Monday, December 4, 2023
| 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
| 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
| 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.
| 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.
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.
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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.
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.
