Firearm and Nonfirearm Homicide in 5 South African Cities: A Retrospective Population-Based Study

Objective. We assessed the effectiveness of South Africa’s Firearm Control Act (FCA), passed in 2000, on firearm homicide rates compared with rates of nonfirearm homicide across 5 South African cities from 2001 to 2005.Methods. We conducted a retrospective population-based study of 37 067 firearm and nonfirearm homicide cases. Generalized linear models helped estimate and compare time trends of firearm and nonfirearm homicides, adjusting for age, sex, race, day of week, city, year of death, and population size.Results. There was a statistically significant decreasing trend regarding firearm homicides from 2001, with an adjusted year-on-year homicide rate ratio of 0.864 (95% confidence interval CI] = 0.848, 0.880), representing a decrease of 13.6% per annum. The year-on-year decrease in nonfirearm homicide rates was also significant, but considerably lower at 0.976 (95% CI = 0.954, 0.997). Results suggest that 4585 (95% CI = 4427, 4723) lives were saved across 5 cities from 2001 to 2005 because of the FCA.Conclusions. Strength, timing and consistent decline suggest stricter gun control mediated by the FCA accounted for a significant decrease in homicide overall, and firearm homicide in particular, during the study period.With the revisiting of the gun control debate both in South Africa following the high-profile shooting incident involving celebrity paralympian, Oscar Pistorius, and in the United States after recent the killings at Newtown, Connecticut, it is instructive to assess the impact of stricter gun control applied in South Africa through the Firearms Control Act (FCA) of 2000. The FCA was implemented in response to the prominent role of firearms in violent crime, identified by the National Crime Prevention Strategy adopted in 1996, active lobbying by an alliance of nongovernment organizations and opinion leaders, and a groundswell of popular support.1 It provided a complete overhaul of the existing firearms-control regime and was unambiguous in its intent to reduce the number of firearms in the country, particularly those in civilian hands. It also included provisions for restrictions and prohibition on the ownership of particular types of firearm and background checks to establish an individual’s physical and mental capacity to use a firearm responsibly.In 2000, South Africa had one of the highest homicide rates in the world.2 The National Injury Mortality Surveillance System (NIMSS), a sentinel system comprising mainly urban mortuaries, indicates that until 2003 firearms were the leading external cause of homicide for all age groups from the age of 5 years,3–7 and in 2003, gunshot injuries accounted for 53% of male and 41% of female homicides.6 The South African Police Service has reported a consistent decline in homicide from 1994 to 2012. The NIMSS data, although not comparable year-on-year because of erratic coverage after 2005, suggest that this decrease might be ascribed to fewer firearm deaths—the latest report for 2008 revealed that sharp force injuries (stabbings) accounted for 41% of homicides compared with just 30% for gunshots.8The stricter licensing conditions under the Firearms Control Act No. 60 of 2000 were part of a broader strategy to reduce the number of guns in circulation, and there was a firearm-access gradient between the FCA being passed in 2000 and its full implementation in 2004. The period was characterized by firearm amnesties and hand-ins, in which legal and illegal guns were recovered by the authorities, more rigorous application of existing licensing conditions, and the destruction of surplus and illegal weapons. The South African Defense Force destroyed an estimated 270 000 weapons between January 1998 and May 2001, and the police destroyed 30 000 in 2001.9 It was also notable that there was a 75% increase in the number of firearms recovered by the police in 2003 compared with the previous year (i.e., from 20 000 weapons confiscated and recovered in 2002 to 35 000 in 2003).10 This coincides with the period in which the decline in firearm homicide became evident. After full implementation of the FCA in 2004, this effort was redoubled and a further 100 000 firearms were collected in the first 6 months of 2005.11The aim of the current study was to investigate a decrease in homicide rates over 2001 to 2005 and to assess whether this decrease was specific to firearm homicide or other factors associated with homicide risk. We hypothesized there would be a significant decrease in firearm homicide specifically attributed to the increasingly stricter gun control coinciding with the phased implementation of the FCA that was fully implemented by 2004. The corresponding nonfirearm homicide rate was expected to remain stable.