Gun use in Orange County claimed 439 lives, many by suicide, over a three-year period and resulted in hospitalization costs of $48 million, according to a report released Wednesday by the Health Care Agency.

The report, covering 2009-11, analyzed 1,292 injuries and deaths caused by firearms as well as air or paintball guns. Among the deaths, 63 percent were ruled suicide, 32 percent homicide and the rest were accidents and shootings by police.

The county’s gun death rate of 4.7 per 100,000 people is lower than that of the state and surrounding counties and has decreased over the past decade.

Among deaths, 63 percent were among whites, 25 percent among Latinos, 8 percent in Asians, and 3 percent in blacks. Among Latinos, 72 percent of deaths were homicides, while for whites 84 percent were suicides.

Mark Lawrenz, the county’s division manager for prevention and intervention in behavioral health, said a statewide campaign is targeting middle-age white men for suicide prevention.

“We have public health campaigns to prevent heart disease and diabetes and this is a very crucial mental-health concern,” Lawrenz said.

Teresa Smith, a licensed clinical social worker and executive director of Catholic Charities of Orange County, which runs a suicide prevention hotline, said guns have a more final result than less violent means of suicide such as taking pills.

“The question is, what would prevent suicide?” Smith said. “What will prevent suicide is better attention to folks with mental-health issues, earlier recognition of a person’s depression, which can lead to despair and despondency, which leads to suicide.”

Nearly half of all gun injuries in the county occurred in Santa Ana and Anaheim, but Laguna Woods had the highest per capita death rate. For patients taken to emergency rooms countywide, 91 percent were male, 24 percent were children age 10 to 17, and 4 percent were younger than age 10.

Among the 300 patients who required hospitalization, 177 were assaulted, 84 were accidentally injured and 15 had wounds that were self-inflicted. Hospitalization costs, for an average stay of eight days, averaged $158,541 per patient. According to the report, 51 percent of bills were paid by Medi-Cal or county indigent programs, 23 percent by private insurance, 14 percent of patients were uninsured and 12 percent were identified as other or unknown.

Contact the writer: cperkes@ocregister.com 714-796-3686