MEDICAL SENTINEL, Vol. 5, No. 6, November/December 2000
Subject: [ALLY] AAPS Series Feature Article
Hi, Folks,
Here’s the feature article from the first part of the “Doctors and Guns”
series. The table referred to in the article lists the 86 UN member nations
alphabetically that provided homicide and suicide data, and was impossible to
reproduce here. Those wishing to see it firsthand are referred to the
magazine’s website (the URL is listed below), but be aware that it is small
and hard to read. The table is mostly an embellishment, as the pertinent
data are included in the article’s text.
The next e-mail will reprint some of the journal’s commentary.
Paul Nelson
———-
MEDICAL SENTINEL, Vol. 5, No. 6, November/December 2000
Special Issue: Doctors and Guns (Part I) – A Failure of the Public Health
Model
Feature Article
http://www.haciendapub.com/stolinsky.html>
AMERICA: THE MOST VIOLENT NATION?
David C. Stolinsky, MD
Is America the most violent nation on earth? Those who blame this country for
most of the ills of the world would have us believe so. They frequently refer
to high rates of homicide and suicide, though they rarely cite actual data.
But before fear impels us to shred the Bill of Rights, we should determine
whether our fear has a factual basis.
The accompanying table (Table 1) gives suicide and homicide rates for all 86
nations for which data are available. Rates are per 100,000 population and
come from the United Nations 1996 Demographic Yearbook published in 1998.(1)
Note that the latest U.S. suicide rate (for 1997) is 11.4, slightly below the
11.9 listed, while the 1997 U.S. homicide rate is 7.3, far below the 9.4
listed here. Figures exceeding published U.S. figures are starred, while
those exceeding only the most recent (1997) U.S. figures are doubly starred.
For a more contemporaneous comparison, the singly starred figures should be
stressed.
Accuracy of the figures varies. Suicide may not be reported to spare the
family. Thus Egypt claims a suicide rate of zero. On the other hand, Japan
lists murder-suicides as suicides; if a man kills his family and himself,
all
are listed as suicides. The thousands of patients “euthanized” by doctors
each year in the Netherlands are listed as dying from disease. There are 185
UN members, so over half of all nations, including the former Soviet Union
and many African and Asian nations, reported no data at all.
Regarding suicide, the U.S. is in the middle of the pack, with 35 of the 86
nations having higher rates (38 using the most recent U.S. figure). Compared
to the U.S. rate of 11.9, Russia has a rate of 41.2, Hungary 32.9, Denmark
22.3, Switzerland 21.4, France 20.8, and Japan 16.7. In general, Northern and
Eastern European and Asian nations tend to have high suicide rates, while
countries in Southern Europe and Latin America tend to have low rates.
Is there a relation between suicide and strictness of gun-control laws?
Northern European and Asian nations tend to have high rates and strict laws,
while Latin American nations tend to have low rates and more lax laws. Hence
one could make a spurious claim that strict gun laws “cause” suicides. Such a
claim would ignore many relevant facts. For example, Latin countries are
mainly Catholic, with severe social pressures against suicide. Still, it
makes as much (or as little) sense to say that gun laws “cause” suicides as
that they “prevent” homicides.
The U.S. suicide rate has fluctuated between 10 and 17 for a century, with
peaks in 1908 and 1932, and shows no relation to gun laws or gun
availability. The current rate is below the midpoint and falling slightly.
Recently suicides in the young increased. Advocates of gun laws blame the
availability of guns. But suicides in older Americans decreased. The
advocates ignore this fact. If something bad happens, they blame guns; if
something good happens, they ignore it. And this is called “research.”
Is there a correlation between suicide and homicide rates? Statistical
analysis(2) shows none (r = 0.08). Nations with low suicide rates may have
low (Greece) or high (Mexico) homicide rates. Nations with high suicide rates
may have low (Switzerland) or high (Russia) homicide rates. Since suicide and
homicide rates are not correlated, it is difficult to see how a single
factor, such as gun laws, could cause major reductions in both of them.
Moving to the homicide data, we recall that America is often said to have the
highest homicide rate of any “civilized,” “Western,” “industrialized,” or
“advanced” nation. Do those who make such claims believe that Mexico is
uncivilized, Brazil is not in the Western Hemisphere, Russia is not
industrialized, or Ukraine is retarded?
Looking at the homicide figures, we again wonder about accuracy. Are
“political” killings (by the government or rebels) in Northern Ireland,
Egypt, Israel, Guatemala, Peru, China, and elsewhere listed as homicides,
listed separately, or concealed? We must admit that the U.S. has a higher
homicide rate than any Western European nation. Still, 23 nations admit to
higher rates: Armenia, Bahamas, Belarus, Brazil, Colombia, Ecuador, El
Salvador, Estonia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Mexico,
Moldova, Paraguay, Philippines, Puerto Rico, Russia, Sao Tome, Tajikistan,
Trinidad, Ukraine, and Venezuela. Using the 1997 U.S. homicide rate of 7.3,
Azerbaijan and Cuba also have higher rates. Nine nations (ten using the 1997
figures) including Russia have both higher suicide and higher homicide
rates.
There may be a lesson here. Perhaps the more we resemble Colombia with its
drug wars, and Eastern Europe with its ethnic strife, the more our homicide
rate will rise. In fact, homicide rates in some central cities, including
Washington, D.C. with its “crack” wars, are already as high as that of
Colombia. This is not an encouraging thought.
The changes in the U.S. homicide rate over time are interesting. In 1900
there were few gun laws. New York had no handgun law and California no
waiting period. Guns of all types could be ordered by mail or bought
anonymously. And the homicide rate was 1.2, about one-sixth of what it is
today. The homicide rate peaked in 1933, during the Depression, and then
fell. It was low during and after World War II, but began to rise in the
1960s and 1970s, and reached its high for this century, 10.7, in 1980. It
then fell to 8.3 in 1985, a fall of 22 percent. This welcome news was
virtually ignored by the media, which emphasize rises in violence but
downplay decreases. Homicide rose again in the late 1980s, but not to its
1980 high. The homicide rate continued to rise following the Gun Control Act
of 1968, while the fall in the early 1980s occurred when anti-crime laws but
no new anti-gun laws were passed.
From 1991 to 1997 the U.S. homicide rate fell 30 percent. Liberals credit a
strong economy and low unemployment; conservatives point to three-strikes
laws and increasing use of the death penalty. We are uncertain which factors
to credit. The portion of the population made up by males aged 15 to 24, the
most crime-prone group, fell by 5 percent, so this can account for only a
fraction of the 30 percent fall in homicide. In any case, the fall began in
1992, while the Brady Act (waiting period for handgun buyers) and the
assault-weapons ban went into effect in 1994. Clearly, these laws cannot be
credited for a fall in homicide that had begun two years earlier. Violence is
often like an Rorschach test — what we read into it depends more on us than
on it.
This subjectivity must be avoided.
Will extremely harsh anti-gun and anti-crime laws be more effective than
conventional laws? Figures for East and West Germany, the last before the
Wall came down, reveal a unique “experiment.” In 1945 a uniform population
was split in two. After four decades of dictatorial rule, the homicide rate
in the Communist East was 0.7, hardly lower than that in the free West, 1.0.
But the suicide rate in the East was 25.8, much higher than 15.8 in the West.
That is, even the harshest regime prevented few homicides, but at the cost of
many suicides — hardly a fair exchange. Overly severe laws may be
counterproductive as well as oppressive.
Israel and Switzerland, where most adult males keep military-type guns at
home, have low homicide rates, so easy access to guns cannot be the key
factor in homicide. Some nations with strict anti-gun laws also have low
homicide rates, but is this cause and effect? The low homicide rate in the
United Kingdom holds for both gun and non-gun homicides; strict gun laws
cannot account for a low rate of fatal beatings. Japan has harsh anti-gun and
anti-crime laws and a low homicide rate, but Japanese-Americans, who live
under our laws and have access to guns, also have a low homicide rate.
Japanese immigrants bring something with them that inhibits homicide and is
transmitted to their children and grandchildren. It may be self-control or
love of education, but it has nothing to do with laws. Cultural factors are
clearly important. To study the effect of gun laws, statisticians would first
have to correct for all the cultural differences between various nations. Not
enough is known to do this. The best we can do is observing what happens when
new gun laws are passed in the U.S. and Germany, or when Japanese live in the
U.S. In these cases, little effect of gun laws is seen.
In telling Americans, especially young ones, that they live in the most
violent nation on earth, we are slandering our country. In addition, we may
be inadvertently increasing the violence. Studies reveal that children whose
teachers believe they will do well actually do better in school. Children may
sense their teachers’ expectations and live up to them. It seems likely that
children raised to believe that they come from the most violent people on
earth will act accordingly. The violence-prone minority will be more violent,
believing that they must strike before others attack them, while the
nonviolent majority will lapse into hopeless passivity. This is not helpful
to a free country.
It really comes down to what we prefer as a basis for our opinions — facts
or myths. Myths may be comforting, but they rarely lead to effective action.
Myths tell us that nations with strict anti-gun laws have low rates of
suicide and homicide, so the answer is easy — pass more laws. And if the
laws don’t work, pass still more. Facts, on the other hand, may be
disturbing. They rarely provide easy answers for complex problems. Without
the deceptive comfort of myths, we are forced to confront reality. Liberals
must face the fact that despite billions spent on social programs, changes to
make the justice system more “fair,” and new gun-control laws, the homicide
rate doubled since the 1960s.
Conservatives must face the fact that despite continuing family breakup,
fatherless boys, decaying schools, and loss of respect for human life, the
homicide rate fell by one-third in the 1990s. Advocates of drug legalization
must face the fact that this fall in homicide occurred as the “war” on drugs
continued. Opponents of violent films and video games must face the fact that
as these increased, homicide as well as school violence fell, despite highly
publicized shootings.
Conversely, liberals must admit that the recent fall in homicide was
associated with three-strikes laws and increasing use of the death penalty,
while conservatives must admit that the fall in homicide was associated with
low unemployment and a strong economy.
In short, we all must admit that we have much to learn about the causes of
violence. This requires more effort and intellectual honesty than looking to
the government to pass yet another law. America is hardly the most violent
nation, and our homicide rate has fallen recently, but we are more violent
than we used to be — and than we should be.
—–
References:
1. 1996 Demographic Yearbook. New York, United Nations, 1998.
2. Stolinsky SA, Stolinsky DC. Suicide and homicide rates do not covary. J
Trauma 2000; 48:1168-1169.
———-
Dr. Stolinsky is a retired medical oncologist and co-author of Firearms: A
Handbook for Health Professionals, published by The Claremont Institute. His
e-mail is [email protected]
Originally published in the Medical Sentinel 2000;5(6):199-201. Copyright
?2000 Association of American Physicians and Surgeons.
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