The rate at which Americans died from firearm injuries increased sharply starting in 2015, a new study shows.
By Kara Gavin
Research and Policy Media Relations Manager
Institute for Healthcare Policy and Innovation (IHPI)
University of Michigan
This recent increase occurred to varying degrees across different states, types of firearm deaths such as homicide and suicide, and demographic groups.
In all, the United States saw a 14% rise in the rate of gun-related deaths of all kinds from 2015 to 2017 compared with the rate from between the years of 1999 to 2014.
During the entire 19-year period, 612,310 Americans died from firearm injuries that were self-inflicted, caused by others, accidental, or were of undetermined cause. Nearly one-fifth of those deaths happened in just the last three years of that time.
The study, which appears in Health Affairs, used data from the federal Centers for Disease Control and Prevention.
“What we can see is a worsening epidemic of firearm mortality that is geographically and demographically broad,” says Jason Goldstick, a research assistant professor of emergency medicine at the University of Michigan Medical School who led the analysis. “But our analysis of subpopulations also reveals clues to how to focus efforts to reverse the overall trend.”
Geographic and demographic differences
The research reveals differences across states in the change of firearm mortality rates over time. From 1999 to 2017, a majority of states had firearm trends that increased by more than 20%, with only a few states showing declines.
For instance, New York, California, and the District of Columbia bucked the national trend and saw decreases in their firearm death rates across most categories of people from 2015 to 2017. Those three areas, plus Arizona and Nevada, also saw an overall decrease in firearm deaths from 1999 to 2017.
Across the country, nearly all demographic groups saw increases in firearm death rates, but the level of increase varied across groups.
For example, males had larger absolute increases than females. Hispanic whites were the only racial or ethnic group that saw reductions in mortality in recent years, while firearm mortality rates among both non-Hispanic whites and African Americans increased significantly. There were broad increases across age groups.
Throughout the study period, suicides and homicides remained consistent in their share of all firearm-related deaths. Specifically, suicide accounted for about 60% of deaths, and homicides about 38%, in both 1999 to 2014 and 2015 to 2017. Rates of firearm deaths categorized as “unintentional” dropped in recent years, but made up less than 1% of all firearm deaths
The researchers also point out state-specific trends in the demographics and causes of firearm deaths. For example, while many states saw their suicide and homicide rates change at about the same pace, some didn’t.
Delaware’s overall firearm mortality rate rise was mainly due to an increase in homicides in recent years, for instance, but this was not the case for most other states. Other states showed sub-population trends that departed from their overall state-level trends.
“In our home state of Michigan, homicide has remained at an unacceptably high, but steady, rate over the period from 1999 through 2017, and we’ve seen an increase in suicide rates in that same time,” says senior author Rebecca Cunningham, a professor of emergency medicine and interim vice president for research. “Also in Michigan, firearm mortality has remained concerningly high among all groups, but we now see increased rates among non-Hispanic whites, and older adults.”
What can states do to cut gun deaths?
Now that the data in the paper and its detailed state-by-state appendices are available, the authors point out that policymakers could identify which subpopulations firearm deaths most affect in their states. They could then seek to determine which approaches may be most appropriate based on evidence about the effects of different policy-based interventions on different subgroups.
“For instance, suicide remains the most common mechanism of firearm mortality in most states and prevention efforts could be concentrated into the highest-risk groups for suicide, such as older males and rural adults,” says Goldstick.
To address domestic violence-related homicides among women, states might want to heed research showing that restricting firearm access among domestic violence offenders and people convicted of violent crime can reduce domestic violence homicide.
To address suicides and unintentional deaths by firearms among young people, states might look to research showing that reducing children’s access to firearms can affect rates of both types of death.
The authors note that they can’t tell from the data they used what factors led to the increase in firearm death rates in recent years, nor the decreases seen in certain groups and geographic areas. They do say that the consistent findings across so many states and demographic groups indicate that the rise from 2015 to 2017 wasn’t due to random variation.
The authors also acknowledge that deaths are only one way to measure the impact of firearms on individuals and society. But data on non-fatal firearm injuries and other impacts of firearm injury hasn’t been compiled.
To protect identities, data from the CDC data wasn’t available (or was “suppressed”) when fewer than 10 people of a given characteristic group died from a firearm injury in a particular state within a year.
Additional researchers from Michigan State University and the University of Pittsburgh contributed to the study.