Forging New Frontiers 2022

Presenter Profile

Lois K. Lee, MD, MPH, FAAP, FACEP

Lois K. Lee, MD, MPH, FAAP, FACEP

Senior Associate in Pediatrics, Boston Children's Hospital
Associate Professor of Pediatrics and Emergency Medicine, Harvard Medical School

Dr. Lois Lee is a pediatric emergency medicine physician and researcher at Boston Children’s Hospital. She is also an Associate Professor of Pediatrics and Emergency Medicine at Harvard Medical School. She received her M.D. at the Perelman School of Medicine at the University of Pennsylvania. She completed her residency in pediatrics at the Children’s Hospital of Philadelphia and her pediatric emergency medicine fellowship at Boston Children’s Hospital. During that time, she also received her M.P.H. at the Harvard T. H. Chan School of Public Health. Dr. Lee has published seminal research on pediatric emergency medicine, health disparities, and injury prevention, including related to firearms. Currently she serves as Chair of the AAP’s Council on Injury, Violence, and Poison Prevention. With her passion for improving the lives of children, she promotes child health through her clinical work, research, teaching, and advocacy.

Presentations

The Cost of Firearm Injuries and Fatalities in the United States, 2019

Lois K. Lee, MD, MPH, FAAP, FACEP
Eric W. Fleegler, MD, MPH

Part of session:
Lightning Round Presentations
Lightning Round
Sunday, December 4, 2022, 10:25 AM to 11:40 AM
Background:
Firearm injuries and deaths result in substantial healthcare and societal costs in the U.S. Non-fatal firearm shootings can result in traumatic brain, spinal cord, orthopedic, and gastrointestinal injury requiring significant medical and surgical care as well as life-long quality of life and medical rehabilitation care costs. The objective of this study was to analyze the medical and societal costs of firearm injuries and fatalities in the U.S.

Methods:
This was a cross-sectional study of costs of firearm-related injuries and fatalities using the Centers for Disease Control and Prevention’s Web-based Injury Statistics Query and Reporting System (WISQARS) Cost of Injury data for 2019. For nonfatal emergency department (ED) visits and hospitalizations, we calculated aggregate total costs and costs in the following categories: medical, work loss, and quality of life loss over the subsequent year. For fatalities, we calculated medical costs and aggregate costs for the value of statistical life. We calculated the total for all ages and by age groups and intent.

Results:
There were approximately 130,000 injuries and 39,707 fatalities from firearms in the U.S. in 2019. Total costs associated with firearm injuries and fatalities was $486 billion. For discharged nonfatal ED visits the total cost was $2 billion: medical $933 million, work loss $90 million, and quality of life loss $952 million. For nonfatal hospitalizations the total cost was $14.9 billion: medical $7.5 billion, work loss $639 million, and quality of life loss $6.7 billion. For fatalities the combined costs were $393 billion: medical $234 million and total value of statistical life costs $393 billion. Young adults 20-29 years old account for a disproportionate amount with total combined fatality costs of $103 billion. By intent, assault accounted for the highest total costs for nonfatal ED visits (84%) and hospitalizations (81%) and for fatalities was suicide (56%).

Conclusions:
The $410 billion cost in firearm-related injuries for a single year are disproportionately borne by young adults for both medical and societal costs. Understanding the healthcare and societal costs are critical for contextualizing the public health impacts of and to emphasize the significance of firearms as a public health problem.

Objectives:
1) Discuss how firearm injuries and deaths result in substantial societal as well as healthcare costs.
2) Describe how costs for non-fatal firearm injuries include medical costs, work loss, and quality of life loss costs.
3) Understand young adults 20-29 years old account for a disproportionate share of costs of firearm related fatalities.