Gun deaths in rural and urban settings: recommendations for prevention.
BACKGROUND
Family physicians can play a vital role in preventing gun violence, and better data on which to base their interventions might result in more effective prevention efforts. Using Washington State data, two assumptions on which interventions can be based were tested: compared with urban areas, rural areas have (1) a higher percentage of gun deaths from shotguns and rifles, and (2) a higher percentage of gun deaths from suicides and accidents


METHODS
From 1990 to 1996, 4,271 gun deaths on Washington death certificates were classified as rural or urban. The data were retrospectively sorted and analyzed by gun type (handguns, rifles, shotguns, or other) and by intent (suicide, homicide, or accidental death).


RESULTS
Compared with urban settings, rural areas had a higher percentage of gun deaths from shotguns and rifles and a higher percentage from suicides and accidents (P < .01). Two similarities, however, stand out as more important than the confirmed hypothesized differences: handguns accounted for more than 50% of gun deaths, and suicides accounted for nearly 70% of gun deaths in both urban and rural areas.


CONCLUSIONS
Family physicians might want to focus their firearm safety efforts on preventing handgun deaths and suicides, which accounted for most gun deaths in rural and urban areas. Also, data from this study suggest that deaths from shotguns and rifles as well as accidental and suicide gun deaths deserve special attention in rural areas.
Dresang
L T
LT
Department of Family Medicine, University of Wisconsin Medical School, USA.
D003625:Data Collection; D003644:Death Certificates; D005389:Firearms / Q000592:standards; D006801:Humans; D009026:Mortality / Q000639:trends; D010819:Physician's Role; D010821:Physicians, Family; D012189:Retrospective Studies; D012424:Rural Population; D013405:Suicide / Q000706:statistics & numerical data*; D014505:Urban Population; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D014861:Washington / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000401:mortality* / Q000517:prevention & control