You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.
 

Table 1.  

  No. (rate*)    
Characteristic 2019 2020 Rate change % Rate change
U.S. population overall†,§ 14,392 (4.6) 19,350 (6.1) 1.6 34.6
Age group, yrs        
<10 125 (0.3) 175 (0.4) 0.1 40.9
10–24 4,474 (7.0) 6,176 (9.8) 2.7 38.5
25–44 7,154 (8.2) 9,685 (11.0) 2.8 34.6
45–64 2,176 (2.6) 2,767 (3.3) 0.7 28.0
≥65 463 (0.9) 547 (1.0) 0.1 14.7
Sex†,§        
Female 2,284 (1.4) 2,954 (1.9) 0.4 29.4
Male 12,108 (7.6) 16,396 (10.4) 2.7 35.5
Race and ethnicity**        
A/PI, non-Hispanic 228 (1.1) 227 (1.0) −0.0†† −4.2
AI/AN, non-Hispanic 172 (6.4) 221 (8.1) 1.7 27.0
Black, non-Hispanic 8,499 (19.0) 11,904 (26.6) 7.5 39.5
Hispanic (any race) 2,301 (3.6) 2,946 (4.5) 0.9 25.8
White, non-Hispanic 3,192 (1.7) 4,052 (2.2) 0.5 28.4
U.S. Census Bureau division†,§,§§        
New England 209 (1.5) 280 (2.0) 0.5 32.2
Middle Atlantic 1,064 (2.7) 1,594 (4.1) 1.4 51.0
East North Central 2,319 (5.2) 3,410 (7.7) 2.5 47.8
West North Central 845 (4.2) 1,149 (5.7) 1.5 36.6
South Atlantic 3,754 (6.0) 4,681 (7.5) 1.5 24.6
East South Central 1,527 (8.5) 2,056 (11.3) 2.9 33.7
West South Central 2,293 (5.7) 3,030 (7.5) 1.8 31.2
Mountain 829 (3.4) 1,057 (4.4) 0.9 27.3
Pacific 1,552 (3.0) 2,093 (4.0) 1.0 35.2
Urbanization level†,§        
Large metropolitan 8,688 (4.8) 11,880 (6.6) 1.8 36.9
Small/Medium metropolitan 4,066 (4.3) 5,380 (5.7) 1.4 32.1
Nonmetropolitan 1,638 (4.0) 2,090 (5.1) 1.1 28.5

Changes in firearm homicide incidence, by selected sociodemographic factors — United States, 2019–2020

Abbreviations: A/PI = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
*Firearm homicides per 100,000 persons.
Excludes decedent records with missing race and ethnicity or age.
§Rates are age-adjusted to the year 2000 U.S. standard population.
Excludes decedent records with missing race and ethnicity.
**Excludes decedent records with missing age.
††A value of "−0.0" denotes a negative change rounded to the nearest tenth.
§§https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf

Table 2.  

  No.* (rate*,†)    
Characteristic 2019 2020 Rate change % Rate change
U.S. population overall§,¶ 23,888 (7.9) 24,245 (8.1) 0.1 1.5
Age group, yrs**        
10–24 2,969 (4.7) 3,393 (5.4) 0.7 14.7
25–44 6,683 (7.6) 7,105 (8.1) 0.4 5.7
45–64 7,863 (9.4) 7,284 (8.8) −0.6 −6.8
≥65 6,373 (11.8) 6,463 (11.6) −0.2 −1.5
Sex§,¶        
Female 3,214 (2.2) 3,108 (2.1) −0.1 −3.2
Male 20,674 (14.2) 21,137 (14.5) 0.3 2.0
Race and ethnicity††,¶        
A/PI, non-Hispanic 381 (2.0) 374 (2.0) −0.0§§ −1.9
AI/AN, non-Hispanic 183 (7.7) 267 (10.9) 3.2 41.8
Black, non-Hispanic 1,588 (4.2) 1,852 (4.9) 0.6 14.3
Hispanic (any race) 1,534 (3.0) 1,790 (3.4) 0.4 13.8
White, non-Hispanic 20,202 (10.4) 19,962 (10.4) −0.0§§ −0.3
U.S. Census Bureau division§,¶,¶¶        
New England 625 (4.4) 587 (4.2) −0.3 −6.1
Middle Atlantic 1,587 (4.0) 1,561 (4.0) −0.0§§ −1.0
East North Central 3,257 (7.6) 3,252 (7.6) 0.0§§ 0.5
West North Central 1,882 (9.9) 1,932 (10.2) 0.3 3.2
South Atlantic 5,254 (8.5) 5,359 (8.7) 0.2 2.1
East South Central 2,041 (11.7) 2,103 (12.1) 0.5 3.9
West South Central 3,487 (9.8) 3,593 (10.1) 0.2 2.5
Mountain 2,911 (13.1) 3,078 (13.6) 0.5 3.8
Pacific 2,844 (5.8) 2,780 (5.6) −0.2 −3.3
Urbanization level§,¶        
Large metropolitan 10,085 (6.0) 10,136 (6.1) 0.0§§ 0.3
Small/Medium metropolitan 8,546 (9.5) 8,727 (9.7) 0.2 2.4
Nonmetropolitan 5,257 (12.4) 5,382 (12.8) 0.3 2.6

Changes in firearm suicide incidence, by selected sociodemographic factors — United States, 2019–2020

Abbreviations: A/PI = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
*Numbers and rates overall and by sex, race and ethnicity, U.S. Census Bureau division, and urbanization level exclude persons aged <10 years.
Firearm suicides per 100,000 persons.
§Excludes decedent records with missing race and ethnicity or age.
Rates are age-adjusted to the year 2000 U.S. standard population.
**Excludes decedent records with missing race and ethnicity.
††Excludes decedent records with missing age.
§§A value of "−0.0" denotes a negative change rounded to the nearest tenth; a value of "0.0" denotes a positive change rounded to the nearest tenth.
¶¶https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf

Table 3.  

Race and ethnicity group/Poverty range (%) 2019 2020 Rate change % Rate change
  % of population in poverty range§ No. (rate) % of population in poverty range§ No. (rate)    
U.S. population overall**            
<9.1 24.7 1,494 (2.0) 26.7 1,972 (2.4) 0.4 21.9
9.1–12.1 24.7 2,428 (3.2) 28.0 4,002 (4.6) 1.4 45.6
12.2–14.6 25.7 4,340 (5.3) 21.3 5,058 (7.5) 2.2 41.0
>14.6 24.9 6,130 (7.7) 24.0 8,318 (10.8) 3.1 40.0
Total 100 14,392 (4.6) 100 19,350 (6.1) 1.6 34.6
A/PI, non-Hispanic††            
<9.1 37.6 49 (0.6) 41.4 64 (0.7) 0.1 14.8
9.1–12.1 23.7 53 (1.0) 23.1 50 (1.0) −0.1 −5.0
12.2–14.6 26.0 71 (1.3) 21.8 68 (1.4) 0.1 5.6
>14.6 12.6 55 (2.0) 13.6 45 (1.4) −0.6 −28.1
Total 100 228 (1.1) 100 227 (1.0) −0.0§§ −4.2
AI/AN, non-Hispanic††            
<9.1 12.9 8 (—¶¶) 16.0 21 (4.7) ¶¶ ¶¶
9.1–12.1 20.6 43 (7.6) 23.5 68 (10.8) 3.2 41.6
12.2–14.6 20.9 34 (5.8) 16.8 27 (5.8) 0.0§§ 0.6
>14.6 45.6 87 (7.3) 43.7 105 (8.8) 1.6 21.5
Total 100 172 (6.4) 100 221 (8.1) 1.7 27.0
Black, non-Hispanic††            
<9.1 16.9 728 (9.6) 15.9 907 (12.7) 3.1 32.0
9.1–12.1 17.8 1,168 (14.5) 23.1 2,163 (20.6) 6.1 41.7
12.2–14.6 27.3 2,559 (20.9) 22.4 3,098 (30.8) 9.8 47.0
>14.6 38.0 4,044 (24.2) 38.6 5,736 (33.6) 9.5 39.1
Total 100 8,499 (19.0) 100 11,904 (26.6) 7.5 39.5
Hispanic (any race)††            
<9.1 17.5 229 (2.0) 19.0 333 (2.6) 0.6 29.0
9.1–12.1 21.6 385 (2.7) 26.1 650 (3.8) 1.1 38.8
12.2–14.6 32.4 850 (4.1) 25.6 921 (5.5) 1.4 34.3
>14.6 28.5 837 (4.7) 29.3 1,042 (5.6) 0.9 19.6
Total 100 2,301 (3.6) 100 2,946 (4.5) 0.9 25.8
White, non-Hispanic††            
<9.1 27.3 480 (0.9) 30.0 647 (1.2) 0.2 22.9
9.1–12.1 27.3 779 (1.5) 30.2 1,071 (1.9) 0.4 24.8
12.2–14.6 23.4 826 (1.8) 19.8 944 (2.6) 0.7 38.5
>14.6 22.0 1,107 (2.7) 20.1 1,390 (3.7) 1.0 39.0
Total 100 3,192 (1.7) 100 4,052 (2.2) 0.5 28.4

Changes in firearm homicide incidence, by race and ethnicity and surrounding poverty level — United States,* 2019–2020

Abbreviations: A/PI = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
*Excludes Kalawao County, Hawaii because of missing poverty data.
For comparability, the county poverty ranges are constant across race and ethnicity groups and years.
§Percentage of indicated group residing in counties within the specified poverty range.
Firearm homicides per 100,000 persons; age-adjusted to the year 2000 U.S. standard population.
**Excludes decedent records with missing race and ethnicity or age.
††Excludes decedent records with missing age.
§§A value of "−0.0" denotes a negative change rounded to the nearest tenth; a value of "0.0" denotes a positive change rounded to the nearest tenth.
¶¶Rate or rate change considered statistically unstable because of homicide count <20.

Table 4.  

Race and ethnicity group/Poverty range (%) 2019 2020 Rate change % Rate change
  % of population in poverty range§ No. (rate¶,**) % of population in poverty range§ No. (rate¶,**)    
U.S. population overall ††            
<9.1 24.7 4,782 (6.5) 26.7 5,439 (6.8) 0.3 4.7
9.1–12.1 24.7 6,353 (8.5) 28.0 7,191 (8.4) −0.0§§ −0.0§§
12.2–14.6 25.7 5,903 (7.6) 21.3 5,248 (8.2) 0.6 7.5
>14.6 24.9 6,850 (9.3) 24.0 6,367 (8.9) −0.3 −3.6
Total 100 23,888 (7.9) 100 24,245 (8.1) 0.1 1.5
A/PI, non-Hispanic¶¶            
<9.1 37.6 107 (1.5) 41.4 136 (1.8) 0.3 16.7
9.1–12.1 23.7 98 (2.2) 23.1 91 (2.1) −0.1 −6.5
12.2–14.6 26.0 111 (2.2) 21.8 95 (2.3) 0.0§§ 1.3
>14.6 12.6 65 (2.7) 13.6 52 (2.0) −0.7 −27.4
Total 100 381 (2.0) 100 374 (2.0) −0.0§§ −1.9
AI/AN, non-Hispanic¶¶            
<9.1 12.9 20 (6.9) 16.0 35 (9.2) 2.3 33.0
9.1–12.1 20.6 48 (9.6) 23.5 64 (10.8) 1.2 12.9
12.2–14.6 20.9 25 (4.9) 16.8 47 (11.3) 6.4 128.8
>14.6 45.6 90 (8.4) 43.7 121 (11.5) 3.1 36.6
Total 100 183 (7.7) 100 267 (10.9) 3.2 41.8
Black, non-Hispanic¶¶            
<9.1 16.9 219 (3.4) 15.9 224 (3.7) 0.2 6.6
9.1–12.1 17.8 285 (4.3) 23.1 427 (4.8) 0.5 12.0
12.2–14.6 27.3 425 (4.1) 22.4 427 (5.0) 0.9 22.1
>14.6 38.0 659 (4.7) 38.6 774 (5.3) 0.6 12.8
Total 100 1,588 (4.2) 100 1,852 (4.9) 0.6 14.3
Hispanic (any race)¶¶            
<9.1 17.5 221 (2.4) 19.0 280 (2.8) 0.4 17.9
9.1–12.1 21.6 304 (2.8) 26.1 483 (3.5) 0.7 26.0
12.2–14.6 32.4 483 (2.9) 25.6 444 (3.3) 0.4 14.2
>14.6 28.5 526 (3.7) 29.3 583 (3.8) 0.2 4.3
Total 100 1,534 (3.0) 100 1,790 (3.4) 0.4 13.8
White, non-Hispanic¶¶            
<9.1 27.3 4,215 (8.2) 30.0 4,764 (8.4) 0.2 3.0
9.1–12.1 27.3 5,618 (10.6) 30.2 6,126 (10.5) −0.1 −0.9
12.2–14.6 23.4 4,859 (10.6) 19.8 4,235 (11.1) 0.5 4.8
>14.6 22.0 5,510 (13.0) 20.1 4,837 (12.6) −0.3 −2.6
Total 100 20,202 (10.4) 100 19,962 (10.4) −0.0§§ −0.3

Changes in firearm suicide incidence, by race and ethnicity and surrounding poverty level — United States,* 2019–2020

Abbreviations: A/PI = Asian or Pacific Islander; AI/AN = American Indian or Alaska Native.
*Excludes Kalawao County, Hawaii because of missing poverty data.
For comparability, the county poverty ranges are constant across race and ethnicity groups and years.
§Percentage of indicated group residing in counties within the specified poverty range.
Numbers and rates exclude persons aged <10 years.
**Firearm suicides per 100,000 persons; age-adjusted to the year 2000 U.S. standard population.
††Excludes decedent records with missing race and ethnicity or age.
§§A value of "−0.0" denotes a negative change rounded to the nearest tenth; a value of "0.0" denotes a positive change rounded to the nearest tenth.
¶¶Excludes decedent records with missing age.

CME / ABIM MOC / CE

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

  • Authors: 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
  • CME / ABIM MOC / CE Released: 8/15/2022
  • Valid for credit through: 8/15/2023
Start Activity

  • Credits Available

    Physicians - maximum of 0.50 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.50 ABIM MOC points

    Nurses - 0.50 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for public health officials, as well as psychiatrists, family practitioners, nurses, and other clinicians caring for patients who may be at risk for firearm violence or suicide.

The goal of this activity is for learners to be better able to describe changes in firearm homicide and firearm suicide rates, as well as disparities by age, sex, race, ethnicity, geography, and poverty level, coinciding with the emergence of the COVID-19 pandemic in 2020, based on Centers for Disease Control and Prevention data.

Upon completion of this activity, participants will:

  • Understand changes in firearm homicide rates and disparities by race, ethnicity, and poverty level coinciding with the emergence of the COVID-19 pandemic in 2020, based on Centers for Disease Control and Prevention data
  • Understand changes in firearm suicide rates and disparities by race, ethnicity, and poverty level coinciding with the emergence of the COVID-19 pandemic in 2020, based on Centers for Disease Control and Prevention data
  • Understand the public health implications of changes in firearm homicide and firearm suicide rates and disparities by race, ethnicity, and poverty level coinciding with the emergence of the COVID-19 pandemic in 2020, based on Centers for Disease Control and Prevention data


Faculty

  • Scott R. Kegler, PhD

    Division of Injury Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Scott R. Kegler, PhD, has no relevant financial relationships.

  • Thomas R. Simon, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Thomas R. Simon, PhD, has no relevant financial relationships.

  • Marissa L. Zwald, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Marissa L. Zwald, PhD, has no relevant financial relationships.

  • May S. Chen, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    May S. Chen, PhD, has no relevant financial relationships.

  • James A. Mercy, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    James A. Mercy, PhD, has no relevant financial relationships.

  • Christopher M. Jones, PharmD, DrPH

    Office of the Director
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Christopher M. Jones, PharmD, DrPH, has no relevant financial relationships.

  • Melissa C. Mercado-Crespo, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Melissa C. Mercado-Crespo, PhD, has no relevant financial relationships.

  • Janet M. Blair, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Janet M. Blair, PhD, has no relevant financial relationships.

  • Deborah M. Stone, ScD

    Division of Injury Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Deborah M. Stone, ScD, has no relevant financial relationships.

  • Phyllis G. Ottley, PhD

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Phyllis G. Ottley, PhD, has no relevant financial relationships.

  • Jennifer Dills, MPH

    Division of Violence Prevention
    National Center for Injury Prevention and Control
    Centers for Disease Control and Prevention 
    Atlanta, Georgia

    Disclosures

    Jennifer Dills, MPH, has no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Laurie Barclay, MD, has the following relevant financial relationships:
    Formerly owned stocks in: AbbVie

Compliance Reviewer/Nurse Planner

  • Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP

    Associate Director, Accreditation and Compliance
    Medscape, LLC

    Disclosures

    Leigh A. Schmidt, MSN, RN, CMSRN, CNE, CHCP, has no relevant financial relationships.


Accreditation Statements



In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

    Contact This Provider

    For Nurses

  • Awarded 0.50 contact hour(s) of nursing continuing professional development for RNs and APNs; none of these credits is in the area of pharmacology.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read about the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or print it out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

CME / ABIM MOC / CE

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

Authors: 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, MPHFaculty and Disclosures

CME / ABIM MOC / CE Released: 8/15/2022

Valid for credit through: 8/15/2023

processing....

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.