Gun Violence in Arizona: A Preventable Public Health Crisis

1,265 Arizonans.?

1,265 lives cut short.?

1,265 families with a missing seat at the dinner table.?

1,265 deaths due to firearms in 2020?alone.?

Firearm violence is one of the leading causes of death among both adults (11th) and children aged 1-19 (2nd) in Arizona.

These deaths are preventable. They are the result of inequality, inadequate and dangerous policies, and a culture deeply concerned with personal rights and individualism.?

A Growing Problem in Arizona: Suicides, Homicides, Police Shootings, Mass Shootings, and School Shootings

Contrary to popular belief, aggravated gun violence (i.e., gun homicide, school shootings, and mass shootings) is not the primary driver of firearm mortality in Arizona; in fact, from 1999-2020, 65% of firearm deaths were due to suicide. Homicides made up about 31% of deaths; police shootings, unintentional, and undetermined deaths made up the remaining 4% of deaths. These deaths don’t come out of nowhere. The U.S. leads the world in gun ownership per capita, and household gun ownership is consistently associated with rates of firearm suicides, homicides, and accidental shootings.

Rates of firearm mortality (suicide, homicide, police shootings, school shootings, and mass shootings) are on the rise in Arizona. The rise in shootings, for instance, is particularly alarming. There have been more school shootings in the?first three years?of this decade than in any previous decade in Arizona. We have witnessed 20 school shootings at 19 schools since 1970, with the majority occurring since 2010.

The problem of gun violence is pervasive and unrelenting, with 2020 bringing an average of 7 nonfatal firearm injuries and 3.5 fatal firearm injuries per day in Arizona. While detailed data on firearm deaths are readily - and freely - available at the state and national level from government and independent sources, there is no comparable complete data source on nonfatal firearm injuries for the U.S. Nevertheless, we found that non-fatal firearm injuries greatly outnumbered fatal injuries in Arizona; without publicly accessible granular data, it is very difficult to determine upon which populations this burden is greatest. This highlights the need for more funding in the area of gun violence research to better understand the distribution of firearm injuries.?

A Social Justice Problem

As with nearly every other health outcome in the United States and Arizona, sociodemographic disparities are present in firearm deaths in Arizona.?

Homicides disproportionately impact non-Hispanic Black people. When compared to the Asian and Pacific Islander population (the least at-risk group in Arizona), non-Hispanic Black people experienced an 8.6-fold increased risk of firearm homicide. This trend is in line with national data showing that residential segregation and structural violence may contribute to the disproportionately high rates of gun homicide in U.S. Census tracts with a higher proportion of Black residents. Disaggregating the data by sex shows that males had significantly higher rates of gun homicide across all racial and ethnic groups.

Suicides, on the other hand, peak in non-Hispanic White males older than 85 years old. Both old age and White race drive this trend; the rate among men over 85 is 24x higher than the rate for females of the same age category, and the rate among non-Hispanic Whites was double the rate of every other racial group.?

Hispanic Arizonans are also at a much higher risk of firearm mortality when compared to Hispanic Arizonans in all other states—in fact, Hispanic Arizonans have the highest rate of firearm homicide of Hispanic populations in any other state.

Police shootings almost exclusively affected males, who accounted for 94% of all fatal police shooting victims. Both Black and Indigenous populations were overrepresented in police shootings relative to their percentage of the population.?

Financial Costs of Gun Violence in Arizona

The human toll of gun violence clearly paints a dramatic problem; nevertheless, the financial toll of gun violence is also extraordinary. The CDC calculates estimates for the total value of a statistical life (i.e., cost of death prevention) due to firearm mortality. In Arizona in 2020, this figure was more than $8.03 billion for suicide and $4.45 billion for homicide.?Everytown for Gun Safety?creates a more comprehensive estimate that also includes non-medical costs like property damage, criminal justice proceedings, and loss-of-work costs. This total societal cost estimated for Arizona in 2019 was nearly $16 billion, which totals about 4.3% of Arizona’s total GDP.

A Path Forward

So, how do we fix this? It won’t be easy, and the road in Arizona is not yet paved, but we can look to the blueprints used in other states and countries that have reduced gun mortality.?

Firearm safety legislation has been implemented in states around the U.S., with much success in curbing gun violence mortality. The figures below show that firearm mortality in A-rated states (i.e., states with comprehensive firearm violence prevention legislation) have significantly lower firearm mortality rates among all racial and ethnic groups than F-rated states such as Arizona, which lack firearm safety legislation.?The graphic below shows the significant difference in firearm mortality in states with strong legislation (e.g., California, New York, Hawaii) vs. states with weak legislation (e.g., Arizona, Texas, Mississippi, Alaska). Firearm safety legislation works.

Based on the evidence outlined in our full report on firearm mortality in Arizona, we have selected five evidence-based policies, listed below, which, if implemented, could have a significant impact on gun violence in Arizona.?

Notably, many of the above policies are highly supported by the public. A January 2021?memo?from Giffords and Everytown found that 93% of those surveyed supported “requiring background checks on all gun sales” (from a national sample of voters in the 2020 election and voters in battleground House districts). Additionally, according to a?2021 survey of gun owners and non-gun owners, requiring a permit for concealed carry is a popular policy, with only 20% of Americans supporting completely?permitless?concealed carry. The same study showed that 74% of respondents also agreed that concealed carry permit applicants should also have to “pass a test demonstrating that they can safely and lawfully handle a gun in common situations they might encounter.” The public supports commonsense measures—do our elected state representatives?

I often think of the Swiss cheese model of harm when I think of firearm violence prevention. (A more in-depth explanation of the model can be found?here). The idea behind this model, which was widely used to describe COVID-19 precautions, is that multiple layers of protection are vital to address public health concerns and that no single prevention measure will work perfectly. There will never be a panacea to the gun violence public health crisis. We need many forms of protection, ranging from conversations about gun safety in our families and communities, advocacy for common sense legislative action, and relentless attention to the tragic deaths that occur every single day. As shown in the political cartoon below, ending gun violence requires many puzzle pieces which include legislation, community engagement, mental health financing, and research funding, among other interventions.

We cannot come to the point where yet another shooting on the nightly news is just background noise. We cannot become complacent. We must mourn the victims and vow to stop the epidemic. Neither policy action nor mortality decreases will happen overnight, but through deliberate, concerted, and committed actions, change is possible, if only we are willing to act. These deaths are not inevitable. Let’s work together to ensure that 1,265 more Arizona families don’t have to eat around a dinner table with an empty chair next year or any year to come.

Citations for all data can be found in the full 130-page report, linked?here. This article is a slightly adapted version of a blog post originally published here. If you or someone you know is experiencing suicidal thoughts or mental health-related distress, call or text 988 for the Suicide and Crisis Lifeline, a free and confidential support line available 24/7/365. You are not alone.?