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Death and Injury by Firearms: Who Cares?-Reply

Janine Jagger, MPH; Park Elliott Dietz, MD, MPH, PhD
JAMA. 1986;256(16):2195. doi:10.1001/jama.1986.03380160053010.
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In Reply.—  Dr Miller's letter strikes a familiar note. The frustration he conveys is shared by many others who attribute the firearm wound epidemic to the repeated failures of legislators to restrict gun availability. We ask Dr Miller and those who share this prevalent outlook to consider the following points:

  1. The significance of a health problem cannot be fully assessed without adequate documentation. Currently, our knowledge of firearm injuries as a national public health problem is based solely on fatalities representing fewer than 20% of all cases. Without data on nonfatal cases, we will remain in the dark about the distributions of disabling and disfiguring sequelae, costs of acute care and long-term rehabilitation, and psychological and societal consequences of firearm trauma. Only information about nonfatal shootings can tell us how they differ from fatal


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