What is NOT in CIVHC's (or the Sun, or CPR) study about the cost of gun violence. The ongoing cost of migrants (watch out UT we're shipping them to you now).
What is NOT in the recent study about the cost of gun violence in Colorado.
The Sun recently did an article about a study released by the Center for Improving Value in Health Care (CIVHC), a group which, among other things, is a Colorado state government contractor.*
The article is linked first below and the CIVHC "About" page is linked second below.
Splashed in great big font across the top, and salted throughout the article, were a series of alarming statistics. The headline itself is pretty hefty: "Gun-related injuries in Colorado cost at least $8.4 million in medical bills in 2022."
Reading the article you can get a pretty clear sense of the drift of things here. In keeping with what I have seen and written about with regard to guns and public health, the push is on for public health to become more involved in advocating for safe gun storage.**
See for example the pair of quotes I pulled from the article and attached as screenshot 1 (to save space).
As I have written in the past, you are wise to ask questions when you read things like this, particularly when they are emotionally charged and what is clearly an attempt to influence policy and/or the public.
What did the Sun and the CIVHC leave out? What does their source data say?
The latter question is a tougher one and something I don't have time or space to go through here. I did, however, get a copy from CIVHC to share (after two attempts). If you are curious to see what their data looks like, what they tabulated, what they didn't, and how they did it, I put a link to the spreadsheet with their data last below.
The former question is something I do have space for. I wanted to go through my questions and CIVHC's answers not only so you would know what they left out, but to also give you a sense of the kinds of things you might consider asking when you read articles like these.
Below, I separated out what I asked and what I got back by Q = question, A = answer, and then I put my thoughts on why these questions matter; that is, why I think their absence is notable.
Q: Does your cost analysis correct for inflation?
A: No, costs in this analysis were not adjusted for inflation.
Why does this matter? Any time you see a study that gives you costs for things, you should ask yourself if they have been adjusted for inflation and/or population (where relevant). Prices have jumped drastically lately and in health care in general. How much of the giant increase in costs due to gun violence is due to price increases? If they don't correct for inflation, we don't know.
Q: Do I have it right that the categories for these firearm incidents are put in by medical coders? I.e. no independent verification or follow up with the injured parties?
A: Correct, these codes are identified on the claim by providers and/or billing experts. We do not have insight into whether those providers verified the codes with the patients.
Why does this matter? "Self-reported" (used loosely here to indicate that the report authors didn't vet the data) results are liable to several errors and/or omissions. I would assume that genuine mistakes might be pretty rare and so we can ignore someone hitting the wrong key.
What we can't ignore, however, is our ignorance with regard to whether or not there were contributing factors involved in each incidence of gun violence--factors that might point to other problems than simply guns and where they're stored. For example, someone who was drunk, thought it'd be fun to shoot a hole through a friend's roof, and ended up shooting themselves is a case substantively different than a child who happens upon a loaded gun on the coffee table. As is someone who injures themselves getting ready to commit a crime, say. Both point to problems outside of those that can be fixed with safe storage.
Q: Does your organization track other types of injury or violence? If so, have you done reports on those (and can you point me to them)?
A: We haven’t done any other specific injury or violence-related analyses that are publicly available.
Why does this matter? Numbers, especially big ones like $8.4 million, can be shocking. But, they should be put into context. Is $8.4 million a big number relative to, say, car crashes? Is it big compared to injury from alcohol abuse? Heart disease. Perhaps if people heard those other numbers, they might decide that guns are a relatively small problem and we should focus our attention elsewhere. Not including a comparator tilts things.
Additionally, when you see percent increases, you should also follow up to ask the raw increase. I took a screenshot of a quote from the Sun article below and (since I don't know the exact source of the reporter's numbers here I guessed at the source) took a screenshot of the firearm injury data by age and attached that as screenshot 2.
You do see a jump in the gun injury rate for those above 18 years of age between 2016 and 2022 (36 up to 48 per 100,000 people) and a bigger jump for those under 18 (30 up to 66). These are both pretty startling as percent increases (33% and 120% respectively), but do we know how other injuries compare? How they've increased as a rate? Not to minimize injury or tragedy, but perhaps 66 per 100,000 is a small number compared to some other way kids are injured and our resources would have a bigger impact chipping away at something that was worse.
Q: Not so much related to this particular study, but I'm curious about this too. I noticed that at the bottom of your press page for this you link to organizations working to reduce firearm violence. One of which is Colorado Ceasefire a group many would consider on the far end of the gun control debate. Do you work with any other groups that advocate gun control policy to the extent Ceasefire does?
A: We do not work directly with any of the organizations listed. The list isn’t meant to be exhaustive or intended to promote the work of any organization over another. Our goal is to provide all types of organizations, regardless of political affiliation, with data that can be used to have meaningful discussions on potential ways to improve the health of Coloradans and lower health care costs.
Why is this important? Despite CIVHC's claim of objectivity, despite quotes in the Sun articles that they are wanting to be objective, to move past "ideologies and rhetoric" who these groups work with, who they get money from, who they associate with matters. It goes to their motives. Know who works with who and how.
I hope that walk away from this rather lengthy post knowing a couple things. I hope you know a little more context than the Sun and CIVHC gave you in this press release disguised as an article.
I hope that you have a sense of things to ask when you see studies and reports such as these.
Because I'll be damned if I see reporters doing it.
*They are, according to their site, "... the administrator of Colorado’s All Payer Claims Database (CO APCD), CIVHC oversees the collection of health care claims from Colorado’s public and private health care insurers."
**Let me make my own views clear here. Done right, in a way that respects privacy, individual choice, and one's ability to defend themselves, I'm okay with efforts to try and encourage safe storage of firearms.
https://coloradosun.com/2024/06/04/colorado-gun-injuries-medical-bills/
https://civhc.org/about-civhc/
I'm catching up on things I'd put in my queue to post on and I'm finally getting around to a recent (5/30/24) report by the conservative-leaning Common Sense Institute that details the costs of undocumented immigrants. This report is linked first below.
The numbers are pretty staggering as you can see in screenshots 1 - 3. Note: these are just City of Denver costs. These do not include school costs nor healthcare costs (separated out by the report's authors).
To help you put things in perspective, I looked up the population of Denver in 2023 (to try and split the study period which totals spending from 2022 to 2024) and divided the total estimated spending by Denver on migrants by its population.
Every man, woman, and child in Denver will spend an estimated $31 for migrants from 2022 up through 2024.
It's easy to forget that when it comes to government spending, money is finite and the government doesn't generate its own income. It gets money by taking from others.
Every dollar used to care for migrants is one dollar that doesn't get put to another use.
Every dollar used to care for migrants is one dollar that has to come from someone else.
Let's end with this. The Biden administration owns a large part of this crisis, but this doesn't absolve the people running this state and/or running Denver. The CPR article I link to second below provides an example of what I mean.
When you incentivize behavior, say, by making it even easier to get a drivers license without being a citizen or legal resident (see the law signed by Polis on 6/5 linked third below), you get more of it.
Our state, Denver too, have made a cottage industry of being welcoming to those here illegally.
And now they (with us footing the bill) are reaping what they sow.
https://commonsenseinstituteco.org/the-ongoing-costs-of-denver-migrants/
https://www.cpr.org/2024/06/05/undocumented-immigrants-will-get-colorado-drivers-licenses-much-more-quickly-under-new-law/
https://leg.colorado.gov/bills/sb24-182
Related:
Denver is busing its migrant problem to other areas, and the most recent to complain is Utah Governor Spencer Cox.
Apparently Denver's sending them there now too.
https://www.thecentersquare.com/colorado/article_c1eb06ec-2a94-11ef-a7e9-f748bffb732b.html