Impact of police and legislative initiatives on urban gunshot wound admissions.

BACKGROUND This study aimed to assess the effects of local and state anti-crime initiatives on the number of gunshot wound admissions to a level 1 trauma center. METHODS A retrospective time series analysis of gunshot wound admissions from July 1, 1990 to July 30, 1999 was performed at a level 1 trauma center. The gunshot wound admissions were divided into four subgroups: assault, suicide, accident, and police-involved gunshot wounds. The effects of the following three initiatives were studied: (1) the Three Strikes law; (2) a local police initiative, the Violent Crime Suppression Unit; and (3) the Use a Gun and You're Done law. The periods that corresponded with each intervention were defined, and the rates of gunshot wound-related admissions for all causes after each intervention were compared. RESULTS During the study, 1,499 patients were admitted with gunshot wounds. These admissions involved 1,220 assaults, 196 suicide attempts, 52 accidents, and 31 police-involved cases. Over the defined periods, an average of 13.7 gunshot wound admissions (range, 7.9-15.5) occurred, most of which were assaults (mean, 10.8; range, 5.5-13). There were no differences across the periods for gunshot wound admissions among three of the subgroups: suicide, accidental, and police-related gunshot wounds. However, the assault subgroup showed a significant decrease across all the periods and a statistically significant decrease after enactment of the Use a Gun and You're Done law (p < 0.005). When control was used for an increasing number of police officers, however, the association was no longer statistically significant. CONCLUSIONS Gunshot wound admissions attributable to assault at a level 1 trauma center decreased during a period when several local and state initiatives focused on decreasing violent crime were enacted. The causes likely were multifunctional, and included increasing the number of police officers as well as the enactment of new laws.