Exploring firearm injury in King County using the new Emergency Medical Services Data Dashboard

 

Note: This blog post was revised on 5/5/2023 to include updated data and resources

A newly published data dashboard uses Emergency Medical Services (EMS) data to provide a unique opportunity to learn about recent firearm injuries in our community. Typically, gun violence data on hospitalization or death have long lag times between the incident and data release. In response to community concerns, Public Health has been working to add more timely data to our dashboard. Information from EMS offers monthly updates of firearm injury activity and trends throughout King County. This resource will help us better track rates of EMS-treated incidents involving firearm injuries by geography, age, gender, and severity over time.

Oftentimes, gun violence data highlight fatal firearm injuries. However, non-fatal injuries are also important to consider. Other data sources Public Health monitors show that the second most common manner of non-fatal firearm injury hospitalization in King County is assault, although the manner of injury is missing for many of the firearm injuries treated by EMS because the focus is on providing care rather than investigation. People who experience non-fatal firearm injuries can suffer lifelong health problems and disabilities. A recent study authored by Song et al. found that survivors of firearm injuries experience “worse mental health, substance use disorders, and higher health care spending for survivors as well as increased mental health disorders for their significant other and children”. When looking at gun violence data, we need to include all types of injuries to incorporate the non-lethal impacts of gun violence. This EMS data dashboard provides insight into nonfatal firearm injury in King County that can help us better understand the full picture of gun violence in our communities.

Key Findings:

Incidents involving firearms treated by EMS increased between 2019 and 2021

At the beginning of the COVID-19 pandemic, there were marked increases in gun sales and new gun ownership. Incidents involving firearms also increased, as these and other data show. Rates of incidents involving firearms treated by EMS appear to vary greatly from month to month throughout the year. As seen in Figure 1, in 2019 and 2020 firearm incidents occurred more often during the warmer spring and summer months, although this trend was not apparent in 2021. But EMS data show that overall rates of incidents involving firearms increased each year from 2019 to a new, unprecedented high through the end of 2021, with an apparent decline in the first half of 2022, followed by an increase.

 

Figure 1: Monthly Emergency Medical Services-treated Incidents that involved a firearm injury.

 

Geography of EMS-treated firearm incidents has changed over time 

The new EMS Firearm Injury dashboard shows how firearm incidents treated by EMS change over time and geography around King County. The map of King County is broken down into different Health Reporting Areas (HRAs) which typically correspond to neighborhoods within large cities and delineate unincorporated areas of King County.

In Figure 2, from 2019 to 2021 we see firearm injuries spreading throughout the County as more areas turn blue, darker blue, or even purple, indicating more EMS responses for injuries from firearms. We continue to see higher concentrations of firearm-related incidents in Downtown Seattle, South Seattle, and South King County.

 

Figure 2: Emergency Medical Services-treated incidents that involved a firearm injury over the past three years.

 

Firearm violence does not always occur in the place people involved live. This dashboard differs from other firearm injury data sources because it shows the location where incidents that are treated by EMS occur, rather than the residence of injured persons. Knowing geographic distribution of firearm injury incidents will help with the development of outreach and firearm injury prevention strategies tailored for different communities.  

The Characteristics of EMS-Treated Firearm Injuries in King County:

There are demographic differences in firearm injury

As we dive into the characteristics of who is involved in gun violence, the majority of EMS-treated incidents involving a firearm occur among males, with genders other than male and female not currently noted in data. We also see that nonfatal gun incidents are substantially higher among younger to middle-aged people in the 25-44 age group. This data corresponds with national gun violence trends.

 

Figure 3: Age and gender of individuals in Emergency Medical Services-treated incidents that involved a firearm injury.

 

Firearm injury is most often moderate or severe 

Although injury severity is not directly captured in the EMS data, it can be estimated through the “transport type” field. The data show that injuries from firearms are often moderate to severe (requiring dispatch of advanced life support or paramedic response) or fatal (where the patient died in the field or prior to EMS arrival), demonstrating the high level of damage that firearms can cause from any type of incident.

 

Figure 4: Injury severity and manner of injury of Emergency Medical Services-treated incidents involving a firearm.

 

EMS data fill a gap but do not stand alone 

EMS involvement in firearm injury events often requires time-critical care.  The EMS providers must rapidly assess and medically manage life-threatening situations during a dynamic setting.  Moreover, the patient may or may not be responsive.  In such circumstances, the primary goal is to deliver effective care and coordinate arrival with the designated hospital, rather than attribute responsibility for the injury or determine a profile of patient sociodemographic characteristics.  For example, EMS does attempt to ascertain objective details such as the number of gunshots, the location of entry and potential exit wounds, and the type of weapon, but not speculate regarding motive.  Similarly, EMS often is not able to ask patients about their race or ethnicity. Without this opportunity, it is not possible to accurately collect this data. Although this information is essential to understanding and addressing racial inequities, it is better assessed at the hospital and is available from other data sources on Public Health’s firearms injury dashboard. 

Summary 

We can see that firearm injury is increasing and most often involves serious injury or fatality, and that there are higher concentrations of firearm-related incidents in Downtown Seattle, South Seattle, and South King County. The EMS data enable a better understanding of gun violence and other firearm injuries in our communities by providing monthly, geographically accurate capture of non-fatal and fatal gun injury.  This type of information can potentially help inform near-term and longer-term strategies to interrupt cycles of violence and address underlying determinants of firearm-related injury.  

Resources

 
Mariko Toyoji