While 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.
Dr. 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 case.
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.
But 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.
The 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.
Dr. 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.
The 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.
Looking 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 years.
Now 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.
Reference: Murder and Medicine: The Lethality of Criminal Assault, 19601999, Homicide Studies, May 2002, Vol. 6, No. 2, pp. 128166, 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.
August 30, 2002