Gun injuries in Oregon nearly doubled in two years

Between 2019 and 2021, emergency department visits for nonfatal gun injuries nearly doubled — 459 to 873 — according to the report. That’s compared to an 18% increase in gun deaths between those years, according to official and preliminary mortality data from the U.S. Centers for Disease Control and Prevention.

The OHSU report marks the first time data on gun-related injuries that people survived has been compiled in Oregon. It was also the inaugural report by the research center, which launched earlier this year in partnership with the Portland State University School of Public Health.

The center aims to treat gun violence as a public health issue. Similar to how society would address the outbreak of infectious disease, researchers will use data-driven science to inform prevention strategies and reduce health impacts.

Public health angle

The approach was effectively blocked by a law that stunted federal funding for gun violence research for more than 20 years until recently, said injury epidemiologist and the report’s lead author, Kathleen Carlson.

In 1996, Congress passed a spending bill with a provision that stopped CDC funds for injury prevention from being used to “advocate or promote gun control.” While the Dickey Amendment, which was lobbied for by the National Rifle Association and named after its author, former Arkansas Rep. Jay Dickey, didn’t explicitly ban gun research, the CDC avoided research on gun violence for fear it would be penalized.

Public health researchers were careful not to talk about guns because they thought they’d lose funding for their work, Carlson said.

In 2018, Congress clarified the provision to allow for such research and the first funding for it came in the 2020 spending bill.

The OHSU-PSU research center has been fueled by that change, partnering with the Oregon Health Authority to monitor gun injuries using CDC funds and seed money from the Silver Family Innovation Fund.

New insights

Improving data on nonfatal gun injuries is a crucial piece of understanding the overall impact of gun violence on communities and creating programs to address it, Carlson said.

“We’ve had pretty robust data on (gun-related) causes of death for a number of years,” Carlson said. “What we haven’t had is a way to home in on nonfatal firearm injuries. If we can get a handle on those numbers in combination with the fatal injuries, those can work together to flatten the curve.”

To produce the report, researchers analyzed injury reports submitted by emergency departments to a state public health surveillance system that was originally created to detect bioterrorism in the aftermath of the 9/11 attacks. The Oregon Health Authority was one of 10 state health agencies to receive CDC funding for three years to use that method. It will allow researchers to access near real-time gun injury reports and update a new dashboard with the data on a quarterly basis, Carlson said.

Much of the increase in gun injuries can be attributed to the Portland area, where nonfatal injury shootings increased by 240% between 2019 and 2021, according data from the Portland Police Bureau.

But the OHSU report reveals that gun injuries are not a Portland problem only, Carlson said.

While Multnomah County had among the highest rates of gun injuries per capita, two rural counties — Douglas and Jefferson — had similarly high rates of more than 80 per 100,000 residents between 2018 and 2021, according to the report.

Carlson speculates that the high rates of gun injuries in more rural areas could be related to a combination of guns being a part of everyday life and there being room for improvement in gun-safety culture and training.

She said researchers are also focused on analyzing the intent behind incidents that result in gun injuries. “That’s really going to help our prevention efforts,” Carlson said.

They manually reviewed more than 2,100 entries into the surveillance system to classify them by intent.

Nearly 20% of the 1,753 emergency room visits researchers classified as gun injuries were unintentional, or not caused by assault or intentional self-harm, based on the researchers’ review.

That’s roughly the same proportion of injuries found to be intentional. Gun injuries caused by assaults made up 15%, and those inflicted due to self-harm accounted for 5%, according to the report.

There’s a lot of room for improvement in terms of classifying gun injuries by intent, Carlson said. Researchers could not determine intent for 60% of the gun injuries they analyzed. That’s partly because it’s complicated to collect that information in an emergency department reliably. Patients are often unable or uninterested in providing the information.

”It may be that they’re too swamped in emergency departments to spend much time coding records,” Carlson said, adding that she and her colleagues are looking for ways to help emergency departments do it.

Disproportionate impacts