GUNS do not make a nation safer, say US doctors who have compared the rate of firearms-related deaths in countries where many people own guns with the death rate in countries where gun ownership is rare.

Their findings, published on Wednesday in the prestigious American Journal of Medicine, debunk the historic belief among many people in the United States that guns make a country safer, they say.

On the contrary, the US, with the most guns per head in the world, has the highest rate of deaths from firearms, while Japan, which has the lowest rate of gun ownership, has the least.

The journal has fast-tracked publication of the study because of the shootings at the Washington navy yard. It was originally scheduled for later this week.

It follows an emotional appeal from a doctor at the trauma centre in Washington where the victims of Aaron Alexis’ random violence were taken. “I would like you to put my trauma centre out of business,” Janis Orlowski, chief medical officer at MedStar Washington Hospital Centre, told reporters in the aftermath of the massacre.

“I would like to not be an expert on gunshots. Let’s get rid of this. This is not America.”

The fraught question of whether gun ownership protects populations from crime or makes them less likely to be killed has been debated for 200 years, say the authors, Sripal Bangalore of NYU Langone Medical Center, and Franz H Messerli of St Luke’s Roosevelt hospital, Columbia University College of Physicians and Surgeons, New York.

They say the arguments began as soon as the second amendment stating “A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed” was passed in 1791.

At one end is the argument that gun control laws are an infringement on the right to self-defence and on constitutional rights, and that there is no evidence that banning assault weapons would reduce crime. At the other end is the view that fewer firearms would reduce crime rates and overall lead to greater safety, they say.

In some of the recent mass shootings—for instance those in Aurora, Tucson, Oak Creek, Virginia Tech—it has been suggested that the killer was mentally ill and that lack of treatment was a bigger issue than gun ownership.

With this in mind, the New York-based doctors looked in their study not only at the relationship of gun ownership to firearms deaths but also mental illness.

They examined data from 27 developed countries, using gun ownership figures from the Small Arms Survey and deaths from the World Health Organisation, the National Centre for Health Statistics and others. They also looked at crime rates compiled by the United Nations for an indication of the safety of each country. More guns meant more deaths, they found.

“The gun ownership rate was a strong and independent predictor of firearm-related death,” says Bangalore.

“Private gun ownership was highest in the US. Japan, on the other end, had an extremely low gun ownership rate. Similarly, South Africa (9.4 per 100,000) and the US (10.2 per 100,000) had extremely high firearm-related deaths, whereas the United Kingdom (0.25 per 100,000) had an extremely low rate of firearm-related deaths.

“There was a significant correlation between guns per head per country and the rate of firearm-related deaths with Japan being on one end of the spectrum and the US being on the other. This argues against the notion of more guns translating into less crime. South Africa was the only outlier in that the observed firearms-related death rate was several times higher than expected from gun ownership.”

High rates of mental illness in any country, on the other hand, did not predict more gun deaths.

“Although correlation is not the same as causation, it seems conceivable that abundant gun availability facilitates firearm-related deaths. Conversely, high crime rates may instigate widespread anxiety and fear, thereby motivating people to arm themselves and give rise to increased gun ownership, which, in turn, increases availability. The resulting vicious cycle could, bit by bit, lead to the polarized status that is now the case with the US,” the doctors write.

“Regardless of exact cause and effect, the current study debunks the widely quoted hypothesis that countries with higher gun ownership are safer than those with low gun ownership.”

By arrangement with the Guardian