While gun violence in the United States continues to claim lives at an alarming rate, it is also taking a quiet toll on the U.S. economy, according to new research by Zirui Song, associate professor of health care policy in the Blavatnik Institute at Harvard Medical School and associate professor of medicine at Massachusetts General Hospital.
In 2020, according to a PEW Research Center analysis of data from the U.S. Centers for Disease Control and Prevention, 45,222 people died from gun-related injuries in the United States—more than any other year on record.
Another study found that the United States accounted for 73 percent of mass shootings and 62 percent of related fatalities in developed countries between 1998 and 2019.
Song’s work has focused on the somewhat hidden aspects of firearm injuries, revealing that the cost of gun violence is far greater than the loss of human life alone. Earlier this year, he and colleagues delved into the long-term repercussions of firearm injuries for those who survive them.
In his newest paper, published in JAMA, Song reports that the overall economic cost of firearm injuries in the United States is some $557 billion annually, or 2.6 percent of gross domestic product. Eighty-eight percent of this cost is attributed to quality-of-life losses among those injured by firearms and their families. Yet, Song said, the business case for reducing firearm injuries has remained largely unaddressed.
Findings from Song's latest analysis include:
- Among U.S. companies with employer-sponsored health insurance, the rate of total firearm injuries in employees and dependents increased more than fourfold from 2007 to 2020 — from 2.6 to 11.7 per 100,000 insurance enrollees.
- Each nonfatal firearm injury leads to roughly $30,000 in direct health care spending per survivor in the first year alone. That is a more than 400 percent increase in health care spending from the pre-injury baseline, relative to peer workers who did not sustain firearm injuries.
- The direct first-year medical spending for treating a firearm injury likely already exceeds the average first-year spending on other common conditions that employers have long aimed to prevent, such as nonfatal myocardial infarction and heart failure.
- Aside from added spending, losses in revenue and productivity are estimated to cost private employers $535 million per year nationwide. Employers also face the physical and mental consequences. Workers who survive firearm injuries experience a 40 percent increase in pain disorders, a 51 percent increase in psychiatric disorders, and an 85 percent increase in substance use disorders.
“This evidence suggests that employers and their health insurers sustain a substantial financial burden from firearm injuries and have a financial incentive to prevent them,” Song wrote. “To date, however, U.S. businesses have by and large not engaged publicly on the subject of firearms, despite spending large sums on other efforts to promote employee health.”
While this business case may resonate with some employers, it may not with others, Song added. The prevalence of firearm injuries among workers remains far lower than the prevalence of common workplace injuries such as musculoskeletal pain. Nevertheless, firearm injuries among workers are increasing, he said.
“For a large, self-insured employer with 100,000 workers, 12 firearm injuries that collectively cost $360,000 in direct medical spending in the first year, not including indirect costs, may not be significant enough to change corporate strategy. However, for businesses that encounter higher or growing rates of firearm injuries in their workforce, the economic rationale for reducing firearm injuries in their workers may be more difficult to ignore,” Song said.
Republished courtesy of Harvard Medical School.