In 2016, the last year for which the CDC provides numbers, 35,353 people died from gun injuries, the majority of them suicides. In other words, out of every 100,000 people living in the US that year, 12 were killed by a gun, compared to 11 in 2015 and 10 in 2014.
“But mortality rates don’t show you how much of your life is lost,” says Bindu Kalesan, a Boston University assistant professor of community health sciences. “Who is dying young, and who is dying old?”
The answer, she and her colleagues at the School of Public Health found, is that those who are killed by guns when they are young are much more often black, while their white counterparts are dying older.
Their study, published in BMJ Evidence-Based Medicine, found a 2.48-year overall decrease in life expectancy nationally from 2000 to 2016. (Health gains in other areas have hidden this loss: US life expectancy decreased for the first time in half a century in 2015, with a reduction of 0.01 years, followed by the loss of another 0.01 years every year since.)
When they looked at these lost years by race, they found that white Americans lost 2.23 years, while African Americans lost 4.14.
This comes down to when and how these deaths are most likely to occur: African Americans are most likely to be shot and killed by someone else when they were around 20 years old, the study found. “Their lives are done with right away,” Kalesan says, and the many decades that they might otherwise have lived are subtracted from the life expectancy of African Americans.
In contrast, white Americans who die from a firearm are most likely to do so in suicide and at an older age. These deaths are tragic and should be prevented, she says, but they have a smaller effect on life expectancy because they occur closer to what would otherwise be the end of an individual’s life.
“We want to prevent all of these deaths—and we cannot do that by just increasing policing,” says Kalesan, who is also an assistant professor of preventive medicine & epidemiology at the School of Medicine.
Funding for public health gun research has long been notoriously limited. Of the funding that is available, Kalesan says she has recently seen a shift toward a focus on how laws and policing can limit gun injuries and deaths. “That’s just not going to fix the problem,” she says.
For example, Massachusetts has some of the country’s strongest gun control legislation and one of the lowest gun death rates—but one person is shot each day in Boston alone, says Kalesan, who also studies nonfatal gun injuries. “We are a model state only for gun death prevention, because our hospitals are very good at saving people’s lives. It doesn’t mean that people are not getting shot.”
As long as the nation’s patchwork of gun laws means guns can flow from states with lax laws to states with more gun control—as School of Public Health researchers have found—gun violence will continue to increase across the country, Kalesan says. “I’m not saying don’t push for gun laws that do work. Get them done by all means.”
But Kalesan says gun laws need to be only one part of a more multidimensional strategy, one that addresses the underlying, varied causes of gun injuries and deaths. The new study illustrates that need: it will take different kinds of interventions to prevent the murder of a black teenager and the suicide of an older white adult.
In another recent study of Kalesan’s, she and her colleagues found that the average profile of an American using a gun for suicide is a married, white man over the age of 50 who is experiencing deteriorating health. “In that case, do you want policing, or do you want doctors talking to their patients and saying, ‘You’ve got a gun, but you also are not feeling well. Maybe you’ve been diagnosed with depression. Now, let’s secure your gun and have a plan with your spouse or a family member,’” Kalesan says. “As of now, there aren’t any such programs.”
The answer to assaultive gun violence, Kalesan says, is not simply more policing, either. Heavily policing—and disproportionately reinforcing gun laws—in black communities “is just going to create more animosity,” she says. Research by her SPH colleagues has also illustrated how structural racism increases the odds of unarmed African Americans being shot and killed by police, and the wider mental health toll of that form of gun violence.
Instead, Kalesan says, gun violence should be prevented like any other disease characterized by a wide disparity: social programs to reduce inequities.
Whether gun suicide or gun assault, Kalesan says, “you can’t just treat the symptoms away. You have to treat the disease from the base.”
This work was supported by the National Institute of Justice, Department of Justice.
A version of this article was originally published in the School of Public Health.