Sunday, May 08, 2022

Misleading numbers: Spectrum Article and Letter to the NEJM


On April 23, published an article by Ryan Chatelain about a letter to the New England Journal of Medicine (NEJM). The letter was about the increase in firearm related deaths among young people aged 0-19. There was a significant increase in 2020 over 2019. Few Americans would be surprised by this, as the increase in homicides, especially in urban centers among young minority adults, is well known.  In a peculiar twist, Chatelain attributes the cause of the deaths to firearms. This was a significant change from the letter to the NEJM. From

Firearms have surpassed automobiles as the leading cause of death among children and adolescents in the United States, researchers at the University of Michigan say.

The letter to the NEJM contained the peculiar grouping of young adults 18-19 as "children and adolescents". It was careful not to claim that firearms were the cause of the deaths.

From, letter to the editor:

The previous analysis, which examined data through 2016, showed that firearm-related injuries were second only to motor vehicle crashes (both traffic-related and nontraffic-related) as the leading cause of death among children and adolescents, defined as persons 1 to 19 years of age.4 Since 2016, that gap has narrowed, and in 2020, firearm-related injuries became the leading cause of death in that age group (Figure 1).


 Although the new data are consistent with other evidence that firearm violence has increased during the Covid-19 pandemic,5 the reasons for the increase are unclear, and it cannot be assumed that firearm-related mortality will later revert to prepandemic levels. Regardless, the increasing firearm-related mortality reflects a longer-term trend and shows that we continue to fail to protect our youth from a preventable cause of death.

There are two important differences between the Spectrumnews article and the NEJM letter.

First, the NEJM letter correctly uses the terms  "firearm-related injuries" and "motor vehicle crashes", not firearms and automobiles

Second, the NEJM letter states "the reasons for the increase are unclear". The Spectrum article implies the reasons are clear: firearms. 

The NEJM letter states the increase in firearm related mortality among people aged 1-19, from 2019 to 2020, was 29.5%. 

The increase in national firearm numbers from 2019 to 2020 was about 441 million, to about 462 million, an increase of about 5%.  It is difficult to believe a 5% increase in firearms resulted in a 29.5% increase in firearm related mortality. 

Increases in the number of firearms have not correlated with increases in the number of firearms related deaths, particularly firearms related homicides, which make up over 80% of the increase noted above. 

Why the research cited in the NEJM letter defines "children and adolescents" as people below the are of 20, is uncertain. People 18 - 19 are considered young adults, not children.  The World Heath Organization (WHO) defines adolescents as somewhere between the ages of 10-19.  The word is imprecise. Some people are considered adolescent up to 24 years old. The NEJM reference research may be using an abbreviated WHO definition.

The legal definition of a child is less than 18 years old. It seems appropriate, as many firearms laws differentiate between legal adults and children.

Including 18 and 19 year olds in the firearm related death categories almost doubles the number of deaths, from 2,281 to 4,368. 

If the firearm related deaths are examined closely, it becomes obvious; certain cultural groups have high homicide rates among young people. Other cultural groups have higher suicide rates among old people.  Most of the homicides and suicides in both cultural groups are among males. 

It is not clear that legal access to firearms increases or decreases either suicide or homicide in either group. What effects there may be are small and difficult to measure. 

Cultural attitudes toward homicide and suicide appear to have large effects, which are easily measured.


To reduce homicide and suicide levels, the focus should be on education and attitudes, instead of firearms.

©2022 by Dean Weingarten: Permission to share is granted when this notice and link are included.

Gun Watch

1 comment:

Anonymous said...

Well they can blame firearms for now. the moron gun grabbers always do. But I think there is a much larger problem . Ok laugh if you like nut look at the number of empty churches where Christian values are learned. Blame the increase of gun violence on the incompetence of the parents that are not taking their families to church. moral people do not run around looking for some one to shoot. a little tolerance never hurts any one quick tempers can be mellowed with a little moral education. This Christian founded nation is quickly turning into a nation of useless a moral jerks. Why because of out side influence from non citizens that have no legal right to be here. With more than 50 million non citizens here with no allegiance to this country what do you expect to happen A society can only tolerate so much out side pressure before that society is adversely affected. This is our country and government had better start cleaning it up and throwing out those that have no respect for our values. Who gets affected the most? our children. the government dumb asses had better wake up while we still have a country to save. The first people that came here left where they were to be I a better place now what they left is coming here. Government could pass laws that would be effective, why haven't they? drug dealing , make it a capitol crime. make the penalties hard enough to detour the interest. car theft 20 years mandatory. I personally believe street crime should be resolved with public flogging. 10 to 20 lashes with a bull whip should be an education for muggings. might work for shop lifting to stripped naked put in stocks in the public square and a taste of the bull whip. and one more thing you do not have to shoot to kill in most instances but I highly recommend giving them something to remember like a leg shot off at the knee I think they will remember how they lost that foot and will be much easier to catch the next time. I lost a very good friend to some one that had no legal right to be in this country. Change the illegal entry law make the second offense a capitol crime. when we say you cant come here mean it bury them so they will always be here and not create any more problems. Mister nice guy just left stage left it is time to get immigration under control. it is our country and we have borders to maintain. and a society we used to value. the friend caught some one breaking in the police arrested him and he was deported. he came right back and hilled her.