Gun violence's toll: $100 billion

PHILADELPHIA — Antoine Rosenbaum, shot in the back by a stranger and paralyzed from the chest down, carries a heavy load for someone just 25.

So does Sophorina Wright as she gets him out of bed, cradles him in her arms and carries his 6-foot frame into their living room. There, the 21-year-old woman seats her husband gently on the sofa, arranges his legs, straightens his feet and settles down next to him to watch TV.

"She sacrificed a lot, because once I got shot she could have just said, 'I can't do this; it's too much.' She stuck with me," Rosenbaum says.

Homicides have become the yardstick for measuring urban crime. But the far more numerous cases across America in which people are shot and wounded exact a terrible toll, too — on the victims, of course, but also on their loved ones, the health-care system, the social safety net and the economy.

"We like to think gun violence is someone else's problem, but it's everyone's problem," says Philip Cook, a Duke University economist and co-author of two widely cited studies about the cost of gun violence in the United States.

Rosenbaum and his wife live in a government-subsidized, handicapped-accessible apartment with extra-wide doors and hallways, easy-to-reach appliances and a linoleum floor crisscrossed with thin black tracks from Rosenbaum's wheelchair. Rosenbaum's wife gets $8.50 an hour as his full-time caregiver and also works part-time in a fast-food restaurant; he gets disability benefits and is eligible for government programs that will pay for schooling and help him find a job.

Despite the government's considerable assistance, Rosenbaum's care places a huge responsibility on his wife.

"I told him, 'You are not staying in that bed anymore. You have got to start getting up and getting out,' " she says.

$100 billion a year

More than 12,000 homicides by gun were reported in the United States in 2005. But the number who are wounded and survive gunshot assaults is much greater — nearly 53,000 were treated in emergency rooms in 2006, the same federal database shows.

A report in the journal Spinal Cord a decade ago estimated the direct lifetime charges for every shooting victim at $600,000, or nearly $800,000 in today's dollars. Some estimates put the indirect costs, including lost wages and productivity, at double that amount.

In a 1999 study in the Journal of the American Medical Association, Cook and his colleagues concluded that gunshot injuries in the United States in 1994 produced $2.3 billion in lifetime medical costs. Taxpayers footed half of that through Medicaid, Medicare, workers' compensation and other programs.

In a follow-up book, "Gun Violence: The Real Costs," published in 2000, Cook and Jens Ludwig estimated that gun violence costs the nation $100 billion a year, with medical costs only a small part of that.

Some gunshot victims recover fully and return to school and jobs and families. But many others face grim futures and are forgotten.

Rosenbaum might have been among the lost if not for a pilot program in Philadelphia that seeks to give young gunshot victims a chance at a meaningful life. For some, case workers say, it's the first real opportunity they've had.

Having to relearn

May 6, 2006, was the last day he could walk.

He and an acquaintance were sitting on a porch when, in the middle of the afternoon, they were robbed at gunpoint. As they tried to flee, shots rang out, and on the sound of the fourth, Rosenbaum remembers falling.

"I didn't know I was shot. ... I was on the ground. I'm looking around and I tried to get up; my foot, my legs, nothing was responsive," he says. A bullet had hit him between the shoulder blades and struck his spine.

He spent a week in the hospital and then a month at a rehab center, where he was fitted with a hard plastic "clamshell" brace. The brace — it still sits in his bedroom as a reminder — covered his torso to prevent his spine from healing crookedly. It was painful, and came off only for bathing and sleeping.

He had to relearn how to dress, bathe, get out of bed and get into his wheelchair using only his arms.

"A lot of opportunity"

Rosenbaum wants to move. There have been shootings and beatings in the neighborhood and, he says, a man in a wheelchair can't protect himself. He also fears that the man who shot him might come back.

"I could see the dude any day," he says. "I don't know if he wants to finish me off, thinking I'm going to snitch on him."

Rosenbaum and Wright are now a family of four. This year, they gained custody of his 4-year-old son and Wright's 4-year-old nephew. He and Wright even dream of having a baby through in-vitro fertilization, if they can get into a safer neighborhood and if they can somehow afford it.

Rosenbaum is looking into doing volunteer work at a nearby educational center that offers courses in art and photography. He is waiting for the center's new elevator to pass inspection so he can get around in the building.

"There's a lot of opportunity, me being in that chair, where I don't have to just sit around," he says. "A lot of doors opened up for me."