Hospitalizations related to firearm use are on the rise in Pennsylvania after a recent decline.

		On the Net The Pennsylvania Health Care Cost Containment Council Web site offers a research brief on the 'Firearms-related Injuries in Pennsylvania' report, in pdf format.

A state report released yesterday indicated that 1,643 hospital stays for firearm-related injuries occurred in 2003, the first increase since 2000. The total does not include emergency room treatment.

An increase also occurred in firearm-related deaths, from 1,169 deaths in 2001 to 1,220 in 2003, according to the Pennsylvania Department of Health.

From 2001 to 2003, firearms were linked to 4,777 hospitalizations and 3,588 deaths in Pennsylvania, according to the report, issued by the Health Department and the Pennsylvania Health Care Cost Containment Council.

Allegheny ranked second among counties, behind Philadelphia, in firearm-related hospitalizations and deaths, according to the report, with 843 hospital stays from 2001 to 2003 and 410 deaths. Philadelphia had 2,566 hospitalizations and 960 deaths.

State officials noted that the toll related to the deaths and injuries extends beyond victims and their families.

"These cases also represent mounting costs to publicly financed health care," said Marc Volavka, executive director of the Cost Containment Council. He noted that 70 percent of the victims were covered by medical assistance or had no health insurance.

The report noted that the average annual total of hospital charges for firearm-related injuries was $127 million.

During the 2001-03 period covered by the report, the median charge for inpatient hospitalization for gun-related injuries was $30,814, more than double the figure from 1996 to 1998.

Eighty percent of hospital charges for those injuries were linked to assault victims, who accounted for 68 percent of hospital stays. About 18 percent of hospital stays were linked to suicide attempts, 8 percent to accidents, and 5 percent were undetermined.

A majority of deaths, however, were suicides. They represented nearly 59 percent of deaths, compared to 38 percent from assaults and 2 percent from accidents.

Differences also existed among rural and urban communities.

In urban counties, 42 percent of deaths resulted from assaults and 55 percent from suicide. But in rural areas, 11 percent of deaths resulted from assaults and 86 percent from suicide.

Older Pennsylvanians were especially at risk for firearm-related suicides, the report noted.

Suicide rates increase with age and are very high among people 65 and older, according to the Centers for Disease Control and Prevention.

The agency noted that in 2001, firearms were used in 73 percent of suicides committed by people over 65. Many suicide victims have been recently diagnosed with depression or suffer from physical illnesses. They also are likely to be divorced or widowed.

The state report also found that young adults, blacks and males had by far the highest hospitalization and death rates, mostly attributable to gun-related assaults.

While noting that gun violence spans racial and income groups, Stephen Thomas, director of the University of Pittsburgh's Center for Minority Health, noted that violence rates among blacks 12 and older are far higher than for Hispanics or whites.

The number of homicides and suicides declined nationally throughout much of the 1990s, including those committed with firearms, said Jim Mercy, an associate director in the Division of Violence Prevention at the CDC's National Center for Injury Prevention. But that decrease has leveled off in recent years, he said, and suicide and homicide rates appeared to increase in at least a few states.

The decline in the '90s related to a continuing drop in violence among people over 30, and to a reduction in an earlier increase of drug-related criminal activity among young people, said Alfred Blumstein, professor of operations research at the Heinz School of Public Policy and Management at Carnegie Mellon University.

In the past five years, trends have been more locally driven, Blumstein said, noting that problems relating to gun violence may be increasing in Philadelphia. He also noted that for both law-abiding citizens and criminals, firearms in Pennsylvania have been "relatively easy to get."