by Steven Gimbel and Gwydion Suilebhan
A new study has revealed a troubling development in the state of Maryland: while murder rates fluctuated between 2005 and 2017—first trending downward, then increasing for a few years—the homicides recorded during that period have grown steadily more violent the entire time.
According to “Increasing Injury Intensity among 6,500 Violent Deaths in the State of Maryland,” which is forthcoming in the Journal of the American College of Surgeons, researchers examined the intensity of deadly incidents over a 13-year period. Intensity was measured by the number of gunshots, stab wounds, and fractures exhibited by victims. Across all three causes of death, while the rate of homicides varied during the period, the percentage of high-violence crimes consistently increased.
Conducting the study was easier in Maryland than it might have been in other states. Maryland is unusual in that its Chief Medical Examiner is required to report on all murders, suicides, and unusual deaths, which means that researchers had access to a broad-based data set. State policy meant that researchers had access to information about victims who died under medical care and those who died at the scene of the crime. The state’s data set was geographically comprehensive, too, including cases from Baltimore’s urban center, the suburban areas around Baltimore and Washington, DC, and the rural areas in the eastern and western parts of the state.
Other similar studies, by contrast, have only focused on data from individual medical centers. Those limited data sets only included cases from nearby areas and excluded cases in which victims died before receiving medical care.
What the study team found in their examination of the data set is that the number of shootings in which victims received at least ten gunshot wounds nearly doubled between 2005 and 2017, increasing from 5.7% to 10%. Individual acts of gun violence, in other words, are becoming more violent.
The increase in violence is particularly stunning when considered alongside the difficulty of hitting a person with a single bullet. According to statistics collected by the Dallas Police Department, only 54% of people who had been shot at were actually struck by a bullet. Two-thirds of all shots fired, in fact, missed their targets altogether… and these particular shots were fired by law enforcement officers who get significant handgun training.
Indeed, half of the officers who used their weapons, according to the study, missed with all of the shots they fired. In other words, hitting a victim with just one bullet is hard, even for highly-trained officers, which means that inflicting ten or more gunshot wounds is statistically very unlikely. Somehow, however, extreme gun violence is still becoming more prevalent. (Possible explanations include the increasing availability of weapons that fire multiple shots, the presence of multiple shooters, and shots being fired at a much closer range.)
It doesn’t actually take ten or more bullets to murder a victim, however. Ten gunshots is overkill.
“The median number of shots you need to kill someone is one,” said Dr. David Efron, co-author of the study and the Medical Director of the R. Adams Cowley Shock Trauma Center and the Thomas M. Scalea, MD Distinguished Professor of Trauma at the University of Maryland Medical School. “It’s highly lethal.”
Incidents in which a victim is shot multiple times, despite the fact that only one shot is typically necessary to cause death, seem to suggest other factors at work. “If you pull a trigger once,” said Dr. Efron, “That’s a pretty intensive event, at least to most of us. But ten or more, you’re over a hump somewhere. And it turns out that the proportion of people who died with ten or more shots went up ridiculously.” Just in 2017, Dr. Efron noted, there were 60 people state-wide who were shot with more than ten bullets.
Dr. Efron is quick to note that the phenomenon he and his fellow researchers studied isn’t restricted to urban areas.
“It’s very important to make sure that studies like this aren’t dismissed as a city problem,” he said. “Trauma is a disease of proximity, and cities happen to just have a lot more proximity.”
Undoubtedly, part of the explanation for the increase in incidents of extreme gun violence involves the nature of the guns being used. Automatic weapons with sizable magazines allow for more shots to be taken more quickly. However, the study in question noted an increasing intensity (though not frequency) of violence of all types. Between 2005 and 2017, the percentage of stabbing victims with at least five wounds rose from 48% to 60%. Among victims who died from blunt trauma, those with at least five bone fractures increased from 24% to 38%.
Taken as a whole, the number of victims who suffered extreme violence of all types increased steadily during the study period, which suggests that addressing the issue will require more than just sensible new gun laws.
It’s important to note again that the study revealed an increase in the intensity of violence, not frequency. During the study period, the frequency of homicides in Maryland decreased for a long period, then increased for a few years (without quite reaching earlier levels) after the murder of Freddie Gray, which resulted in new policing strategies being adopted by the Baltimore Police Department. While the number of homicides decreased and increased, in other words, the intensity of violence only grew. The state saw fewer murders, but those murders were far more violent.
What accounts for that transformation? The answer is surely multifaceted, with sociological, psychological, and economic factors all playing roles.
“The field of violence prevention,” the researchers noted, “has long studied factors associated with homicide including access to weapons, social isolation, structural socio-economic barriers, and the narcotic trade.”
Dr. Efron was more blunt: “Is it an erosion of the social fabric, less community, less religion, less stable families?” he asked. “I don’t know.”
The research team does note that other studies suggest those who perpetrate violent crimes “were more likely to have experienced interpersonal trauma” themselves, including merely witnessing violence, especially when young. Both the victims themselves and those who are present at the scene acquire an increased likelihood of acting violently themselves. Acts of violence cause a nuclear chain reaction, multiplying potential triggers for further violence, thereby giving rise to concerns about escalation.
“It doesn’t matter what kind of violence you witness when you’re young,” said Dr. Efron. “It could be a terrorist explosion. It could be domestic violence. It could be something you see on the street. You are at much greater risk of perpetrating a violent event as an adult.”
Unfortunately, outreach programs can locate and help victims of violence—and even perpetrators—but providing aid for witnesses is much more challenging.
Solutions for the rise in overkill, however, fall outside the purview of the study, which also doesn’t attempt to identify any clear causes for the phenomenon. The researchers’ paper, however, does reveal, for the very first time, the extent of the problem, at least in one state, which might be the first step in addressing a troubling problem.