Vital Signs

Changes in Firearm Homicide and Suicide Rates — United States, 2019–2020

Scott R. Kegler, PhD; Thomas R. Simon, PhD; Marissa L. Zwald, PhD; May S. Chen, PhD; James A. Mercy, PhD; Christopher M. Jones, PharmD, DrPH; Melissa C. Mercado-Crespo, PhD; Janet M. Blair, PhD; Deborah M. Stone, ScD; Phyllis G. Ottley, PhD; Jennifer Dills, MPH

Disclosures

Morbidity and Mortality Weekly Report. 2022;71(19):656-663. 

In This Article

Abstract and Introduction

Abstract

Introduction: The majority of homicides (79%) and suicides (53%) in the United States involved a firearm in 2020. High firearm homicide and suicide rates and corresponding inequities by race and ethnicity and poverty level represent important public health concerns. This study examined changes in firearm homicide and firearm suicide rates coinciding with the emergence of the COVID-19 pandemic in 2020.

Methods: National vital statistics and population data were integrated with urbanization and poverty measures at the county level. Population-based firearm homicide and suicide rates were examined by age, sex, race and ethnicity, geographic area, level of urbanization, and level of poverty.

Results: From 2019 to 2020, the overall firearm homicide rate increased 34.6%, from 4.6 to 6.1 per 100,000 persons. The largest increases occurred among non-Hispanic Black or African American males aged 10–44 years and non-Hispanic American Indian or Alaska Native (AI/AN) males aged 25–44 years. Rates of firearm homicide were lowest and increased least at the lowest poverty level and were higher and showed larger increases at higher poverty levels. The overall firearm suicide rate remained relatively unchanged from 2019 to 2020 (7.9 to 8.1); however, in some populations, including AI/AN males aged 10–44 years, rates did increase.

Conclusions and Implications for Public Health Practice: During the COVID-19 pandemic, the firearm homicide rate in the United States reached its highest level since 1994, with substantial increases among several population subgroups. These increases have widened disparities in rates by race and ethnicity and poverty level. Several increases in firearm suicide rates were also observed. Implementation of comprehensive strategies employing proven approaches that address underlying economic, physical, and social conditions contributing to the risks for violence and suicide is urgently needed to reduce these rates and disparities.

Introduction

Firearm homicides and suicides represent persistent and significant U.S. public health concerns. In 2020, 79% of all homicides and 53% of all suicides involved firearms (somewhat higher than during the preceding 5 years, when 73%–75% of all homicides and 50%–51% of all suicides involved firearms each year).[1] Although all population groups experience firearm homicides and suicides, some are disproportionately affected. Firearm homicide rates are consistently highest among males, adolescents and young adults, and non-Hispanic Black or African American (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons; firearm suicide rates are highest among males, older adults, and non-Hispanic White (White) and AI/AN persons.[1]

Economic conditions in communities contribute to risk for violence, including firearm-related violence, and related racial and ethnic inequities.[2] For example, multiple indicators (e.g., income inequality, unemployment, and housing and economic instability) are associated with risk for homicide and suicide.[3–5] Youth firearm homicide and suicide rates have been associated with poverty at the county level,[6] and the percentage of youths living in conditions of household poverty is higher among racial and ethnic minority populations.[6] The economic and social challenges associated with the COVID-19 pandemic could have exacerbated such risks.[2,7]

This study examined changes in firearm homicide and firearm suicide rates coinciding with the COVID-19 pandemic in 2020, in conjunction with existing and potentially widening inequities by race and ethnicity and poverty level. The findings in this report can help identify disproportionately affected populations and guide the development and implementation of evidence-based strategies for communities experiencing social and structural conditions contributing to violence and disparities in violence.

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