Orange County health officials track and publicize almost all manner of death, counting up the number of people who perish every year of everything from heart disease and cancer to COVID-19 and Alzheimer’s.

A big exception is guns.

While most public health departments in Southern California treat firearm injuries like other causes of death – tabulating the numbers and telling the public how many people in their community die as a result of gunshots, intentional or otherwise – such data has not been listed on public websites run by the Orange County Health Care Agency since the middle of the last decade.

Even over the past three years, as gun purchases and gun homicide and suicide rates have spiked nationally, and at least three mass shootings have taken place in Orange County, the local health department has released no data that researchers or the general public might use to compare local gun death rates to the rest of the country.

The one mention of “firearms” on county public health websites is as a cause of suicide, and even in that case guns are listed only as part of a combined category, “firearms and explosives.” That makes it impossible to track the exact number of people, locally, who choose to use a gun to end their life.

Current and former county officials insist that’s not intentional. They say there is no overt effort to hide or obscure public data about firearm deaths because such numbers might be politically sensitive.

“In my experience, none of the supervisors or anybody ever told me you’re not to report on (gun deaths),” said Dr. Clayton Chau, who led the Orange County Health Care Agency during most of the pandemic before stepping down earlier this year to take a job in the private sector.

“But, yes, it’s true that the public numbers on (gun deaths) aren’t easily available.”

Lack of local public data doesn’t mean the information doesn’t exist. State and federal health experts track gun deaths in every county in the country, and recent numbers suggest Orange County is below the California average of 7.9 gun deaths for every 100,000 people.

But the county’s exact gun death rate hasn’t been publicized, and it’s unclear if local gun deaths are more or less common. It’s also unknown if a recent national trend – a historic spike in childhood mortality in the three years since firearms supplanted auto accidents as the No. 1 killer of kids – is playing out locally.

Experts say not going public with health information is bad for public health.

“Understanding and tracking the data is important, and publicizing it is everything,” said Marizen Ramirez, a public health professor and epidemiologist at UC Irvine who studies the role that violence plays in public health.

Ramirez compared gun data to auto accident data. Just as it’s important to know how many people die each year in auto accidents – in part so the information can be used to calibrate everything from auto insurance rates to freeway speed limits – she said publicizing gun death numbers can help society weigh the broader costs, in lives and dollars, of gun ubiquity.

“It isn’t about demonizing guns,” Ramirez said. “I have friends who have guns, I know of epidemiologists who own guns.

“But understanding the cost those guns actually have for all of us can’t be measured unless we have public data about them. And death data is part of that.”

Though they haven’t made the information public, Chau and others said the county’s Health Agency routinely tracks gun-related fatalities. Officials use data from the county coroner to monitor gun-related homicides, suicides, accidents and officer-involved shootings.

And a new report looking at several years of local gun deaths – the first since 2014 – has been awaiting formal approval for publication from county County Executive Officer Frank Kim for several months.

“I don’t know why it hasn’t come out,” said Chau, who left the county in June and now works for National Healthcare & Housing Advisors, a company that works with public agencies and hospitals to provide health care and shelter options for people struggling with homelessness.

“I know (Kim’s office) needs to talk with different supervisors.”

When asked if it would take months to produce a report about Alzheimer’s disease deaths or cancer deaths, Chau said, “probably not.”

Kim, who didn’t offer detailed comment on the record, confirmed that the report exists and said the county won’t issue any report until it has been “thoroughly vetted” for accuracy.

In the past, Orange County health officials have researched gun deaths and publicized their findings.

In 2014, the county issued a report called “Firearm-Related Injuries and Death in Orange County (2009-2011).” In addition to tracking negative gun outcomes in the county, and in each city, over the three-year window, that report also highlighted at least some of the financial burden that gun violence – in the form of paying for shooting-related injuries – placed on local taxpayers.

“Charges associated with these 300 firearm-related hospitalizations averaged $158,541 per admission and a length of stay of eight days. During the three-year time period of 2009 to 2011, the sum total charges amounted to about $48 million or an average of about $16 million per year,” health officials wrote. An accompanying table showed that about half (51%) of those expenses were covered by Medi-Cal or other government insurance programs, while private insurers picked up about a quarter (23%).

Another report from the same era tracked deaths of people age 17 and younger during a five-year period starting in 2007, and it also included data about gun deaths. During those years  29 children in Orange County died in gun-related homicides and seven died in gun-related suicides.

Since then it’s likely – though, again, unknown because of a lack of information – that guns have killed more children in Orange County. A report from the American Academy of Pediatrics found that the national firearm death rate for children 17 and younger jumped 41.6% from 2018 through 2021, and that 6 in 10 of those deaths were homicides.

The report found that Black teenage boys living in southern states were more likely than any other demographic group to be victims of gun violence, with death rates roughly 11 times higher than children living in comparatively low gun death-rate states like California.

Over time, experts say, such detailed public health findings can be used to slow violence and save lives.

“Sometimes data shows us what we already know. But if we’re looking to prevent gun deaths, to keep our community safer, we have to identify basic data to be on the same page and tackle the same problem,” said Katherine Williamson, a pediatrician from south Orange County who is associated with Children’s Hospital of Orange County and a member of the local chapter of the American Academy of Pediatrics.

“The idea that data about gun deaths isn’t available to the public is disappointing,” she said. “Particularly when you’re talking about children.”

County Supervisor Katrina Foley agreed. She said she wasn’t aware that gun data wasn’t included on the Health Agency’s website, but will work to find out why and work with county officials to fix what she said is “a problem.”

“It’s not something we’ve discussed, to be honest.”

Still, when pressed why an agency that can tabulate and publicize the number of local deaths from fentanyl (555 last year), or heart disease (5,114 in 2021), or COVID-19 (3,466 in 2021), can’t offer matching data for firearm injuries – which, based on other public trend lines is one of the 10 leading causes of death in the county – Foley demurred.

“I don’t know,” she said. “But I think it’s important to figure out why we’ve stopped and how to start again.”

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