A startling jump in the percentage of murder victims who were shot in the head in recent years could explain why Baltimore's homicide rate hasn't fallen nearly as precipitously as the number of total shootings.
A review of the Baltimore Police Department's annual analyses of homicides shows that as murders fell, the number of people shot in the head rose from a small portion of the total killings more than a decade ago to about half last year. Police say those figures, along with anecdotal evidence, indicate an increasing number of close-range, execution-style shootings.
"I don't think they all got to be better shots over the years," said Maj. Terrence McLarney, chief of the homicide division. "Not only are they hitting them in the head, but we can tell from the transference of gunpowder and other indicators that they're getting close enough to effect that shot."
Police believe an overwhelming majority of the city's homicides are related to the drug trade, and closer shots would mean fewer drive-by killings or indiscriminate spraying of bullets that can injure bystanders. But it also means that those who are injured stand a far greater chance of dying before reaching a hospital.
Dr. Thomas M. Scalea, physician in chief at Maryland Shock Trauma Center, said he has not seen a marked increase in victims shot in the head, but said that could be because they are going straight to the morgue. The options to treat a brain injury are more limited than treating a gunshot to the chest or abdomen.
"We can either use medicine or surgery to relieve the pressure on the brain, but you can't change the fact that the brain is injured," Scalea said.
A 1997 study, prompted after questions arose over how nonfatal shootings could drop so significantly while homicides fell at a less precipitous rate, estimated that 17.5 percent of victims in 1996 had been shot in the head, up from about 13.3 percent in 1994 and 1995.
"Drive-bys are out, executions are in," Police Commissioner Thomas C. Frazier said at the time. "It's not trauma care. It's not response time. It's multiple shots in vital areas with bigger guns."
The numbers have continued to rise, according to department statistics. In 1998, 69 of the city's 313 murder victims were shot in the head, about 22 percent. Of the 238 people killed in 2009, 116 were shot in the head - nearly half. The number who were shot in the head and survived was unavailable.
"These are targeted. If, say, someone resisted a robbery on the street and it went bad and a suspect decided to shoot them, hitting them in the head is probably not going to occur," McLarney said.
Daniel Webster, a researcher at the Johns Hopkins University who in 1997 was part of a team that studied trends in shootings, said the reason for the increase in the execution-style shootings is unclear. He theorized that youth violence-prevention efforts and smarter policing might be deterring "guys who are knuckleheads and think they're tough, but don't have the anti-social makings of a murderer."
"These guys might have access to a gun and pop off some rounds when provoked, but wouldn't necessarily plan and carry out an assassination," Webster said. "But the more hard-core criminals, who typically grow up in inhumane environments, with neurological deficits to boot, have been less responsive to these efforts."
He speculated that another reason could be divergent changes in social norms: Shootings might be less fashionable or acceptable in general, but hardened criminals are more apt to shoot to kill. "Because if you don't, you will have a bull's-eye on you for retaliation," he said.
More close-range, targeted shootings could explain why the homicide rate remains stubborn in light of more significant reductions in gun crime. Though both have fluctuated and are down considerably from two years ago, department statistics show that in the past decade, reported shootings fell 38 percent, from 725 in 2000 to 449 in 2009, while homicides dropped by 8.8 percent, from 261 to 238.
The drop in total shootings is part of a nationwide phenomenon involving gun crime that stretches back to the mid-1990s. According to the National Crime Victimization Survey, the rate of nonfatal firearm- related violent crime has fallen from 6 incidents per 100,000 people in 1994 to about 2 per 100,000 in 2006.
Of course, the validity of the department's statistics might also play a factor. A steep drop hailed by Mayor Kurt L. Schmoke in the 1990s was muted when a review found that earlier numbers had been inflated by a faulty computer program. And in 2006, then-Police Commissioner Leonard D. Hamm told WBAL-TV that he was fine with officers not taking a report on every shooting, such as ones in which the victims refused to cooperate with police.