I have always been wary of measures designed to get tough on crime, especially mandatory minimum sentences and three strike laws. These laws destroy judicial discretion and punish individuals based on history instead of on their accused crime. We should not be surprised that the United States leads the world in incarceration rate, with 686 out of 100,000 Americans in prison. Draconian drug laws have also played a large role in creating a society where approximately 2 million people are in jail.
However, my concern over these laws had been tempered by their apparent success in diminishing violent crime. This success does not extend to the drug war, which remains a miserable failure. Most impressive was the dramatic drop in murders. The nationwide homicide rate in 2000 was 5.5 people per 100,000. This homicide rate is much lower than the peak in 1991 of nearly 10 people per 100,000. The murder of 15,517 people in 2000 is disturbingly large, but much better than the 25,000-30,000 murders that might have been expected if the 1991 rate had continued.
Clearly something has been working. This precipitous drop in homicide is offered as proof that tough new laws have been a success. Our large prison population becomes much more palatable if it means saving 10,000 people a year from being murdered.
Yet before we accept the conclusion that murder rates have dropped because of the enactment of new tough laws, we should remind ourselves of a basic principle of statistics-correlation does not equal causation. I advise constantly chanting this mantra under your breath when reading any news story that uses statistics. Are new laws the best explanation for the decrease in murder? No, the best explanation, as detailed in Popular Science, surprisingly comes from medicine.
Popular Science is a magazine that is best known for its description of interesting but useless new inventions, the garden trowel with a built in computer chip as one example among many. However, their article \Yesterday They Would Have Died"" in the October issue is a piece of stellar journalism that chronicles the stunning advances in emergency medical care and the impact it is having on murder. Basically, murder rates have decreased in large part because many of the victims of violent assaults that would have died 10 or 20 years ago can now be treated and saved.
Trauma care was an area of medicine that did not receive much attention before the 1960s. That changed with the studies of Dr. Adams Cowley, who first identified what he called the ""Golden Hour."" If a person could be stabilized within an hour they had a good chance of survival; after that, mortality rates increase dramatically. This realization led to the implementation of coordinated statewide emergency response teams, the creation of 911 and the use of helicopters.
Moreover, the amazing developments in imaging technologies have taken some of the guesswork out of trying to treat patients with gun or knife wounds. CT scanners, which allow the doctor to image soft tissue that is invisible to X-rays, were the most important development. The CT scanners were introduced in the late '80s and have only recently become fast enough to be used on a routine basis in emergency medicine.
New technology, focused research and training and better organization have combined to make trauma care incredibly effective. Guns were used in 17 percent of assaults in 1964 and the fatality rate for those assaults was 16 percent. In contrast, guns were used in 19 percent of assaults in 1999, but only 5 percent of these assaults were fatal. The rate of death decreased considerably, despite an increase in gun assaults, because of advances in emergency care.
This trend was recognized and studied by criminologist Anthony Harris. In 2002, he published ""Murder & Medicine"" in the Journal of Homicide Studies. From his statistical analysis (keep chanting) he estimates that without advances in trauma care, there would likely have been between 45,000-70,000 murders a year instead of the actual 15,000. That is a truly astounding statistic.
This estimate may be high and certainly other factors played a role in the decreasing murder rate. However, this study strongly suggests that the key factor was not tough new crime laws, but improvements in emergency medicine.
We have become adept at treating the result of attempted murder, but have been much less successful at treating the cause. This is great news for the field of medicine, but must make us wonder what we have gained by becoming the worlds leader in the rate of incarceration.
