One out of every 66 Americans will die of a drug overdose and one out of every 108 Americans will die of a gunshot wound during their lifetime if current death rates hold, according to a study published this week in the American Journal of Medicine.
The lifetime risk of being killed by a gun in the United States is slightly greater than that of being killed in a motor vehicle crash. One out of every 109 Americans will die in a motor vehicle crash during their lifetime, the study also found.
These statistics aren’t really new. They’re based on death data previously released by the Centers for Disease Control and Prevention (CDC) for the year 2018. But by presenting the data as cumulative lifetime risks (“one out of every 108 Americans”) rather than as large absolute numbers (“39,740 firearm deaths”) or as small annual rates (“12.1 firearm deaths per 100,000 population”), the study’s author — Dr. Ashwini Sehgal, a professor of medicine at Case Western Reserve University — hopes to make a point.
He wants people to grasp the real meaning behind the numbers: the tragic — and all-too-common — impact that firearm and overdose deaths have on individuals, their families and the broader society.
“While absolute numbers and annual death rates describe mortality over a short period of time, lifetime risk tells us more about long-term consequences,” he says in a released statement.
Translating the data
According to the CDC, 2.8 million Americans died in 2018, including 67,367 from drug overdoses, 39,740 from gun injuries and 39,404 from injuries incurred as a result of a motor vehicle crash. Seghal used that data to estimate the cumulative risk of death from birth to age 85 for each of those three causes.
He found that those risks are substantial and vary considerably by gender, race, ethnicity and state.
Black men are most likely to die of a gunshot wound during their lifetime (one in 38), followed by white men (one in 69), Native American men (one in 79), Hispanic men (one in 115) and Asian-American men (one in 260).
Women are much less likely to be killed by a firearm, although the rates are still grim. The lifetime risk of a gun-related death is one in 287 for Black women, one in 374 for white women, one in 411 for Native American women, one in 802 for Hispanic women and one in 1,225 for Asian American women.
Drug overdoses kill Black and white men in the U.S. at similar rates. One in 44 Black men and one in 47 white men will die of an overdose during their lifetime, according to the Sehgal’s estimates. Among women, whites are far and away the likeliest to die of a drug overdose (one in 88), followed by Native Americans (one in 106), Blacks (one in 118), Hispanics (one in 245) and Asian-Americans (one in 617).
Native American men are most at risk of dying in a motor vehicle crash during their lifetime (one in 77), while Asian-American women are the least likely (one in 291).
The lifetime risks also vary greatly across states. People living in Mississippi have the greatest risk of dying from a gunshot (one in 59), while those living in Massachusetts have the lowest (one in 351). For Minnesotans, the risk is relatively low compared to most of the other states: one in 161.
Residents of West Virginia are at the greatest risk of dying from a drug overdose during their lifetime (one in 28 — more than twice the national average), while those living in South Dakota have the lowest risk (one in 196). For Minnesotans, the risk is again relatively low: one in 117.
Mississippians have the highest lifetime risk for death from a motor vehicle crash (one in 57), while New Yorkers have the lowest (one in 239). The risk for Minnesotans is one in 142.
Seghal says he thought about the study’s findings regarding his own state — Ohio — when he recently toured a newly constructed elementary school near his home.
“I had a hard time concentrating on the gleaming whiteboards, the new computers, or the cheerfully decorated walls,” he recalls. “I realized that one child on every floor of the school would likely die from firearms and another one from a drug overdose in the years ahead.”
“If I were across the border in West Virginia, then one child per classroom will have their life ended by an overdose,” he adds.
Limitations and implications
The study assumes that death rates in the coming years will be similar to those in 2018 — an assumption that may under- or overestimate the actual future risk. Also, as Seghal points out in his paper, “The lifetime risk estimates in this analysis are average values, and different individuals may have substantially lower or higher risks.”
Still, the findings are in line with previous research that has looked at demographic differences in death rates from drug overdoses, firearms and motor vehicle crashes, including a 2015 study that found men in the U.S. were six times more likely than women to die from gun-related injuries.
Sehgal hopes his findings will not only educate the public about these mostly preventable deaths, but also prod policymakers to take steps to reduce them, such as by implementing background checks and waiting periods for gun purchases and by increasing access to substance use treatment and needle exchange programs.
He also urges health care providers to talk about gun safety with their patients and to practice more responsible prescribing of opioid medications. (More than 70 percent of overdose deaths in the U.S. in 2018 involved either prescription or illicit opioids.)
The study’s lifetime risk predictions are not inevitable, Sehgal stresses. But to change the trajectories of those predictions, we must get our death rates down.
“Let’s take sensible steps now to help our children avoid the preventable tragedies of firearm and overdose deaths,” he says.
FMI: You can read the study in full at the American Journal of Medicine’s website.