Current Epidemiological Trends in Firearm Mortality in the United States

Jason E. Goldstick, PhD1,2Patrick M. Carter, MD1,2Rebecca M. Cunningham, MD1,2Author AffiliationsArticle Information

JAMA Psychiatry. Published online September 23, 2020. doi:10.1001/jamapsychiatry.2020.2986

More than 652 000 people in the US died from firearm injuries between 1999 and 2018.1 Given that firearms are embedded within US culture (in 2018, 21.9% of individuals owned a firearm and 35.2% lived in households with firearms2) evidence-based public health measures and policies that enhance firearm safety are needed. Firearm injuries are multifaceted; for example, there are nearly twice as many nonfatal firearm injuries as deaths, and assaults comprise a majority of nonfatal injuries while suicides comprise a majority of deaths.3 In this Viewpoint, we narrowed the scope to firearm mortality trends from 1999 to 2018 and current regional/demographic trends available from US Centers for Disease Control and Prevention WISQARS/WONDER.1,4

National Temporal Trends

Total mortality fluctuated around 10.3 firearm-related deaths per 100 000 person-years from 1999 to 2014 before increasing to 11.3 per 100 000 person-years in 2015 and thereafter shifting to approximately 11.8 per 100 000 person-years from 2016 to 2018 (Figure). Age-adjusted firearm suicide rates decreased from 2002 to 2006 (7.1%; 5.92 vs 5.54) and increased nearly every year from 2007 to 2018, mirroring trends in nonfirearm suicides. Age-adjusted firearm homicide rates, while consistently higher than nonfirearm homicide rates, fluctuated more from 1999 to 2018. From 1999 to 2014, firearm homicide rates varied around 4.0 firearm-related deaths per 100 000 person-years and were highest from 2005 to 2007 (approximately 4.3 per 100 000 person-years) and lowest from 2009 to 2014 (approximately 3.8 per 100 000 person-years); in 2015, rates rebounded to 4.3 firearm-related deaths per 100 000 person-years, leading to a higher plateau (approximately 4.7 per 100 000 person-years in 2016-2018). Unintentional firearm death rates decreased from 1999 to 2018, reaching rates of 0.15 or fewer firearm-related deaths per 100 000 person-years in recent years (2014-2018), continuing longer-term trends in decreasing unintentional firearm deaths.5 Suicides comprised a consistent majority of firearm deaths during this period, ranging from 54.6% (2006) to 63.7% (2014) of firearm deaths.

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About S. R. Zelenz 119 Articles
S.R. Zelenz has worked in education for 20 years. Working with students from all walks of life, cultures, races, and social diversity, Zelenz’s research in Educational Leadership led to finding a better way to approach learning for students with trauma histories. Many were juvenile offenders, gang members, diagnosed with varying behavioral disorders, or had family histories of violence, murder, or narcissistic parenting. This research could not be effectively accomplished without further understanding: how epigenetic trauma inheritance may be impacting these students; how brain development from trauma may be impacting their behavioral and emotional development; as well as deep understanding of psychology and its varying classifications for behavioral and personality disorders. The goal is to find solutions for changing the conversation and making a real difference for these students. She has also worked with nonprofits of varying focus areas for the last 25 years. Her undergraduate degree in Arts Administration and Music prepared her for managing nonprofits of any size as well as procuring funding so that they can achieve their goals. Pairing her nonprofit background with her education background, she has been able to make a difference for over 200 nonprofits worldwide, written curriculum for schools across the globe, and assisted many arts organizations through performance and management.