Medical Advances Are Reducing American Deaths From Violence, But Violence Itself Is Rising

The tragic shooting at a school today in Connecticut, the general increase in such mass shootings in the United States, and the silence of policymakers in the face of the problem all hint at a remarkable contradiction in modern American crime: although medical advances ensure that fewer lives are being lost to violence, incidences of such violence are actually increasing.

A recent report in the Wall Street Journal found that serious gunshot and stabbing wounds rose 47 percent over the last decade, even as the number of homicides dropped during the 1990s and then again after 2007:

Emergency-room physicians who treat victims of gunshot and knife attacks say more people survive because of the spread of hospital trauma centers — which specialize in treating severe injuries — the increased use of helicopters to ferry patients, better training of first-responders and lessons gleaned from the battlefields of Iraq and Afghanistan. […]

After a steady decline through the 1990s, the annual number of homicides zigzagged before resuming a decline in 2007, falling from 16,929 that year to an estimated 14,722 in 2010, according to FBI crime data.

At the same time, medical data and other surveys in the U.S. show a rising number of serious injuries from assaults with guns and knives. The estimated number of people wounded seriously enough by gunshots to require a hospital stay, rather than treatment and release, rose 47% to 30,759 in 2011 from 20,844 in 2001, according to data from the Centers for Disease Control and Prevention’s National Electronic Injury Surveillance System-All Injury Program. The CDC estimates showed the number of people injured in serious stabbings rose to 23,550 from 22,047 over the same period.

Drawing conclusions about causation from those numbers is an inexact science — especially because the process of collecting and classifying information from emergency rooms can be haphazard. “Homicide is the one thing we’re measuring well,” Jens Ludwig, a law professor and the director of the University of Chicago Crime Lab, told the Wall Street Journal. “Everything else is subject to much more uncertainty.”


But other reports also suggest that trauma centers are improving the chance of survival for victims of violent crimes. A New England Journal of Medicine study in 2006 determined that treating patients at trauma centers, rather than regular hospitals, significantly lowered their risk of death.

According to the American Trauma Society, 90 percent of Americans lived within an hour of a trauma center by helicopter or ambulance in 2010. But the propagation of those trauma centers is a costly endeavor. The Trauma Center Association of America, a lobbying group for that sector of the medical industry, estimates that those centers lose $230 million a year providing the uninsured with treatment — and that’s not including the emergency care they provide for their low-income patients, which is also often funded by Medicaid, a federal program that provides far lower reimbursement rates than private insurers.


One important caveat to keep in mind: The number of people seriously wounded did increase 47 percent over the last decade, but the country’s population increased by a significantly greater amount over the same period. As a result, the rate of violent crime actually dropped over the last two decades, as did the murder rate — though medical advances could very well be holding the murder rate lower than it otherwise would be. Unfortunately, even accounting for the population numbers, America remains a more violent country than its western neighbors.