Special Article
Adolescents and Children Injured or Killed in Drive-By Shootings in Los Angeles
N Engl J Med 1994; 330:324-327February 3, 1994DOI: 10.1056/NEJM199402033300506
- Abstract
Background
Drive-by shootings by violent street gangs contribute to early morbidity and mortality among adolescents and children in Los Angeles. This study attempted to determine the frequency of this problem and the population at greatest risk. We also studied the most frequently injured areas of the body, the seasons in which the most shootings occurred, the most common sites for drive-by shootings, and the types of firearms used.
Methods
We retrospectively reviewed the files of the Gang Information Section of the Los Angeles Police Department to identify all drive-by shootings in Los Angeles in 1991 in which a child or adolescent under the age of 18 was shot at, injured, or killed.
Results
A total of 677 adolescents and children were shot at, among whom 429 (63 percent) had gunshot wounds and 36 (5.3 percent) died from their injuries. Three hundred three of those with gunshot wounds (71 percent) were gang members. Arms and legs were the areas of the body most commonly injured. Handguns were the most frequently used type of firearm. All the homicide victims were African American or Hispanic, and 97 percent were boys. African American and Hispanic children and adolescents, especially male gang members, had a significantly higher risk than their Asian and white counterparts of injury and death from drive-by shootings in Los Angeles (P<0.001).
Conclusions
Drive-by shootings involving adolescents and children are frequent in Los Angeles. Although Los Angeles may be an atypical case, understanding why violent street gangs form, preventing causes of violence, and limiting access to firearms are essential steps in preventing this serious problem.
Media in This Article
Figure 1
Number of Children and Adolescents Who Received Gunshot Wounds in Drive-by Shootings, as Compared with the Number Who Were Shot at.Table 1
Rates of Injury and Death among Victims of Drive-by Shootings under 18 Years of Age, According to Race and Sex.Article Activity
- Article
In the city of Los Angeles, drive-by shootings are an important cause of early morbidity and mortality among children and adolescents. According to the Los Angeles Police Department, more than 90 percent of such shootings are perpetrated by members of violent street gangs. Los Angeles has the most such gangs of any city in the United States, with more than 400 different gangs and approximately 60,000 gang members. According to the police department, 58 percent of gang members in Los Angeles are Hispanic, 37 percent are African American, 3 percent are Asian, and 2 percent are white. The vast majority of inner-city children do not join street gangs, however.
The primary purpose of drive-by shootings is to terrorize members of rival gangs; the secondary purpose is to kill1. Drive-by shootings are endemic in Los Angeles and are no longer confined to the inner city2,3. They have become a national phenomenon1.
The principal objective of this study was to determine the frequency of drive-by shootings involving children and adolescents in Los Angeles in 1991 and to identify the population at greatest risk for injury and death. We also studied the areas of the body that were most commonly injured, the most common sites of shootings, the seasons in which the most shootings occurred, and the types of firearms used in these shootings.
Methods
This study was a retrospective review of drive-by shootings in Los Angeles in 1991 that were determined by the Gang Information Section of the Los Angeles Police Department to have had involvement by a street gang. The police department defines a drive-by shooting as a gang-related or gang-motivated incident in which the suspect (or suspects) discharges a firearm from a vehicle and causes a homicide, attempted murder, or felonious assault or shoots into an inhabited dwelling4.
Gang-related crimes are defined by the Los Angeles Police Department as any of a number of crimes in which either the victim or the suspect is identified in the files of the Gang Information Section as a gang member. Gang-motivated crimes are defined as any of a number of crimes in which either the victim or the suspect is an active gang member and the crime occurs as a result of that membership. Both groups of crimes include homicide, robbery, kidnapping, arson, rape, drive-by shooting, the intimidation of a witness, extortion, felonious assault, and assault and battery of a police officer4.
If the weapons used in drive-by shootings were not confiscated, they were identified from shell casings, bullets retrieved, bullet holes, victims' descriptions of weapons they had seen, and the number of shots fired.
We reviewed all the 1991 records of the Gang Information Section in order to identify victims of drive-by shootings through the age of 17. The records were reviewed for each victim's age, race, and sex; the time of day and the month when the shooting occurred; the type of weapon, the area of the city, and the location (house, street, or car); the area of the body injured; and the victim's status as belonging or not belonging to a gang. An associated victim was defined as a person over the age of 17 who was shot at or received a gunshot wound in a drive-by shooting involving a child or adolescent.
Population data were obtained from the 1990 U.S. Census5. The data were compiled with Paradox 4.0 software (Borland International, Scotts Valley, Calif.) and analyzed with the chi-square test6 on Epi-Info, version 5,7 except for data pertaining to police bureaus, for which the chi-square goodness-of-fit test6 was used. Differences were considered to be statistically significant when the two-tailed P value was less than 0.01.
Results
There were 1548 drive-by shootings involving violent street gangs in Los Angeles in 1991, during which 2222 people were shot at. A total of 583 of the incidents (38 percent) involved children and adolescents under 18 years of age, and in these incidents 677 children and adolescents were shot at. Figure 1Figure 1
Number of Children and Adolescents Who Received Gunshot Wounds in Drive-by Shootings, as Compared with the Number Who Were Shot at. shows the number of children and adolescents who were shot at and the number who had gunshot wounds, according to age.Table 1Table 1
Rates of Injury and Death among Victims of Drive-by Shootings under 18 Years of Age, According to Race and Sex. shows the race and sex of the children and the adolescents who were shot at, the number who had gunshot wounds, and the rates of injury. Of the 677 children and adolescents who were shot at, 429 (63 percent) had firearm injuries, 221 (33 percent) did not, and in 27 cases (4 percent) it was not known whether such an injury had occurred. Of the children and adolescents who had gunshot wounds, 76 percent were Hispanic and 22 percent were African American. Eighty-six percent of those injured were boys. Table 2Table 2
Incidence of Drive-by Shootings, Injuries, and Homicides in Victims under 18 Years of Age, According to Race and Sex. shows the incidence of shootings and firearm injuries.Further analysis of the 429 children and adolescents who were injured revealed that 303 (71 percent) were documented members of violent street gangs. Of the injured gang members, 99 percent were African American or Hispanic, and 89 percent of them were boys. Among the victims who had firearm injuries, 122 (28 percent) had no gang affiliation; for the other 4, it was unknown whether they were involved with a gang. Ninety-eight percent of those with no gang affiliation were African American or Hispanic, and 81 percent were boys.
Three hundred thirty-seven of the children and adolescents with firearm injuries (79 percent) had a single gunshot wound, whereas 92 (21 percent) had multiple gunshot wounds. Two hundred twenty-nine (53 percent) had injury to an extremity, either singly or in association with another gunshot wound. The leg was the most commonly injured area, with 168 victims (39 percent) having gunshot wounds in the leg. The severity of injury could not be determined from the police files unless the injury was fatal.
In 1991, there was an average of 49 drive-by shootings per month involving children and adolescents; 56 children and adolescents were shot at per month, and 36 were injured. Each month, 50 percent or more of the children and adolescents who were shot at had firearm injuries. The worst month was August (with 69 drive-by shootings and 61 injured). Three hundred eight incidents in which there were firearm injuries (77 percent) occurred at night, 91 (23 percent) occurred during the day, and 3 (<1 percent) occurred at unknown times.
The Los Angeles Police Department is divided into four bureaus, each of which has four or five divisions. Injuries from drive-by shootings occurred in the area covered by every bureau and division in 1991. Among the incidents that involved injuries, 177 (42 percent) were accounted for by the Central Bureau; 122 (30 percent) by the South Bureau; 67 (17 percent) by the Valley Bureau; and 43 (11 percent) by the West Bureau.
Among the injuries inflicted in drive-by shootings, 359 (84 percent) occurred on city streets; 50 (12 percent) occurred when gang members shot into a car while it was being driven, stopped at a traffic light, or parked; and 14 (3 percent) occurred when gang members shot into homes. Public schools and parks were the sites of two injuries each (<1 percent).
The most commonly used firearm in drive-by shootings was a handgun (73 percent). In 31 percent of incidents when a handgun was used, it was a semiautomatic (usually a 9-mm handgun). Shotguns were used in 13 percent of the incidents, and rifles in 3 percent. Use of an assault weapon was documented in one incident (<1 percent). In 15 incidents (4 percent), multiple weapons were involved. In 47 incidents (12 percent), the type of weapon used was unknown.
Of the children and adolescents shot at, 36 (5.3 percent) had fatal gunshot wounds (Table 1). All the homicide victims were African American or Hispanic. Thirty-five of the homicide victims (97 percent) were boys. Thirty-one (86 percent) were gang members, whereas five (14 percent) had no gang affiliation. Incidence rates for homicide are shown in Table 2. Rates of drive-by shooting, injury, and homicide were significantly higher among African Americans and Hispanics than among Asians and whites (Table 2) (P<0.001). African Americans did not differ statistically from Hispanics with respect to rates of injury and homicide (P = 0.49 and 1.00, respectively), but their rate of drive-by shootings was marginally higher (P = 0.036). All rates were significantly higher among boys than among girls in each racial or ethnic group (P<0.001).
Twenty-five homicide victims (69 percent) died from a single gunshot wound, and 11 (31 percent) from multiple gunshot wounds. Twenty-six homicides (72 percent) occurred on city streets, whereas nine (25 percent) involved shooting into cars. Twenty-six homicides (72 percent) occurred at night. August and September were the months with the most homicides, at seven (19 percent) each.
In the course of the 583 drive-by shootings involving children and adolescents, 351 people over the age of 17 were shot at, 139 had gunshot wounds, and 4 died.
Discussion
Of 677 child and adolescent victims of drive-by shootings in Los Angeles in 1991, 429 had gunshot wounds and 36 died from their injuries. African American and Hispanic boys who were members of street gangs accounted for the overwhelming majority of the victims. Most children and adolescents were shot at in the inner city, on public streets, and at night; handguns were the most commonly used firearms. There was an average of 38 firearm injuries per month involving children and adolescents. African American and Hispanic children were at significantly higher risk for injury and death from drive-by shootings than their Asian and white counterparts. Because of the large number of violent street gangs and gang members in Los Angeles, the incidence of injuries and homicides as a result of drive-by shootings is probably higher than in other cities in the United States.
The number of injuries from firearms rose abruptly as children reached mid-adolescence, probably because the ages from 15 to 21 are the peak years for involvement in violent street gangs2. The majority of perpetrators of drive-by shootings involving children and adolescents were probably adolescents, since people tend to shoot others within their own age group,8 as well as those within their own ethnic group9.
Children and adolescents who receive gang-related firearm injuries live in areas where there are large numbers of street gangs and where rivalry and retaliatory shootings are frequent. Gang members are 60 times more likely than members of the general population to die through homicide10. Therefore, those who associate with gang members, live with them, or play on the streets where there is increased gang activity are at substantially higher risk for injury and death from drive-by shootings. Contrary to the general assumption, drug trafficking is not a major causative factor11,12.
The majority of drive-by shootings occurred in the areas of Los Angeles with the most violent street gangs. These were also the areas with the most economically deprived and marginalized African American and Hispanic children.
The summer months had the highest numbers of drive-by shootings, people shot at, and injuries. This is the time of year when children are out of school and inner-city young people are generally unemployed. Drive-by shootings usually occurred at night, when it was difficult to identify automobiles, license plates, and faces, thus lessening the possibility of apprehension.
Firearms are used in 70 percent of homicides involving adolescents,13 and in 90 percent of gang-related homicides. In our study, handguns were the most common firearms used, and approximately one third of the handguns used were semiautomatics. Some semiautomatic handguns can fire up to 17 bullets without being reloaded. For street gangs, this increases the probability of injuring or killing rival gang members and innocent bystanders in drive-by shootings.
The 36 homicides resulting from such shootings represented 9 percent of all deaths among children and adolescents and 23 percent of all homicides among children and adolescents in Los Angeles in 1991, according to the Los Angeles County Department of Health Services. There were an additional 49 gang-related homicides in which the victims were children and adolescents in 1991 that did not involve drive-by shootings. The total number of gang-related homicides among children and adolescents (85) accounted for 53 percent of all homicides involving children and adolescents in Los Angeles in 1991. Nor is the problem limited to homicide victims. Ten to 20 percent of inner-city children in Los Angeles have witnessed a homicide14. Many of these children may suffer from a post-traumatic stress disorder14,15.
In Los Angeles, drive-by shootings are not random events. They constitute a major public health problem, particularly in the inner city. Since a large number of people can be injured or killed in one incident, the morbidity and mortality, the total medical cost, and the cost to society are enormous1. Law enforcement alone cannot eliminate gang violence. The United States must develop a national policy on street gangs,16 with its principal focus being the prevention of the root causes of gang violence (stressed families, poverty, lack of education, unemployment, racism, and the breakdown of social and cultural institutions)2,17. Programs that are culture-specific and age-appropriate must be developed to enable children to progress from adolescence to adulthood nonviolently18. Counseling must be made available for victims of drive-by shootings. Strategies that have been proposed to prevent firearm injuries in children and adolescents include the legislation, regulation, and institution of a firearm-reporting system13,19-21. Our data from one large U.S. city, although they may present an atypical case, underscore the urgency of this important public health problem.
We are indebted to the Los Angeles Police Department, in particular the members of the Gang Information Section, for their assistance in this study; to Dr. David McArthur and Dr. Jess Kraus for their assistance in compiling and analyzing the data; and to Dr. Linda Chan for her assistance with the statistical analysis.
Source Information
From the Department of Emergency Medicine, Los Angeles County and University of Southern California Medical Center (H.R.H., D.A.), and the University of Southern California (M.J.P.) -- both in Los Angeles.
Address reprint requests to Dr. Hutson at the Department of Emergency Medicine, Rm. 1011, Unit I, Los Angeles County and University of Southern California Medical Center, 1200 North State St., Los Angeles, CA 90033.
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David H., SongGideon P., NaudeDebra Ann, GilmoreFred, Bongard. (1996) Gang Warfare. The Journal of Trauma: Injury, Infection, and Critical Care 40, 810-815
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H. Range, HutsonDeirdre, AnglinMarc, Eckstein. (1996) Drive-by Shootings by Violent Street Gangs in Los Angeles: A Five-year Review from 1989 to 1993. Academic Emergency Medicine 3:10.1111/acem.1996.3.issue-4, 300-303
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Michael, DudleyChris, CantorGreg de, Moore. (1996) Jumping the gun: firearms and the mental health of Australians. Australian and New Zealand Journal of Psychiatry 30, 370-381
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Petko T., Dontschev. (1995) Applied criminology. Current Opinion in Psychiatry 8, 376-379
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Edgar A., Suter. (1995) Letter to the Editor. The Journal of Trauma: Injury, Infection, and Critical Care 38, 673-674
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