• Yongwen Jiang, Megan L Ranney, Brian Sullivan, Dennis Hilliard, Samara Viner-Brown, and Nicole Alexander-Scott.
• Rhode Island Department of Health, Center for Health Data and Analysis, Providence, Rhode Island (Dr Jiang and Ms Viner-Brown); Departments of Epidemiology (Dr Jiang) and Health Services, Policy and Practice (Drs Ranney and Alexander-Scott), School of Public Health, Brown University, Providence, Rhode Island; Injury Prevention Center at Rhode Island Hospital, Providence, Rhode Island (Dr Ranney); Department of Emergency Medicine, Emergency Digital Health Innovation Program, Alpert School of Medicine, Brown University, Providence, Rhode Island (Dr Ranney); Lincoln Police Department, Lincoln, Rhode Island (Mr Sullivan); Rhode Island State Crime Laboratory, University of Rhode Island, Kingston, Rhode Island (Mr Hilliard); Rhode Island Department of Health, Providence, Rhode Island (Dr Alexander-Scott); and Department of Pediatrics and Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island (Dr Alexander-Scott).
• J Public Health Manag Pract. 2019 Mar 1; 25 (2): 137-146.

ContextNational data on the epidemiology of firearm injuries and circumstances of firearm deaths are difficult to obtain and often are nonreliable. Since firearm injury and death rates and causes can vary substantially between states, it is critical to consider state-specific data sources.ObjectiveIn this study, we illustrate how states can systematically examine demographic characteristics, firearm information, type of wound, toxicology tests, precipitating circumstances, and costs to provide a comprehensive picture of firearm injuries and deaths using data sets from a single state with relatively low rates of firearm injury and death.DesignCross-sectional study.SettingFirearm-related injury data for the period 2005-2014 were obtained from the Rhode Island emergency department and hospital discharge data sets; death data for the same period were obtained from the Rhode Island Violent Death Reporting System.Main Outcome MeasureDescriptive statistics were used. Healthcare Cost and Utilization Project cost-to-charge ratios were used to convert total hospital charges to costs.ResultsMost firearm-related emergency department visits (55.8%) and hospital discharges (79.2%) in Rhode Island were from assaults; however, most firearm-related deaths were suicides (60.1%). The annual cost of firearm-related hospitalizations was more than $830 000. Most decedents who died because of firearms tested positive for illicit substances. Nearly a quarter (23.5%) of firearm-related homicides were due to a conflict between the decedent and suspect. More than half (59%) of firearm suicide decedents were reported to have had current mental or physical problems prior to death.ConclusionsUnderstanding the state-specific magnitude and patterns (who, where, factors, etc) of firearm injury and death may help inform local injury prevention efforts. States with similar data sets may want to adopt our analyses. Surveillance of firearm-related injury and death is essential. Dissemination of surveillance findings to key stakeholders is critical in improving firearm injury prevention. States that are not part of the National Violent Death Reporting System (NVDRS) could work with their other data sources to obtain a better picture of violent injuries and deaths to make the best use of resources.

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