From Relative Risk to Absolute Risk of Negative Outcomes with Firearms – And Back

I have been writing quite a bit lately about negative outcomes with firearms for my book on American gun culture. As I’ve stated repeatedly state on this blog and in various publications over the years, unlike most scholars studying guns, my starting point is not the deviance of guns but their normality.

But people care about negative outcomes with firearms such as homicide and suicide, including myself and other gun owners, so here we are.

I recently posted about the importance of considering absolute risk compared to relative risk when looking at negative outcomes with firearms. I mentioned, for example, that the relative risk of dying from an unintentional firearms injury in the U.S. is TWICE that of Italy. But the absolute risk of dying from an unintentional firearms injury in Italy is 1 in a million and in the U.S. it is 2 in a million, so some perspective is in order not to spark irrational fear.

In retrospect, the title “absolute vs. relative risk” was not the best, especially for someone who is constantly preaching the importance of both/and in understanding guns and gun culture rather than either/or. We need to understand BOTH relative risk AND absolute risk.

One of my top former students at Wake Forest read the absolute/relative risk post on my Facebook page and commented:

I think these numbers would be more meaningful too compared to some baseline that people can relate to more easily – say, the risk of being injured in a car accident.

I don’t disagree, though this does take us back to the question of relative risk.

Again using data from the Institute for Health Metrics and Evaluation (IHME) and its cross-national Global Burden of Disease (GBD) database, I explore the relative risks of unintentional death by various mechanisms, including firearms.

To my former student’s point, the risk of dying from a car accident injury is 8.61 per 100,000 population as compared to 0.21 per 100,000 population for firearms. So, the relative risk of dying from a car accident is 41 times greater than dying from a firearms accident.

This excludes what the IHME calls “road injuries” (including pedestrian, cyclist, motorcyclist, and other injuries) that alone have a rate of 4.00 per 100,000 — 19 times greater risk than firearms. If we add all “road injuries” together, their relative risk (8.61 + 4.00 = 12.61) is 60 times greater than that of firearms accidents.

I haven’t used this data in previous posts, but the IHME GBD data also includes a measure called “Years of Life Lost” (YLL). I haven’t looked under the hood of the IHME GBD study, but this is typically calculated in the United States by subtracting the age of death from 80 (a rough estimate of life expectancy). So, for example, if someone 65 dies from a fall, the YLL for that person is 15. If someone 36 dies from a motor vehicle road injury, the YLL for that person is 44.

Looking at the table above, we can see the number of years of life lost to motor vehicle road injuries (1,231,236) is 37.6 times higher than the number of YLL to unintentional firearm injuries (32,743).

One final sort of the data highlights a major reason people are particularly concerned about firearms: accidental deaths often affect younger people. And the most horrifying incidents involve very young people, including toddlers.

Unlike falls — which have the highest death rate (13.47) among accidents but the lowest average YLL (14.68) — unintentional firearms deaths have the 11th highest rate of accidental deaths (out of 14, 0.21) but the second highest YLL (48.6). Thankfully, because the rate of deaths from unintentional firearms injuries is so low, the total YLL is also low.

I am sometimes accused of seeking to minimize the harm caused by firearms. Far from it. But if we are going to understand negative outcomes with guns, we need to look at the data dispassionately. My former student asked how accidental gun deaths compared to car accident deaths and this post gives that answer.

It also hints at a very significant difference between car deaths and gun deaths (although public health scholars frequently compare the two in unhelpful ways):

Almost all car deaths are accidents; almost all gun deaths are intentional.

If you appreciate this or some of the other 250+ posts on this blog, please consider supporting my research and writing on American gun culture by liking and sharing my work.

3 thoughts on “From Relative Risk to Absolute Risk of Negative Outcomes with Firearms – And Back

  1. This is a very rational, studied way to look at it but people (and the media) tend to focus on let’s say total deaths to the exclusion of all else. While sometimes it is mentioned that approximately 2/3 of total deaths are suicides, people react to the total number given. Also I can not recall if deaths related to gang activity are given but a factor that increases people’s fears due to it being a large percentage of what is left after removing suicides.
    Suicide is a mental health issue that culturally we are reluctant to discuss much less do something about. The gang issue plays well into the hands of those who want to eliminate all firearms as does suicide.
    I love the study above but fear that it is Not emotional enough for it to gain interest and so it would be hard for it to become common knowledge. It needs to be but as the old song goes: Keep on Truckin.


  2. “the relative risk of dying from an unintentional firearms injury in Italy is TWICE that of the United States. But the absolute risk of dying from an unintentional firearms injury in Italy is 1 in a million and in the U.S. it is 2 in a million”

    Is this a typo?


  3. Given the media focus on AR-15 style rifles, the FBI crime reports put things in perspective. For the year 2019 (latest data I could find on line) they show 216 homicide offenses committed with rifles (all types) and 341 homicide offenses committed with “personal weapons,” which I believe is FBIspeak for “bare hands and feet.”

    I.e., despite what the popular media would have us believe, it sees the average person is more likely to be beaten to death than killed with a rifle of any kind and, in fact, unlikely to suffer either fate.


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