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Gun violence generates more than $1 billion annually in hospital bills

Costs are impacted both in the immediate aftermath of a gun violence incident and in the long term due to the physical and mental toll it causes.

Jeff Lagasse, Editor

Photo: Stephanie Keith/Getty Images

Adding to the hardship that victims and their families face, gun violence injuries in the U.S. cost more than $1 billion each year in initial direct medical costs alone, a federal committee has found.

The U.S. Congress Joint Economic Committee released data this week ahead of a hearing on the economic impact of gun violence that showed other ancillary effects of mass shootings and gun violence, such as the harm done to local economies due to slowing business development and decreasing housing prices.

Healthcare costs are impacted in both the immediate aftermath of a gun violence incident and in the long term, owing to the physical and mental toll it causes. A study by the Government Accountability Office found that each year, firearm-related injuries cause 30,000 initial inpatient hospital stays that cost an average of $31,000 each, and 50,000 initial emergency room visits that cost an average of $1,500 each, for a total annual cost of more than $1 billion. 

Yet that's likely a significant underestimate because it does not include physician costs, which could increase total costs by about 20%, the committee found.

The financial burdens on both survivors and healthcare providers are considerable. For those who required initial hospital care and survived their injuries, up to 16% require re-admittance at least once in the first year post-injury, costing an additional $8,000 to $11,000 per patient. In fact, survivors of gun-related injuries see their healthcare spending increase by nearly $2,500 per month on average for the year following the injury, with spending soaring by over $25,000 in the first month alone.

For victims of fatal firearm injuries, medical expenses totaled $290 million in 2020 and cost an average of $9,000 per patient. Much of these costs are paid for by public health insurance providers, such as Medicaid, creating significant and avoidable costs for these programs.

In addition to the direct cost of medical care for gun-related injuries, the mental and emotional impacts of exposure to gun violence can cause significant health effects down the road, which further add to healthcare costs. For survivors of gun violence injuries, psychiatric disorders increase by 200% in the month after injury. For children exposed to a fatal school shooting in their local area, antidepressant use increases by 21% in the two years following the incident. 

Treatment of these conditions, through therapy or medication, can be long term and expensive, with spending for all mental health treatment reaching $225 billion in 2019 alone.

Gun violence also impacts victims' families. One study that the committee cited found that family members of survivors sustaining a non-fatal gun-related injury saw a 12% increase in the incidence of psychiatric disorders when compared to families who experienced no such injury.

WHAT'S THE IMPACT?

The committee's findings cover a wide swath of the economy and public life, including education. A study of school shootings in Texas found that in schools that experience a shooting, the absence rate rises by 12% and chronic absenteeism increases by 28%. In the two years following a school shooting, the rate of grade repetition more than doubles.

This indicates gun violence negatively impacts educational attainment and worsens academic outcomes, as does another study showing that children who survived the Sandy Hook elementary school shooting saw decreased test scores in math and English. In California, high school students who remained enrolled after being involved in a school shooting saw lower test scores on standardized tests.

Meanwhile, increased security is straining school budgets, and many schools are diverting educational funds toward security to the tune of about $3.1 billion in 2021.

The committee also found that in some higher crime cities, a surge in area gun homicides led to a slowing of home value appreciation by nearly 4%. Meanwhile, a surge in gunshots decreased home value growth by 3.6%.

THE LARGER TREND

Uniformed Services University's (USU's) National Center for Disaster Medicine and Public Health recently released a number of recommendations they hope will facilitate a better response to mass shootings from the healthcare industry, including readiness training and public education.

One recommendation that emerged was readiness training: regular, multidomain training activities that mirror the realism of actual events, to ensure readiness of the entire community system. They also recommended prior public education or immediate direction from web-based mapping programs about the appropriate hospitals to bring mass shooting patients for care.

The number of mass shooting incidents has been increasing in recent years, rising nearly 40% from 2019 to 2021, according to the Gun Violence Archive. Although research has been done to identify ways to prevent mass shootings and reduce death and injury, there have not been specific details about the medical system response to such events.

In June, a bipartisan gun proposal that would give grants to states for red-flag laws, provide spending for mental health treatment and school security, and give extra scrutiny for gun buyers under the age of 21 drew praise from the American Medical Association.

Ten Republican senators signed on to the Senate proposal, which means that legislation based on the proposal could get the 60 votes needed to overcome a filibuster.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com