The Economic Cost of Gun Violence in America

Twice as many people are shot and survive, meaning that each year tens of thousands of people are treated for firearm injuries and  hospitalized across the country. But the impact of gun violence doesn’t end at the bullet. 

While the total cost of gun violence is difficult to calculate, here’s what we know. Let’s say you get shot and go to the emergency room to be treated. That visit alone would cost on average $1,388, twice the cost of unarmed assault injuries, and nearly 60% more than assault injuries from sharp objects. If you are then hospitalized from the gunshot injury, the median medical cost is typically around $27,820, adjusted for 2022 inflation. And that’s just the starting point. The more serious the injury, the higher the bill: Hospitalization costs for abdominal injuries average $66,780, and head and neck injuries average $81,000.

Even after surviving gun shots, many people continue to bear the burden of further medical costs. In a study of firearm injury readmission rates, researchers found that roughly one in 10 patients treated for a gunshot wound were readmitted to the hospital for additional medical care within 90 days of discharge, with patients most likely to be readmitted in the lowest income quartile and on public insurance like Medicaid. Medical costs associated with gunshot wounds are often compounded over time: Families with children injured by guns spend an additional $1,878 in the first four months after their child’s injury, and continue to use outpatient services at higher rates for at least one year after their injury.

Initial medical expenses represent only a fraction of the broader toll inflicted by gun violence. Research shows that gunshot survivors experience a 51% increase in psychiatric disorders and an 85% increase in substance use disorders. Other factors such as reduced mobility, impaired physical function, and chronic pain also contribute to the long-term impact of gun injuries. Although the costs for coping with these physical and psychological stresses are harder to quantify, research suggests that they also impose a significant financial burden for survivors of firearm injury. 

Just as gun violence afflicts communities unequally, states vary widely in their rates of violence. Looking across regions of the country, the South experiences the highest rate of gun deaths, with nearly eight people per 100,000 dying from gun homicides. The Northeast sees the lowest rate of gun homicides with three people dying per 100,000 residents. Nonfatal shootings are also more common in the South compared to the Northeast. 

At the state-level, the contrast in medical care spending for firearm injuries is even more striking. Between 2015 and 2020, Alabama spent roughly $3.39 per child in the state on medical care for pediatric firearm injuries. In contrast, Massachusetts had an average cost of $0.72 per child. 

It’s not a coincidence that areas that experience more gun violence also incur higher costs: More gun injuries translate into additional medical costs. However, there is an important predictor of which places see higher rates of gun injuries and thus higher costs. In fact, research is abundantly clear that states with stronger gun laws see lower rates of firearm injuries—suggesting that these policies could also help reduce the costs associated with firearm injury care. 

So, it shouldn’t be surprising that Massachusetts has the lowest per-child spending on medical care for pediatric firearm injuries, while Alabama has the highest level of such spending. Each year, GIFFORDS Law Center grades states based on their gun death rate and strength of their gun laws. When you compare these in-state spending amounts to the grades these states have received the past few years, a clear pattern emerges. Massachusetts has consistently earned an A for their strong gun laws. Conversely, Alabama has some of the weakest gun safety policies in the country and persistently scores an F.

The evidence is clear: Amid the national conversation about ways to reduce spending, investing in gun violence prevention is a clear path forward to save lives and reduce the long-term financial costs of violence on families and communities. 

Gun violence takes an enormous human toll, but it is also devastating for survivors, their families, and communities. The progress we see from states passing gun safety policies is promising, but no state is exempt from the responsibility of continuing to work toward reducing violence. It is imperative that we tackle this crisis with evidence-based approaches we know can work to save lives and save money. By investing in gun violence prevention, we can mitigate the financial and long-term burden on our communities and create safer environments for all.