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HomeMy WebLinkAboutMINUTES - 05211996 - D8 •'TO: BOARD OF SUPERVISORS F&HS-06 Contra FROM: / FAMILY AND HUMAN SERVICES COMMITTEE . 's Costa County DATE: May 13, 1996 SUBJECT: REPORT ON THE HEALTH SERVICES DEPARTMENT'S REPORT ON FIREARM INJURIES SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. DIRECT the Health Services Director to present the report on Firearm Injuries to the Police Chiefs' Association and seek their comments on the extent to which the information seems to be valid, useful and what recommendations they would have for further follow-up. 2. DIRECT the Health Services Director to present the report on Firearm Injuries to the School District Superintendents and County Superintendent of Schools and seek their comments on the extent to which the information seems to be valid, useful and what recommendations they would have for further follow-up. 3. Recognizing that both pro and anti-gun advocates have firmly held views on this subject, indicate the interest of this Committee in identifying effective strategies and programs which will reduce the incidence of firearms injuries and DIRECT the County Administrator to seek input from all interested parties on what actions by the Board of Supervisors would be most likely to be effective in reducing the incidence of firearm injuries, and, in particular, with reducing the incidence of suicides and unintentional injuries by firearms. 4. DIRECT the Health Services Director to prepare a two or three page paper which describes a timeline over the next 3 to 5 years which discusses whether funding will be available to continue this type of research, whether we can expect to expand the research to do linkage to public safety data bases and whether we can gain an ability to track weapons. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD,COMMIT EE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON May 21, 1996 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. I ATTESTED May 21, 1996 Contact: PHIL BATCHELOR,CLERK OF THE BOARD OF cc: IS AND COUNTY ADMI OR See Page 3 Y r F&HS-06 5. DIRECT the County Administrator to schedule a further discussion of this subject with our Committee at which reports on all of the above recommendations can be presented and considered. BACKGROUND: On April 16, 1996, the Board of Supervisors referred to our Committee the Health Services Department's study entitled "Profile of Firearm Injuries & Deaths in Contra Costa County: A Report of the Firearm Injury Reporting, Surveillance, and Tracking (FIRST) Project". In referring the report to our Committee, the Board asked that our Committee: • coordinate an overall policy for effective implementation by the Board which includes specific programs and projects relative to the access to guns and reduction of overall violence in Contra Costa County, • correspond with the Police Chiefs' Association and the superintendents of the school districts in the County to obtain their input, and • hold hearings on this subject. On May 13, 1996, our Committee met with Dr. Wendel Brunner, Public Health Director and staff from the Community Wellness and Prevention Program, including Jennifer Balogh, data coordinator for the Community Wellness and Prevention Program. Ms. Balogh summarized the background of the report and some of the more significant numbers, including those which are included in the Executive Summary to the Report. In response to questions from the audience, it was noted that the study does not attempt to address: how often firearms actually prevent an injury by discouraging an individual from using a firearm. the extent to which guns that cause injuries have been obtained illegally. whether a firearm injury is caused by a criminal who has previously been convicted of a violent crime and is back on the street. Dr. Brunner noted that justified shootings constitute only about 1% of all firearms injuries. Supervisor Smith noted the very high rate of suicide with guns and commented on the fact that those who want to commit suicide and use a gun are more likely to be successful than those who try other methods which are less lethal. He also noted the number of unintentional firearm injuries to youth and the elderly. Our Committee is interested in identifying those strategies which are most likely to be effective in reducing the incidence of firearms injuries and is seeking input and suggestions from whoever has suggestions to make in this regard. -2- • Dr F&HS-06 cc: County Administrator District Attorney Sheriff-Coroner Health Services Director County Probation Officer Public Health Director Mental Health Director Susan Leahy, Director, Community Wellness and Prevention Programs, HSD -3- t D- 9 t Proffle -of Firearm Injuries and Deaths in Contra Costa County: A Report of the Firearm Injury Reporting, Surveillance, and Tracking (FIRST) Project 120 Rate per 100,000 FMale 100 - - - - - - - - - - - - - - - - - - - - Female - 80 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 60 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 40 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 20 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 0 0-04 5-09 10-14 15-19 20-24 25.29 3034 3539 40.44 45-49 50-54 55-59 60.64 65.69 70.74 Age Group Firearm Homicide Rates in Contra Costa County from July 1, 1993-June 30,1994, by Victim Sex and Age. Contra • County DepartmentHealth Services Pre.ventio.n Program -'597 Center Awe., Suite 115 Martinez, CA ., -553 '(511 646-6.511 ..� Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Jim Rogers, 1st District William B.Walker, M.D. Jeff Smith,2nd District aE_•s ;oa Director&Health Officer Gayle Bishop,3rd District - - Mark DeSaulnier,4th District / 20 Allen Street Tom Torlakson,5th District — - Martinez,California 94553-3191 o`• (510)370-5003 FA510 ( ) County Administrator FAX 370-5099 ....° _ Phil Batchelor cOSrA cbut+� County Administrator April 1996 The Contra Costa County Health Services Department is pleased to publish the "Profile of Firearm Injuries and Deaths in Contra Costa County:A Report of the Firearm Injury Reporting, Surveillance, and Tracking (FIRST) Project." The study's findings are a result of comprehensive research and data integration, an unusual effort by a local health department, yet essential to the formulation of effective programs and policies that address the health effects of firearm violence. This report follows the Health Department's ground-breaking research and publications on firearms dealers, childhood injury, and violence in the county. These studies have revealed that, since 1988, Contra Costa has experienced higher rates of death from firearms than from automobile injuries. Throughout the nation, violence has emerged as the number one public health concern. As a health professional, I have seen education and policy initiatives that have helped to reduce the risks associated with motor vehicles,including seat belts, air bags, and stiffer penalties for drinking and driving. Now is the time to focus on one of the most deadly and most preventable health risks of modern American society: firearm injuries. The FIRST Project Report, as most state and national research supports, shows that African American males are most at risk for assault and homicide by firearms, while white males are most at risk for suicide by firearms. But, it also tells us more: that there is a correlation between poverty and violence, not just race; that people are more at risk from friends and intimates who possess firearms than from armed strangers; that victims of firearms violence are predominately assaulted by members of their own race; and that more than three-quarters of all homicides are committed with handguns. It is my hope that the FIRST Project Report will be utilized by community agencies, law enforcement, hospital staff and other health workers to reduce and prevent violence.Among other applications, the FIRST Project Report can be used as: a foundation for formulating policies to restrict the availability of and access to firearms; a source of clearly documented statistics that describe the dimensions of the problem; and a baseline measure that will reveal our progress toward the goal of reducing firearm violence and unnecessary injuries in our communities. The FIRST Project Report is a unique profile of firearm injuries during a one-year period. Without the complete cooperation and voluntary assistance of area hospitals and law enforcement, this study would have not been possible. I wish to thank health department staff who produced this report, as well as the California Emergency Medical Services Authority who funded the Contra Costa County Health Services Department to conduct the FIRST Project. William Walker, MD Health Services Director Merrithew Memorial Hospital&Health Centers • Public Health • Mental Health • Substance Abuse • Environmental Health Contra Costa Health Plan • Emergency Medical Services • Home Health Agency • Geriatrics A-345 (1/96) Profile of Firearm Injuries and Deaths in Contra Costa County: A Report of the Firearm Injury Reporting, Surveillance, and Tracking (FIRST) Project Heather McLaughlin, M.P.H./M.S.W. Kamala Deosaransingh, M.P.H. Jennifer Balogh, M.P.H./M.S.W. Contra Costa County Health Services Department Prevention Program April 1996 The FIRST Project and this report were Funded primarily by the State of California Emergency Medical Services Authority under Special Projects Grant #EMS-2026, 2028. For additional copies, please contact: Contra Costa County Health rmw-mmrgoGWw Services Department Prevention Program.597 Center Avenue,Suite 115,Martinez,CA 94553.Phone:(510)646-6511. Acknowledgments The Prevention Program acknowl- Walnut Creek. edges the following agencies and indi- We wish to thank the following hospi- viduals who were instrumental in tals that provided us with data and assis- completing this study. Without their tance: Brookside Hospital in San Pablo, contributions to the Firearm Injury Re- Children's Hospital Oakland,Delta Me- porting, Surveillance, and Tracking morial Hospital in Antioch, Doctors (FIRST)system,this project would not Hospital in Pinole,Highland Hospital in have been possible. In particular, we Oakland, Kaiser Permanente Oakland, thank the Contra Costa County Child- Kaiser Permanente Richmond, Los hood Injury Prevention Coalition Medanos Community Hospital in (CIPC); Contra Costa County Sheriff- Pittsburg, Merrithew Memorial Hospi- Coroner's Office;the State of California tal in Martinez,and Mt.Diablo Medical Emergency Medical Services Authority Center in Walnut Creek. (with special thanks to Art Lathrop,Barb This report was prepared by the staff Center, and Linda Ruiz-Allen); John of the Prevention Program,Contra Costa Muir Medical Center Injury Prevention County Health Services Department: Program (with special thanks to Kristi Heather McLaughlin, M.P.H./M.S.W., Gaub, Susan Shapiro, and Kacey Kamala Deosaransingh, M.P.H., and Hansen);the Policy,Action,Collabora- Jennifer Balogh,M.P.H./M.S.W. tion and Training(PACT) for Violence The Prevention Program staff provided Prevention Coalition;the Richmond Po- research, editorial support, and a lot of lice Department(with special thanks to patience. Special thanks to Fidelito S.P. Austin, Carolyn Gaspar; and Lieu- Cortes (primary editor), Susan T. tenant Mike Tye),and Linda C.Moulton, Mashiyama (editing and design), Amy Ph.D.,demographer,who was invaluable Hill, Susan Swift, Marianne Sullivan, in providing denominator data for rate Carter Pratt,and Lupe Alcala. calculations. The Prevention Program,located in the We would like to thank the police de- San Francisco Greater Bay Area,is an in- partments that provided us with data and terdisciplinary public health program assistance: Antioch, BART (Bay Area that focuses on the prevention of vio- Rapid Transit) Police Services, lence, childhood injuries, and chronic Brentwood, Clayton, Concord, Contra disease.Rather than creating new,stand- Costa Community College District Po- alone programs,the Prevention Program lice Services,East Bay Regional Park Dis- coordinates,cultivates,and links existing trict,EI Cerrito,Hercules, Kensington, community resources in a systems-wide Martinez, Moraga, Pinole, Pittsburg, approach. The Program has a national Pleasant Hill, San Pablo, State of Cali- reputation for establishing and develop- fornia Department of Parks and Recre- ing effective,health-related community ation, Diablo District Rangers, and coalitions. Table of Contents Executive Summary . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . 3 Methodology . .. ... . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . .. . . . 5 Results and Analysis, Part I . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Firearm Injuries and Deaths in Contra Costa County. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Age and Sex-specific Firearm Rates for Assaults and Homicides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Race/Ethnic-specific Rates for Firearm Assaults and Homicides. . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Firearm Assaults and Homicides by City and County Region. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Firearm Assaults and Homicides by Gun Caliber . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Firearm Assaults and Homicides byGun Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Firearm Assaults and Homicides by Victim-Offender Relationship. . . . . . . . . . . . . . . . . . . . . . . . . . 24 Firearm Assaults and Homicides by Victim-Offender Relationship and Victim Sex. . . . . . . . . . . . . . . . 25 Firearm Assaults and Homicides by Victim-Offender Relationship and Victim Race/Ethnicity . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Firearm Assault Rates by Victim Race/Ethnicity and Offender Sex and Race/Ethnicity . . . . . . . . . .. . . . . . . . . . . . 26 Firearm Homicide Rates by Offender Sex and Race/Ethnicity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Firearm Assaults and Homicides by Shooting Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Firearm Assaults and Homicides by Shooting Circumstances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Table of Contents Firearm Assaults by Shooting Circumstances Appendix E:Poverty,Unemployment, and Victim Race/Ethnicity . . . . . . . . . . . . . . . . 29 and Firearm Injuries by County Region . . . . . . E-1 Firearm Assaults and Homicides Appendix F:Firearm Assault Rates by Shooting Circumstances and Victim Sex . . 30 by Victim Sex and Age. . . . . . . . . . . . . .. . . . . F-1 Firearm Homicides by Shooting Circumstances Appendix G:Firearm Homicide Rates and Race/Ethnicity. . . . . . . . . . . . . . . . . . . . . . 31 by Victim Sex and Age. . . . . . . . . . . . . . . . . . G-1 Firearm Type and Shooting Circumstances . . . . . 31 Appendix H:Firearm Assault Rates Firearm Assaults and Homicides by Victim Age and Race/Ethnicity. . . . . . . . . H-1 by Month and Time . . . . . . . . . . . . . . . . . . . . . 32 Appendix 1:Firearm Assault and Homicide Rates Firearm Homicide Victims Testing Positive by City or Unincorporated Area . . . . . . . . . . . I-1 for Alcohol and Other Drugs Appendix J:Firearm Suicides . . . . . . . . . . . . . . . . J-1. at the Time of Death . . . . . . . . . . . . . . . . . . . . 33 Appendix K.Firearm Suicides by City Firearm Suicides . . . . . . . . . . . . . . . . . . . . . . . . . . 34 or Unincorporated Area. . . . . . . . . . . . . . . . . K-1 Firearm Suicides by Victim Sex,Age, Appendix L:Unintentional Firearm Injuries . . . .. L-1 and Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Appendix M:Firearm Diagrams . . . . . . . . . . . . . M-1 Firearm Suicides by Type of Gun . . .. . . . . . . . . . 36 Appendix N:Map of Contra Costa County . . . . N-1 Firearm Suicides by City and County Region. . . . 36 Firearm Suicides by Place of Shooting or Place of Death . . . . . . . . . . . . . . . . . . . . . . . . . 37 Firearm Suicides by Month and Season . . . . . . . . 37 Firearm Suicide Victims Testing Positive for Alcohol . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Unintentional Firearm Injuries and Deaths. . . . . . 38 Legally Justifiable Firearm Injuries and Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Results and Analysis, Part II Hospital Data . . . . . . . . . . . . . . . .. . . .... . . . . 41 Firearm Injury Hospitalizations by Type of Injury. . ... . . . . . . . . . . . . . . . . . . . . . . 42 Cost and Source of Payment. . . . . . . . . . . . . . . . . 42 Receiving Hospitals . . . . . . . . . . . . . . . . . . . . . . . 43 Mode of Transport to Receiving Hospital. . . . . . . 43 Injury Severity Scores. . . . . . . . . . . . . . . . . . . . . . 44 Average Length of Stay. . . . . . .. . . . . . . . . . . . ... 45 Alcohol Involvement. . . . . . . . . . . . . . . . . . . . . . . 45 Glossary. . . . . . . . . . .. . . ... . .. . . . . .. . .. .. 47 References. . . . . . . . . . . .. . .. . . .. . . .. .. . .. 49 Appendices Appendix A:FIRST Project Reporting Forms. . . . A-1 Appendix B:CPC Charges and UCR Classifications . . . . . . . . . . . . . . . . . B-1 Appendix C:Firearm Injury Totals . . . . . . . . . . . C-1 Appendix D:Firearm Injuries by Intent and Victim Race/Ethnicityy . . . . . . . D-1 List of Figures Methodology 26. Firearm Assaults by Time of Day . . . . . . . . . . 32 A. Data Sources for Identifying 27. Firearm Homicide Victims Firearm Injuries by Intent Testing Positive for Alcohol/Other Drugs. . . 33 B. Variables Collected for the FIRST System. . . . 8 28. Self-Inflicted Firearm Injury Rates . . . . . . . . . 34 29. Firearm Suicide Rates Results and Analysis, Part 1 by Victim Sex and Age . . . . . . . . . . . . . . . . . 35 1. Firearm Injuries and Deaths by Intent . . . . . . 14 30. Firearm Suicide Rates 2. Firearm Deaths. . . . . . . . . . . . . . . . . . . . . . . . 14 by Victim Race/Ethnicity and Sex . . . . . . . . . 35 3. Nonfatal Firearm Injuries . . . . . . . . . . . . . . . . 15 31. Firearm Suicides by Gun Type. . . . . . . . . . . . 36 4. Firearm Injury Rates by Intent 32. Firearm Suicides by County Region . . . . . . . 36 and Outcome. . . . . . . . . . . . . . . . . . . . . . . . . 15 33. Firearm Suicides 5. Firearm Assault and Homicide Rates by Place of Shooting/Place of Death. . . . . . . 37 by Victim Sex. . . . . . . . . . . . . . . . . . . . . . . 16 34. Firearm Suicides by Month . . . . . . . . . . . . . . 37 6. Firearm Assault Rates 35. Firearm Suicide Victims by Victim Sex and Age . . . . . . . . . . . . . . . . . 17 Testing Positive for Alcohol. . . . . . . . . . . . . . 38 7. Firearm Homicide Rates 36. Firearm Unintentional Injury Rates by Victim Sex and Age . . . . . . . . . . . . . . . . . 17 by Victim Sex. . . . . . . . . . . . . . . . . . . . . . . . . 38 8. Firearm Assault and Homicide Rates 37. Firearm Unintentional Injury Rates by Victim's Race/Ethnicity . . . . . . . . . . . . . . . 18 by Victim Age . . . . . . . . . . . . . . . . . . . . . . . . 39 9. Firearm Homicide Rates by Victim Race/Ethnicity and Victim Sex . . . 18 Results and Analysis, Part II 10. Firearm Assault Rates 38. Firearm Injury Hospitalizations by Victim Age and Race/Ethnicity. . . . . . . . . 19 by Intent of Injury . . . . . . . . . . . . . . . . . . . . . 42 11. Firearm Assaults by County Region. . . . . . . . 20 39. Payment Sources 12. Firearm Assault and Homicide Rates for Firearm Hospitalizations . . . . . . . . . . . . . 42 by County Region . . . . . . . . . . . . . . . . . . . . . 20 40. Hospitalization Cost by Type of Injury. . . . . 43 13. Assaultive Violence Rate,Poverty Level 41. Receiving Hospitals for Firearm Victims . . . . 43 and Unemployment by Region . . . . . . . . . . . 21 42. Hospitalizations by AIS Score. . . . . . . . . . . . 44 14. Firearm Assaults by Gun Caliber. . . . . . . . . . 22 43. Hospitalizations by Intent and AIS . . . . . . . . 44 15. Firearm Homicides by Gun Caliber. . . . . . . . 22 44. Hospitalizations by AIS Score 16. Firearm Assaults by Gun Type . . . . . . . . . . . . 23 and Length of Stay . . . . . . . . . . . . . . . . . . . . 45 17. Firearm Homicides by Gun Type. . . . . . . . .. 23 45. Hospitalizations by Average Length 18. Firearm Assaults and Homicides of Stay and Intent . . . . . . . . . . . . . . . . . . . . . 45 by Victim-Offender Relationship . . . . . . . . . 24 Appendices 19. Firearm Assaults by Victim-Offender Relationship and Victim Sex . . . . . . . . . . . . . 25 i. Lists of CPC Charges and 20. Firearm Homicides by Victim-Offender UCR Classifications that Potentially Relationship and Victim Sex 25 Correspond with FIRST Classifications. . . . . B-2 p . . . . . . . . . . . . . 21. Firearm Assaults and Homicides ii. Firearm Injury Totals . . . . . . . . . . . . . . . . . . C-1 by Shooting Location . . . . . . . . . . .. . .. . . . 28 iii. Firearm Injuries by Intent and 22. Firearm Assaults and Homicides Victim Race/Ethnicity . . . . . . . . . . . . . . . . . D-1 by Shooting Circumstances. . . . . . . . . . . . . . 29 iv. Poverty and Unemployment 23. Firearm Assaults by Shooting by County Region . . . . . . . . . . . . . . . . . . . . . E-1 Circumstances and Victim Sex. . . . . . . . . . . . 30 v. Firearm Assault Rates and 24. Firearm Homicides by Shooting Numbers by County Region . . . . . . . . . . . . . E-1 Circumstances and Victim Sex. . . . . . . . . . . . 30 vi. Firearm Homicide Rates and Numbers 25. Firearm Assaults and Homicides by Month. . 32 by County Region . . ... . . . . . . . . . . . . . . . . . E-1 List of Figures vii. Firearm Suicide Rates and Numbers by County Region . . . . . . . . . . . . . . . . . . . . E-2 viii. Firearm Assault Rates by Victim Sex and Age . . . . . . . . . . . . . . . . . F-1 ix. Firearm Homicide Rates by Victim Sex and Age . . . . . . . . . . . . . . . . G-1 X. Firearm Assault Rates by Victim Age and Race/Ethnicity . . . . . . . H-1 xi. Firearm Assault and Homicide Rates by City or Unincorporated Area . . . . . . . . . I-1 xii. Firearm Assault Rates and Poverty by City or Unincorporated Area(Map) . . . . 1-3 xiii. Firearm Assault Rates and Unemployment by City or Unincorporated Area(Map) . . . . I-4 xiv. Firearm Suicides by Data Source . . . . . . . . . J-1 xv. Firearm Suicides by Victim Sex . . . . . . . . . . J-1 xvi. Firearm Suicides by Victim Race/Ethnicity. . J-1 xvii. Firearm Suicides by Victim Age and Sex . . . J-2 xviii.Firearm Suicides by City or Unincorporated Area . . . . . . . . . . . . . . . K-1 xix. Unintentional Firearm Injuries by Outcome . . . . . . . . . . . . . . . . . . . . . . . . . L-1 xx. Unintentional Firearm Injuries by Victim Sex . . . . . . . . . . . . . . . . . . . . . . . . L-1 xxi. Unintentional Firearm Injuries by Victim Race/Ethnicity . . . . . . . . . . . . . . . L-1 xxii. Unintentional Firearm Injuries by Victim Age. . . . . . . . . . . . . . . . . . . . . . . . L-2 xxiii.Two Types of Handguns(Diagram) . . . . . . M-2 xxiv. Types of Ammunition(Diagram) . . . . . . . . M-3 xxv. Contra Costa County(Map) . . . . . . . . . .. N-2 Executive Summary The Firearm Injury Reporting,Surveil- with 20 law enforcement agencies, 11 lance, and Tracking (FIRST) Project hospitals and the county coroner, the Report is the result of one of the first FIRST system was able to access and firearm injury surveillance systems to be computerize most of the firearm injury implemented in the United States. data available locally,analyze the data, Funded by a one-year grant from the and synthesize these into information State of California Emergency Medical that could.assist in violence prevention Services Authority and published by the programming and firearm policy devel- Contra Costa County Health Services opment. Department,the"Profile of Firearm In- The FIRST Project not only engen- juries and Deaths in Contra Costa dered a productive collaboration be- County:A Report of the Firearm Injury tween local agencies, but supported Reporting, Surveillance, and Tracking inquiry into areas that have until now (FIRST) Project" describes the firearm remained largely unexamined, such as injuries and deaths that occurred in the circumstances surrounding shootings, county between July 1, 1993 and June victim-offender relationships,and types 30, 1994. of firearms used in homicides, self-in- Two previous studies of childhood in- flitted and unintentional shootings. jury and intentional injury,respectively, had shown that firearm-related injuries Results and Analysis are a serious problem in Contra Costa County.From 1988-1990,firearms were Between July 1, 1993 and June 30, the number one cause of injury death 1994, there were 613 firearm injuries for children 10-14 years old in the and deaths in Contra Costa County. c ounty,and contributed to one-third of This number includes 111 homicides injury deaths for 10-19 year olds and 310 assaults. (Balogh et al, 1992). Between 1988 to Young people ages 15-19 had the 1992, firearms were the number one highest firearm assault rate (137.1 per weapon used in committing homicide, 100,000).Young adults ages 20-24 had accounting for approximately 75%of all the highest firearm homicide rate(53.8 homicides in Contra Costa County per 100,000). (Sullivan et at, 1994). Although the African American popu- Funding forthe FIRST Project allowed lation comprised only 9.2% of the the health department to investigate Contra Costa County population in further the problem of firearm injuries. 1994, African Americans were victims By establishing reporting relationships in 65.2%of the assaults and 64%of the homicides. were more likely to be shot unintention- The region with the highest rate of ally than other age groups. Young assaultive firearm injury (assaults and people 10-14 years old had the highest homicides combined)was West Contra unintentional firearm injury rate (14.9 Costa County (151.5 per 100,000). per 100,000), followed by 20-24 year Among the four county regions, West olds(14.4 per 100,000)and 15-19 year County also had the highest proportion olds(13.7 per 100,000). of people living below the poverty level, Nearly two-thirds of victims hospital- at 11.7% (1990 Census). ized for firearm injuries were uninsured The three communities with the high- or used public insurance to pay hospi- est firearm assault and homicide rates talization costs. Among gunshot pa- were the unincorporated area of North tients,46.0%(n=217)were uninsured, Richmond(1,193 per 100,000),and the 18.2% (n=86) used private insurance, cities of Richmond(253.6 per 100,000) 16.3% (n=77) used public insurance and San Pablo(175.6 per 100,000)—all (e.g., Medicare, Medi-Cal, Victim of located in West Contra Costa County. Crime, Workers'Compensation, Basic Similarly,these localities had high per- Adult Care), and 2.3% (n=11) used centages of people living below the pov- other payment sources. erty level (North Richmond, 52.8%; Firearm injuries were extremely costly. Richmond, 16.1%;San Pablo, 19.0%). Hospitalization costs for firearm inju- More than three-fourths of firearm ries totalled$5,329,599. Private insur- homicides were committed with hand- ance paid$1.5 million,public insurance guns(76.6%, n=85). $1.3 million,and$0.3 million was self- Females were more likely than males paid or came from charity. to be killed by a current or ex-spouse or Other data contained in the FIRST lover.Both males and females were more Project Report include: age, sex and likely to be assaulted-with a firearm by race/ethnic characteristics of firearm acquaintances than by strangers. injury victims,types,and calibers of guns Homicide victims were likely to be involved,relationships between victims shot and killed by offenders of the same and offenders,circumstances and loca- ethnic background. Among African tions of shootings, involvement of al- American homicide victims, 57.7% cohol and other drugs, firearm injury (n=41) were killed by African Ameri- severity scores, and average length of cans.Among.Latino homicide victims, stay in hospitals.More than 60 graphs, 64.3% (n=9) were killed by Latinos. tables, maps, and diagrams were used Among White homicide victims,52.4% to present the data in this report. (n=11)were killed by Whites.Among Asian/Other homicide victims, 50°x6 (n=2) were killed by Asians/Other. A similar pattern of victims being shot by offenders of the same race/ethnicitywas found among firearm assault victims. Suicides accounted for 25.5%of fire- arm deaths in Contra Costa County. The suicide rate for the total popula- tion was 5.4 per 100,000. Central County had the highest number (35.6%,n=16)of firearm suicides in the county. Whites were more likely to commit suicide with a firearm than any other ethnic group. Whites accounted for 83.0% (n=39) of the total suicides. White males had the highest suicide rate (10.9 per 100,000) among all sex and race/ethnic groups. Children,teenagers,and young adults u 2 The FIRST Project Report Executive Summary 11 Introduction Firearm Violence: States,a young person between the ages A National Epidemic of 10 and 19 was unintentionally shot every 19 hours;committed suicide with Violence is a critical public health a gun every 6 hours;and was murdered problem in the United States. Firearm with a firearm every 3 hours.From 1979 violence accounts for an increasingly to 1993, the firearm homicide rate for large proportion of the country's deaths young people between the ages of 15 and injuries. In 1991, a total of 38,317 to 19 increased by 61 percent, while Americans died from gunshot wounds, homicide rates by all other methods for a 60 percent jump from the 23,875 fire- the same age group.remained stable or arm deaths recorded in 1968(Fingerhut decreased(Fingerhut, 1993). et al, 1994). A recent study of a cross-section of Counting deaths from firearms pro- youth attending urban, suburban, and vides only a glimpse of the magnitude rural public and private schools indicates of the firearm injury epidemic. For ev- that no young person is immune.Thirty ery firearm death,researchers estimate five percent of the students surveyed that there are 7.5 nonfatal firearm inju- believe that their chances of"living to a ries (Wintemute et al, 1992). Accord- ripe old age will be cut short because of ing to a recent study of nonfatal firearm the threat of being wiped out by guns injuries,more than 150,000 Americans (Harris, 1993). The impact of firearm are treated annually in hospital emer- injuries on African American males ages gency departments for firearm injuries 15-19 is especially devastating.For this (Annest et al, 1995). group,gun homicide has been the lead- In 1991,firearm-related fatalities sur- ing cause of death since 1969 passed motor vehicle-related fatalities as (Fingerhut,1992).It is important to bear the leading cause of injury death in in mind, however, that some research- seven states,including California(Cen- ers have identified poverty,not race or ter for Disease Control (CDC), 1994). ethnicity, as a primary contributor to Unfortunately,this trend continues.In high rates of assaultive violence 1992,5,814 Californians died from fire- (Rosenberg and Mercy, 1991). Some arm-related injuries, while 4,185 died racial or ethnic groups are at higher risk from motor vehicle-related injuries for violence because poverty dispro- (California Department of Health Ser- portionately affects communities of vices(CA DHS), 1994). color. Young people are particularly vulner- More than 210 million firearms are able to firearm violence,both as victims currently in private hands in the United and perpetrators.In 1990,in the United States(Bureau of Alcohol,Tobacco,and Firearms, 1991). According to the Pa- one (CA DHS, 1994). The following and 1991,motor vehicle-related deaths cific Center for Violence Prevention year,firearms accounted for 80 percent decreased by 21 percent(CDC, 1994). (1994), the manufacture and importa- of Contra Costa homicides(n=97)and As with motor vehicle-related injuries, tion of handguns reached an all-time 43 percent of suicides(n=33).Firearms a variety of approaches to prevent fire- high in 1992,Californians alone legally were used in 53.2 percent of suicides be- arm-related injuries are now being re- purchased an average of 1,000 handguns tween 1988 and 1992 (Sullivan et al, searched, implemented and evaluated. daily during that year. Research shows 1994). In 1994, there were 700 gun New public health strategies for reduc- that people who have guns in their dealers in Contra Costa—more than the ing gun injuries and deaths, including homes are at a much greater risk of ho- number of schools, groceries, gas sta- public information campaigns, gun micide and suicide than people who do tions, and libraries combined (Contra safety education programs,and commu- not keep guns in their homes Costa County Health Services Depart- nity organizing in support of initiatives (Kellermann, 1992, 1993). Guns are ment Prevention Program, 1995). like local ordinances that regulate gun marketed aggressively to women as a Contra Costa youth,like their national dealers,are emerging nationwide.Each means of self protection, yet for every counterparts,are disproportionately af- of these approaches requires the collec- time a woman used a handgun in 1992 fected by firearm-related homicides and tion and analysis of accurate and up-.to- i to justifiably kill a stranger in self-de- unintentional shootings. From 1988 to date firearm injury data. fense,239 females were killed in hand- 1990, gunshot wounds were the lead- Data are critical in assessing the extent gun homicides(Violence Policy Center, ing cause of death for children between of firearm injuries and for developing j 1994). the ages of 10 and 14,and caused more appropriate programs and policies.With Firearm injuries are not only traumatic than one-third of all deaths for 10 to 19 accurate data,public health practitioners for victims and their loved ones, they year olds. During this period,gunshot can identify communities most at risk are costly. In 1990, the societal cost of wounds accounted for more than 45 for gun violence,implement prevention firearm injuries in the U.S.totaled 20.4 percent of injury deaths among African strategies,and evaluate the impact and billion dollars(Max, 1993).Eighty per- American children, compared to 21.7 outcomes of their work. Data can also cent of the medical cost of firearm inju- percent of injury deaths among white provide individuals and organizations ries is paid by taxpayers (Wintemute, children(Balogh, 1992). that are involved in violence prevention 1992). The average cost of treating a Although California minors cannot with a better understanding of the risk hospitalized gunshot wound patient is legally purchase guns or ammunition, factors for firearm injuries. more than$33,000(Rice, 1989). Gun- incarcerated youth have reported how The urgent need for firearm data has shot wounds are the single largest finan easily firearms can be acquired by juve- only recently been acknowledged by cial drain on hospitals and trauma niles. This anecdotal information sup- public and private violence prevention centers, which lose millions of dollars ports the finding of Shelley et al(1993), funding sources. The Pacific Center for annually treating patients injured by who found that only a third of the ur- Violence Prevention cites numerous i firearms(Wintemute, 1992). ban male students surveyed thought it data deficiencies and notes that more would be a lot of trouble or nearly im- money is spent on newspaper adver- Firearm Violence in possible to acquire a gun. tisements for and against gun control Contra Costa County than on research on firearms and A Public Health violence.Funding of the Firearm Injury Contra Costa County(estimated 1994 Reporting, Surveillance, and Tracking population: 874,693) is one of nine Approach to Reducing (FIRST)Project,which is in many ways counties in the San Francisco Bay Area. Firearm Violence a pioneer firearm data project, was Ethnically and economically diverse,the significant because it indicates that grant county is one of the fastest growing in The goal of public health is to reduce funders are paying more attention,and the state.Population data for 1994 show morbidity and premature mortality. hopefully committing more resources, that 67.5 percent of the county popula- Because injury is the leading cause of to local data efforts. tion is White, 12.4 percent Latino, 10.7 death in the U.S. for people between The FIRST Project engendered a percent Asian/Other, and 9.1 percent the ages of one and 44 (CDC, 1994), unique collaboration between law en- African American.Twenty five percent public health efforts have for many years forcement agencies,hospitals,a county of the population is under age 18.More focused on injury prevention, specifi- coroner,and divisions of a local health than 7 percent of Contra Costans were cally on motor vehicle-related injuries. department. This collaboration sup- living in poverty in 1990—among these, Efforts to prevent motor vehicle injuries ported inquiry into areas that have until 1 1.1 percent of children aged 0 to 17. have included programs and policies to recently remained largely unexamined, Contra Costa firearm injury data, improve the safety features of motor such as circumstances surrounding while following national trends,are even vehicles, ensure safer roadways, shootings, victim-offender relation- more striking. In 1992, firearm injury promote safe driving practices,and up- ships, and types of weapons used in deaths outnumbered motor vehicle grade emergency and hospital care.This homicides, suicides, assaults and unin- deaths in the county by almost two to work has proved fruitful:between 1969 tentional shootings. 4 The FIRST Project Report Introduction • i i Methodology An Integrative Approach edge about local public health problems, to Usln Local Data such as identifying populations at risk g for violence.This in turn leads to an in- The Firearm Injury Reporting,Surveil- crease in the department's capacity to lance and Tracking(FIRST) Project of make informed decisions,such as devel- the Contra Costa County Health Ser- oping appropriate violence interven- vices Department(HSD)is one of only tions. a few similar projects in the country that Data studies which use an integrative have used multiple local data sources to approach often utilize data aggregated examine injuries and deaths from fire- at the state or federal level. However, arms. Using the FIRST system, data since these large data sets are created from Contra Costa County law enforce- from summarized data of local agencies, ment (police and sheriff) agencies, they lose much of the detail that the hospitals,and the county coroner were original, local reports contained. The aggregated and analyzed.An analysis of FIRST system broke new ground by the.data from any single agency would acquiring data directly from local have yielded an incomplete picture of agencies rather than using data aggre- firearm injuries and deaths in the county, gated at the state level.Substantial time but as a result of this cooperative project, and effort by both FIRST staff and a comprehensive, countywide.profile agency staff were required to abstract emerged. the desired data from the local agencies' Traditionally, data sets are analyzed records,which were generally not com- individually.However,recent advances puterized. However, this extra effort in technology have made possible the resulted in a richness and completeness of data that would otherwise have been merging of information from separate difficult or impossible to acquire...In sources, even at the local level. There addition, the connections established are several advantages to using an inte- between the HSD and other agencies grative approach to analyzing data.This strengthened the capacity of the HSD approach provides a more complete pic- to conduct future targeted data studies ture of the study's subject than would and learn about other local issues. be possible by analyzing the sources Another potential advantage of using separately. Also, such a data synthesis local data sources is that more current achieves cost-efficiency because it re- data are available than can be acquired lies on existing data sources.The result through state or federal sources. For of such studies can enhance a health example,it is common to expect a one department's capacity to acquire knowl- year lag time before data are available d from the state, whereas local data may lisped in the Profile, it was found that system collected data such as shooting be available within a few months or even firearms accounted for 63.5%of all in- locations,types of firearms used,victim immediately. Even before the analysis tentional injury deaths by mechanism demographics,severity of injuries,medi- of all variables of FIRST data was com- in the county between 1988 and 1992. cal treatment costs,and morbidity and pleted,the HSD could use the informa- Firearms were also the leading method mortality outcomes. tion to examine trends and apply this of suicide(53.2%)during the same per- Data on socioeconomic status (SES) knowledge to local prevention efforts. iod. are important to understanding patterns However,completing the FIRST Project Recognizing that firearm injury was a of violence. Researchers have shown Report did require significant time for public health problem locally,the HSD poverty to be a risk factor in homicide steps such as gaining cooperation from and Childhood Injury Prevention Coa- (Loftin and Hill, 1974;Williams, 1984). local agencies,abstracting data,and in- lition (CIPC) initiated efforts to study SES data were not routinely collected tegrating multiple data sets(e.g.,remov- the nature and extent of firearm injuries by the reporting agencies in this study. ing duplicate records). These factors and deaths within the county.Statewide However,FIRST staff developed a map should be considered when planning data sets provided insufficient detail for using data from the FIRST system and and implementing a similar study. developing a countywide picture of fire- the 1990 U.S. Census that shows the arm injuries.Therefore,the first step was rates of firearm-related homicides,sui= HSD's Efforts in Local to develop a model for abstracting and cides, and assaults by city of shooting, aggregating relevant data from local along with percent below poverty and Studies of Violence agencies. With significant input from percent unemployed, to illustrate the and Firearms local law enforcement representatives, relationship between these variables. the HSD and the CIPC conceptualized The HSD Prevention Program was the the FIRST system. FIRST Methodology: lead agency for several recent studies Shortly after the FIRST model was employing an integrative approach to developed,the HSD Emergency Medi- Establishing Data data analysis. In addition to the FIRST cal Services (EMS) Agency received Reporting Relationships Project, two other studies (described funding for the project from the State below) had also used multiple data of California Emergency Medical Ser- While data aggregated by state and sources, but unlike the FIRST Project, vices Authority(Special Projects Grant federal agencies can be accessed with these studies primarily used large data #EMS-2026, 2028). Discussions about little difficulty, inter-agency channels sets aggregated at the state level, not how to implement'FIRST took place must be established in order to access local data. among staff from EMS,CIPC, and the local data. In the FIRST Project, local The Status Report on Childhood In- Prevention Program. The Prevention agencies that had never before shared jury in Contra Costa County(Balogh, Program was designated as the FIRST their data with the Health Services De- et al, 1992), established baseline data implementation site, and EMS and partment raised legitimate concerns re- on childhood injury in the county.The CIPC agreed to provide advice and garding case confidentiality, what Status Report used data from the Cali- oversight.This arrangement was based agency resources would be required for forma Department of Health Services on: 1) the long-standing partnership participation,and how their data would (CDHS) and a subset of information between EMS and the Prevention Pro- be used. FIRST staff worked with from the Uniform Hospital Discharge gram; 2) the Prevention Program's re- agency staff on various organizational Data Set (UHDDS) for hospitals in sponsibility for staffing CIPC;and 3)the levels to resolve these issues.Open com- California.This report established that Program's successful history of imple- munication was essential to developing from 1988 to 1990, firearms were the menting surveillance systems,analyzing common agreement between all the leading cause of death for youths 10 to data,and developing countywide injury participants in the FIRST system. i 14 years old and the second leading prevention programs.' The unanimous,voluntary consent of cause of injury death for children under The FIRST system compiled data on all reporting agencies to participate in the age of 20. firearm injuries and deaths that occurred the FIRST Project was an acknowledge- Another study,which was initiated af- between July 1, 1993 andjune 30, 1994. ment of the project's importance.Also, ter the Status Report,was the Profile of Data on all gunshot wound victims in these agencies formed a virtual net for Violent Injury (Sullivan et al, 1994). the county were collected and aggre- capturing the total scope of injuries and This study analyzed violent injury(in- gated from three types of agencies in deaths by firearms in the county. Had cluding domestic violence and suicide) the county:law enforcement(police and any agency refused to participate,cases as it affected all age groups and sheriff),hospitals(including the county would have slipped through the net,and ethnicities. Like the Status Report,this trauma center),and the coroner. Infor- the resulting profile of firearm injuries study used CDHS and UHDDS data mation was obtained about all gunshot in the county would have been less com- and,additionally,data from the Califor- injuries, whether intentional (e.g., as- plete. nia justice Department and the Contra saults,homicides,suicides)or uninten- The cooperative agreement with the Costa County Coroners Office.As pub- tional (i.e., "accidents'). The FIRST coroner's office was relatively easy to se- 6 The FIRST Project Report Methodology cure because close ties had already been injury investigation. For example, the den or unusual deaths or deaths in which established with the HSD.Additionally, coroners office was the best data source the deceased was not attended by a phy- since the coroner's data are computer- for the identification of all deaths,while sician in the last 20 days. Thus, the ized,data were transmitted to the FIRST law enforcement was the expert on as- coroner's records were used as the au- system with little difficulty.In contrast, sault cases and hospitals were best at col- thority on the total number of deaths accessing police and hospital data lecting data on unintentional injuries. caused by firearms. proved to be much harder.In most cases, (See figure A for data sources and their The fatalities identified in the coroners data were not computerized and had to areas of expertise in firearm injuries.) data were cross-checked in law enforce- be manually abstracted by police offic- Similarly, each agency differs in the ment and hospital data sets to catch any ers, nurses, and FIRST staff. New rela- list of variables it collects.For example, fatalities missed by data abstractors in tionships were developed by FIRST staff only hospitals collected data on length these two data sets. Law enforcement with each participating law enforcement of hospital stay and method of pay- agencies and hospitals contain variables agency(n=20)and hospital(n=t t)that ment, whereas only law enforcement not collected or computerized by the responded to shooting incidents in the agencies collected information on the coroner(such as circumstances of shoot- county.Ultimately,protocols for iden- victim-offender relationship.(See figure ingorlength of hospital stay),and these tifying and reporting firearm injuries B for data variables collected by each variables were used to supplement the were established for each law enforce- reporting agency). coroner's data in the FIRST system's ment department and hospital. Certain data variables were common analysis of fatalities due to gunshot to all reporting agencies.Data for these wounds. Classification of Data: variables were pooled and used to cal- culate overall incidence rates. Because Law Enforcement Data Overview of the possibility of overlapping data In aggregating data from different when using multiple data sets (for ex- Collection sources,a common classification system ample, a hospital record and a police Twenty Contra Costa County law en- must be established.The FIRST system record may exist for the same victim), forcement agencies reported data to the classified intent of injury or death in the care was taken to identify and eliminate FIRST system. The primary source of following categories:homicide,assault, duplicate records before analysis. local law enforcement data for the completed suicide, attempted suicide, FIRST system was the crime offense re- fatal or nonfatal unintentional injury, Coroner Data Collection Port,a full report of a crime on file with legally justified fatality,legally justified each law enforcement agency. In addi- nonfatal injury,and fatal or nonfatal in- The coroner's office made available to tion to a standard,one-page form,these jury by undetermined intent.This clas- FIRST staff its computerized data on all reports can include dozens of supple- sification scheme was based on deaths that were reported in Contra mental pages,depending on the serious- traditional health and law enforcement Costa County(including deaths of non- ness of the crime and availability of categories. county residents).The coroner records information. An.offense report must Because each reporting agency has its all deaths related to trauma(e.g.,motor contain descriptions of the offense(s), own existing categorization system for vehicle-related, drowning, homicide, victim(s), suspect(s), and witness(es) data, information of interest to the suicide,gunshot-related),including sud- involved in a crime.They are often ac- FIRST system had to be identified and re-categorized according to FIRST classi- fications. For example, law Data Sources for Identifying Firearm Injuries by Intent enforcement agencies Cate- gorize reports according to type of crime, not by injury. In order to access data of ata 5au GHamteidea Asseutts Suicides Sl� 6Uut��prl1 other �Y a a lnlite+� .. 2 interest to the FIRST Project, .....¢'°t w ro.T .n. a list was developed of crime A codes that might involve a LawT expert , g �rtareem�: - firearm injury (e.g., rob- beries, ob bevies assaults etc.) and this Sheriff expert expert experlt list was used to identify law Coroner �r x enforcement reports with otentiall relevant data. iasptials expert ..... PY Each reporting agency has its own area of expertise and set of protocols for firearm Figure A Methodology The FIRST Project Report 7 Variables Collected for the FIRST System coroner law enforcement hospitals trauma center age x x x x sex x x x x ethnicity x x x x city where shooting/death x x occurred firearm type x x caliber of firearm x x drug use/alcohol use x x x* suspect sex, age, and x ethnicity location of shooting/death x x (victim's home,other residence, hospital, victim's workplace, school, etc.) month of shooting x x x** x** time of shooting x x*** x*** circumstances of shooting x (argument, drive-by, etc.) victim-offender x relationship length of hospital stay x x outcome of firearm injury x x x x (death vs. survival) (all deaths) cost of treatment x x payment source x x injury severity x (abbreviated injury severity code) hospital taken to x x x Victim's zip code x x x injury intent (assault, homicide, etc.) x x x x law enforcement x x jurisdiction alcohol use only **admit month ***admit time Figure 8 8 The FIRST Project Report Methodology companied by supplemental reports, firearm injuries.Law enforcement agen- tem was again used as a guide for iden- which may include details about crime cies then used these classification lists tifying relevant offense reports,and the scenes, interviews with victims, wit- to search their records and ascertain individual offense reports were used in nesses,and suspects,and forensic infor- which reports fell into these classifica- abstracting data onto the FIRST report- mation about victims or evidence. tions. For more information on CPC ing forms. While many departments computer- charges, UCR classifications, and the Reporting was a laborious process for ize specific data on homicides, lists developed by the FIRST system to law enforcement personnel,who often information on all other crimes is com- search for reports of shooting incidents, needed to review case files to abstract puterized on a limited basis or not at please see Appendix B. the desired information. FIRST staff all. Consequently, law enforcement filled out reporting forms for the two agencies were asked to provide data to Data Reporting departments with the highest numbers the FIRST system by abstracting data Arrangements of firearm injuries. Because of limited from the offense report onto a one-page staff resources, these two law enforce- FIRST reporting form for each firearm Departments agreed to report gunshot ment agencies would not have been able injury incident.This reporting form was injuries on a monthly basis with a one to participate in the FIRST Project with- based on the format of offense reports month lag time(e.g.,July reports were out this assistance. and modeled on forms used in other sur- submitted by the first of September). veillance projects.(For a sample of this This lag time was necessary because . Suicides and form,please see Appendix A.) pertinent case information was often Unintentional Injuries Department crime and "calls-for- unavailable for a month(sometimes be- service"logs,which contain basic infor cause:it was part of an active crime in- In both the CPC and UCR classifica- mation about the incidents to which vestigation);full case details sometimes tion systems,suicides and unintentional police respond,were often used to iden- were not available for many months. injuries are not considered crimes and tify the relevant offense reports for data Various data reporting arrangements thus were not assigned a crime classifi- abstraction. In other cases, FIRST re- were made with law enforcement de- cation.Although one department could ports might have been filled out when partments which were dictated by fac- do a computer search for suicides,most police officers reviewed offense reports ton such as department size,resources departments had little capability for for compiling a monthly statistical re- available,and department record-keep- identifying suicides and unintentional port, known as the Uniform Crime ing protocols. injuries.These incidents are often clas- Report(UCR) summary,which is sub- For some small departments,gunshot sified in broad categories which include mitted to the State Department of' wound incidents occurred infrequently, many types of reports, such as "unex- Justice. and a FIRST report was filled out as soon plained deaths" or "miscellaneous." In as an officer responded to an incident. order to ensure more complete informa- Law Enforcement Other departments kept a list of gun- tion on these cases, the coroner and Classification Systems shot wound incidents as they occurred hospital records were analyzed for miss- and periodically filled out FIRST forms. ing or supplemental suicide and unin- Crimes are classified by police and Larger departments searched through tentional firearm injury data. The sheriff agencies in two ways:according their logs daily or monthly to identify coroner's expertise on fatal cases was to California Penal Code (CPC) offense reports that potentially involved relied upon to identify fatal suicides and charges, which are recorded on the firearm injuries. Since log entries may the hospitals'expertise was used to iden- offense reports; and according to the contain CPC charges, UCR classifica- tify unintentional injuries and nonfatal U.S. Department of Justice, Federal tions,and/or general descriptions of the (attempted)suicides.Analysis of coro- Bureau of Investigation UCR classifi- crime committed, the list of CPC and ner and hospital data revealed that many cations, which are used in the UCR UCR classifications developed by the suicides and unintentional shootings summaries produced each month by FIRST Project was used to search the were not identified by law enforcement each law enforcement agency.The CPC logs. The individual offense reports agencies.In the case of fatal suicides,it charges describe all crimes, including were then individually reviewed to de- was found that nearly half of the vic- those not involving firearms.The UCR termine if a gunshot wound had oc- tims identified in the coroners data were classifications describe eight types of curred. A FIRST reporting form was not identified in law enforcement crimes. Thus, neither of these classi- then completed for each gunshot wound records. fication systems provided readily incident. accessible information regarding firearm Other departments filled out FIRST Hospital Data Collection injuries. reporting forms at the same time that In order to identify all potential reports they went through their offense reports After establishing relationships with of shooting victims, FIRST staff devel- to re-classify and compile statistics for each of the eight hospitals in Contra oped a listing of both CPC charges and the monthly UCR summary.The CPU Costa County and three selected neigh- UCR categories which might involve UCR list developed for the FIRST sys- boring hospitals in Alameda County,the Methodology The FIRST Project Report 9 FIRST system was able to collect infor- use of a firearm. The E codes included and a hospital. However, if police are mation on all firearm injury patients(in- were: 1)Unintentional injury:Accident not called to respond to a shooting and cluding those wounded by BB, pellet, caused by firearm missile (E922.0- the gunshot wound victim does not seek and air guns) treated during the study E922.3, E922.8, E922.9); 2) Suicide: hospital care,which is much more likely year.Because a small number of gunshot Suicide and self-inflicted injury by fire- for minor wounds,no record of the in- wound victims are transported out of arm(E955.0-E955.4);3)Assault:Assault cident would exist. Contra Costa County for treatment,ei- by firearm and explosives (E965.0- Because of the nature of firearm inju- ther to avoid police involvement or be- E965.4);4) Legally justified firearm in- ries,most victims will seek hospital care, cause the county's trauma center is jury: Injury due to legal intervention even if police are not called to the scene. unable to accommodate additional with firearm (E970); and 5) Undeter- State law requires hospitals to contact cases, FIRST secured the participation mined firearm injury:Injury by firearm, police if agunshotwound patient arrives of three neighboring, out-of-county undetermined whether accidentally or without an ambulance or police escort. hospitals.These three hospitals,located purposely inflicted(E985.0-E985.4). If,as happens occasionally,hospital staff in the city of Oakland,were:Children's Records were checked for duplicates fail to call the police as required, or if Hospital,Highland Hospital,and Kai- between the two data sets in order to the police are called but do not com- ser Oakland.All the participating hos- avoid counting a gunshot injury victim plete a report, no police record will be pitals reported data from July 1, 1993 twice (e.g., a victim initially admitted filed.Some victims may opt for on-the- through June 31, 1994,with the excep- to one of the ten hospitals could be sta- scene treatment only,which will not be tion of Doctors Hospital,which began bilized and then transferred to JMMC documented in hospital records.Finally, reporting on October 31, 1993,and Los for treatment). No duplicates were Contra Costa gunshot wound victims Medanos Hospital, which stopped re- found.Gunshot injuryvictims shot out- may be transported by friends or family porting when it closed on April 12, side of Contra Costa County were re- members to hospitals in neighboring 1994. moved from the analysis. Common counties in order to avoid police in- Except forJohn Muir Medical Center variables in both data sets were stan- volvement. If hospital staff and police (JMMC),which collects data on trauma dardized in order to combine both data are not able to determine the true loca- patients, non-trauma walk-ins, and sets into one file for analysis of hospital tion of the shooting,this patient would victims of BB and pellet gun shootings, data. not be classified as a Contra Costa vic- none of the participating hospitals tim.Discussions with staff from hospi- maintain computerized emergency Missing Cases tals,law enforcement and EMS revealed department and hospital discharge that these types of situations are rare. databases. Therefore, FIRST staff was The FIRST system's net of reporting able to obtain specific data fields from agencies may not have captured every Re-classification of JMMC's databases in a computerized file nonfatal gunshot wound victim in the on diskette.The other hospitals used a county (coroner data ensured that Duplicate Records one-page FIRST reporting form to FIRST data included all gunshot wound abstract data about gunshot wound deaths).Thus,the FIRST system results In cross-referencing the coroner's data with law enforcement data,it was found patients from emergency room logs. may include an underestimation of fire- (For a sample of this form, please see arm injuries in the county. that among the cases classified by the coroner as homicides,only 5.1% Appendix A.) Some hospitals had A reporting system such as the FIRST la sufficient resources to abstract addi. system can expect some degree of were classified differently in thee w law tional information from patient records. underreporting(missed cases). For in- enforcement data set:3.4%(.9% were The FIRST Project was fortunate to stance, police may miss incidents that classified as legally justified,0.9%(n=1) obtain the help of two nurses from are misclassified or termed "miscella- was classified as undetermined, and JMMC to assist three other participating neous in their records. Hospital staff 0.9%(n=1)was classified as fatal unin- hospitals with data collection. may miss cases in which firearm injury tentional injury.These six cases were re- Hospital data were originally con- victims' wounds are misdiagnosed in classified for the FIRST system tained in two separate data sets, one emergency department logs. (EMS's according to law enforcement catego- containing data for the ten hospitals and computerized Trauma Base Log,which ries because these categories allowed for one containing data for JMMC.These lists victims transported by ambulances a broader range of classifications than data sets were then combined into one to hospitals, provided an additional did the coroners categories. For ex- "hospital"data set. Analyses of JMMC means of checking hospital reporting.) ample, the coroner has no category of trauma registry patient data were con- Although resources did not permit "legally justified death." ducted only for patients who were as- FIRST staff to conduct audits of agency Upon cross-referencing the hospital signed codes under the International logs to determine how often agencies data set with the law enforcement data Classification of Diseases(ICD)exter- missed cases, it is unlikely that many set, it was found that of the total cases nal cause-of-injury and poisoning serious cases would have escaped report- (n=112) classified as undetermined by scheme (E codes) which involved the ing by both a law enforcement agency hospitals,26.8%(n=30)were also con- 10 The FIRST Project Report Methodology tained in the law enforcement data set sets were identified and removed. but were under different classifications. Records were identified as duplicates if Law enforcement classified 27 of these they matched on victim age, sex;race/ cases as assaults,two as homicides,and ethnicity,the intent of injury,and if ap- one as an unintentional injury. Because plicable,zip code,name of hospital and law enforcement protocols often involve date of admission. Cases identified as more investigation and result in a more possible duplicate records were matched detailed description of a gunshot inci- on additional variables to ensure that dent than hospitals,the 30 cases classi- they were in fact duplicate records. fied by hospitals as undetermined were Data entry and analyses of law en- re-classified according to law enforce- forcement, coroner, and hospital data ment categories.Additionally,one case were conducted using Epi-Info 5.0, a classified as an unintentional injury by program developed by the Centers for hospitals was classified in the law en- Disease Control and Prevention, and forcement data set as an assault. This SPSS/PC+ 4.0 (Statistical Package for case was re-classified according to law the Social Sciences). enforcement categories for similar rea The law enforcement data set con- sons. tained 469 records, and the coroners After re-classification, a substantial data set contained 158 records. The proportion (13.8%, n=86) of firearm combined hospital data set contained a injuries and deaths in Contra Costa total of 472 records;the data set for the County were still classified as undeter- ten hospitals had 243 patient records, mined.The majority of these cases were and the John Muir Medical Center data found in the hospital data set (94.3%, contained 229 patient records. John n=82), whereas only four cases were Muir Medical Center data contained found to be classified as undetermined variables unique to trauma data (e.g., in the law enforcement data file(these injury severity measured by the Abbre- four cases were unique to this data set). viated Injury Severity(AIS)score),and The coroner's records had no firearm therefore these variables were analyzed deaths of undetermined intent. separately. Undetermined cases found in the hos- Analysis consisted of frequencies and pital data were largely abstracted from cross tabulations on variables relevant emergency room logs.In the emergency to injury surveillance. room, when the cause of a firearm in- jury is unknown(or because the patient Calculating Incidence can't or won't disclose the cause), the injury is classified as undetermined. A Rates for Injury hospital staff's primary concern is the Classification treatment of the gunshot injury rather than determining the intent with which After duplicate records were removed the injury was inflicted.Therefore,the from the data sets, the resulting totals substantial number of undetermined for injury intent were used as numera- firearm injuries may represent an under- tors to calculate firearm injury incidence estimation of specific injury classifica- rates for 1994. tions(e.g.,assault,unintentional). Firearm injury and death incidence rates were calculated by intent of injury Data Analysis (e.g., homicide, assault, suicide, unin- tentional injury,legally justified injury After the FIRST data had been col- and undetermined injury), in addition lected and entered,records were edited to intent of injury by sex, age, race/ for completeness and accuracy. When ethnicity, sex and ethnicity, age and information was missing or incorrect ethnicity.Population estimates for 1994, (e.g., a non-existent zip code was re- were calculated using estimates from corded), the original reporting agency 1990 and the year 2000,obtained from was contacted to correct the record. the California Finance Department. Records in one data set that were du- plicated in one or both of the other data Methodology The FIRST Project Report 11 Results .and Analysis, Part Firearm Injuries and Deaths in Contra Costa County From July 1, 1993 to June 30, 1994,a total of 613 injuries and deaths from firearms were reported by the 20 local law enforcement agencies, the county Firearm Injuries and Deaths by Intent coroner's office,and the eleven hospitals contra costa county,July 1,1993-June 30,1994 participating in the Firearm Injury Reporting, Surveillance, and Tracking Total (N=613) (FIRST)System. (See figure 1.)Of the 613 firearm injuries and deaths,68.7% (n=421) were assaultive, 8.2% (n=50) Undetermined =65 were unintentional, 7.7°x6 (n=47)were Assaultive =421 (13.9%) self-inflicted, 1.6%(n=10)were legally (68•7%) justified, and 13.9% (n=85) were of I e9aliyJustie) =10 undetermined intent. (1 = 1111 Unintentionall =50 There was a total of 157 deaths from (e2%) firearm injury. Seventy point seven Sett-Inflicted =47 percent (70.7%, n=11 1) were homi- (7,7%) r cides, 25.5% (n=40) were suicides, FIRST SWdy,Prevention Program:Law enforcement,coroner hosprai,John Muir Medica]Center data 2.5% (n=4) were legally justified, and 1.3% (n=2) were unintentional. (See figure 2.) Figure 1 There was a total of 456 nonfatal firearm injuries: 68.0% (n=310) were t assaults, 10.5% (n=48) were uninten- tional, 1.5% (n=7) were self-inflicted 1.3% (n=6) were legally justified, and Firearm Deaths the remaining 18.6% (n=85) were of Contra Costa County,July 1,1993-June 30,1994 undetermined intent.(See figure 3.) j n=157 Firearm Injury Rates For every fatal firearm injury, three Homicide =111 (70.7%) Log.Jude =4 (2.5%) nonfatal firearm injuries occurred.The nintentional =2(1.3%) death rate from all firearm injuries in Contra Cost County for the study year, 17.8 per 100,000, exceeded the 1994 Suicide =40 (25.5%) California firearm death rate of 10.3 per 100,000 and the 1992 national death rate of 14.8 per 100,000. FIRST SU*,Prevention"ram:Law enforcement daft Firearm injury rates were calculated by intent of injury,e.g.whether the injury Figure 2 was an assault, homicide, suicide, unintentional, legally justified, or injuries and deaths (1.1 per 100,000). the lowest among the four race/ethnic undetermined injury.Assaults accounted (See figure 4.) categories. Latinos had the second for the highest rate, 35.4 per 100,000, The African American firearm injury highest rate(69.3 per 100,000);Asians/ followed by homicides (12.7 per rate, fatal and nonfatal (417.8 per Other had a firearm injury rate of 26.7 100,000), unintentional injuries (fatal 100,000), exceeded all race/ethnic per 100,000. Race/ethnic-specific and nonfatal; 5.7 per 100,000), self- groups. This is about sixteen times firearm death rates were highest for inflicted injuries(fatal and nonfatal;5.4 higher than the firearm injury rate for African Americans (90.8 per 100,000), per 100,000), and legally justified Whites,which at 25.9 per 100,000 was followed by Latinos(14.8 per 100,000), 14 The FIRST Project Report Results and Analysis, Part 1 Whites (7.5 per 100,000), and Asians/ Other(5.3 per 100,000).' Age and sex stratification by race/ ethnic group revealed that African Nonfatal Firearm Injuries American males ages 20-24 exceeded all contra costa county,July 1,1993-June 30,1994 other age-sex-ethnic groups in their rates of firearm injury and death for all n=ass intents for the study year(1,298.2 per 100,000 and 1,027.2 per 100,000, respectively). Assault =310 (6a.0%) Hospitalization Outcome etermined _85(18.6%) For all firearm injury victims, 80.4% (n=379)lived,while only 12.1%(n=57) Legafl Justftd =e(1.3%) died.For 7.6%(n=36),the outcome was. senannl�tad = pint tions =48 (10.5%) reported to be unknown or the informa- tion was missing. FIRST Study;PmwnWn PMnun:Law entoreement data Data Sources' Ability to Figure 3 Capture Firearm Injuries and Deaths . There was a total of 613 ascertained Firearm Injury Rates by Intent and Outcome cases of firearm injuries and deaths. .contra costa county,July 1,1993-June 30,1994 Eighty-.eight point five percent of the n=528 Rate per 100,000 157 fatal firearm injuries and 71.6%of 40.0 the 456 nonfatal firearm injuries were 4 ONonfatal Fatal identifiable from police records.Sixty- 300 _ _ _ - _ _ - - _ eight point five percent of the nonfatal and 28.26/6"6f the fatal firearm injuries were identifiablefrom hospital data 20.0 - - - - - - - - - - - - - - - - - - - - - - (hospitali'zation records and emergency department records). For fatal firearm 12.7 injuries, coroner data were.theonly 10.0 - - - - - - - - - - - - - - - - - - - - - source from.which 100% of the cases 4.8 4.8 could be identified.Police records were 0.8 0.2 0.8 0.5 almost as comprehensive as coroner o,0 Assaultive SeHlnflicted Unintentional Legally Justified data, recording 88.5% of the fatal n=421 n=47 n=so n=to FIRST Study,Pnmntlon Pmgmm:Law entonmrnon%oomner,hosplwl,John Muir Medical Center data firearm injuries.Police records identified 71.5% of the total nonfatal firearm Figure 4 injuries and were better than emergency room records or hospital records for the identification of nonfatal cases(46.8% and 43.9%, respectively). However, when hospitalization data and emer- gency room data were combined,they identified 91% of nonfatal injuries. (Note: It should be mentioned that because reliability checks were not conducted to determine the accuracy of the reporting of firearm injuries and deaths by hospital staff and police _ departments to the FIRST System,some cases may have been overlooked during data abstraction.) Results and Analysis, Part I The FIRST Project Report 15 Age and Sex-specific Firearm Rates for Assaults and Homicides Adolescents and young adults are at highest risk for firearm assault and homicide.Adolescents and adults 15-24 Firearm Assault and Homicide Rates by Victim Sex years old accounted for over half of the Contra costa county,July t,1993-Jure 30,t 994 total assaults(51.1%)in which age was Rate Per 100,000 reported. For the study year, the age- mMale OFemale specific assault rate was highest for those m _ _ _ _ _ _ _ between the ages of 15 and 19 (137.1 64'4 per 100,000), followed by 20-24 year 00 - - - - - - - - - - - - - - - - - - - - - - olds (136.4 per 100,000). The firearm 50 - - - - - - - - - - - - - - - - - - - - - - assault rate decreased by more than half 40 - - - - - - - - - - - - - - for ages 25-29 and further decreased for , every age group 30 years and older.The 30 " " " - - - - - - " " " - -222 " " " " " - " age-specific homicide rate was highest for young adults ages 20-24 years(53.8 e per 100,000), followed by 25-29 year 10 31 - - - - - olds(30.6 per 100,000), 15-19 year olds ° ,assault Homicide (27.4 per 100,000)and 30-34 year olds (25.1 per 100,000). FIRST S".ProwmmnPmgmm:Law«,bte«nxdaeft Males in Contra Costa County were more likely than females to be victims Figure 5 of firearm assaults and homicides.The A differential also exists between These rates decreased by almost half for male assault rate was 64.4 per 100,000 national homicide rates for males and age groups 25-29 years and older. and the female assault rate was 8.2 per females(Mercy, 1993). a 100,000. Men were therefore eight17 Females ages 15-19 had the highest a times more likely to be victims of firearm Age and Sex firearm assault rate(14.3 per 100,000), assault than women.This sex differential while females 30-34 years old had the was also apparent for homicide, with When assaultive violence is examined highest homicide rate (11.4 per males nearly six times more likely than further by both age and sex,males ages 100,000). (See figures 6 and 7. See females to be victims of firearm 20-24 had the highest rates of firearm Appendices F and G for tables of rates.) homicide(22.2 per 100,000 and 3.8 per assault and homicide(253.6 per 100,000 100,000, respectively). (See figure 5.) and 100.0 per 100,000, respectively). 1 •v i 1 1i 16 The FIRST Project,Report Results and Analysis, Part I Firearm,Assault Rates by Victim Sex and Age Contra Costa County, July 1, 1993-June 30, 1994 n=310 300 ate per 100,000 250 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 200 - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - 150 - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - 100 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 50 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - B 0 4 25-29 3034-35,19 40 44 45.0 50-54 55-59 60-64 65-69 70-74 Age Group First Study,Prevention Program:Law enforcement data Figure 6 Firearm Homicide Rates by Victim Sex and Age Contra Costa County, July 1, 1993-June 30, 1994 n=111 120 Rate per 100,000 100 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 80 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 60 - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 40 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 20 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 0 0-04 5-09 10-714 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 Age Group FIRST Study,Prevention Program:Law enforcement data Figure 7 Results and Analysis, Part I The FIRST Project Report 17 ------------ Race/Ethnic-specific Rates for Firearm Assaults and Homicides Although the African American population comprised only 9.2%of the total Contra Costa population in 1994, Firearm Assault and Homicide Rates by Victim's Race/Ethnicity African Americans were victims of Contra Costa County,Juy1,1993-June 30,1994 65.2% of the assaults and 64% of the n=421 homicides experienced in Contra Costa Race per 100,000 County for the study year. African - - - - - - - - - - - - - - - -oAssauRHomicide Americans had the highest assault and „, 251.2 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - homicide rates(251.2 per 100,000 and - - - - - - - - - - - - - - - - - - - - - - - - 88.3 per 100,000, respectively). (See '°° - - - - - - - - - - - - - - - - - - " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - figure 8.) Latinos comprised 12.4% of ,,, - - - - - - - - - - - - - - - - - - - - - - - - - the population and accounted for 12.6% _ _ _ of all assaults and homicides.Latinos had ,0 -8e.3 - - - - - - - - - - - - - - - - - - - - - - the second highest assault and homicide b - - - - - - - - - - - - - - - - - - - - - - - a rates (36.0 per 100,000 and 12.9 per b - - - - - - - - - - - - - - is- - - - 100,000, respectively). Asians/Other, m t2.9 _ - �.s - 3.s 4.3- a who comprised 11%of the population, African American Lejno whim Asian/Other had assault and homicide rates of 16.0 Race/Ethnicity per 100,000 and 4.3 per 100,000, FIRST Study.Praysntlon Program:Law anbm reemrt data respectively.Whites,who made up 68% of the population, had assault and Figure 8 . homicide rates of 8.5 per 100,000 and 3.6 per 100,000, respectively. The African American firearm assault rate Firearm Homicide Rates by Victim Race/Ethnicity and Victim Sex Contra Costa CourlyJuy1,1993-June 30,1994 was approximately seven times the Rate per 100,000 n=111 Latino rate and thirty times that of -A Whites, who had the lowest firearm 180.0i68.9- - 0 - - - - - - - - - - - - - - - - - - Male oremale ! - assault rate. 180.0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - When assaults and homicides were combined,African American males were 100 - thirteen times more likely to be a victim 12010 - - - - - - - - - - - - - - - - - - - - - - - - - - - - o f assaultive firearm violence than 100.0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - White males (349.4 per 100,000 and 00.0 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 26.4 per 100,000 respectively). Latino males had the second highest rate of 1 firearm assaults and homicides com- '0° - 21s bined(97.4 per 100,000), followed by 1- _ _ _ ss l Ano - - - - - - - - - - - - - - - 4.9 - - - - Asian/Other males(41.1 per 100,000), oa African American Latino AsiaNOther White and White males(26.4 per 100,000). Race/Ethnicity FIRST Serdy,Prwwdbn Program:Law enforcamerd data Sex and Race/Ethnicity Figure 9 All race/ethnic-gender groups had higher assault rates than homicide rates, figure 9.) These rates were followed by 14.1 per 100,000,and homicide,4.9 per except for Latino females, who were Latino males(assault,68.5 per 100,000, 100,000). Latino females had a firearm 4 twice as likely to be killed than assaulted and homicide, 21.6 per 100,000), homicide rate of 3.8 per 100,000 and a with a firearm.The assault and homicide African American females(assault,68.5 firearm assault rate of 1.9 per 100,000. rate of African American males was per 100,000, and homicide, 16.8 per White females had an assault rate of 3.3 higher than any other race/ethnic- 100,000), Asian/Other males (assault, per 100,000 and a homicide rate of 2.3 gender group (467.1 per 100,000 and 30.3 per 100,000,and homicide,6.5 per per 100,000. Asian/Other females had 168.9 per 100,000, respectively). (See 100,000), and White males (assault, an assault rate of 2.0 per 100,000 and a 18 The FIRST Project Report Results and Analysis, Part I i Firearm Assault Rates by Victim Age and Race/Ethnicity Contra Costa County, July 1, 1993-June 30, 1994 n=310 1000 Rate per 100,000 900 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 800 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 700 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - 600 - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - 500 - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - 400 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 300 - - - - - - - - - - - - - - - - - - - - --- - - - - - - 200 - - - - - - - - - - - - - - - - - - - - - 100 - - - - - - - - - - - - - - - - 0 11 A 0-04 5-0910-1415-19.20-2425-2930-3435-394044454950-5455-5960-6465-6970-7475-79 Age Group 1-�-African American -e-Latino -x-Asian/Other -*-Wh7fte] FIRST Study,Prevention Program:Law enforcement and coroner data Figure 10 homicide rate of 2.0 per 100,000. African-Americans ages 20-24 had the ethnic groups.Latino males ages 15-19 highest homicide rate (400.7 per (311.2 per 100,000) had the highest Age and Race/Ethnicity 100,000) of all age-ethnic groups. assault rate among all non-African Among Latinos,35-39 year olds had the American males. Among females of all African Americans ages 20-24 had the highest homicide rate (51.9 per age-ethnic groups, African American highest assault rate(865.4 per 100,000) 100,000); among Asians/Other, 15-19 females ages 15-19 had the,highest among all age-race/ethnic groups, year olds had the highest homicide rate assault rate(213.8 per 100,000). followed by African Americans 15-19 (27.8 per 100,000);and among Whites, African-American males ages 20-24 years old (812.6 per 100,000). (See 25-29 year olds had the highest had the highest homicide nate (742.1 figure 10. See Appendix H for table of homicide rate(10.2 per 100,000). per 100,000) among all age-sex-race/ rates.) ethnic groups.Latino males ages 30-34 Among Latinos, young Latinos ages Age, Race/Ethnicity had the highest homicide rate(78.0 per 15-19 had the highest assault mte(175.7 and Sex 100,000) among all non-African per 100,000).Among Asians/Other and American males.Among females of all Whites, those ages 25-29 had the African Arnefican males 20-24 years age-ethnic groups, African American highest assault rates(86.0 per 100,000 old had the highest assault rate(1,613.3 females ages 20-24 had the highest and 20.3 per 100,000,respectively). per 100,000) among all age-sex-race/ homicide rate(63.7 per 100,000). Results and Analysis, Part I The FIRST Project Report 19 Firearm Assaults and Homicides by City and County Region Assault Assault and homicide rates were Firearm Assaults by County Region calculated for cities(incorporated areas) contra costa County,July 1,1993-June 30,1994 and unincorporated areas in Contra Costa County.The majority of firearm n=310 assaults occurred in the city of central 4.5% Richmond (60.3%), which is part of West Contra Costa County.The unin- ? East corporated area of North Richmond, 1x.196 also in West County, had the highest K firearm assault rate(553.9 per 100,000), southo% j followed by Richmond (201.8 per 100 000),the city of San Pablo in West County(126 per 100,000),the unincor- porated area of Rodeo in West County West (52.6 per 100,000),the unincorporated 79.396 area of Bay'Point in East County(51.6 per 100,000), the city of Pittsburg in FlRWS",PrewntbnPMramtewonbrcennMdata East County(37.4 per 100,000),and the city of Antioch in East County(22.1 per Figure 11 100,000). Please see Appendix I for assault and homicide rates for incor- porated and unincorporated areas of Contra Costa County. Firearm Assault and Homicide Rates by County Region Contra Costa county,July 1,1993-June 30,1994 Homicide n=421 The majority of firearm homicides 140 Rate per 100,000 OAssauft MHorn Ido occurred in Richmond(42.3%, n=47). 120 112.8 - - - - - - - - - - - - - - - - - - - - - - - - - The areas with the highest firearm homicide rates in Contra Costa were t00 - - - - - - - - - - - - - - - - - - - North Richmond(639 per 100,000),the so - - - - - - - - - - - - - - - - - - - - - - - - - unincorporated area of Bethel Island in East County (94.6 per 100,000), Richmond (50.7 per 100,000), San ,a 38.8 Pablo (49.7 per 100,000), the city of Brentwood in East County (19.1 per20 13.3 42 1.8 p 1.1 100,000),Antioch(11.1 per 100,0000), p and the unincorporated area of El Wast East central South Sobrante in West County (10.2 per FWWsn*,P,,„nwnProgm LikwwdorownemddR 100,000). i Assault and Homicide Figure 12 When assaults and homicides were per 100,000), Bethel Island (94.6 per County (79.4%, n=246). East County taken together, people in North 100,000),Bay Point(74.5 per 100,000), accounted for 16.1%(n=50)of firearm Richmond were found to be most at risk Rodeo (52..7 per 100,000), and assaults, followed by Central County for assault or homicide, with an Brentwood(38.2 per 100,000). with 4.5% (n=14)of the total assaults. assaultive firearm injury rate of 1 193 per The Southern region did not experience 100,000. Other areas with high Region any firearm assaults during the study assaultive rates include: Richmond The greatest proportion of firearm year. (See figure 11.) (253.6 per 100,000), San Pablo (175.6 assaults occurred in West Contra Costa West County had the highest assault 20 The FIRST Project Report Results and Analysis, Part I rate, 112.6 per 100,000, followed by East County (30.3 per 100,000); and Central County(4.2 per 100,000).(See Assaultive Violence Rate, Poverty Level figure 12.) and Unemployment by Region ItCounty,Ju West County had the highest ntraCosaouny, yt,tss3-Juneao,lssa n=421 proportion of firearm homicides County Reglon (73.0%), followed by East County 151.5 (19.8%), Central County (5.4%), and West 11.7 South County(0.9%). Homicide rates 72 calculated by region revealed that West 43'6 East 9.5 County had the highest homicide rate 6.7' (38.9 per 100,000), followed by East 6 County (13.3 per 100,000), Central central 4.7 County (1.8 per 100,000), and South 3A Assaultive Rate County(1.1 per 100,000). 1.6 t•t 1 1 0%Below Poverty South I �� , ®%Unemployment City of Shooting and 2.6 0 20'I 40 60 60 100 120 140 160 160 Victims Residence FIRSTsn,dy,PrwentbnProgmm:Law enbreementdatkINOCensus The majority of firearm assaultand homicide victims (67.4% and 59.5%, Figure 13 respectively) were shot in the city in the third highest unemployment rate (assaultive rate, 74.5 per 100,000; which they lived.Twenty percent of the (3.4%), which correlate to having the poverty rate, 13.9%; unemployment assault victims and 15.3% of the third highest regional assaultive violence rate,8.3%),Rodeo(assaultive rate,52.7 homicide victims were shot in a -rate (6.0 per 100,000). South County per 100,000; poverty rate, 9.2%; neighboring city, 6.5% of the assault had the lowest percentage of people unemployment rate, 5.1%), and victims and 19.8% of the homicide living below the poverty level (1.8%) Pittsburg (assaultive rate. 47.3 per victims had no known residence or other and the lowest unemployment rate 100,000; poverty rate, 10.8%; address.The remainder,4.2%of assault (2 6%), which correlate to having the unemployment rate, 7.1%) are other and 5.4%of homicide victims,were shot lowest assaultive violence rate(1.I per areas that exemplify the correlation in a city thatwas not a neighboring city, 100,000) among the four county between high assaultive, poverty and i.e., a city that does_not share borders regions:(See figure 13.) unemployment rates. (Please see with their city of residence. There.was also a correlation between Appendix L) the percentage of people living in It must be noted that the Bureau of Poverty and poverty, the unemployment rate, and Census determines just one poverty Unemployment the assaultive firearm injury rate of threshold for the entire nation. Al- individual cities and unincorporated though this threshold is updated each In numerous studies,violence has been areas in Contra Costa County. Cities year based on the consumer price index, shown to be statistically associated with and unincorporated areas with the it does not take into account the low socioeconomic status or poverty. . highest assaultive rates also had the differences in living costs among West County had the highest propor- highest percentages of people living localities throughout the United States. tion of people living below the poverty below the poverty level, as well as the Depending on the locality,the poverty level (11.7%) and the highest unem- highest unemployment rates. North threshold is considered by some critics ployment rate(7.2%) of any region in Richmond had the highest assaultive to be too low or too high.Based on the the county This correlates with West rate (1 193 per 100,000) among all very high cost of living in the Bay Area, County having the highest assaultive localities in the county,and also had the the 1990 Bureau of Census poverty firearm injury rate (assaults and homi- highest percentage of people living threshold may havetherefore been an cides combined, 151.5 per 100,000). below the poverty level(52.8%)and the underestimate of the true poverty levels East County had the second highest highest unemployment rate (29.0%). experienced by the residents of Contra proportion of people living below the Richmond had the second highest Costa County.It is extremely likely that poverty level (9.5%) and the second assaultive rate(253.6 per 100,000),with Contra Costa County regions,cities and highest unemployment rate(6.7%),and 16.1% of its population living below unincorporated areas have higher experienced the second highest poverty and an unemployment rate of percentages of people living below the assaultive injury rate in the county(43.6 9.5%. San Pablo had an assaultive rate poverty threshold than the percentages per 100,000). Central County had the of 175.6 per 100,000,with 19.0%of its obtained from the 1990 Census,which third highest percentage of people liv- people living below poverty and an are used here. ing below the poverty level(4.7%)and unemployment rate of 10.2%.Bay Point Results and Analysis, Part I The FIRST Project Report 21 1 1 Firearm Assaults and Homicides by Gun Caliber The most commonly reported caliber used in firearm assaults was 9mm (21.9%,n=68),followed by.380 caliber Firearm Assaults by Gun Caliber (8.1%,n=25),.22 caliber(6.1%,n=19), Contra Costa County,July 1,1993-June 30,1994 .25 caliber (5.2%, n=16), and .38 n=310 Special(4.5%,n=14).The gun's caliber was unknown for 39.0% of shooting unknown 121 assaults. (See figure 14.) 9mm se The caliber most commonly reported •380 cal 2s in firearm homicides was 9mm(37.8%, 22 cal 19 n=42), followed by .38 Special (7.2%, Other 25 cal js16 ; n=8)and.22 caliber(5.4°x6, n=6).The �g � 1h Pec firearm caliber was reported as unknown .357 Magnum 10, , in 30.6%of homicides.(See figure 15.) BB 7 For homicides and assaults combined, .45 cal 7 the caliber most commonly reported 12 gauge s was 9mm(26.1%,n=110),followed by Pellet 2 .380 cal (6.9%, n=29), .22 cal (5.9%, 0 20 40 60 so 100 120 140 n=25), .38 Special (5.2%, n=22) and FIRST SU*,Prevention Program Lawenbrcemantdaft other(4.8%,n=20).The firearm caliber was unknown in 36.8% (n=155) of Figure 14 homicides and assaults. Firearm Homicides by Gun Caliber Firearm Assaults cornracastacoumy,July 1,,993-June 30,,994 and Homicides 9rnm42 Unknown 34 by Gun Type .38 special .22 Cal More than two-thirds(67.1%,n=208) s ; of firearm assaults were committed with .25 cal a ; handguns. Of the handguns used in .3eor� 4 ; these assaults, 70.2% (n=146) were , semiautomatics, 18.8% (n=39) were .as eal a revolvers,and 11.1%(n=23)were of an other 4 unknown type. Airguns (BB and pellet .357 Magnum 3 ; guns) were used in 4.2% of assaults (n=13), rifles in 3.2% (n=10), and 12 gauge 2 shot 2.6% n=8). The a of o 10 20 30 ao so 13uns in ( typ RBST Study.Prevantlon Program:Lew snbnxmerd dem gun used for 22.9% (n=71) of assaults was reported as unknown. (See figure Figure 15 16.) More than three-fourths of all type.Shotguns were reported to be used by the police,the type of firearm used homicides (76.6%, n=85) were in 3.6%and rifles in 2.7%of homicides. can sometimes be inferred from the committed with handguns. Of the The type of gun used was unknown in evidence at the crime scene, witness handguns used in homicides, 70.6% 17.1%of homicides. (See figure 17.) accounts or a coroner's investigation. were semiautomatics,20.0%revolvers, Note: Although a gun used in a See Appendix M for gun type j and 9.4%were of an unknown handgun shooting may not have been recovered illustrations. i 22 . The FIRST Project Report Results and Analysis, Part I Firearm Assaults by Gun Type Contra Costa County,July 1, 1993-June 30, 1994 rtiMeu l 10 34 ) — - — — — — — — — Unknown =23(11.1%) Shotgun -a(Z.6%) Revohrer=39 (18.8%) n =208(67.1%)- . Unknown =71 (22.9% Semlautomaft =146(70.2%) . Total assaults (n=310) Handgun types (n=208) FIRST Study,Prevention Program:Law enforcement data Figure 16 Firearm Homicides by Gun Type Contra Costa County, July 1, 1993-June 30, 1994 Rifle — — — — — — — — — — _ (n=3) 2.7% Unknown (n=8) 9.4% Revolver (n=17) 20.o% Unknown Handgun (n=19) 17.1% (n=85) 76.6% Semlatrto (n=60) 70.696 Shotgun — (n=4) 3.6% — Total Homicides Handgun Types (n=111) (n=85) FIRST Study,Prevention Program:Law enforcement data Figure 17 Results and Analysis, Part I The FIRST Project Report 23 Firearm Assaults and Homicides by Victim-Offender Relationship More than half of all victim-offender relationships for homicides and assaults were reported to local law enforcement Firearm Assaults and Homicides by Victim-Offender Relationship agencies as being unknown or missing contra costa county,Juy 1,1993-June 30,1994 (59.5% for homicides and 50.6% for n=421 assaults). The lack of data on the50.6% relationship of victim to offender may unknown ;59.5% be accounted for by: 1) victim and 25.2% Acquaintance 21.5%' witness reluctance to provide this infor- , mation to police because they feared to.a% 21.5%- Stranger ' ' retaliation, distrusted the police, or , preferred to handle the situation on their Family/Non-Spouse 1.3% own,or 2)witnesses or victims may not 3.6%,6% have seen or known who shot them. spouse/lover 0.6% Similar surveillance projects done 4.5% uft nationally as well as locally have found Other 096% ; oAs� � � �Homicfrnid de comparable percentages of missing data for victim-offender relationship. o% 10% 20% 30% 40% 50% 60% 70% National studies show that in MSTS'"'Pre°°""D°Pignun: `VVenbn ntd°m homicides where offenders were reported as being unknown, the offen- Figure 18 ders were most likely to be strangers did not want to reveal the offenders' reported, a person was more likely to because murders between intimates are identity. Therefore, in many firearm be shot by an acquaintance (25.2% of usually solved or cleared up and the assaults where the victim-offender assaults,21.6%of homicides)than by a offenders identified. However, anec- relationship was reported to be stranger (21.6% of assaults, 10.8% of dotal information from police reports unknown,the offenders are believed to homicides). More homicides (4.5%) indicates that in most nonfatal firearm be acquaintances. than assaults (0.6%) were reported to assaults, the victims or witnesses may For assaults and homicides where the have been committed by a current or have known who the offenders were but victim-offender relationship was ex-spouse/]over.(See figure 18.) 24 The FIRST Project Report Results and Analysis, Part I Firearm Assaults and Homicides by Victim- Offender Relationship and Victim Sex As previously mentioned, the victim and offender relationship was reported as"unknown"for the majority of firearm' Firearm Assaults by Victim-Offender Relationship and Victim Sex assaults and homicides.When analyzed contra costa county,July 1,1993-June 30,1994 by sex, data on victim-offender n=310 relationships for assaults were missing 51.696 in 43.2% of female victim cases and unknown 432% 51.6%of male victim cases. 24.296 Acquaintance 32.4%, Assaults Stranger 21.996; ; 16.9% The most frequently reported victim- o% offender relationship for both male and spouse/Lover 5.4% ; female firearm assault victims was that Family/Non-Spouse Spouse o%5% of acquaintance.A higher proportion of =aLlfemales, 32.4% (n=12) than,males Other o.a7% (24.2%, n=66) were assaulted by o% acquaintances. This was followed by 096 10% 20% 30% ao% 50% so% assault by a stranger(21.9% for mates FIRST Su ,P,e"n"°nP`9mm:Law erdomnwrytd"a and 18.9%for females).(See figure19.) In law enforcement reporting,if more Figure 19 than one person is suspected of shooting the victim or if the primary offender is unknown,a second offender is.listed.In Firearm Homicides by Victim-Offender Relationship and Victim Sex approximately one quarter(24.3%) of contra costa county,July 1,1993-June 30,1994 firearm homicides and one fifth(20.3%) n=111 of firearm assaults, more than one unknown 61.7% person was suspected of shooting the 47.1% victim. These figures do not include 25 % persons suspected of having been Acquaintance o% ; involved in the crime but not of shooting the victim. Spouse/Lover 0% Homicides 9.2%; Family,Non-Spouse ' The victim-offender relationship was unknown or missing in a large percen- 9.6% Male tage of male and female homicides stranger 176% oFemale (61.7% and 47.1%, respectively). o% 10% 20% 30% 40% 50% 60% 70% Females were more at risk for being FlRSTSwdy,PmwnllonPmpam:Lawanb"n*ntdata killed by a current/ex-spouse/lover (29.4%, n=5) than males (0.0%). In Figure 20 contrast, males were more likely to be killed by an acquaintance(25.5%,n=23) than females(0.0%). (See figure 20.) Results and Analysis, Part I The FIRST Project Report 25 Firearm Assaults and Homicides by Victim-Offender Relationship and Victim Race/Ethnicity Information on victim race/ethnicity 28.2% (n=1 1) of Latino victims, and 23.8% (n=5) of White victims. Being and victim-offender relationship was 13.9% (n=28) of African American killed by a stranger was the second missing or unknown for a large number victims.Acquaintances were reported to leading type of relationship reported for of assaults and homicides.Where data have assaulted 26.7% (n=4) of Asian/ African American and White victims, were available, being assaulted by a Other victims, 30.0%(n=15)of White while being shot by a spouse or a family stranger was the most frequent victim- victims, and 23.1% (n=9) of Latino member was the second most frequent offender relationship reported by all victims. relationship reported for Latino victims. race/ethnic groups except for African Acquaintance was also the most For Asians/Other, only two homicides Americans, who were more often frequently reported victim-offender were reported in which the victim- assaulted by acquaintances (23.8%, relationship for firearm homicides. offender relationship was known (one n=48).Strangers were reported to have Acquaintances shot and killed 22.5% was killed by a spouse and the other was assaulted 53.3% (n=8) of Asian/Other (n=16) of African American victims, killed by a stranger). victims,38.0%(n=19)of White victims, 21.4% (n=3) of Latino victims, and Firearm Assault Rates by Victim Race/Ethnicity and Offender Sex and Race/Ethnicity Assault victims tend to be shot by Other, 33.3% were shot by African 2.6% (n=8) of the assaults reported. offenders from the same race/ethnic Americans, 20% (n=3) were shot by Females committed assault at a rate of background.Among African American offenders of unknown ethnicity, and only 1.8 per 100,000, in contrast to firearm assault victims,62.2%(n=125) 6.7%(n=1)each were shot by a White males,who committed assault at a rate. were assaulted by African Americans; and a Latino. of 49.3 per 100,000, a rate 27.4 times 32.8% (n=66) were assaulted by When rates were calculated by sex and higher. When females committed offenders of unknown race/ethnicity, ethnicity,African American males were assault, their victims were 2.5% (n=5)were assaulted by Whites, found to have the highest offender- predominantly males(62.5%,n=5)than and 2.5% (n=5) were assaulted by assault rate, 398.5 per 100,000. This females(37.5%, n=3). Males assaulted Latinos. high offender-assault rate means that more than seven males (88%, n=184) Among Latino assault victims,43.2% African American males were also being for every female they assaulted. (n=16) were shot by Latinos, 32.4% victimized at a high rate. They were (n=12)were shot by African Americans, followed by Latino males (50.5 per 21.6%(n=8)were shot by offenders of 100,000), African American females unknown ethnicity, and 2.7% (n=1) (14.4 per 100,000),Asian/Other males were shot by Whites. (13.0 per 100,000), White males (8.1 Among White assault victims, 36.0% per 100,000)and White females(6.7 per (n=18) were shot by Whites, 26.0% 100,000). The order of rates by race/ (n=13) were shot by offenders of ethnicity and sex are similar to-victim- unknown ethnicity,30.0%(n=15)were assault rates. shot by African Americans,6.0%(n=3) Although females comprised more were shot by Latinos, and 2.0% (n=1) than fifty percent of Contra Costa's were shot by Asians/Other. population in 1994 and accounted for Among Asian/Other assault victims, 11.9%(n=37)of the assault victims for 33.3% (n=5) were shot by Asians/ the study year, they committed only 26 The FIRST Project Report Results and Analysis, Part I Firearm Homicide Rates ,by Offender Sex and Race/Ethnicity As with assaults, homicide victims killed by an offender of unknown race/ per 100,000;African American females, were likely to be killed by offenders of ethnicity. 4.8 per 100,000;Asian/Other males,4.3 the same race/ethnic background. Sex and race/ethnicity were reported per 100,000;and White males, 4.2 per Among African American homicide as unknown for more than one-third 100,000. These rates should be victims, 57.7% (n=41) were killed by (34.5%, n=38) of homicide offenders. interpreted with caution since over one- African Americans,while the offenders This may be because the suspect was third of the data was missing for both race/ethnicity was reported as unknown still under investigation when the police sex and race/ethnicity of suspect. for the remaining victims (42.2%, abstracted information from crime or Although females comprised more n=30). supplemental reports onto FIRST than fifty percent of Contra Costa's Among Latino homicide victims, reporting forms. For homicides where population in 1994 and accounted for 64.3% (n=9) were killed by Latinos, the suspect's sex and ethnicity were 15.3% (n=17)of the homicide victims 28.6%(n=4)by African Americans,and known. African American males for the study year, they were reported 7.1%(n=1)byWhites. committed 40.9% (n=45) of the to have committed only two homicides Among white homicide victims, homicides, followed by White males (1.8%)where the victim was male and 52.4% (n=11) were killed by Whites, (10.9%, n=12), Latino males (9.1%, one(0.9%)where the victim was female. 33.3% (n=7) were killed by offenders n=10),Asian/Other males(1.8%,n=2) Females committed homicide at a rate of unknown race/ethnicity,9.5%(n=2) and African American females (1.8%, of 0.4 per 100,000,in contrast to males were killed by African Americans, and n=2). who committed homicide at a rate of 4.8% (n=1)were killed by Latinos. When rates were calculated for 16 per 100,000, or 40 times that of Among Asian/Other homicide victims, available data,African American males females. Males killed other males 50.0% (n=2) were killed.by Asians/ were.found to have the highest (84.3%, n=59) more than they killed Other, one was killed by an African homicide-offender rate, 118.8 per females(15.7%, n=11). American, and the other victim was 100,000;followed by Latino males, 18.0 Results and Analysis, Part I The FIRST Project Report 27 Firearm Assaults and Homicides by Shooting Location Assaults and homicides committed with a firearm were most likely to occur on a street, parking lot, or sidewalk. Firearm Assaults and Homicides by Shooting Location Over one-third (36.1%, n=1 12) of Contra Costa County,July 1,1993-June 30,1994 assaults occurred on a street,parking lot, n=421 or sidewalk,while 24.3%of homicides (n=27)occurred at these locations.This street/Lot/sidewalk 24.3% '�% was followed by being assaulted(18.7%, 1e.�% n=58) or killed (21.6%, n=24) in a Other Residence 21 6% , residence other than the victim's(or in 14.8% the yard or driveway of this residence). victim's Home 1i 4% The victim's home was the location of 12.8% ; Car 14.8% (n=46) of assaults and 17.4% 15.3% (n=19)of homicides. (See Figure 21.) store17.1% Inside a car was where 12.8% (n=40) of assaults and 15.3% (n=17) of other �^ 7.2% �Homidde homicides were committed.Stores were the location of 7.1%(n=22)of assaults. 0% 10% 20% 30% 40% 50% There was a slightly higher proportion FIRST St*,PreyentbnPmymm:lawenfomementdaft of fatalities occurring in closed-in areas such as houses or cars than in more open Figure 21 street, parking lot, or sidewalk areas. This may be due to the proximity of the offender to the victim inside houses and' can,where more shootings are done at close range. Firearm Assaults and Homicides by Shooting Circumstances The shooting circumstances categories shot by offender who fired gun from a unknown (11.5%, n=48),victim in car were based on police reports of the motor vehicle; (d) victim indoors: (6.0%,n=25),other(4.3%,n=18),and immediate circumstances of,and not the shooting occurred indoors;not a drive- indoors(2.9%, n=12). actual reason for,a shooting.Although by and no conflict apparent;(e)robbery: For assaults, a person was most likely police are seldom able to determine a shooting occurred during robbery or to be shot and injured while walking, single reason for a shooting, most attempted robbery; (f)victim walking, standing,or bicycling outdoors(24.8%, firearm homicides and assaults are standing, or bicycling: not a drive-by, n=77), during a drive-by (20.3%, believed to be acts of retaliation or and no conflict apparent (victims n=62), during an argument or fight intimidation rather than random gunfire. wishing to avoid police involvement (19.4%, n=59), during a robbery Categories into which shooting often described shooting incidents in (13.5%,n=42),circumstances unknown incidents are classified are:(a)argument this way);(g)other;and(h)unknown. or missing(7.1%,n=22),while in a car or fight, verbal or physical: conflict The circumstances that immediately (6.8%, n=21), other circumstances occurred at time of shooting(not used preceded the shootings were reported (3.5%, n=11), while indoors (3.5%, if shooting was in retaliation to a to police agencies. For both assaults and n=10), or under drug-related previous conflict); (b) victim in a car: homicides, walking, standing, or circumstances (1%, n=3). (See figure not a drive-by,and no conflict apparent; bicyclingwas the shooting circumstance 22.) (c) drug crime: not a drive-by, and reported most frequently (21.3%, For homicides where circumstances primary reason for shooting known to n=89), followedby argument/fight were reported, the order of frequency be drug-related; (d) drive-by: victim (20.1%,n=84),drive-by(18.5%,n=77), of occurrence was as follows:during an 28 The FIRST Project Report Results and Analysis, Part I argument or fight (22.5%, n=25),. during a drive-by(14.4%,n=15)',while walking,standing,or bicycling(10.8%, Firearm Assaults and Homicides by Shooting Circumstances n=12), other circumstances (6.3%, Contra Costa County,July 1,1893-June 30,1994 n=7), during a robbery (5.4%, n=6), n=421 while in a car(3.6%,n=4),under drug- Unknown 7.1%, related circumstances(1.8%,n=2),and 3 3.3% while indoors(1.8%, n=2). (See figure WalkingxMMMMMM11_'0_ , 24.e% 22.) Drhm-by as.4% =3% m , For some victims shot while walking Arguent(Flght 40.4%2ZS or in a drive-by shooting, an argument Robbery s.4% +a.s% or confrontation could have occurred one or two days prior to the shooting, In Car �a+� but the shooting circumstance reported Indoors to law enforcement refers to what the other eax OAssatdt victim was doing immediately preceding Drug Crime the shooting. Shooting circumstances. were 0% s% 10% 15% 20% 25% 30% 35% 40% unknown or missing for 33.3% of the FIRST.Slticly.Pwnntbn Imrm:I"enfomenwntdata homicides. By comparison, only 7.1 of the nonfatal assaults reported the Figure 22 circumstances to be unknown or missing. This large difference may be due to the fact that homicide victims, being dead, are unable to relate what they were doing prior to the shooting. Firearm Assaults by Shooting Circumstances and Victim Race/Ethnicity Of the 202 African American firearm victims,the largest proportion was shot victims were shot while walking, assault victims, the highest proportion in arguments or fights (30.0%, n=15) standing or bicycling(23.1%, n=9), in was shot while walking, standing, or and in drive-bys (24.0%, n=12). The drive-bys (20.5%, n=8), during bicycling(22.9%,n=46); 17.8%(n=36) remaining victims were shot during robberies (15.4%, n=6), in other of African American assault victims were robberies(18.0%,n=9),while walking, circumstances (10.3%, n=4), and in shot in drive-bys, 15.3%(n=31)during standing or bicycling(12.0%,n=6),in unknown circumstances(5.1%,n=2). arguments or fights, 11.9% (n=24) other circumstances(6.0%,n=3),inside Of the 11 Asian/Pacific Islander during robberies, 9.4% (n=19) in cars, cars (4.0%, n=2), during.a drug crime firearm assault victims, more than half 5.4% (n=11) indoors, 1.0% (n=2) (2.0%, n=l), and in unknown were shot in drive-bys (54.5%, n=6). during drugcrimes, 1.5%(n=3)in other circumstances(4.0%,n=2). The remaining were shot while walking, circumstances, and 8.4% (n=17) in Of the 39 Latino victims, more than standing, or bicycling (18.2%, n=2), unknown circumstances. one-fourth(25.6%,n=10)were shot in during an argument or fight (9.1%, Among the 50 White firearm assault arguments or fights. The remaining n=1), during a robbery(9.1%), and in other circumstances(9.1%). Results and Analysis, Part I The FIRST Project Report 29 Firearm Assaults and Homicides by Shooting Circumstances and Victim Sex Assaults The circumstances surrounding Firearm.Assaults by Shooting Circumstances and Victim Sex firearm assaults varied when data were contra costa county,July 1,1893-June 30,1994 stratified by sex. Most males were n=310 assaulted with a firearm while walking, Walking standing, or bicycling(26.7%, n=73), 1o.e% while only 10.8% (n=4) of women Argument 13.5% assault victims were shot in similar Dfire-by e.3 13S.1% circumstances. Women were most Robbs 14.7% Robbery 5.4% frequently assaulted in drive-by shootings (35.1%, n=13), compared Ind a.1% with 18.3%(n=50)of men shot during Unknown 7.3% ; 5.4% , drive-bys.Arguments were the second Other 3.3% leading circumstance in assaults on men Indoors 1.6% 1s.2 �M�e (20.1%, n=55) and the third leading Drug came 1.1% aFernale circumstance in assaults on women (13.5%, n=5). One in seven males o% 10% 20% 30% 40% (14.7%, n=40) and one in twenty FIRST Study,Pre"redon Program:tawentorvementdata females (5.4%, n=2) were assaulted during robberies. Only 1.8% (n=5) of Figure 23 males were assaulted indoors,compared with 16.2% (n=6) of females; 6.6% (n=18)of male victims and 8.1%(t1=3) of female victims were shot in cars.(See Firearm Homicides by Shooting Circumstances and Victim Sex Figure 23.) Contra Costa County,July 1.1993-June 30,1994 n=111 Homicides Unknown 41.2% Argument 2%, Shooting circumstances were Arg ' Drive-by 1796 unknown or not reported for 31.9%of 12.1% male and 41.2% of female homicide walks 12.8%victims.Where the circumstances were Robberys.9%known, the majorityof males (22.3%, ;n=21)and females(23.5%, n=4)were �1ef 176% shot and killed during arguments or to cars 9%fights. Males were killed in drive-by Drug crime shootings (17.0%, n=15), while Indoors oFemale walking,standing,or bicycling(12.8%, 5.8' o% 10% 20% 30% 40% 50% n=12),during robberies(5.3%,n=5),in FIRST Study.PmontlonProgmm:lawenbreemerddeta other circumstances(4.2%,n=4),while inside cars (3.2%, n=3), during drug Figure 24 crimes(2.1%, n=2),and while indoors n=1). No women were killed in drive-by shootings,during drug crimes,or while walking,standing,or bicycling.Women were killed in other circumstances (17.6%, n=3), while indoors (5.9%, n=1),while in a car(5.9%),and during a robbery(5.9%). (See Figure 24.) 30 The FIRST Project Report Results and Analysis, Part I Firearm Homicides by Shooting Circumstances and Race/Ethnicity Circumstances surrounding these racial groups.Large amounts of data are American, 28.6% (n=6) of White, and shootings must be carefully interpreted missing due to law enforcement 42.9%(n=6)of Latino homicide victims because a large proportion of the data agencies not knowing or reporting the were reported to be engaged in was missing for each of the race/ethnic circumstances surrounding,a shooting arguments or fights before being shot groups. Unknown or missing circum- incident, and the deceased not being and killed. stances were reported for 37.2%(n=26) present to report the circumstances. African Americans were killed in drive- of African American firearm homicide For homicides where the shooting bys (17.1%, n=12) more often than victims, 38.0% (n=8) of Whites, and circumstances were reported,arguments Whites,(9.5%, n=2). Eleven African 14.3% (n=2) of Latinos. Due to the or fights were the most frequent American homicide victims (15.7%) small numbers reported for each cir- circumstance that preceded homicides were shot while walking, standing or cumstance,caution_must be used when on African Americans, Whites and bicycling, and three were killed while comparing frequencies across ethnic/ Latinos: 18.6% (n=13) of African inside cars(4.3%). . Firearm Type and Shooting Circumstances Assaults 4.3%in unknown circumstances. circumstances (29.5%, n=5), in other When airguns were used in assaults, circumstances (11.8%, n=2), during a When semiautomatics were used in 61.5%(n=8)were used when the victim I robbery (5.9%, n=1), during a drug assaults, 25.3% (n=37) were used in was walking, standing or bicycling, crime(5.9%),and while the victim was drive-by shootings,20.5%(n=30)were 15.4%(n=2)in drive-by assaults,7.7% walking(5.9%). used during arguments, 17.1% (n=25) (n=1) during an argument, 7.7% When handguns of unknown type when the victim was walking,standing outdoors, and 7.7% in other were used in homicides,they were used or bicycling, and 15.1% (n=22) in circumstances. to kill victims in cars(37.5%, n=3), in .robbery assaults. The remaining Next to a shotguns,rifles were the least unknown circumstances(25.0%,n=2), semiautomatics were used on victims frequent weapons used in assaults.Three during an argument(12.5%, n=1), in a inside cars(8,2%,n=12),indoors(4.1%, people were shot with rifles in drive-by drive-by shooting (12.5%), and while n=6), during drug crimes(1.4%, n=2), shootings, three were shot while the victim was walking, standing or and in other circumstances(0.7%,n=1). walking, standing or bicycling, two bicycling(12.5%). Semiautomatics were used in 10 assaults were shot while indoors,and two were Shotguns were used to kill victims (6.8%) where the circumstances were assaulted in other circumstances. during arguments (n=3) and in one unknown. unknown circumstance.Rifles were used When revolvers were used in assaults, Homicides to commit homicides during an they were most likely to be used during argument(n=1), indoors(n=1),and in arguments (43.6% n=17), followed by When semiautomatics were used in unknown eircumstances(n=1). assaults on victims who were walking, homicides,23.3%(n=14)were used in See Appendix M for gun type standing or bicycling (25.6%, n=10), drive-bys, 23.3% in unknown illustrations. robbery assaults (12.8%, n=5), and circumstances, and 21.7% (n=13) other circumstances(7.7%,n=3). The during arguments. The remaining remaining revolvers were used in a drug semiautomatics that were used in crime assault (2.6%, n=1), drive-by homicides were used when the victim assault (2.6%), and assault that took. was walking, standing or bicycling place in a car(2.60x6). (15.0%, n=9), in other circumstances Of the handguns of an unknown type (6.7%, n=4), during robberies (5.0%, that were used in assaults,39.1%(n=9) n=3),in a car(1.7%,n=1),during a drug were used in robbery assaults, 21.7% crime(1.7%),andwhile indoors(1.7%). (n=5) during arguments, 17.4% (n=4) When revolvers were used in when the victim was walking,standing homicides, they were used during or bicycling, 13.0% (n=3) inside cars, arguments (41.2%, n=7), in unknown 4.3%(n=1)in a drive-by shooting,and Results and Analysis, Part I The FIRST Project Report 31 Oil r Firearm Assaults and Homicides by Month and Time Firearm Assaults and Homicides by Month Contra Costa County, July 1, 1993-June 30, 1994 n=421 Number of Assaults and Homicides 50 0Assault MHomicide 40 - - - - - - - - - - - - - - - - - - - - - -Z9- - - - - - - - - - - - - - - - - - 37 31 30 28- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 26 25 24 22 22 22 20 18 13 110 13 13 11 10 10 e s $ 13 s 6 0 Jan Feb Mar April May June July Aug Sep Oct Nov Dec n=36 n=35 n=40 n=39 n=30 n=28 n=51 n=45 n=29 n=35 n=18 n=31 FIRST Study,Prevention Program:Law enforcement data Figure 25 Firearm assaults occurred most often in July (12.6%) and August (11.9%), while homicides occurred most Firearm Assaults by Time of Day frequently in April(11.7%)and October contra costa county,July 1,1993-June 30,1994 (11.7%). The smallest percentage of n=310 assaults and homicides occurred in Number of assaults November. (See figure 25.) 250 The majority of the assaults (59.7%, n=184) occurred between 4 p.m.- 200 taa midnight.The remainderwas spread out almost equally between 12 a.m.-8 a.m. 150 - - - - - - - - - - - - - - - - - - - - - - - (n=63, 20.5%) and 8 a.m. - 4 p.m. (n=61, 19.8%). Most homicides were 100 - - - - - - - - - - - - - - - - - - - committed (53.4%, n=55) between 4 6a61 p.m.and midnight;25.2%(n=26)were 50 - - - - - - - - committed between 12 a.m.-8 a.m.,and the remaining 21.4% (n=22) were o committed between 8 a.m.-4 p.m.(See 12am-7:59am 8am3:59pm 4pm-11:59pm figure 26.) Flawsn,ay,Pre�enaenPc�:taw«*nMdaft Figure 26 32 The FIRST Project Report Results and Analysis, Pail I Firearm Homicide Victims Testing Positive for Alcohol and Other Drugs at the Time of Death Firearm Homicide Victims Testing Positive for Alcohol/Other Drugs Contra Costa County, July 1, 1993-June 30, 1994 n=111 Alcohol' Other Drugs Unknown 5.4% No 54.1% Unknown 5.4% No 36.9% No Test 24.396 o Test 4.5% Yes 36.0% Yes 33.3% FIRST Study,Prevention Program:Coroner data Figure 27 Using coroner data, information was negative.One-third of homicide victims were not tested for drugs. Information available on alcohol and drug use by tested positive for other drugs(33.3%), about alcohol or drug consumption was homicide victims.More than one-third while 36.9%tested negative for drugs. reported as unknown for 5.4% of of homicide victims tested positive for Four point five percent(4.5%)of victims victims.(See figure 27.)Information on alcohol (36.0%), while 54.1% tested were not tested for alcohol,and 24.3% alcohol and drug use by assailants is unavailable. 0 Results and Analysis, Part I The FIRST Project Report 33 Firearm Suicides Suicides made up 25.5%of the firearm deaths and 1.5%of the nonfatal injuries in Contra Costa County during the Self-Inflicted Firearm Injury Rates study period.A total of 47 intentionally contra costa County,July 1,1993-June 30,1994 self-inflicted injuries were committed n=47 with firearms;85%of these self-inflicted Rata per 1100,000 injuries were fatal (n=40) and 15% b 4.6 NFatal ONontatal (n=7) were nonfatal. The suicide rate for the total population was 5.4 per 4 - - - - - - - - - - - - - - - - - - - - - - - 100,000.The fatal suicide rate was 4.6 per 100,000 and the nonfatal rate was 3 - - - - - - - - - - - - - - - - - - - - - - 0.8 per 100,000. (See figure 28.) The larger proportion of fatal firearm 2 - - - - - - - - - - - - - - - - - - - - - - - suicides found by FIRST corresponds to research indicating that the fatality of 1 -0.e - - - - - - - - - suicide attempts is much higher when firearms are used than when other methods are used (Pacific Center for ° Violence Prevention, 1994).This shows FIRSTS",Pmentlon ProCmn:C*ww anti that when a person attempts to commit suicide using a gun,the outcome is most Figure 28 likely to be fatal. Firearm Suicides by Victim Sex, Age, and Ethnicity Males were more likely than females 100,000), 15-19 year olds (13.4 per the total suicides and had the second to commit suicide using firearms,78.4% t 00,000),and 30-34 year olds(13.2 per highest suicide rate, 3.7 per 100,000. (n=37) to 19.6% (n=9). The male 100,000). Among females, 75-79 year Latinos accounted for 6.4%(n=3)ofthe suicide rate,8.7 per 100,000,was more olds had the highest suicide rate of 8.3 total suicides and had a rate of 2.8 per than four times that of the female suicide per 100,000, followed by 50-54 year 100,000. Asians/Other accounted for rate,2.0 per 100,000.This ratio mirrors olds(7.3 per 100,000), 30-34 year olds the lowest proportion of attempted or the ratio between male and female (5.7 per 100,000),20-24 year olds(3.6 completed firearm suicides(4.3%,n=2). suicide rates nationally. Research has per 100,000),and 35-39 year olds(2.6 indicated that the presence of a firearm per 100,000). (See figure 29. See Race/Ethnicity and Sex in the home is a major situational factor Appendix J for table of rates.) White males had the highest suicide in suicide deaths(Kellerman and Reay, rate (fatal and nonfatal) at 10.9 per 1986; Kellerman et al, 1992).Firearms Race/Ethnicity 100,000,followed by Latino males(5.4 account for nearly 60% of all suicide per 100,000), African American males deaths;it is the weapon used most often Suicide data analyzed by race/ (5.3 per 100,000), and Asian/Other by both men and women, followed by ethnicity revealed that Whites were males (4.3 per 100,000). Females had drugs or medicinal substances for more likely to try to take their lives using lower suicide rates across all race/ethnic women and hanging for men. a gun than any other race/ethnic group. groups. African American females had When data was stratified by both age Whites accounted for 83.0%(n=39)of the highest rate (2.4 per 100,000), and sex,males 75-79 years old had the the total suicides and had a suicide rate followed closely by White females(2.3 highest suicide rate(35.5 per 100,000), of 6.6 per 100,000, three times that of per 100,000),and Asian/Other females followed by 60-64 years olds(35.4 per Asians/Other, who had the lowest (2.0 per 100,000). Latino females did 100,000), 70-74 year olds (26.1 per suicide rate of 2.1 per 100,000.African not experience any self-inflicted injuries 100,000), 80-84 year olds (21.3 per Americans accounted for 6.4%(n=3)of due to firearms. (See figure 30.) 34 The FIRST Project Report Results and Analysis, Part I Pr a � Firearm Suicide Rates by Victim Sex and Age Contra Costa County, July 1, 1993-June 30, 1994 n=47 Rate per 100,000 40 -�•Male -e-Female 30 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 20 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - - - - - - - - - - - - - - - - - - - 00704 4-09 10-14 15-19 20-24 30.34 3539 40-44 45-49 50-54 60-64 65-09 70-74 75-79 80-84 85+ Age Group FIRST Study,Prevention Program:Law enforcement,coroner,hospital data Figure 29 i i Firearm Suicide Rates by Victim Race/Ethnicity and Sex Contra Costa County, July 1, 1993 June 30, 1994 n=47 12 Rate per 100,000 10.8 MMale OFemale 10 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g5.3 - - - - - - - - -5.4 - - - - - - - - - - - - - - - - 4.3 4 - - - - - - - - - - - - - - - - - - - - - - 2.3 . 2.4 2 - - - - - - 2 r' 0 0 White African American Latino Asian/Other FIRST Study,Prevention Program:Law enforcement,coroner,hospital data Figure 30 Results and Analysis, Part I The FIRST Project Report 35 Firearm Suicides by Type' of Gun Firearm Suicides by Gun Type Contra Costa County,July 1, 1993-June 30, 1994 Unknown — — — — — — — — — Undetermined (n=4) 9.5% (n=3) 10.3% Revolver Handgun (n=17) 58.6% Shotgun (n=29) 69.0% (n=6) 14.3% I i? W1 Semiautomatic Rifle (n=9) 31.0% n=42 n=29 FIRST Study,Prevention Program: Law enforcement data Figure 31 The firearms most often used to commit suicide were handguns,which accounted for 69%(n=29)of all firearm suicides. Revolvers (n=17) accounted Firearm Suicides by County Region for 58.6% of these handguns; 31.0% Contra costa County July1,19x3-June 30,1994 n=45 (n=9)were semiautomatics,and 10.3% (n=3)were of an unknown type. Shotguns accounted for 14.3%(n=6) Easty R 24.4% west of firearm suicides,and rifles accounted ,. 31.1% for 7.1% (n=3). For 9.5% (n=4) of suicide victims,the type of firearm was unknown. (See figure 31.) See Appendix M for gun type South illustrations. 6' Firearm Suicides Central 35.6% byCity and FIRST Swdy,Pmentlon Pmgrmn:law enbrosmsnt,oaoror,hospW data County Region Figure 32 The five cities or unincorporated areas 100,000),Oakley in East County(10.9 per 100,000), and Pleasant Hill in with the highest suicide rates in Contra per 100,000),Walnut Creek in Central Central County(6.2 per 100,000).(See Costa County were San Pablo(22.9 per County(9.5 per 100,000),Antioch(6.9 Appendix K.) 36 The FIRST Project Report. Results and Analysis, Part I Dig t , Unlike firearm homicides and assaults, which occurred disproportionately in West County, firearm suicides were Firearm Suicides by Place of Shooting/Place of Death spread out more evenly throughout the contra costa county,July 1,1993-June 30,1994 county. Where data were available, Central County reported the majority 35 Number of Suicides n=4z of firearm suicides, 35.6% (n=16), 30 30 - - - - - - - - - - - followed by West County, 31.1% - - - - ' - - - - - - (n=14), EastCounty, 24.4% (n=11), 25 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ and South County, 8.9% (n=4). (See figure 32.)When calculating rates by 20 - - - region and taking into account the pop- 15 - - - - - - - - - - - - - - - - - - - - - - - - ulation differences between the regions, East County experienced the highest suicide rate of 6.7 per 100,000,followed 5 -3- - - 3 - - - - - - - - - - - - - - - - by West County (6.0 per 100,000), 2 t 1 1 t Central County(4.8 per 100,000),and O hom other hmptml cewmsklc+ perk shaetbthdwk oar workp6oe Place of Shooting/Death South County(4.6 per 100,000). FIRST St*,P Pfwram:Lawet*wcettbKoinnerdam Firearm Suicides I Figure 33 by Place of Shooting or Firearm Suicides by Month Place of Death contra costa county.July 1,1993-June 30,1994 n=47 The majority of suicide victims t2 Number of Suicides committed suicide at home (71.4%, 10 n=30). The location of shooting or 10 - - - - - - - - - - - - - - - - - - - - - - place of death reported for the 6 remaining suicides were other'location (7.1%, n=3), hospital (7.1%), other 65 s 5- - - - - - - - - - - 5- - - - - - residence(4.8%,n=2),car(2.4%,n=1'), a a park (2.4%), street, parking lot, or sidewalk (2.4%), and school, 2.4% 2 1 2 1 (which was a suicide that followed a homicide). (See figure 33.) o Jan Feb March April May June July Aug Sep Oct Nov Dec Month FirearmSuicides FIRST Ste,,Provendon Pteprem:Law eribmement,oommr,hospital data by Month and Figure 34 Season April and October(10.6%, n=5);June seasons,winter accounted for approxi- The greatest number of people andjuly(8.5%,n=4);May(6.4%,n=3); mately one-third of all firearm suicides committed suicide with firearms in November(4.3%,n=2);and September (34%, n=16), followed by summer January (21.3%, n=10), followed by and December(2.1%,n=1).(See figure (29.8%, n=14), spring(27.7%, n=13), August(12.8%,n=6);February,March, 34.)When months were grouped into and fall(17.0%, n=8). Results and Analysis, Part I The FIRST Project Report 37 1 Firearm Suicide Victims Testing Positive for Alcohol Information on alcohol use was available for 93.6%, (n=44) of the suicides.Of these,34.1%(n=15)of the Firearm Suicide Victims Testing Positive for Alcohol suicide victims tested negative for alcohol, 20.5% (n=9) tested positive, Contra Costa County,July 1,1993-June 30,1994 and 31.8%(n=t 4)were not tested. (See No n=44 figure 35.) Alcohol use data were 34.1% missing for 13.6%(n=6)of the victims. 0. w Missing 13.8% Yes 20.5% No test 31.8% FIRST Study,Pre entbn Program:Coroner,hosplW feta Figure 35 Unintentional Firearm Injuries and Deaths Approximately 8.0% (n=50) of the firearm injuries and deaths reported - duringthe studyyearwere unintentional Firearm Unintentional Injury Rates by Victim Sex injuries (often considered"accidents"). contra costa county,Juty 1,1993-June 30,1994 Unintentional injuries can be self- n=50 inflicted or inflicted by another person. Rate per 100.000 10 The overall unintentional injury rate was 9 WFatal ONoMatal 5.7 per 100,000,the third highest rate due to intent. The nonfatal e - - - - - - - - - - - - - - - - - - - - - unintentional injury rate was 4.8 per 100,000 and the fatal rate was 0.2 per a - - - - - - - - - - - - - - - - - - - - - - 100,000 during the study year. There were six unintentional firearm injuries a - - - - - - - - - - - - - - - - - - - - - - that had unknown outcomes and therefore could not be included in the 2 - - - - - - - - - - - - - - - - - - - - - - - computations for the fatal and nonfatal 0 0.4 0.9 unintentional injury rates.Hospital data o files were the source of most Male Female FIRST So*.PwAnWnPro mm:laweMnrcemerrt,hospitaldata unintentional injury reports (n=43). Since unintentional shootings are not considered crimes,they are not usually Figure 36 reported in law enforcement records. Males were eight times more likely to 1.8 per 100,000 respectively.This figure The male nonfatal unintentional suffer from unintentional firearm injuries included the unintentional injuries of firearm injury rate was 9.0 per 100,000, than females.The total rates for males unknown outcomes(n=4 for males and in contrast to the female nonfatal and females were 9.9 per 100,000 and n=2 for females). unintentional injury rate of 0.9 per 38 The FIRST Project Report Results and Analysis, Part I Firearm Unintentional Injury Rates by Victim Age Contra Costa County, July 1, 1993-June 30, 1994 n=50 18 Rate per 100,000 16 137 14.4 14 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 12 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10 - - -- - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - 9.8 A- 8 - - - - - - - - - - - -7.4 - - - - - - - - - - - - - - - - - - - - - - - - - - - 4 6 - - - - - - - - - - - - - - - - - - - -- - - -4.8 - - - - - - - - - - - - - - - - 4 4 3.8 - 2. 2. 2 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - 01 1 10-14 15-19 20-24 25-29 3034 3539 4044 45-49 50-54 55-69 6034 75-79 85+ Age Group FIRST Study,Prevention Program:Law enforcement,hospital data Figure 37 100,000. No males died from unin- African Americans were found to have highest unintentional firearm injury rate tentional firearm injuries during the the highest unintentional injury rate (14.9 per 100,000), followed by 20-24 study period. During the same period, (16.2 per 100,000),followed by Latinos year olds and 15-19 year olds. The females died from unintentional,firearm (6.5 per 100,00), and Whites (4.1 per unintentional firearm injury rate injuries at a rate of 0.4 per 100,000 100,000). No unintentional firearm dropped by almost half for persons 25 (n=2). (See figure 36.) injuries were reported for Asians/Other. years and older,and remained relatively When stratified by race/ethnicity, Persons 10-14 years old had the low until increasing again for persons 75 years and older. (See figure 37.) Legally Justifiable Firearm Injuries and Deaths The rate for legally justifiable 198.5 (home protection; fear of death of District Attorney or court decisions shootings was the lowest of all the injury or great bodily injury). With the regarding these shootings. intent groups (1.1 per 100,000). In all exception of justifiable homicide,no law Five of the legally justifiable shootings. shootings (n=10), according to law enforcement or public health category were nonfatal, four were fatal,and one enforcement accounts, the offenders exists that easily classifies such had an unknown outcome. Five of the appeared to act in accordance with shootings; FIRST staff developed shootings were committed by police California Penal Code Sections 196 classifications to capture these incidents officers, three were committed in self- (public officers, legal duty), 197 (See Appendix B). FIRST's one-year defense by ordinary citizens, and two (preventing an atrocious felony), or study period did not allow for the review were domestic violence-related. Results and Analysis, Part I The FIRST Project Report 39 Results and Analysis, Part II Hospital . Data This section analyzes hospital data intent of firearm injury is usually alone,without considering law enforce- undetermined because hospitals are not ment and coroner data.These hospital as involved as law enforcement in data are presented to complement the resolving this issue.Most of the firearm latter two data sources,as well as provide injuries that were found in hospital additional and unique information about records,but not in police records,may the impact of gunshot injuries on the have been among victims who walked health sector. in orwere taken to the emergency room Of the 85 firearm injuries and deaths on their own, unaccompanied by the in the study that were of undetermined police, whom the hospital staff then intent, 82 (96.5%) were treated in failed for various reasons to notify. hospitals but were not found in the law °Hospital data consist of both emer- enforcement data set.State law requires gency room data and hospitalization hospitals to report all firearm injuries data. Hospitalization data for firearm and deaths to the police, but this does injuries and deaths were taken from the not always happen. In the cases where John Muir Medical Center Trauma the hospitals failed to make a report,the Registry. Firearm Injury Hospitalizations by Type of Injury The majority of the firearm injury hospitalizations (61.7%, n=291) were caused by assaults, followed by Firearm Hospitalizations by Intent of Injury unintentional (9.1%, n=43), self- Contra Costa County,July 1,1993-June 30,1994 inflicted (3.0%, n=14), and police- n=472 inflicted shootings(6%,n=3).Intent for iso Number of Hospitalizations 25.6% (n=121)of hospitalized firearm injuries was reported as undetermined. 300 2fl1- - - - - - - - - - - - - - - - - - - - - - - - - - (See figure 38.) Undetermined cases 250 - - - - - - - - - - - - - - - - - - - - - - - - - were largely abstracted from emergency room logs. In the emergency room, 200 - - - - - - - - - - - - - - - - - - - - - - - - - when the cause of a gunshot wound is unknown, the injury is classified as 150 - - - - - - - - - - - - - - - - - - - - - i2i - - undetermined.Due to time and protocol 100 - - - - - - - - - - - - - - - - - - - constraints, further investigation of firearm injuries of undetermined intent 14 are usually not carried out.Also, many a assaultive unintentional Self-Inflicted Legally Justified unknown gunshot wound patients are unable or FlRST seely.I'mvention Pfognun:HospUel,John Muir Medical Center data unwilling to disclose circumstances. Assaults were the most frequent cause of nonfatal firearm injury hospitali- Figure 38 zations in Contra Costa (29.2 per 100,000), followed by unintentional (4.9 per 100,000),self-inflicted(0.7 per Payment Sources for Firearm Hospitalizations 100,000),and police-inflicted shootings contra costa county,July 1,1993-June 30,1994 (0.2 per 100,000). Unknown Other Cost and Source 172% 2.3% of Payment A conservative estimate places the Private Insurance 18.2% societal cost of firearm injuries in the United States at about $200 billion. Uninsured Eighty percent of the medical cost of 46.0% firearm injuries are paid for by taxpayers (Rice et al, 1989).The,cost of firearm Public Insurance injury to American society is absorbed 16.3% by various payers: federal (e.g., n=472 Medicare, Medicaid), state, and local FIRST Sw*,Prevention Prog,e Hospltal,John Muir MadcodCeMerdata governments, private insurance, workers` compensation, and private Figure 39 individuals. Method of Payment used public insurance (e.g., Medicare, Cost and Method of Medi-Cal, Victim of Crime, Workers' Payment Source Among the firearm victims treated at Compensation, Basic Adult Care),and y area hospitals and the John Muir 2.3% (n=11) used other methods of In Contra Costa County, hospitali- Medical Center, 46.0% (n=217) were payment. Of the remaining 17.2% zation costs for firearm injuries totalled uninsured (e.g., self-pay, charity), (n=81), the method of payment was $5,329,599 dollars fromjuly 1, 1993 to 18.2% (n=86) used private insurance unknown or the data were missing.(See June 30, 1994.Private insurance paid a (e.g., PPO or HMO), 16.3% (n=77) figure 39.) total of$1.5 million, public insurance 42 The FIRST Project Report Results and Analysis, Part 11 paid $1.3 million, the uninsured paid $300,000, and $8,527.09 came from Hospitalization Cost by Type of Injury other sources.The payment source was unknown for$2.2 million ofhospitali- Contra Costa county,July 1,t993-June 30,1994 zation costs. Millions of Dollars 5 4.6 Cost and Intent of Injury Hospitalization for assaults cost$4.6 million,self-inflicted injuries$370,000, 3 - - - - - - - - - - - - - - - - - - - - - - - - - - unintentional injuries$150,000,injuries of unknown intent $240,OOO, and 2 - - - - - - - - - - - - - - - - - - - - - - - - legally justified injuries $14,000. (See figure 40.) 1 - - - - - - - - - - - - - - - - - - - - - - - - - - 0.37 0.15 r 0.24 0.014 0 AssauRive Self-inflicted Unintentional Unknown LegallyJustlfled FlRST Sa,dy,Premftn Pmgmm Fbq"s-,d Jot Mir Madful C~da0a Receiving . Hospitals Figure 40 Combined emergency room and Receiving Hospitals for Firearm Victims hospitalization data revealed that the Contra costa County,Juty;1,1ss3-June 30,1994 majority(48.5%,n=229)of the firearm n=472, injury victims were taken to John Muir John Muir 46.5% Medical Center's trauma center in Brookside 22.6%, Walnut Creek.County trauma protocol currently dictates that anyone with a Kaiser Richmond 8.1% ; penetrating firearm injury be trans- Delta Memorial 6.1% ported to John Muir Medical Center. Los Medanos 42% The remainder of the cases were taken Merrithew 3.6%' to Brookside Medical Center in San Pablo (22.6%, n=108), Kaiser other Hospitals 3.6%; ; Richmond (8.1%, n=38), Delta Doctors 1.9% ' Memorial in Antioch(6.1%,n=29),Los Mt.Diablo 1.1% ' Medanos in Pittsburg (4.2%, n=20), o% 10% 20% 30% 40% 50% 60% Merrithew in Martinez (3.6%, n=17), FIRST Sh*,Prevention Program Hospital,John MurMedical Centardata other surrounding hospitals (3.6%, h=17), Doctor's Hospital in Pinole (1.9%, n=9), and Mt. Diablo Hospital Figure 41 in Concord(1.1%,n=5).Another 1.1% were found in the John Muir non-trauma comprised 8.2% (n=26)of the firearm collected from all hospitals(excluding registry (which was a separate injury hospitalization cases that were John Muir Medical Center). computerized ER log in which non- trauma walk-ins and BB and pellet gun injuries were captured). The other Mode of Transport to surrounding hospitals included Children's Hospital, Oakland (0.6%, Receiving Hospital n=3), Highland Hospital, Oakland (1.5%, n=7), and Kaiser Oakland Nearly half of gunshot victims were modes of transport; followed by (0.4%,n=2). (See figure 41.) taken to the emergency room (49.4%, ambulance (43.2%, n=105), unknown Transfer cases, which are gunshot n=120, excluding John Muir Trauma or`.missing(6.2%,n=15),and the police wound victims that were transferred to Center) by private means, i.e. family (1.2%, n=3). another hospital for treatment, member,stranger,self,or other private Results and Analysis, Part 11 The FIRST Project Report 43 Injury Severity/ Scores Specifying injury severity is an essential function of injury epide- miology. Severity scores are used in Contra costa County,Juy 1,1993-June 30,1994 acute and follow-up medical care to n=229 soPercerrt Hospftallzed triage patients (Le_decide where and by whom patients should be treated), 42•4% plan the different levels of care needed 40 - - - - - - - - - - - - - - - - - - - - - - - - - according to severity distributions,and 29.3x evaluate the effectiveness of treatment. - - ' - ' - ' - - - - - - ' - ' - - - - - - Epidemiologists use severity scores to establish minimal criteria for the surveil- 20 - - - - - - - - - - - - - - - - - - - - - lance of injury and to measure the effects 12-x° 10.9% of energy and other factors on injury 10 severity, including the effects on 4.3% mortality, disability and cost (Baker, 0 1 2 3 4 5 1983). as score The Abbreviated Injury Scale(AIS)is FIRST sway.PmwnfionPwg +:John Muir►odicalcanWdata seldom used for triage,but is used in the evaluation of medical care outcomes and Figure 42 costs.The scoring procedure has been simplified into a standardized computerized emergency department moderate injury, 3 is a serious injury,4 instrument that can be used in case records;AIS scores were not collected is a severe injury, 5 is a critical injury, abstractions from medical records at other hospitals. Other hospitals and 6 is considered unsurvivable.Of the (Barancik and Chatterjee, 1981). -measured severity of injury by number of gunshot injury patients The AIS score was collected.-for determining the most severe injury treated at John Muir Medical Center gunshot injury patients at John Muir reported.AIS is measured on a scale of (n=229), the majority (42.4 %, n=97) Medical Center as part of the Center's 1 to 6. One is a minor injury, 2 is a suffered from a minor firearm injury, Hospitalizations by Intent and AIS Contra Costa County, July 1, 1993-June 30, 1994 n=229 100 89 AIS Score IC31 ®2 =3 M4 i/5 80 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 61 60 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 40 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 6 25 20 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -5 3 3 1 3 0 0 2 2 0 2 0 0 1 0 0 0 0 0 0 2 0 Assault Unintentional Self-Inflicted Legally Justified Unknown FIRST Study,Prevention Program:John Muir Medical Center data Figure 43 44 The FIRST Project Report Results and Analysis, Part 11 29.3% (n=67) from a serious firearm injury, 12.7% (n=29) from a moderate Hospitalizations by AIS Score and Length of Stay gunshot injury, 10.9% (n=25) from a contra costa county,July 1,1993-June 30,1994 serious injury, and 4.3% (n=10)from a n=229 critical injury. The average AIS a vera go Length of Say pays) experienced in the study group was a 12 10.8 moderate injury(mean AIS=2.2).(See figure 42.) AISby Intent of 8 - - - - - - - -7.1 " - - - -B- - ` - - -'.5- - - Y Injury i� The majority of the assaults (43.6%, B - - - _ - - n=89)were classified as minor injuries 4 -3.6- (AIS 3s_(AIS 1), yet a substantial proportion (29.9%,n=61)were classified as serious, 2 AIS 3. The remainder of the assaults were distributed as follows: 12.7% ° 1 2 3 4 5 (n=26)moderate,AIS 2; 12.3%(n=25) AIS score severe,AIS 4;and 1.5% (n=3)critical FlRSTSWdy,Prov.nmnProgren,:J,nnMurM.alcalca,b.ma AIS 5. Figure 44 The majority of self-inflicted firearm John Muir Medical trauma center, received the most experienced was a puncture wound, injuries admitted toJo Center were classified h minor dica, number of seriously injured people.The graze/laceration, fracture, or multiple n=5), and the remainder were divided average length of stay in the hospital wound.The average LOS was less than orrespondedwith the severity of injury one day for all injury types,except for equally(18.2%each)between moderate c (n=2),serious(n=2),and critical(n=2). experienced i.e., the more severe the multiple gunshot wounds, where the (See figure 43.) injury, the longer the patient stayed average LOS was 2.3 days. hospitalized.The average length of stay Average was higher for those who survived their Length of Stay by Intent injury (mean LOS = 6.1 days) than Of 'Injury those who died(mean LOS=3.1 days). Length of Stay (See figure 44.) The average length of stay was longest for suicides attempted by firearm, 5.9 John Muir Medical Center Emergency Room Data days, followed by assaults (4.3 days), Since AIS was not collected at the legal intervention (3.0 days), The average length of stay(LOS)by emergency rooms of all other hospitals, unintentional (1.0 day), and unknown a gunshot injury victim was 5.7 days. injury severity was measured by the (0.5 days). (See figure 45.) John Muir Medical Center, being a extent of the injury,whether the injury Alcohol Hospitalizations by Average Length of Stay and Intent Contra Costa County,July 1,1993-June 30,1994 Involvement n=453 70 Average Length of Stay(Days) Every gunshot wound victim who 6.0 5=9 comes to John Muir Medical Center - (JMMC) is tested for alcohol involve- 5.0 - - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ menta unless they are under 14 years of 4.3 age.Among gunshot patients tested for 4.0 - - - - - - - - - - - - - - - - - - - alcohol involvement at JMMC, 56.3% 3.0 _ _ - _ _ _ _ _ 3.0 _ _ _ _ _ (n=129)were found not to be under the influence of alcohol at the time of 2.0 - - - - - - - - - - - - - - - treatment and 30.6%(n=70)were found 1.0 1.0 _ - - o.s " from to have blood alcohol levels ranging _ _ _ _ 0.1 to 0.35.A blood alcohol level 0.0 of.08,is considered legally intoxicated. Assaultive Sekt nflicted Unintentional Legally Justified Unknown The effect of a high blood alcohol level raasTStudy.Pr6~69n PMmm.John Mwr Me&W rentor data depends'o n a person's level of tolerance Figure 45 for alcohol as well as body size. Results and Analysis, Part It The FIRST Project Report 45 Glossary Abbreviated Injury Severity Scale condition, using information reported Homicide: The killing of one human (AIS): Anatomical scale used by some on the death certificate. being by another. In this report, as in hospitals to rate the severity of injuries. most health statistics, no distinction is The scale ranges from 1 (minor injury) Case: Container which holds primer, made between criminal homicide(mur- gun powder,and the bullet or shot. to 6 (maximum injury, virtually der/non-negligent), manslaughter unsurvivable). Coroner: A public officer whose pri- (through gross negligence)or justifiable maty function is to investigate by in- homicide. Those individuals killed by Age-specific injury rate:Generally,the quest any death thought to be from legal intervention are coded separately number of injuries per 100,000 of a other than natural causes.The coroner by health and law.enforcement agen- specified age group. records all deaths related to trauma,such cies. Aggravated Assault:An unlawful attack as motor vehicle-related, drowning, Injury Rate: A statistical measure de- or attempted attack by one person on homicide,suicide,firearm-related,etc. scribing the number of injuries observed another person, with the intent of in- Domestic Violence: Abuse committed or expected to occur in a defined num- flicting severe bodily injury.This type against an adult or fully emancipated ber of people(usually 100,000)during of assault is usually accompanied by the minor who is a spouse, former spouse, a definedtime period(usually one year). use of a weapon or other means likely cohabitant,former cohabitant,or a per- Used as an expression of the relative risk to produce death or great bodily harm. son with whom the suspect has hada among different injuries or groups.(Na- (U.S.Department of Justice, 1994.) child or a dating or engagement rela- tional Committee for Injury Prevention Ammunition: Any powder, shot, or tionship. (U.S. Department of Justice, and Control[NC1PC], 1988.) bullet used in rifles, pistols, and shot- 1994.) Intentional Injury: An injury that is guns. E codes: Numerical codes that describe judged to have been purposely inflict- Arrest:"...Taking a person into custody, the external cause and judged intent of ed, either by one's self(suicide) or an- in a case and in the manner authorized injury,developed by the World Health other(homicide).(Rice et at., 1989.) by law. An arrest may be made by a Organization as part of its International International Classification of Disease peace officer or by a private person." Classification of Diseases system. (ICD)codes: Numerical codes devel- (Penaf Code 834.) E codes include, for example, injuries oped by The World Health Organiza- causedby motorvehicles,firearms,poi- ' Automatic:Firearm that loads,fires,and tion to clarify both the nature(N codes) ejects ammunition continuously with sonings,_falls and other causes.(Rice et and external cause of illness and inju- gger squeeze. Often confused al 1989.) ries(E codes), one tri ' with a semiautomatic firearm.Machine Fatality: An injury that results in death. Magazine: Part of a semiautomatic fire- guns are true automatic weapons. Firearm: Tool designed to propel a pro- arm that holds ammunition until it is Barrel:Metal tube of a firearm through jectile by burning powder. ready to be fed into the chamber. which the bullet or shot passes. Forcible Rape: Carnal knowledge of a Magnum: Ammunition designation Caliber:Measurement of the inside part female, done forcibly and against her implying larger loads of powder in a of the barrel of a firearm. Caliber is will.By U.S.Department of Justice defi- cartridge. measured in hundredths of an inch(e.g., nition, sex assaults against men are ex- N codes: Numerical codes that describe .45 caliber),but is also measured in mil- cluded and are classified as assaults or limeters(e.g.,9 mm). other sex offenses, depending on the the nature of injury and the body part nature of the crime and the extent of affected. Developed by The World California Penal Code:The California the injury.(U.S.Department of Justice, Health „Organization as part of its Penal Code contains statutes that de- 1994) International Classification of Diseases fine criminal offenses, specify corre- system, N codes include head injury, sponding punishments, and describe Gauge: Shotgun measurement that is spinal cord injury,fractures,and others criminal justice system mandates and determined by the number of lead balls, (Rice et a1,1989). procedures. of the same diameter as the barrel,that it would take to weigh one pound. Pistol:Any handgun that does not con- Cartridge:A round of ammunition that tain its ammunition in a revolving cyl- includes primer,gun powder,an explo- Handgun: Short-barreled firearm that inder (see revolver). Pistols can be sive cap to ignite the powder,gun cas- is usually held at arm's length, rather manually cocked or semiautomatic. ing,.and the bullet or shot. than at the shoulder,to fire.Among the most common types of handguns are Primer: Explosive cap used to ignite the Cause of Death: Each individual's death revolvers and semiautomatic pistols.See powder when struck with a sharp blow is formally attributed to one underlying diagram in Appendix M. from a gun's firing pin. Glossary The FIRST Project Report 47 Glossary Revolver: Firearm having a revolving agencies.The California Department of cylinder that holds the ammunition. Justice administers and forwards the data Ammunition (usually five or six car- for the state to the federal program. tridges) is placed in chambers in the cUnintentional Injury: An injury that is cylinder, allowing the gun to be fired judged to have occurred without any- several times without requiring reload- one intending that harm to be done. ing. (Rice eta], 1989.) Rifle: A long-barreled firearm designed to be fired from the shoulder. Bullets leave rifle barrels generally at a higher velocity than they do from handgun barrels. Robbery: The taking or attempting to take anything of value from the care, custody,or control of a person or per- sons,by force,or threat of force or vio- lence, and/or by putting the victim in fear.(U.S.Department of Justice, 1994.) Semiautomatic: Refers to a type of fire- arm action used in some shotguns,rifles, and handguns. When fired, semiauto- matics automatically extract and eject the empty ammunition case and cham- ber a new cartridge with each pull of the trigger. Shell: Container that holds the shot and other parts(wad,powder,primer)of the ammunition for shotguns. Shot: Balls of lead or steel used to fill a shotgun shell. Shotgun: A long-barreled firearm that fires many lead or steel pellets (shot) with each discharge. Special: Ammunition designation that indicates differences in the ammunition case shapes among.38 and.44 calibers. Distinguishes newer ammunition from older/more rare ammunition of the same caliber.Firearms cannot use regular and. Special ammunition of the same caliber interchangeably. Surveillance:The ongoing and system- atized collection,analysis,and interpre- tation of data in the process of describ- ing and monitoring a health event. (NCIPC, 1988.) Uniform Crime Reporting (UCR): A federal reporting system that provides data on crime based on police statistics submitted by local law enforcement 48 The FIRST Project Report Glossary References Annest, J.L., Mercy,J.A., Gibson, D.R., NY:L.H.Research,inc. Teret, S,, Wintemute, G., Beilenson, P. Ryan G.W. 1995.National estimates of non- 1992.The firearm fatality reporting system: fatal firearm-related injuries,beyond the tip Ketlermann,A.L.,Rivara,EP,Somes,G., A proposal.Journal of the American Medi- of the iceberg. Journal of the American Reay, D.T., Francisco, J., Banton, J.G., cal Association.267:3073-3074. Prodzinski,J., Fligner, C., Hackman, B.B. Medical Association.273(22):1749-1754. 1992.Suicide in the home in relation to gun United States Department of Justice. 1994. Baker,S.P. 1983. Panel:Current status of ownership.New England journal of Medi- Uniform Crime Reporting Handbook. trauma severity indices.Journal of Trauma. cine. 327:467-472. Washington,DC: Federal Bureau of inves- 23:193-196. Kellerman,A.L.,Reay,D.T. 1986.Protec- tigation. Balogh,J.J., Leahy,S.M.,Valverde,M.R. tion or peril?An analysis of firearm-related Williams,K.R. 1984.Economic sources of 1992.Status Report on Childhood Injury in deaths in the home. New England Journal homicide:Reestimating the effects of pov- Contra Costa County. Pleasant Hill, CA: of Medicine.314(24):1557-60. erty and inequality.American Sociological Contra Costa County Health Services Pre- Loftin,C.,Hill R.H. 1974.Regional sub- Review.49:283-289. vention Program. culture and homicide.American Sociologi- Wintemute,G.J.,Wright,M.A. 1992.ini- Barancik,J.1.,Chaterjee,B.F. 1981.Meth- cal Review.39:714-724. tial andsubsequent costs of firearm injuries. odological considerations in the use of the Max,W.,Rich,D.P.1993.Shooting in the The Journal of Trauma.33:556-560. abbreviated injury scale in trauma epidemi- dark:Estimating the cost of firearm injuries. Wintemute,G.,Hancock,M.,Loftin, L., ology.Journal of Trauma.21:627-63 i. Health Affairs. 12(4):171-185. McGuire,A.,Pertschuk,M.,Teret,S.1992. Bureau of Alcohol,Tobacco,and Firearms. Mercy,J.A. 1993.The public health im- Policy options of firearm violence.in:Fire- 1991.Printout.Office of Public Affairs. pact of firearm injuries.Americanjournalof arm Injuries: A Public Health Approach. California Department of Health Services. Preventive Medicine.9(Suppl. 1):8-11. Conference proceedings from "Handgun 1994. California Public Health Statistical Injuries:A Public Health Approach."Iowa Report, Vital Statistics. Sacramento, CA: National Committee for Injury Prevention City,IA:University of Iowa. Department of Public Health. and Control. 1988.Injury Prevention:Meet- ing the Challenge.New York,NY:Oxford Centers for Disease Control. 1992. Set- University Press. ting the National Agenda for Injury Con- trol in the /990's:Position Papers from the Pacific Center for Violence Prevention. 1994.Preventing Third National Injury Control Conference. Youth Violence:Reducing AAccess to Firearms.San Francisco,CA:Pa- Atlanta,GA:Centers for Disease Control. cific Center for Violence Prevention. Centers for Disease Control. 1993.Injury Control in the 1990s:A National Plan for Rice, D.P., MacKenzie, E.J., and Associ- Action. Atlanta, GA: Centers for Disease ates. 1989. Cost of Injury in the United Control. States:A Report to Congress.San Francisco, CA: institute for Health and Aging, Uni- Centers for Disease Control. 1994. Mor- versityof California, and Baltimore, MD: bidity and Mortality Weekly Report.3 3(3). Injury Prevention Center,Johns Hopkins Fingerhut, L.A. 1993. Firearm mortality University. among children, youth, and young adults Rosenberg, M.L., Mercy, J.A. 1991. 1-34 years of age,trends and current status: Assaultive violence.in:Rosenberg,M.L.and United States, 1985-90.Advance Data,no. Fenfey,M.,eds.Violence in America:A Pub- 231. Hyattsville,MD:National Center for lic Health Approach. New York, NY:Ox- Health Statistics. DHHS, Pub No. (PHS) ford University Press. 93-1250. Sheley,LE,Wright,J.D. 1993. Gun Ac- Fingerhut, L.A., Ingram, D.D., Feldman, quisition and Possession in SelectedJuvenile J.j. 1992. Firearm homicide among black Samples.Washington,DC:Department of teenage males in metropolitan areas. Jour- justice,Office of justice Programs,National nal of the American Medical Association. institute of Justice,Office of Juvenile Jus- 267:3054-3058, tice and Delinquency Prevention. Fingerhut, L.A., Ingram, D.D., Feldman, Sugarmann,J. 1994. Cease Fire:A Com- J.J. 1992.Firearm and nonfirearm homicide prehensive Strategy to Reduce Firearm Vio- among persons 15 through 19 years of age. lence. Washington, DC: Violence Policy Journal of the American Medical Associa- Center. tion. 267:3048-3053. Sullivan, M., Balogh, J.J., Starkey, M. Harris,L. 1993.Harvard School of Public 1994. Profile of Violent injury in Contra Health. A Survey of Experiences, Percep- Costa County.Pleasant Hill, CA: Contra tions, and Apprehensions About Guns Costa County Health Services Department Among Young People in America.New York, Prevention Program. References The FIRST Project Report 49 APPENDIX A FIRST Project Reporting Forms Appendix A The FIRST Project Report A-1 FIRST Law Enforcement Data Reporting Form Please complete for each gunshot victim (7/1/93 to 6/30/94) Your name: Today's date: Your department: Case number: Code section: ❑ PC 245 A.-2 ❑ PC 187 ❑ PC 187-664 ❑ other: ENVIRONMENT/CIRCUMSTANCES OF SHOOTING Date of shooting: Time of shooting(24 hour clock): Street address: City:— Location(check all that apply): Cl victim's home ❑ other residence ❑ victim's workplace ❑ school ❑ store/commercial ❑ vacant building/unit ❑ park ❑ empty lot ❑ street/parking lot ❑ victim in car/vehicle ❑ other Clrcuttlstances(check all that apply): ❑ sexual assault ❑ argument/fight ❑ robbery ❑ victim walking/standing (but not drive-by) ❑ drive-by ❑ suicide attempt f I, ❑ unintentional/accident ❑ police fire ❑ other i' VICTIM INFORMATION Sex: 4 male ❑ female ❑ unknown Age:. years ❑ unknown Race: ❑ Asian/PI ❑ Black ❑ Latino ❑ White ❑ Other ❑ unknown City of residence: ❑ unknown Relationship to suspect: ❑ spouse/lover (cunentorex) ❑ other family member ❑ acquaintance (close or distant) a stranger ❑ other' ❑ unknown Hospital care:(name of hospital) when:(datemime) chart#: _ it SUSPECT INFORMATION (person suspected of shooting victim) Sex: ❑ male ❑ female ❑ unknown Age: years a unknown l; Race: ❑ Asian/PI ❑ Black ❑ Latino ❑ White ❑ Other ❑ unknown Was arrest made? ❑ yes ❑ warrant issued ❑ no, lack of evidence ❑ other ❑unk:nown i, INFORMATION ON FIREARM INVOLVED IN SHOOTING I . Firearm type: ❑ semi-auto handgun ❑ revolver ❑ rifle ❑ shotgun ❑ other ❑ unknown Caliber: ❑ 9 m ❑ .380 ❑ .357 magnum ❑ .38 special ❑ .22 ❑ other ❑ unknown brand name: ❑ unknown I COMMENTS: — I Please return to: Heather McLaughlin,Project Coordinator- -646-6511, fax: 646-6520; fContra Costa Health Services Prevention Program,75 Santa Barbara Road, Pleasant Hill, CA 94523 t a a FIRST Hospital Data Reporting Form Please complete for each gunshot wound patient(711193 to 6130194) Your name: Today's date: Your hospital: Medical record number. Date of gsw injury: Time of emergency room/dept admission(24 hour dock): Method of transport: ❑ ambulance ❑ helicopter ❑ police ❑ family/acquaintance ❑ stranger ❑ self ❑ other ❑ unknown PATIENT INFORMATION Sex: ❑ male ❑ female ❑ unknown Race: ❑ Asian/Pi ❑ Black o Latino ❑ White ❑ Other ❑ unknown Age: years ❑ unknown Zip code of residence: ❑ unknown Was patient under influence of alcohol or drugs at time of care? ❑ yes ❑ no ❑ unknown Location(s) of body wound(s):❑ head/neck❑ trunklchest❑ upper limb ❑ lower limb ❑ unknown Most severe injury: ❑ puncture wound ❑ graze/laceration ❑fracture ❑ other ❑ unknown Were trauma criteria met? ❑ yes ❑ no ❑ unknown Likely circumstance for gsw(check alt that apply): ❑ inflicted by self ❑ inflicted by other ❑ police fire ❑ unintentional/accident ❑ suicide (attempt orsuccess) ❑ assault/homicide (attempt or success) ❑ unknown ❑ other Patient disposition:❑ admitted to hospital ❑ discharged ❑ died in emergency care ❑ transferred to: ❑ other ❑ unknown Clinical outcome following hospital admission (or expected outcome): ❑ full recovery ❑ partial recovery ❑ died in hospital ❑ unknown Length of stay: days .. . PAYMENT INFORMATION Source of payment for medical care: ❑ HMO ❑ insurance ❑ Medi-Cat ❑ other government ❑ self pay ❑ other ❑ unknown Hosp. charges for emerg. care: $ Additional physician emerg. care charges: $ Hosp. charges for inpatient care:$ Additional physician inpatient care changes:$ Comments: Please return to: Heather McLaughlin, Project Coordinator-s 646-6511,laic 646-6520 Contra Costa Health Services Prevention Program,75 Santa Barbara Rd,Pleasant Hill, CA M23 APPENDIX B CPC Charges .and UCR Classifications In order to identify all potential reports tion of"homicide,"CPC charges do not according to UCR classi fications.These of shooting victims in law enforcement indicate the injury status of crime classifications are names of crime records,FIRST staff developed a listing victims. Charges of "rape," "robbery," categories. For example, "willful/non- of both CPC charges and UCR cate- and "assault" may or may not involve negligent homicide" is a UCR Classi- gories which might involve firearm physical injuries. For example, an fication. injuries. (See Figure i.) Law enforce- incident in which a victim is directly UCR reporting procedures require ment agencies then used these lists to threatened with a gun is considered an that for crime incidents involving search their records and ascertain which assault, whether or not the victim is multiple offenses, the offense that is reports fell into these classifications. injured. highest in the offense classification hierarchy (and therefore carries the California Penal Code Uniform Crime Report most serious punishment) must be (CPC) Charge (UCR) Classifications assigned as the primary offense. (A partial offense classification hierarchy is: Classifications Each law enforcement agency in criminal homicide, forcible rape, California voluntarily submits crime robbery, and aggravated assault.) If a California Penal Code(CPC)Charges statistics to the State Department of victim is shot in the arm and then are numerical criminal charges. For justice, Bureau of Criminal Statistics robbed,for example,the incident would example, "CPC 187" is a homicide. (BCS)in the form of a monthly Uniform : be classified in a UCR summary as a When a crime is committed, the law Crime Report (UCR) summary. The "robbery," because "robbery" precedes enforcement officer investigating the BCS then consolidates these reports for "aggravated assault" in the offense crime fills out an offense report and the Federal Bureau of Investigation's hierarchy. Uniform Crime Reports do determines which CPC charge to assign Uniform Crime Reporting program not include data about suicides or. to each offense committed,a procedure (FBI-UCR), which compiles the UCR "accidents," with the exception of that can result in numerous charges for summaries into annual Uniform Crime "manslaughter by gross negligence," one crime incident. The, District Reports. which falls under the UCR"homicide" Attorney makes the final decision about UCR summaries are prepared by each category. When classifying reports for which charges to pursue. (The District local law enforcement agency's statistics a UCR summary,the statistics unit may Attorney's decisions did not affect the unit, which reviews its department's change the crime's classification from results of this report.)With the excep- offense reports and re-classifies them thargiven by the officer who conducted the original investigation. Appendix B The FIRST Project Report B-1 Lists of CPC Charges and UCR Classifications that Potentially Correspond with FIRST Classifications FIRST Classification California Penal Code(CPC) UCR Classification (injuries or deaths due to firearms only. Charge Classification The basis for classification is in parentheses) Homicide(based on UCR definitions 187 (homicide) Willful/non-negligent homicide for willful/non-negligent homicide) Assault*(based on UCR definitions 261 (rape); 211 (robbery); Forcible rape; for rape, robbery, or aggravated 211-664(attempted robbery); Robbery with firearm; assault with firearm,and CA 212.5(residential armed robbery); Aggravated assault with firearm Penal Code Charge 246) 215 (carjack); 245 (assault, including some subclassifications;e.g., 245A2); 187-664(attempted homicide); 246(shoot at inhabited dwelling, vehicle, etc.) 4 Completed suicide(based on No such charge Not counted coroner determination) Attempted suicide(based on No such charge Not counted police accounts) Fatal unintentional (based on 187(homicides determined to be Manslaughter by gross UCR definition for manslaughter manslaughter by gross negligence) negligence(if considered , by gross negligence and police No charge if determined to be accidental, not counted in UCR) accounts of accidental fatalities) accidental death Nonfatal unintentional (based on Generally no charge,though acts of Not counted police accounts of accidental injuries) negligence may be charged(e.g., 246) Legally justified fatal(based on 196.2(officer killed suspect in line Justified homicide police accounts, these are incidents of duty) in which the offender acted in 187(the District Attorney or adjudication accordance with CA law for legal process determines whether justified) justification") Legally justified nonfatal(based on 245(the District Attorney or No such category(counted as police accounts, these are incidents in adjudication process determines the crime being committed by the which the shooter acted in accordance whether justified) person who is shot) with CA law for legal justification`*) Undetermined (based on police No such charge No such category accounts; injury classification deemed impossible) Fig.i *Assaults include any intentionally inflicted,nonfatal shootings that,according to police accounts,were intended solely to harm the injured person. **Legal justification for the use of deadly force according to California Penal Code include Sections 196(public officers,legal duty); 197(prevent an atrocious felony);or 196.5(home protection;fear of death or great bodily injury). B-2 The FIRST Project Report Appendix B APPENDIX C Firearm Injury Totals Contra Costa County July 1, 1993 - June 30, 1994 INTENT FATAL NONFATAL TOTAL Or INJURY Number Percent Number Percent Number Percent Homicide 111 18.1 111 18.1 Assault 310 50.5 310 50.5 Self-Inflicted 40 6.5 7 1.1 47 7.7 Unintentional 2 0.3 48 7.8 50 8.2 Legally 4 0.7 6 1.0 10 1.6 Justified Undetermined 0 0 85 13.9 85 13.9 Total 157 25.6 456 74.4 613 100 Fig.ii Appendix C The FIRST Project Report C-1 Dd APPENDIX D Firearm Injuries by Intent and Victim Race/Ethnicity Contra Costa County July 1, 1993 - June 30, 1994 INTENT African White Asian/Other Latino No Total OF American Data INJURY # Rate # Rate # Rate # Rate Assault 202 251.2 50 8.5 15 16.0 39 36.0 4 310 Homicide . 71 88.3 21 3.6 4 4.3 14 12.9 1 111 Self-Inflicted 3 3.7 39 6.6 2 2.1 3 2.8 0 47 Unintentional 13 16.2 24 4.1 0 0 7 6.5 6 50 Legally 3 3.7 4 0.7 0 0 3 2.8 0 10 Justified Undetermined 44 15 ------ 4 ------ 9 ------ 13 85 Total 336 417.8 153 25.9 25 26.7 75 69.3 24 613 .]: Fig.iii Rates are per 100,000 Appendix D The FIRST Project Report D-1 APPENDIX E Poverty, Unemployment and Firearm Injuries. by County Region Contra Costa County July 1, 1993 - June 30, 1994 Poverty and Unemployment 1990 U.S.Census Re ion WUnem to ment % Below Pov2rty West 7.2 11.7 East 6.7 9.5 Central 3.4 .4.7 South 2.6 1.8 Fig.iv Firearm Assault Rates and Numbers Re ion Rate Number Population Denominator West 112.6 243 215,836 East 30.3 50 165,003 Central 4.2; 14 335,670 South 0 0 87,223 Fig.v Firearm Homicide Rates and Numbers Region Rate Number Population Denominator West 38.9 84 215,836 East 13.3 22 165,003 Central 1.8 6 335,670 South 1.1 1 87,223 Fig.A Rates are per 100,000 Denominators are from 1990 Census figures Assault and homicide data are from the FIRST Project Appendix E The FIRST Project Report E-1 Firearm Suicide Rates and Numbers Region Rate Number Population Denominator West 6.0 13 215,836 East 6.7 11 165,003 Central 4.8 16 335,670 South 4.6 4 87,223 Fig.vii Rates are per 100,000 Denominators are from 1990 Census figures Suicide data are from the FIRST Project E-2 The FIRST Project Report Appendix E APPENDIX F Firearm Assault Rates by Victim Sex and Age Contra Costa County July 1, 1993 - June 30, 1994 Age Male Rate per Female Rate per 100,000 100,000 0 to 4 1 3.1 0 0 5to9 2 6.4 0 0 10 to 14 6 19.4 5 17.0 15 to 19 71 237..5 9 31.6 20 to 24 71 253.6 5 18.0 25 to 29 39 128.7 3 9.4 30 to 34 28 85.3 5 14.3 35 to 39 21 -,58.7 4 10.4 40 to 44 11 30.4 3 7.7 45 to 49 6 19.6 1 3.1 50 to 54 9 34.8 0 0 55 to 59 2 9.8 0 0 60 to 64 0 0 1 5.3 65 to 69 1 6.8 1 5.8 70 to 74 1 8.7 0 0 75 + 0 0 0 0 Total 273 64.4 37 8.2 Fig.viii Appendix F The FIRST Project Report F-1 APPENDIX G Firearm Homicide Rates by Victim Sex and Age Contra Costa County July 1, 1993 - June 30, 1994 Age Male Rate per Female Rate per 100,000 100,000 0to4 0 0 0 0 5 to 9 0 0 1 3.3 10 to 14 0 0 0 0 15 to 19 15 50.2 1 3.5 20 to 24 28. 100.0 2 7.2 25 to 29 18 59.4 1 3.1 30 to 34 13 39.6 4 11.4 35 to 39 8 22.4 3 7.8 40 to 44 3 8.3 1 2.6 45 to 49 2 6.5 1 3.1 50 to 54 1 3.9 0 0 55 to 59 2 9.8 1 4.6 60 to 64 0 0 0 0 65 to 69 0 0 0 0 70 to 74 0 0 1 6.9 75 + 0 0 0 0 Total 94 22.2 17 3.8 Fig.Ix Appendix G The FIRST Project Report G-1 APPENDIX H Firearm Assault Rates by Victim Age and Race/Ethnicity Contra Costa County July 1, 1993 - June 30, 1994 Age African White Asian/Other Latino American 0to4 12.8 0 0 0 5 to 9 27.4 0 0 0 10 to 14 130.9 2.8 0 0 15 to 19 812.6 19.7 27.8 175.7 20 to 24 865.4 11:8 46.8 162.6 25 to 29 419.4 20.3 86.0 21.0 30 to 34 393.2 11.3 25.9 10.4 35 to 39 217.3 19.8 0 11.4 40 to 44 129.9 7.5 0 27.4 45 to 49 60.0 6.6 0 18.3 50 to 54 121.7 7.6 0 0 55 to 59 0 0 51.4 0 60 to 64 0 3.6 0 0 65 to 69 0 3.9 0 0 70 to 74 0 4.7 0 0 75 + 0 0 0 0 Total 251.2 8.5 16.0 36.0 Fig.x All rates are per 100,000 Appendix H The FIRST Project Report H-1 Cri o � �d o O n b CCD i o CD 0 CD " CD owo � o o � CDCD' o a D' cn CD N O �-t O O O Dti �n CD L APPENDIX I Firearm Assault and Homicide Rates by City or Unincorporated Area Contra.Costa County .. July. 1, 1993 - June 30, 1994 City/Area Assaults Rate Homicides Rate Total Total 1994 Rate Population Antioch 16 22 1 8 1''1 1 24 33"2 < 72;263 Bay Point 9 51.1; 4 22.'O::: 13 74 5 97,453* Bethel Island 0 0 2 2 94:6 2,115 . Blackhawk 0 0 0 0 0 0 ------ Brentwood 219. 2 19 1 4 38.2 10,467 Byron 1aot 0 0" 1 not ------ aV ail• avail. Concord 12 10: 4 3.5 16 14:0 113,927 Crockett 1 31:0 1 310. 2 62;0 3,228 Danville 0 LAM1 2 9 1 2 9 ,`. . 34,972 East Brentwood 0 0 0 0 0 0 ------ East Richmond 0 0. 0 0 0 0 ------ EI Cerrito 1 4 2` 1 4 2, 2 $.5 23,581 EI Sobrante 1 10 2 1 10 2, 2 20,3 9,852* Hercules 0 Q 1 5.3 " 1 5.•3" 18,898 Lafayette 0 0 0 0" 0 Q, ------ Martinez 2 5 6 "'' 0 0 2 5.6 ! 35,539 Moraga 0 0 0 0 0 0 North Richmond 13 553,9. "' 15 639 1.. 28 1193.Q 2,347* Oakley 3 16 3 1 5 4 4 18,374* Pinole 1 5 Vii, 0 0 1 5 5 18,317 Pittsburg 19 37;4 5 9.8 24 47.3 50,789 Fig.A(continued on the next page) Appendix I The FIRST Project Report 1-1 City Assaults Rate Homicides Rate Total Total 1994 � � Rate Population Richmond 187 2Q1 8 48 5Q 7 235 253 8 92,644 Rodeo 4 527, <.' 0 b .. ' 4 52.7 7,589 San Pablo 33 128 0 13 49.7 46 178 8 26,181 San Ramon 0 0 0 0 0 0 ------ Walnut Creek 0 g ` fla o 1 1 ti 1 1 6 62,859 Concordt 0 0 1 T1pt 1 not ------ avail San Pablot 5 not, 1 .not 6 ..not ----- aYatl Walnut Creekt 0 0 0 0 0 0 ------ Total 310 110 420 ----- Fig.A(continued from previous page) Rates are per 100,000 "1990 Census data used for population of unincorporated areas tUnincorporated area located within city limits 1-2 The FIRST Project Report Appendix I �J _\gg � � �\ 4 r �f RIM \\\ ....� \\ \: \ \ \ \ON SRI \ - - ON OR MIM \, ON r� WES �,, \ \ N\M \ r \��W \ MIR �\\ .� . �� APPENDIX J Firearm Suicides Contra Costa County July 1, 1993 - June 30, 1994 By Data Source Data Source Total Fatal Non- Coroner 18 18 ------ Hospital 5 0 5 Law 24 21 3 Total 47 39 8 Fig.xiv BY Victim Sex Sex Number Percent Rate per 100,000 Unknown 1 2.1 - Male 37 78.7 8.7 Female 9 19.1 2 Total 47 99.9 5.4 Fig.xv By Victim Race/Ethnici Race/Ethnicity Number Percent Rate per 100,000 White 39 83 6.6 African American 3 6.4 3.7 Latino 3 6.4 2.8 Asian 2 4.3 2.1 Total 47 100.1 5.4 Fig.xvi Appendix J The FIRST Project Report J-1 D6 �, By Victim Age and Sex Age Female Rate per Male Rate per 100,000 100,000 10 to 14 0 0 2 6.5 15 to 19 0 0 4 13.4 20 to 24 1 3.6 2 7.1 30 to 34 2 5.7 4 13.2 35 to 39 1 2.6 3 9.1 40 to 44 0 0 3 8.3 .45 to 49 1 3.1 1 3.3 50 to 54 2 7.3 3 11.6 60 to 64 0 0 6 35.4 65 to 69 0 0 1 6.8 70 to 74 0 0 3 26.1 75 to 79. 1 8.3 3 35.5 80 to 84 0 0 1 21.0 85 + 0 0 0 0 Total 8 2.0 37 8.7 Fig.xvii J-2 The FIRST Project Report Appendix J t APPENDIX K Firearm Suicides by City or Unincorporated Area Contra Costa County July, 1, 1993 - June 30, 1994 City/Area Number Percent Rate per 100,000 Antioch 5 10.6 6.9 Baypoint 1 2.1 5.7 Byron 1 2.1 not available Concord 6 12.8 5.3 Danville 2 4.3 5.7 East Bay 1 2.1 not available Regional Park EI Cerrito 1 2.1 4.2 Lafayette 1 2.1 4.2 Martinez 1 2.1 2.8 Oakley 2 4.3 10.9 Pinole 1 2.1 5.5 Pittsburg 2 4.3 3.9 Pleasant Hill 2 4.3 6.2 Port Costa 1 2.1 not available Richmond 4 8.5 4.3 San Pablo 6 12.8 22.9 San Ramon 2 4.3 5.1 Walnut Creek 6 12.8 9.5 Missing 2 4.3 not available Total 47 100.1 5.4 Fig.xviii . Appendix K The FIRST Project Report K-1 APPENDIX L Unintentional Firearm Injuries Contra Costa County. July 1, 1993 -.June 30, 1994 BY Outcome Fatal Rate per Nonfatal Rate per Unknown 100,000 100,000 Outcome IL_2 0.2 42 4.8 6 Fig.xix BY Victim Sex IF- Sex Number Rate per 100,000 Male 42 9.9 Female 8 1.2 Fig.xx By Victim Race/Ethnicity IFRace/Ethnicity Number Rate per 100,000 Unknown 6 ------ African American 13 16.2 Latino 7 6.5 White 24 4.1 Asian/Other 0 0 Total 50 5.7 Fig.xxi Appendix L The FIRST Project Report L-1 By Victim Age Age Number Rate per 100,000 10 to 14 9 14.9 IF- 15 to 19 8 13.7 20 to 24 8 14.4- .25 4.4...25 to.29 4,. 6.4 30 to 34 5 7.4 35 to 39 3 4 40 to 44 2 .2.7 45 to 49 3 4.8 50 to 54 2 3.8 55 to 59 1 2.4 60 to 64 2 5.6 : . 75 to 79 2 9.8. 85 + 1 9.1. Fig.xxii L-2 The FIRST Project Report Appendix L ( �t -pI t APPENDIX M Firearm Diagrams Appendix M The FIRST Project Report M-1 Two Types of Handguns parts usually include: ejection port slide hammer barrel/muzzle safety O ' trigger trigger guard O grip magazine `a azine wel l 0 0 0 0 0 revolvers parts usually include: cylinder barrel hammer muzzle ) CO cylinder release extractor rod chambers grip trigger guard trigger Fig.xxiii Types of Ammunition i • I i C MM shdtgun shell parts usually include: parts usually include: bullet shot cartridge pbl sdtic case y (hull) powder :"" `" � wad ^`�`'�.in.^"'S`w^.''i.`".�...0^.��.`.n^YCn U 1111-M powder isa`sis ^:�-:ys .:a .M:::ilr� yy... .;p.,;y..... ,.t3:'i''�`....:-C: ' r• x -:^ �w, :~: brass head �';"'...yr;� �• :fi)�!il�>^l�.�k.��1.^-• primerM primer Fig.xxiv APPENDIX N Map of Contra Costa County Appendix N The FIRST Project Report N-1 a� O � A 0 o � V a � � a t � aG