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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 8; 335(7618): 470–471.
PMCID: PMC1971154

Proliferation of firearms is growing global health problem

The growing number of civilians holding firearms is fuelling gun crime worldwide and is putting healthcare systems, especially in poor countries, under stress, an expert report says. Gun crime kills about 250 000 people a year and injures many more.

“The proliferation of civilian gun arsenals is not likely to slow anytime in the foreseeable future,” says the report.

The study was conducted under the auspices of the Graduate Institute of International Studies, Geneva, and was funded by European governments; the United States; Canada; and United Nations agencies, including the World Health Organization. It highlights that “civilians are acquiring greater numbers of increasingly powerful guns.”

The researchers estimate that civilians own about 650 million firearms, from handguns to assault rifles, worldwide—about 75% of the world's 875 million known total. US citizens account for 270 million or 90 guns for every 100 citizens.

“There is a correlation between firearm ownership and firearm related injuries and death,” David Meddings, medical officer at WHO's department of injuries and violence prevention, told the BMJ.

Keith Krause, programme director of the survey, says that a variety of factors are behind the increase in gun ownership among civilians.

“The main one is generally increasing wealth in some parts of the world that make people able to buy weapons, and, frankly, the failure of many states to provide for the security of individuals and their communities . . . leads to raising insecurity in urban zones, especially some parts of Africa and Latin America.”

The report says that 36 091 deaths in Brazil in 2004 were related to firearms and adds that men in South America's largest nation are 17 times more likely to be victims of gun violence in urban areas than women. It attributes the risk factors for firearm violence in Brazil to “being young (aged 15-29), out of school, and out of work.”

Overall, the report says its main findings show that large scale urbanisation “tends to be associated with increased rates of armed violence . . . and is often coupled with decreasing levels of public safety, posing serious challenges to the provision of security and justice.

In the US, for example, between 1985 and 2004, the mean homicide rate was 19.04 per 100 000 population for cities with a population of a million, 13.86 for cities of population 500 000 to a million, and 7.21 for cities of population 100 000-250 000.

Dr Meddings said that gun related violence has a considerable effect on healthcare systems.

He pointed out that research in South Africa has showed that non-fatal shootings, such as serious abdominal gun shot injuries, require care that costs on average 13 times the per capita health expenditure.

Professor Krause cautioned, however, that “there is no simple equation between weapons availability and weapons misuse in any country.”

With regards to the United Kingdom he noted that there are tight regulations and low levels of gun ownership (six for every 100 citizens in England and Wales), and he remarked that increased armed homicides are linked to “a network of criminal gangs and some gangs operating in poor suburbs, and of course they are giving access to weapons being smuggled in.”


Small Arms Survey 2007: Guns and the City is available at

Articles from The BMJ are provided here courtesy of BMJ Publishing Group