Hospital costs from firearm injuries in the United States that occurred between 2003 and 2010 amounted close to a whopping $19 billion, a longitudinal study finds.

The finding, which was presented for the first time at the American Public Health Association’s 141st Annual Meeting in Boston, aimed to better understand why unintentional injuries, suicides, and homicides stemming from firearms were the three leading causes of death for 15- to 34-year-olds in the United States.

Researchers from University Hospitals and Rainbow Babies & Children’s Hospital in Cleveland, Ohio, found over 250,000 firearm-related hospitalizations occurred during these eight years. These quarter-million victims of gunfire equated to 1.8 million days of hospital service — or an average of 7.1 days per incident with a mean hospital charge of $75,884.

“One of the key points is that this is probably an underestimation,” Veerajalandhar Allareddy, Case Western Reserve University School of Medicine pediatrician and study co-author, told Medical Daily. “This data captured those patients who are admitted into the hospital. The real way of looking at this problem is that there are some patients who come to the emergency department and die there. That particular data is not being captured by this study. If you add that, hospital cost is going to be substantially higher.”

Other costs that were not included in the study’s calculations were health complications that arose from a patients’ firearm injury that kept them returning to the hospital, as well as the costly toll the injuries took on emotional wellbeing and productivity. “If you add all those costs, the problem is much bigger,” Allareddy observed. “My assumption is that this is probably just the tip of the iceberg.”

Apart from the fiscal repercussions that firearm injuries had on the health economy, the study also found that a certain group was at a consistently higher risk for such injuries; adolescents and young adults (80 percent), male (89 percent), African American (48 percent), and the uninsured (approximately one-third).

Allareddy described the increase in gun injuries to the uninsured population compared to those who were insured as “another bad signal.”

“Every single year it’s the same people,” Allareddy pointed out. “We showed that this is a very substantial problem and nothing has changed in the last decade. The real implications are how this is impacting the overall health economy. In our opinion, $20 billion for a problem that should not exist is very substantial. This will probably be the motivation to fund such studies so that more in-depth analysis can be done to see how the problem is evolving.”

One avenue that Allareddy aims to explore is how gun control laws, which vary according to state, have an impact on the demographic trends that his study identified. “Even in this study we have seen that southern states have a higher incidence of firearm injuries when compared to the western states,” he said. “This means there is a huge signal lighting up saying that certain populations in certain regions of the US are at a very high risk. That begs further research funding so we can assess why there is a geographic variance.”

Research that explores the health and economic impact of firearms has been a political hot-topic. In 1993, the New England Journal of Medicine released a much-publicized study that was funded by the Centers for Disease Control and Prevention (CDC) and associated guns kept in the home with an increased risk of homicide.

In response, the National Rifle Association campaigned for the elimination of the CDC’s National Center for Injury Prevention — which did not happen. Instead, the Dickey amendment came into effect in 1997, which stipulated that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” Since then, federal support for firearm injury prevention research has been restrictive.

Allareddy et al’s study, for example, wasn’t supported by federal funding or grants, so as to ensure “an unbiased view of the current scenario,” he explained. “Research of firearm injuries always is underfunded," he observed. "There has been the general perception throughout the medical field that it’s strange that no one wants to bring it up because there are some political implications.”