As medicine improves, homicide rates decline

Experts credit ties between military medicine and civilian trauma care

Despite an increase in serious injuries caused by guns and knives, improved medical care has helped drive down homicide rates in the United States, according to a Wall Street Journal analysis of survey data.

According to CDC, the number of gunshot victims requiring inpatient care has increased by 47%, from 20,844 in 2001 to 30,759 in 2011. Meanwhile, the number of people who experienced serious stabbings increased from 22,047 in 2001 to 23,550 in 2011.

However, as of 2010, gunshot mortality rates had fallen to 13.96% of shooting victims, nearly two percentage points lower than in 2007, according to research commissioned by the Wall Street Journal. Deaths from knife wounds also have decreased. In addition, according to FBI crime data, the total number of homicides fell from 16,929 in 2007 to 14,722 in 2010.

"Did everybody become a lousy shot all of a sudden?" asks Jim Pasco, executive director of the National Fraternal Order of Police. "No. The potential for a victim to survive a wound is greater than it was 15 years ago."

The Journal reports that experts in medical and crime fields credit the symbiotic relationship between military medicine and trauma care for the improvements, including:

The increased use of helicopters to ferry patients, a practice honed during the Korean and Vietnam wars;

Better training of the military's first-responders to stem blood loss by maintaining low patient blood pressure; and

Battlefield experience in Iraq and Afghanistan that demonstrated how giving bleeding patients platelets and plasma to aid in clotting was more effective than giving them red blood cells.

According to the Journal, experts also believe that the spread of trauma centers factors into declining homicide rates. As of 2010, 90% of U.S. residents lived within an hour of a trauma center by ambulance or helicopter. The risk of death was "significantly" lower when patients were treated at trauma centers compared with regular hospitals, according to a 2006 study in NEJM (Fields/McWhirter, Wall Street Journal reports, 12/8).

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