns of fatal child abuse or neglect (CAN) among children younger than 5 years old. DESIGN: A death certificate-based model to estimate the occurrence of fatal CAN. SETTING: United States, 1979 to 1988. PARTICIPANTS: The population of children younger than 5 years old. INTERVENTIONS: None. MAIN RESULTS: We estimate that from 868 to 1815 deaths annually occur among children younger than 5 years old from CAN. The lower figure is the estimate of confirmed CAN, and the higher is the estimate of the sum of confirmed, probable, and possible CAN. Death rates were highest in the South and West, intermediate in the North Central, and lowest in the Northeast. A threefold difference was noted between rates in the lowest- and highest-ranking states (ie, Connecticut, 2.9 to 5.2 per 100,000, and Nevada, 6.7 to 15.4 per 100,000, respectively). When the 39 largest metropolitan areas were ranked, a similar variation between the lowest and the highest was observed (ie, Boston, Mass, 2.7 to 5.5 per 100,000, and Phoenix, Ariz, 6.6 to 15.5 per 100,000, respectively). CONCLUSION: Understanding the sizable geographic variation in CAN deaths rates could lead to effective interventions. If the US fatality rate were reduced to that of Connecticut, between 434 and 908 fewer CAN deaths might occur annually.

Cause of Death↗
PubMed1993

Public health policy for preventing violence.

The current epidemic of violence in America threatens not only our physical health but also the integrity of basic social institutions such as the family, the communities in which we live, and our health care system. Public health brings a new vision of how Americans can work together to prevent violence. This new vision places emphasis on preventing violence before it occurs, making science integral to identifying effective policies and programs, and integrating the efforts of diverse scientific disciplines, organizations, and communities. A sustained effort at all levels of society will be required to successfully address this complex and deeply rooted problem.

Adolescent↗
PubMed1992

Weapon involvement and injury outcomes in family and intimate assaults.

OBJECTIVE: To compare the risk of death and the risk of nonfatal injury during firearm-associated family and intimate assaults (FIAs) with the risks during non-firearm-associated FIAs. DESIGN: Records review of police incident reports of FIAs that occurred in 1984. Victim outcomes (death, nonfatal injury, no injury) and weapon involvement were examined for incidents involving only one perpetrator. SETTING: City of Atlanta, Ga, within Fulton County. PARTICIPANTS: Stratified sample (n = 142) of victims of nonfatal FIAs, drawn from seven nonfatal crime categories, plus all fatal victims (n = 23) of FIAs. MAIN OUTCOME MEASURES: Risk of death (vs nonfatal injury or no injury) during FIAs involving firearms, relative to other types of weapons; risk of nonfatal injury (vs all other outcomes, including death) during FIAs involving firearms, relative to other types of weapons. RESULTS: Firearm-associated FIAs were 3.0 times (95% confidence interval, 0.9 to 10.0) more likely to result in death than FIAs involving knives or other cutting instruments and 23.4 times (95% confidence interval, 7.0 to 78.6) more likely to result in death than FIAs involving other weapons or bodily force. Overall, firearm-associated FIAs were 12.0 times (95% confidence interval, 4.6 to 31.5) more likely to result in death than non-firearm-associated FIAs. CONCLUSIONS: Strategies for limiting the number of deaths and injuries resulting from FIAs include reducing the access of potential FIA assailants to firearms, modifying firearm lethality through redesign, and establishing programs for primary prevention of violence among intimates.

Family↗
PubMed1992

Identification of nonfatal family and intimate assault incidents in police data.

We examined different strategies for identifying nonfatal family and intimate assaults (FIAs) in police data. Police most often classify such incidents in the "assault" category, but they also use other crime categories. We estimated that, during 1984, 3300 FIAs (or 837 per 100,000 population) occurred in Atlanta. Of those, 77% were classified as assaults; 23% were classified in nonassault categories. Research measuring the magnitude of FIAs should take into account incidents classified in nonassault crime categories.

Crime↗
PubMed1992

Men, women, and murder: gender-specific differences in rates of fatal violence and victimization.

To study the potential differences that distinguish homicides involving women as victims or offenders from those involving men, we analyzed Federal Bureau of Investigation Uniform Crime Reports data on homicides that occurred in the United States between 1976 and 1987. Only cases that involved victims aged 15 years or older were included. Persons killed during law enforcement activity and cases in which the victim's gender was not recorded were excluded. A total of 215,273 homicides were studied, 77% of which involved male victims and 23% female victims. Although the overall risk of homicide for women was substantially lower than that of men (rate ratio [RR] = 0.27), their risk of being killed by a spouse or intimate acquaintance was higher (RR = 1.23). In contrast to men, the killing of a woman by a stranger was rare (RR = 0.18). More than twice as many women were shot and killed by their husband or intimate acquaintance than were murdered by strangers using guns, knives, or any other means. Although women comprise more than half the U.S. population, they committed only 14.7% of the homicides noted during the study interval. In contrast to men, who killed nonintimate acquaintances, strangers, or victims of undetermined relationship in 80% of cases, women killed their spouse, an intimate acquaintance, or a family member in 60% of cases. When men killed with a gun, they most commonly shot a stranger or a non-family acquaintance.(ABSTRACT TRUNCATED AT 250 WORDS)

Family↗