listening to NPR in my car, I heard a report on recently published
research by Dr. Stephen Thomas of Harvard Medical School and his
two colleagues from the University of Massachusetts at Amherst and
one colleague from the Emergency Medical Services in Lawrence Massachusetts.
The combination of NPR and Harvard almost led me to tune my radio
to a country music station, but the report was enlightening.
Thomas's thesis is that improvements in the quality and quantity
of medical care over the last forty years have resulted in an increasing
percentage of lives being saved when people are shot or stabbed
in an attempted murder. With improvements in emergency vehicle response
time, trauma systems, medical technology, and pharmaceuticals –
all attributable to the private sector – this is no doubt the
issue at hand is the surprising decline in the murder rate over
the last decade or so. Reported crime rates have been declining
during the 1990s, but most of this reduction in crime rates is the
result of two factors. First, the private sector defense industry
has expanded in response to high rates of crime to provide defense
weaponry, alarm and security systems, and private police and security
services. Read Bruce Benson's great book, To
Serve and Protect, to find out all the details, but the
conclusion is that private police defense is now larger, more effective,
and less costly compared to its public sector counterpart. Second,
many types of crimes are now routinely not reported to the police.
Most victims now realize that unless you can tell the police who
the criminal was, it's not worth reporting crimes unless your insurance
policy requires it. In high crime areas, victims fully realize that
it is not worth reporting crimes and they usually don't have insurance.
with murder, it is hard to overlook the victim. I must say, that
as a researcher on drug prohibition (the number one cause of crime
and murder), I have found the decrease in the murder rate during
the 1990s to be particularly puzzling.
most widely accepted arguments were the statist claim that the police
were getting better at their jobs and the Marxian argument that
crime recedes with the boom phase of the business cycle. Both no
doubt have marginal impact, but neither stands up against rigorous
examination. There is no doubt that the police are arresting record
numbers of Americans. We now have a criminal population of over
6.5 million (3.9 on probation, .7 on parole, and 2 million behind
bars) and millions more with a criminal record. And it certainly
is true that putting a real criminal behind bars does reduce potential
crime, though it automatically victimizes the taxpayer to the tune
of 10s of thousands of dollars each year.
Thomas and his team looked at the period from 1960 to 1999 and examined
improvements in medicine in light of the murder rate and attempted
murders. They found that improvements in medicine were responsible
for saving an increasing percentage of people who were shot or stabbed.
They noted that medical professionals with long experience in emergency
room care would not find this conclusion surprising at all, but
just common sense.
number of murders in 1993 was about 23,000. (The way in which crime
statistics are calculated was changed in 1993) This results in a
back-of-the-envelope calculation of a murder rate (number of murders
per 100,000 population) of 8.5. Dr. Thomas estimates that in that
same year, that if they were still using 1960s medical technology
and response times, the number of murders would have been around
67,000, or a murder rate of 24.8. This ghastly figure gives us a
much clearer picture of what is happening in America, because the
24.8 rate is a better reflection of the number of attempted murders
that would otherwise have resulted in death.
at the historical record, there is little doubt that prohibitions
have had the biggest impact on crime and crime statistics. The murder
rate prior to alcohol prohibition ranged between 5 and 6. During
alcohol prohibition the murder rate leaped higher, and continued
to climb, until alcohol prohibition was repealed in 1933, reaching
a rate of almost 10 murders per 100,000 population. After the repeal
of alcohol prohibition, the murder rate declined sharply throughout
the Great Depression (so much for the Marxian view) and bottomed
out around 1960. The murder rate then began to climb beginning with
Nixon's "War on Drugs," rising above the rate of 10, during
the 1970s and 1980s, before beginning its mysterious decline during
the early 1990s. Taking Dr. Moore’s findings into account, we would
extend the uptrend that started in the 1960s, but instead of leveling
off around 10 during the 1970s, the trend would continue increasing
at that angle until it hit a rate of 25 over the past couple of
we know, thanks to insights and research of Dr. Thomas and his colleagues
that if you factor out improvements in medicine, that the "real"
or "medical-adjusted" murder rate has continued to skyrocket
during the war on drugs. The fact the victims actually survive is
a gratifying success of the private sector, but it can no longer
be used to hide the abysmal failure of the policy of drug prohibition.
Murder and Medicine: The Lethality of Criminal Assault, 1960–1999,
Homicide Studies, May 2002, Vol. 6, No. 2, pp. 128–166,
by Anthony R. Harris, PhD Department of Sociology, University of
Massachusetts Amherst, Stephen H. Thomas, MD MPH Division of Emergency
Medicine, Harvard Medical School, Gene A. Fisher, PhD Department
of Sociology, University of Massachusetts Amherst, and David J.
Hirsch, BS Emergency Medical Services, Lawrence Massachusetts.