America’s gun epidemic is deadlier than ever, and there are huge disparities in who dies


Gun deaths have increased in the US during the Covid-19 pandemic, killing a record number of people in 2021. But as America’s gun epidemic worsens, its severity is unequaled.

A new study published Tuesday in JAMA Network Open analyzed gun deaths over the past three decades — a total of more than 1 million lives lost since 1990. The researchers found that gun death rates have increased for most demographic groups in recent years — especially during the pandemic — and huge disparities persist.

While recent data show some familiar patterns, the sheer scale of the problem brings the United States to “a new moment in the history of gun deaths,” said Dr. Eric Fligler, a pediatric emergency physician and researcher at Boston Children’s Hospital and Harvard Medical School and co-author of the study.

“At this point, we are witnessing a dramatic increase that is truly unparalleled,” he said. “During the Covid pandemic, from 2019 to 2021, we saw over a 25% increase in deaths in just two years. This has never happened.”

In general, men are significantly more at risk. Nearly 86 percent of all gun deaths since 1990 have been among men, according to the study, which used data from the U.S. Centers for Disease Control and Prevention. The researchers found that gun homicides were highest among black men, and gun suicide rates were highest among older white men.

The firearm homicide rate for both men and women nearly doubled between 2014 and 2021, but men are still more than five times more likely to die than women. The rate of suicide by firearm was also seven times higher among men than among women in 2021, despite increasing suicide rates among women over time.

Racial differences are even starker. The homicide rate among young black men — 142 homicide deaths for every 100,000 black men ages 20 to 24 — was nearly 10 times higher than the overall rate of gun deaths in the U.S. in 2021.

The homicide rate among blacks and Hispanics is highest in the 20 to 24 age group. But for white men, the rate is highest in the 30 to 34 age group. When comparing these groups, the homicide rate is nearly four times higher among young Hispanic males than among white males, and the homicide rate among young black males is an astonishing 22 times higher than among white males.

“When we think of bad margins, we often think of a 20% increase or a 50% increase. With infant mortality in the United States, when you look at black babies versus white babies, there’s over twice the (difference in) mortality. And that’s a huge number to think about,” Fligler said. “And we’re talking over 20 times here. These are orders of magnitude differences that are only getting worse. And they demand that kind of attention.

A county-level analysis showed that gun deaths shifted from the west to the south over time, as gun homicide rates remained concentrated and grew in the south and gun suicide rates spread more evenly In the whole country.

Urban areas have higher gun deaths than rural areas.

There are two key factors driving community gun violence, says Jonathan Jay, an assistant professor at Boston University’s School of Public Health: neighborhood-level inequality and individual-level exposure to gun violence.

“Gun violence is most likely in spaces that show signs of physical disinvestment. Sometimes that looks like untidy, empty lots or abandoned houses that are boarded up, maybe a high density of liquor stores and a low density of healthy food options,” he said.

For Jay, who received a grant from the National Institutes of Health to study racial disparities in firearm injuries among U.S. youth, it’s no surprise that patterns in gun death rates have only gotten worse — because the pandemic has only exacerbated existing ones. differences.

“It makes sense that the worst early impacts would be in neighborhoods that faced the most disadvantage and the impact of segregation before the pandemic,” he said. “Some people talk about it as a mystery why gun violence will remain high even as things change in the pandemic. I think one possible explanation is that things – the social conditions – haven’t changed that much.

But also, the pandemic has exposed people to a lot of things that have made them feel insecure and may have made people more likely to feel like they need to carry a gun for protection, he said.

Mental health challenges have grown during the pandemic and violence has increased, but a separate analysis by researchers at Johns Hopkins University found that guns are doing those things significantly more lethal. Between 2019 and 2021, all of the increase in suicides and most of the increase in homicides were due to guns. The firearm suicide rate increased by 10%, while the non-gun suicide rate decreased by 8%, and the firearm homicide rate increased by 45%, while the non-gun homicide rate increased by only 6%.

“What we’ve seen is that economic and social stressors during Covid have exacerbated health disparities across the spectrum,” said Ari Davis, policy advisor at the Johns Hopkins Bloomberg School of Public Health Center for Gun Violence Solutions.

“The same stressors – social isolation, limited social services and support – are risk factors for violence. I think all of these things have contributed to an increase across the board, but disproportionately burdening those who are most vulnerable.”

The study, released Tuesday, “confirmed much of what we already know,” University of Michigan researchers wrote in a related editorial — that there are large gender, urban-rural and racial disparities in gun death rates in USA.

“This burden is not evenly distributed, and recent increases in firearm mortality have been most pronounced among demographic groups and regions already among the most affected,” they wrote.

But the analysis helps identify high-risk groups that could benefit most from targeted interventions.

Dr. Christopher Rees, an emergency room physician at Children’s Healthcare of Atlanta, a researcher at Emory University School of Medicine and co-author of the study, moved from Boston to Atlanta just over a year ago. He said he cared for “far more” children who were injured by firearms in Atlanta than in Boston — living up to the trends he found in his research.

“Every time I just think, ‘First of all, this is terrible. Second, it’s someone’s child. And I immediately think of my two children at home. And then three, I’m thinking, ‘This shouldn’t have happened, especially to a child,'” he said. “It’s very personal every time.”

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