It’s impossible to quantify the cost of gun violence. There’s no way to add up pain and grief. No way to multiply that by shock and outrage. But emotional suffering and physical injuries do become real numbers when traumatic shooting events, like other public-health epidemics, contribute to the national health care burden. A 2021 review of hospital costs from the Government Accountability Office revealed about 33,000 inpatient stays and about 51,000 emergency room visits every year to treat firearm injuries. Those initial hospital visits were nearly triple the average patient cost, and collectively topped $1 billion annually. More than half of the cost was for patients with Medicaid and other public coverage.
For gun-wound survivors and their families, there’s a hefty price tag affixed to the healing process following a shooting incident, according to a Harvard Medical School study published in April that analyzed Medicare and commercial insurance claims between 2008 and 2018. Compared with their peers, gunshot survivors had a 40% increase in pain diagnoses, a 51% increase in psychiatric disorders, and an 85% increase in substance-use disorders in the aftermath of the shooting. Their family members had a 12% increase in psychiatric disorders.
Among injured survivors in the study, medical spending topped $25,000 per person one month after the shooting. Over 12 months, the costs totaled about $30,000 per survivor—or approximately $2.5 billion when multiplied by the 85,000 people who survive firearm wounds every year in the U.S., the study found. The costs were linked to treating survivors’ physical injuries and also subsequent mental health conditions in the first year following the shooting.
Gunshot survivors included in the study all had insurance coverage, and so didn’t pay out of pocket for all those expenses. Still, the study found that their co-pays and deductibles combined went up about $100 per month, on average, in the first year. What’s more, that financial burden didn’t account for lost productivity, wages, or employment (which could impact their ability to pay for health care), nor did it account for longer-term rehabilitation costs in later years.
For survivors’ significant others, parents, and children, medical spending was nearly $80 higher per person in the first month after the injury, but not statistically different over a one-year period. However, the study didn’t account for the population of families that lost a loved one to gun violence, nor the financial hardships associated with caring for a gunshot victim.
Another analysis from Everytown Research, a gun safety advocacy organization, puts medical costs even higher than the Harvard study, at $3.5 billion a year, though that figure accounts for survivors’ long-term care, coroner services for fatally shot victims (of which there are some 40,000 a year), and mental-health services for family members.
The Everytown analysis notes that, beyond the direct medical and health costs, the overall financial toll of gun violence on American society is hundreds of billions of dollars, including quality-of-life costs that are inherently intangible, but can be loosely estimated based on jury awards and victim settlements.
In the wake of high-profile mass shootings, like the most recent shootings at a Buffalo, N.Y. supermarket and a Uvalde, Texas elementary school, there’s often a flurry of fundraisers to support the affected families and communities. Some instances of gun violence result in remuneration following lawsuits. Such financial buffers—that is, the ones that no one ever wishes for—don’t bring down the costs that the broader health care system has to shoulder. Nor do they relieve the personal and collective sorrow that the U.S. has endured time, and time, and time again.
More Must-Read Stories From TIME