The Unrelenting Epidemic of Firearm Violence

Abstract

Firearm violence in the US is an unrelenting clinical, public health, societal, and political concern of major proportion. The morbidity and mortality attributed to firearms have continued to increase; have adversely and profoundly affected individuals, families, and communities; and have exceedingly important consequences for all of society. The frequent occurrence of firearm violence and the repetitive episodes of mass shootings highlight the pervasiveness of firearms and the accessibility of assault weapons and serve as grim reminders that every person in the US is potentially vulnerable to firearm violence.According to data from the Centers for Disease Control and Prevention, more than 45 000 firearm-related deaths occurred in the US in 2020, representing the highest reported rate (6.1 deaths/100 000 population) since 1994, with more than half of deaths due to suicide and more than 40% due to homicide. 1 Provisional data indicate that these deaths have increased in 2021, reaching more than 48 000 firearm-related fatalities in the US, 2 which would reflect nearly the same number of deaths as those attributable to influenza and pneumonia (53 000) and kidney disease (52 000) in 2020. 3 Firearm fatality rates also demonstrate critically important inequities; in 2020, the firearm homicide rate among Black individuals (26.6/100 000) was substantially greater than the rate among White individuals (2.2/100 000). 1 The number of nonfatal firearm injuries also is substantial. From 2018 through 2021, an estimated 100 000 persons experienced fatal or nonfatal firearm injuries each year, 4 with nonfatal injuries thought to represent more than twice the number of fatal injuries, although the ratio of nonfatal to fatal injuries may be higher. For example, in Chicago, 797 homicides were reported in 2021, along with more than 3500 reported shooting incidents, representing one of the most violent years on record. 5 This issue of JAMA includes 11 scholarly Viewpoints that provide state-of-the-science information about a wide range of issues related to firearms and violence in the US.Three articles in this issue describe the epidemiology of firearm injuries and homicide. Kaufman and Delgado 6 summarize current data on firearm injuries in the US, including homicides, suicides, nonfatal injuries, mass shootings, and shootings by law enforcement. The authors highlight the limitations of available data sources and propose measures for a comprehensive system to track firearm injury and death. This proposed system could expand national data infrastructure to provide reliable, real-time information on the incidence, epidemiology, health

National Trends and Resource Utilization Associated with Penetrating Trauma Recidivism

“…Non-fatal GSWs are two-fold more common than fatal injuries, and surviving victims are predisposed to a cycle of violence. 9 Among patients experiencing gunshot recidivism, present study showed that 91.8% of initial gunshot wounds occur due to assault or accident. These findings highlight the prevalence of urban violence resulting from inadequate firearm regulation.…”

“…Patients with GSW recidivism had shorter unadjusted index LOS (5 [2-10] vs 8 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] days, P<0.001) and lower median index hospitalization cost ($18,000 [8,800-37,600] vs $28,800 [14,500-61,100], P<0.001), relative to others. Compared to those without recidivism, GSW-R had higher rates of non-home discharge (30.6 vs 25.9%, P<0.001).…”

Changes in the Demographic Distribution of Chicago Gun-Homicide Decedents From 2015-2021: Violent Death Surveillance Cross-sectional Study

“…Although there is much discussion of firearm violence in Chicago in news publications [ 12 ] and, less often, research literature [ 13 , 14 ], there is little detailed information available on the demographics of gun-homicide decedents in the face of changes in violence other than to note broad populations at the highest risk at one point in time. This study examined the intersection of race/ethnicity, sex, and age among of Chicago gun-homicide decedents over a 7-year period in which there were year-to-year changes in overall gun-homicide rates.…”

Looking Back and Moving Forward—JAMA 2022 Year in Review

“…As the COVID-19 pandemic continued in 2022, original research on COVID-19 and reflections on the implications of the pandemic for science and medicine continued to dominate much of the scientific content at JAMA . But we also tackled other major threats to health, including theme issues on gun violence and on health care access and reproductive rights, and the trials, observational studies, and policy analyses we published provided evidence on a range of important issues from the care of critically ill patients to outpatient management of obesity. We also remained committed to the publication of evidence synthesis and guidelines that inform the practice of medicine, publishing 32 reports from the US Preventive Services Task Force, including Recommendation Statements, Evidence Reviews, Modeling Studies, and other articles related to screening or interventions for common diseases and disorders.…”