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Cited by 499Gun Ownership and Violence ResearchHomicide, Infanticide, and Child AbuseSuicide and Self-Harm Studies

Firearm injuries in the United States

Open access
Fowler, Katherine A., Dahlberg, Linda L., Haileyesus, Tadesse, Annest, Joseph L.·2015·Preventive Medicine
DOI 10.1016/j.ypmed.2015.06.002PMC PMC4700838
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Abstract

Objective This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact.Method Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries.Results More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995.Conclusion Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence.

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Crossref · 10.1016/j.ypmed.2015.06.002

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  • Lethal means counseling, secure firearm storage, and firearm safety policies can reduce suicide risk.

    “Lethal means counseling, secure firearm storage practices, and firearm safety policies can reduce the risk of suicide.”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [26]

    The Discussion (page unavailable) says that restricting access to a highly lethal method can matter during a suicidal crisis, supporting the general rationale for reducing firearm access. It mentions safe storage in relation to unintentional injuries among children, but does not establish that lethal means counseling, secure storage, or firearm safety policies reduce suicide risk. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Community risk factors such as poverty, unemployment, and higher firearm ownership/access may contribute to adolescent suicide.

    “Rural communities are known to have higher rates of adolescent suicide compared to urban ones, while other community risk factors may come into play such as poverty and unemployment, and higher firearm ownership and access [26, 32].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [26]

    The Results/Discussion (page unavailable) links economic downturns and unemployment to firearm-suicide trends and explains why access to a firearm can make a suicide attempt more likely to be fatal. It does not establish poverty, unemployment, or higher firearm ownership as community risk factors specifically for adolescent suicide, nor does it compare rural and urban adolescents. (LLM, conf=0.84)

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  • Living in a home with a firearm increases risk of suicide by firearm, which has a fatality rate up to 85%.

    “In addition, living in a home with a firearm increases the risk of suicide by firearm, which has a fatality rate of up to 85% [26].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [26]

    The Results section (‘The extent of firearm injuries and deaths in the U.S.’; page unavailable) reports an 85% case-fatality rate for firearm-related self-harm in 2010–2012. The Discussion also says about 85% of people who attempt suicide with a firearm die from the injury. Neither passage establishes that living in a home with a firearm increases the risk of firearm suicide. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Firearms are lethal in 74-85% of suicide attempts and are tied for the second leading mechanism of adolescent suicide.

    “Firearms are lethal 74–85% of the time when used for a suicide attempt and tied for the second leading mechanism of adolescent suicide [1, 26].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [26]

    The Discussion reports that about 85% of people who use a firearm to attempt suicide die from their injury, supporting the upper end of the stated range. Our copy does not establish the 74% lower bound or rank firearms as tied for the second leading mechanism of adolescent suicide; its Introduction instead discusses firearm homicide among youth. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Rural communities have higher adolescent suicide rates than urban ones.

    “Rural communities are known to have higher rates of adolescent suicide compared to urban ones, while other community risk factors may come into play such as poverty and unemployment, and higher firearm ownership and access [26, 32].”

    From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [26]

    The Results section reports firearm-suicide rates by age and by U.S. region, but not adolescent suicide rates in rural versus urban communities. Searches for rural, urban, and the adolescent suicide comparison found no passage addressing that comparison. (LLM, conf=0.76)

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3 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Blumstein A Wallman J The Crime Drop in America, revised edition 2006 New York, NY Cambridge University Press

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Authors
Fowler, K. A., Dahlberg, L. L., Haileyesus, T., & Annest, J. L.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Fowler, Katherine A.
ORCID
Fowler, Katherine A.
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2015-10
Volume
79
Pages
5-14
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2015.06.002
PMC
PMC4700838
OpenAlex
W2201785016
Cited by
499
References
48
Citations by year
2026: 24 · 2025: 37 · 2024: 47 · 2023: 45 · 2022: 70 · 2021: 85 · 2020: 55 · 2019: 56 · 2018: 32 · 2017: 27 · 2016: 17 · 2015: 3
FWCI
32.71
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (CC999999)
Topics
  • Social Sciences › Health › Gun Ownership and Violence Research
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
firearm injuries, gun violence, homicide, firearm assault, firearm suicide, unintentional firearm injury, case fatality rate, injury costs, racial and ethnic disparities, firearm injury epidemiology
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Firearms, Humans, Infant, Infant, Newborn, Male, Middle Aged, Population Surveillance, United States, Violence, Wounds, Gunshot, Age Distribution, Sex Distribution, Crime Victims, Young Adult

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