Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017

Kaufman, Elinore J.; Wiebe, Douglas J.; Xiong, Ruiying; Morrison, Christopher N.; Seamon, Mark J.; Delgado, M. Kit

doi:10.1001/jamainternmed.2020.6696

Cited by 163 publications

(162 citation statements)

References 35 publications

Supporting

Mentioning

150

Contrasting

Order By: Relevance

“…These data suggest that half are unintentional injuries and the remainder are primarily assault-related (41 %). 3 % are from suicide attempt, as the vast majority of suicide attempts with firearms result in fatality [31]. There is some concern, however, about the possibility of mis-classifications of intent in this data (specifically, over-classification of unintentional injuries and underclassification of assault-related injuries) [32].…”

Section: Us Firearm Suicide Epidemiologymentioning

confidence: 92%

See 1 more Smart Citation

Clinical strategies for reducing firearm suicide

Pallin

Barnhorst

2021

Inj. Epidemiol.

View full text Add to dashboard Cite

Suicide is complex, with psychiatric, cultural, and socioeconomic roots. Though mental illnesses like depression contribute to risk for suicide, access to lethal means such as firearms is considered a key risk factor for suicide, and half of suicides in the USA are by firearm. When a person at risk of suicide has access to firearms, clinicians have a range of options for intervention. Depending on the patient, the situation, and the access to firearms, counseling on storage practices, temporary transfer of firearms, or further intervention may be appropriate. In the USA, ownership of and access to firearms are common and discussing added risk of access to firearms for those at risk of suicide is not universally practiced. Given the burden of suicide (particularly by firearm) in the USA, the prevalence of firearm access, and the lethality of suicide attempts with firearms, we present the existing evidence on the burden of firearm suicide and what clinicians can do to reduce their patients’ risk. Specifically, we review firearm ownership in the USA, firearm injury epidemiology, risk factors for firearm-related harm, and available interventions to reduce patients’ risk of firearm injury and death.

show abstract

Section: Us Firearm Suicide Epidemiologymentioning

confidence: 92%

“…According to emergency department data, over 85,000 non-fatal firearm injuries occur in the USA each year [31]. These data suggest that half are unintentional injuries and the remainder are primarily assault-related (41 %).…”

Section: Us Firearm Suicide Epidemiologymentioning

confidence: 99%

Clinical strategies for reducing firearm suicide

Pallin

Barnhorst

2021

Inj. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…This analysis of the nonfatal firearm injury episodes from both ED and inpatient discharges provides a unique and more complete picture of the incidence of firearm injuries. Previous analyses of HCUP data often focused on either NEDS 8 , 9 or NIS 10 , 11 but not both. A study of NEDS from 2006–2014 found the incidence of nonfatal ED visits (including those admitted as inpatients) to be 23.2 per 100,000, similar to the rate of 23.40 found here for 2016–2018.…”

Section: Discussionmentioning

confidence: 99%

Nonfatal Firearm Injuries by Intent in the United States: 2016-2018 Hospital Discharge Records from the Healthcare Cost and Utilization Project

Schnippel¹,

Burd-Sharps²,

Miller³

et al. 2021

WJEM

View full text Add to dashboard Cite

Introduction In addition to the nearly 40,000 firearm deaths each year, nonfatal firearm injuries represent a significant public health burden to communities in the United States. We aimed to describe the incidence and rates of nonfatal firearm injuries. Methods We calculated nonfatal firearm injury estimates using the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, including the Nationwide Emergency Department Samples and the National Inpatient Samples. We used the International Classification of Diseases, 10th Revision, Clinical Modification to identify firearm injury episodes. Deaths in the emergency department (ED) or as inpatients were excluded. Results In addition to the 118,171 persons shot and killed by firearms from 2016–2018, 228,380 people were shot (ratio 1.9:1) and treated at a hospital ED or admitted to hospital, a rate of 23.4 nonfatal firearm injury episodes per 100,000 population. The number of nonfatal injury episodes varied by year: 2018 had the lowest at 69,692, compared to 84,776 in 2017 and 73,912 in 2016. Unintentional injury episodes were the most frequent, accounting for 58.5% (n = 81,217) and 38.9% (n = 34,820) of total nonfatal firearm hospital discharges from the ED and inpatients, respectively. Assault episodes were the next most frequent, at 36.3% (n = 50,482) of ED and 49.5% (n = 44,290) of inpatient discharges. The highest rate of nonfatal firearm injury by five-year age group was for 20- to 24-year-olds. With an annual rate of 73.53 per 100,000 population, the rates for ages 20–24 were more than 10 times higher than the rates for patients younger than 15 or 60 years and older. More than half (53.4%, n = 121,884) of hospital-treated, nonfatal firearm injury episodes were patients living in ZIP codes with a median household income in the lowest quartile, compared to 7.5% (n = 17,102) for patients residing in the highest income quartile ZIP codes, a sevenfold difference. Conclusion For every person shot and killed by a gun in the US, two more are wounded. Unlike firearm deaths, which are predominantly suicides, most nonfatal firearm injury episodes are unintentional or with an assault intent. Having a reliable source of nonfatal injury data is essential to understanding the incidence of firearm injuries.

show abstract

“…In particular, epidemiological studies demonstrate that after a period of relative stability from 1999 to 2014, firearm mortality began increasing in 2015, resetting to a higher endemic level of approximately 12 deaths per 100,000 people thereafter (Goldstick, Carter, & Cunningham, 2020). At the same time, nonfatal firearm injuries which patients survive after receiving hospital care are twice as common as fatal firearm injuries, and have increased to their highest level in the past decade, reaching over 30 injuries per 100,000 people in the most recent data (Kaufman et al, 2021). Not only do the dynamics of fatal and nonfatal injuries differ, but it is easy to see that trends in firearm injury burden vary considerably by region, nature of death (suicide, homicide, unintentional), and demographics (Goldstick et al, 2020; Kaufman et al, 2021), highlighting important health disparities.…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, nonfatal firearm injuries which patients survive after receiving hospital care are twice as common as fatal firearm injuries, and have increased to their highest level in the past decade, reaching over 30 injuries per 100,000 people in the most recent data (Kaufman et al, 2021). Not only do the dynamics of fatal and nonfatal injuries differ, but it is easy to see that trends in firearm injury burden vary considerably by region, nature of death (suicide, homicide, unintentional), and demographics (Goldstick et al, 2020; Kaufman et al, 2021), highlighting important health disparities. While epidemiological studies are critical for identifying populations with the greatest need, and providing context for prevention – for example, many of those with self‐directed firearm violence do not reach the hospital (Kaufman et al, 2021), suggesting primary prevention is necessary – leveraging that information requires understanding what drives those disparities.…”

Section: Introductionmentioning

confidence: 99%

Commentary: Reducing youth firearm violence and the associated health disparities requires enhanced surveillance and modern behavioral intervention strategies – a commentary on Bottiani et al. (2021)

Goldstick

Kaufman

Delgado

et al. 2021

Child Psychology Psychiatry

Self Cite

View full text Add to dashboard Cite

Youth firearm injury is a worsening public health crisis, and the risks are not distributed evenly. Bottiani et al. skillfully explicated those health disparities, described sociological factors underlying them, and explored avenues for prevention. We supplement their analysis by detailing problems and solutions related to a critical barrier to firearm violence prevention – the nonexistence both of reliable ‘gold standard’ nonfatal firearm injury surveillance data, and systems for near real‐time surveillance of firearm injuries at granular spatial scales that would enable to optimization of rapid response protocols and neighborhood‐based prevention programs. We conclude with a discussion of modern, scalable, behavioral intervention approaches that could be leveraged to fill the largely absent evidence base resulting from the documented underfunding of youth firearm violence prevention research.

show abstract

Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017

Cited by 163 publications

References 35 publications

Clinical strategies for reducing firearm suicide

Clinical strategies for reducing firearm suicide

Nonfatal Firearm Injuries by Intent in the United States: 2016-2018 Hospital Discharge Records from the Healthcare Cost and Utilization Project

Commentary: Reducing youth firearm violence and the associated health disparities requires enhanced surveillance and modern behavioral intervention strategies – a commentary on Bottiani et al. (2021)

Contact Info

Product

Resources

About