Background: Firearm-related deaths are a substantial public health crisis in America, with studies reporting an increasing rate in the past decade. Effective public health interventions rely on comprehensive information about risk and protective factors.
Aim: This study aims to provide a comprehensive examination of trends in firearm-related deaths over the past 55 years, shedding light on the changing landscape and identifying key risk and protective factors associated with firearm-related deaths in the United States.
Methods: This retrospective study utilizes data from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System (WISQARS) for 1968-2022 to determine trends in firearm-related deaths. A multivariate logistic regression model was employed to identify independent predictors of firearm-related suicides, homicides, and unintentional deaths, exploring intersectionality by introducing interaction terms between race/ethnicity and level of education.
Results: Firearm-related deaths showed a fluctuating but upward trend from 12.0/100,000 persons in 1968 to 14.5/100,000 in 2022, with firearm-related suicides consistently accounting for a significant proportion of firearm-related deaths, from 45.7% in 1968 to 56.1% in 2022, with a peak of 63% in 2013. From the multivariate regression analysis, individuals aged 10-19 years had the highest risk of firearm-related suicides (OR = 3.04, 95% CI = 2.92-3.16) and homicides (OR = 2.87, 95% CI = 2.77-2.97). In addition, White people with higher education (OR = 1.42, 95% CI = 1.40-1.45) had the highest risk of firearm-related suicides, while Black people with lower educational attainment (OR = 6.68, 95% CI = 6.50-6.87) had the highest risk of firearm-related homicides. Conclusion: Our findings underscore the urgent need for targeted, evidence-driven public health interventions and policies. Primary suicide prevention strategies focusing on means restriction and reshaping perceptions around firearm ownership emerge as critical components. Comprehensive, multidimensional approaches that engage firearm owners and communities and address structural factors are imperative to curbing the multifaceted challenges associated with firearm-related injuries and deaths. Targeted interventions must include individuals aged 10-19 and specifically focus on suicides and homicides in the most relevant demographic segments of the population.
Keywords: firearm-related death; injury prevention and control; suicide; suicide prevention; united states; violence; violence prevention.
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