Substance abuse is the leading cause of death in the United States accounting for nearly one-quarter of all mortality.  The combined effects of alcohol, tobacco and other drugs inflict a greater toll on the health and well-being of Americans than any other single preventable factor.  After tobacco, alcohol is the most abused addictive substance in the United States, accounting for over 100,000 deaths annually.

Firearm-related deaths are the second leading cause of injury death in the United States accounting for over one-fifth of all injuries.  In the 1990s, over 35,000 people died from gunshot wounds and almost twice as many people were admitted to U.S. hospitals for nonfatal gunshot wounds.  Nationally, 22% of assaults involving firearms result in death (and are thus labeled homicides) and 83% of self-inflicted injuries involving firearms result in death (and are thus labeled suicides). 

Both interpersonal violence (including homicide) and self-directed violence (including suicide) are the end-results of a "causative web" of contributing factors that includes alcohol, firearms, and risky neighborhoods.  Geographic research that addresses the relationship between alcohol, firearms, and risky neighborhoods has been beneficial to the design of politically feasible, yet effective, interventions to reduce the burden of violence in America's communities.

We are conducting an epidemiologic study in Philadelphia to better delineate the relationship between alcohol consumption, alcohol outlets, and firearm violence. Information on the use of and access to alcohol for victims of interpersonal and self-directed violence (that is, case subjects) is being sent to us from 10 local, state, and national sources.  For each adult who is shot in Philadelphia, will we contact a Philadelphia resident of the same age, gender and race (that is, control subjects) and conduct an interview to learn about their use of alcohol at the time the shooting occurred. By employing a surveying technique that uses randomly picked telephone numbers, we will ensure that all adult residents of Philadelphia have an equal chance of being asked to participate in the survey.