The trend was driven largely by the sharp drop in the rate of traffic fatalities, a result of a series of laws and safety measures aimed at making driving safer. Gun homicide rates also have fallen in recent years, but have been offset by the rising prevalence of suicides. Today, suicides account for roughly two out of every three gun deaths.
Frank McGeorge, an emergency medicine physician who works midnight shifts at Henry Ford Hospital in Detroit, said he has seen a big change in the types of cases he gets over his 25 years in medicine.
“Cars are safer. Diagnoses and treatments have improved, with regard to accidents,” McGeorge said. “At the same time, guns are not any safer. There has been no change in the speed at which a 9 mm bullet travels; no change in the size of a 9 mm bullet.”
Based on steady trends in recent years, public health experts have for some time expected gun deaths to catch up with traffic deaths. The 2014 rates were reported this month by the Centers for Disease Control and Prevention.
Medical ailments, like cancer and heart attacks, kill considerably more people each year than either guns or automobiles, according to the CDC. But firearms and motor vehicles are among the leading non-medical causes of mortality in the U.S., killing more people than falls and considerably more people than alcohol.
Guns and traffic accidents each killed about 34,000 people in the U.S. last year, or about 93 people per day.
The rate at which Americans are killed in traffic accidents has dropped by more than half since the late 1960s. That decline can be attributed to a combination of improved technology, smarter regulation, and improved care in the hospital.
The federal government mandated the presence of seat belts in the 1960s. The ‘70s brought anti-lock brakes. The ‘80s saw a rise in anti-drunk driving advocacy and mandatory seat belt use. Then airbags came along in the '90s. More recent years have seen mandates on electronic stability systems that help prevent vehicles from spinning out and increased penalties for distracted driving.
Brian Schaeffer, assistant chief of fire department in Spokane, Wash., said simple changes to highway engineering, such as erecting a physical divider between two lanes of traffic on a highway, also have dramatically improved chances of survival.
In the 1990s, Schaeffer said he regularly saw penetrating traumas or amputations in car collisions and routinely needed the Jaws of Life to extricate people from deadly accident scenes.
“We’d just have horrible trauma, something you’d probably would only see in a battlefield,” Schaeffer said. Now, when responding to a high-speed crash, first responders often find the passengers and drivers walking around, he said.
On gun deaths, the story has been more complicated. Fatalities declined precipitously during the 1990s, but have plateaued since then. While gun homicides have continued to decline, suicides have risen.
Those divergent trends reflect two different pictures of gun violence in the U.S. Black Americans are significantly more likely to be victims of homicide, but just one in five black households have guns. White Americans are more than twice as likely to have guns in their homes and they experience gun violence largely through suicides.
Richard Reeves, a Brookings researcher who studies inequality, said the differences in how guns affect black and white Americans speak to the need to “think multidimensionally” about the problem. “The nature of those deaths are hugely different,” he said. Opponents and supporters of gun rights often “need to be honest that one blanket solution will not solve the problem.”
The history of regulations on guns has been erratic. Restrictions passed in earlier eras, like the assault weapons ban, have been undone recently in the face of strong political opposition. During the Bush administration, Congress passed laws that prohibited law enforcement from releasing data that shows where criminals obtained their guns and granted gunmakers immunity from some civil lawsuits.
Technological advances, like smart-gun technology that prevents people other than the owner from firing a gun, have been stymied by opposition from the National Rifle Association and from many gun owners. Even regulatory changes that enjoy overwhelming support from the American public, like universal background checks, have been thwarted.
Congress has a longstanding ban on many types of federal gun research, which has affected not only federal agencies like the CDC, but also academic researchers.
On the other hand, government and the auto industry have all invested in research, generating a lot of information on how cars crash and improvements in highway safety.
“Tell me a scenario on how you crashed your car and I can almost always tell you what your injuries are without even looking at you,” said Babak Sarani, director of trauma and acute care surgery at the George Washington University Hospital.
But limited research funding has restricted innovations in gun safety and the development of policies that can improve gun safety and reduce firearm deaths.
“We made an important difference with motor vehicle-related violence, and we chose not to do that with firearms,” Wintemute said. “This is the result.”