US Firearm Related Mortality

Yves here. The authors of this analysis of CDC data don’t seem to know what to make of this disheartening change, nor does Angry Bear author run75441, but firearm death rates are up meaningfully in the US after being flat for 15 years.

By run75441. Originally published at Angry Bear

New analysis of 1999-2017 firearm deaths looks at changes in each state and within age, gender and racial/ethnic groups

Nationally, firearm-related mortality rates increased in period 2015–2017 after remaining relatively stable in period 1999–2014. Firearm mortality increases can be seen in “most” states and the demographics to the mortality seen in varying degrees. The increases suggest a worsening epidemic of firearm mortality geographically and demographically abroad. In both time periods, the fractions of firearm deaths due to suicide and homicide remained consistent.

In order of magnitude, the rates of homicides, suicides, and unintentional deaths incurred in the United States are 25.2, 8.0, and 6.2 times higher than rates occurring in other developed countries. While remaining relatively stable from 1999 to 2014, the age-adjusted firearm mortality rates in the US increased for three consecutive years starting in 2015 as shown in Exhibit 1. One has to wonder why this could be.

The increases are also apparent across the nations demographics (race, sex, age), mechanisms of death (suicide, homicide, etc.), and are broken down by states across the nation which I will not be showing today. Well beyond a majority, the states saw increases and a few have experienced decreases. The Health Affairs study “US Firearm-Related Mortality: National, State, And Population Trends, 1999–2017,” is the first to define the mortality of deaths by state. The Health Affairs state detail is too massive to display here and the study is only open to subscribers. I believe the more important part of this study is the upturn in the death rate starting in 2015. One can only speculate what has brought on the increase.

After the leap, Methodology, Limitations, and Conclusions

Methodology: The CDC WONDER mortality database and the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), codes (W32–W34, X72–74, X93–95, Y22–Y24, Y35.0, and U01.4); firearm-specific mortality rates for each state including the District of Columbia were collected for each year in the period 1999–2017. Subsequent queries extracted the mechanisms of suicide-specific, homicide-specific, and unintentional firearm deaths numerics for each code. Overall firearm mortality rates by sex (male or female), race/ethnicity (black or African American, non-Hispanic white, Hispanic white, Asian/Pacific Islander, and American Indian/Alaska Native), and age group (ages less than 1, 1–4, 5–14, up to 75–84 and 85 or more). The Hispanic ethnicity was not analyzed among nonwhite races because of high suppression rates (counts below ten are suppressed in all CDC WONDER queries. All rates (except age-specific rates) were age adjusted using data from the 2000 census. All mortality rates are expressed per 100,000 person-years.

State and subpopulation-specific changes in firearm mortality rates in the period 1999–2014 were compared to those in period 2015–2017. The study calculates those rates across states and subpopulations in periods 1999–2014 and 2015–17 and percentage changes between the two time periods. The analysis was also done for overall firearm mortality, firearm suicide, and firearm homicide.

Limitations: The analysis was limited by the suppression of rates “in lower-population areas and among smaller subpopulations (see footnote 1).” This may limit the generalizability of the results; however, the risks that affect the greatest numbers of people were able to be characterized. The analysis did not consider nonfatal firearm injuries. The subpopulation-specific trend analysis relied on some interpolation to present the most complete picture possible. The thrust of the analysis was to focus on the recent increase in the 2015-17 mortality in comparison to period 2009 – 2017.

Briefly: In period 1999–2014 there were 497,627 firearm deaths or 10.4 per 100,000 person-years of which 291,623 (58.6 percent) were suicides and 191,531 (38.5 percent) were homicides. In period 2015–2017, there were 114,683 firearm deaths or 11.8 per 100,000 person-years which reflects a 13.8 percent increase from period 1999–2014 in “per 100,000 person-years.” Sixty percent or 68,810 were suicides and 37.9% or 43,483 were homicides. All of the non-suppressed rates together, 81.2 percent showed increased mortality in period 2015–17 in comparison to period 1999–2014. The percentage change differed across states, demographics, and mechanisms. Only California (88.2 percent), New York (87.5 percent, with one rate suppressed), and the District of Columbia (90.0 percent, with seven rates suppressed) saw mortality reductions in a majority of categories. The only “demographic” showing majority decreases in mortality were Hispanic whites (55.6 percent, with fifteen rates suppressed); the only mechanism was unintentional firearm deaths (78.3 percent, with twenty-eight rates suppressed). Across period 1999 -2017, some states had a decreased trajectory while the same states showed increases in period 2015 – 2017. The factors leading up to the increase in period 2015 – 2017 can not be identified (footnote 2).

The study does go further in its breakdown by state, demographics, and overall 1999 – 2017 trend (as compared to looking at two different time periods). In particular, there may be one event which triggered the beginning of the increase in 2015 after a plateau of firearm-related violence from 1999 to 2014.


US Firearm-Related Mortality: National, State, And Population Trends, 1999–2017,” Health Affairs Jason E. Goldstick, April Zeoli, Christina Mair, and Rebecca M. Cunningham, October 2020

I happened upon the author’s study at University of Michigan and included the link for it below and a couple of footnotes.

Study: U.S. firearm death rate rose sharply in recent years across most states & demographic groups,” Rebecca Cunningham, Jason E. Goldstick, April Zeoli, Christina Mair,

Footnote 1. To protect identities, CDC data were not available (or “suppressed”) when fewer than 10 people of a given characteristic group died from a firearm injury in a particular state in a year.

Footnote 2. The authors note that they can not tell from the data they used what factors led to the increase in firearm death rates in recent years, nor the decreases seen in certain groups and geographic areas. They do say that the consistent findings across so many states and demographic groups indicate that the rise from 2015 to 2017 was not due to random variation.

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  1. JBird4049

    They do say that the consistent findings across so many states and demographic groups indicate that the rise from 2015 to 2017 was not due to random variation.

    It is past my bedtime so I will read again and probably comment again, but considering that the various deaths from despair is increasing a lot as noted by this site…

    Also the coroners do apparently have a habit of deciding that an “accident” and not suicides is the cause of death, the police’s lethal justification of “fearing for their life” appears to be increasing along with the continued acceptance of it, and perhaps most important (although I really will have to dive into the numbers despite the suppression to check) the increasing lawlessness of our country means that the official legal system will not be used for justice.

    One of the truly fantastic improvements in the past few centuries is in the decreasing murder rate due partly to the quid pro quo of the state taking exclusive control of the use of force from its citizens while guaranteeing that it would also enforce the laws fairly, or at least apply something close enough to justice for its usurping of violent force. When a country becomes corrupt enough that the rules and its punishments are for the weak and not for the powerful including those wielding the “law” ostensibly to keep us safe then the average person stops using the law.

    So we have an entire country whose bottom 60% is (stealing a phrase from a writer of policing in the black community) over policed and underserved being governed by people who can assassinate people including government officials without fear (Soleimani), have a child pimp for the rich and powerful an open secret for two decades (Jeff Epstein) assassinated, the opioid epidemic (the jail free Sacklers) or all those homeless encampments that didn’t exist thirty years ago. Add the multi decade campaign to have Americans fear everything especially each other.

    I know some will start complaining about them evil guns, but I rather think of such talk like I think of Identity Politics. A means of distraction. Or perhaps like those trying to justify our war with the rest of the world. Somehow, someway, someone is out to get us so let’s invade Iran or drone an apartment building. Then again that is also the excuse of NRA for gunz.

    1. tegnost

      Only California (88.2 percent), New York (87.5 percent, with one rate suppressed), and the District of Columbia (90.0 percent, with seven rates suppressed) saw mortality reductions in a majority of categories

      Hmmm… what do these three locations have in common?

        1. JBird4049

          “Lies, damn lies, and statistics.” ;-)

          They are all Blue areas, true, but the suppression is what bothers me. It reminds of when the police until after Ferguson, as a whole, reported only half of all police homicides. The numbers before were 500-600 yearly and now are between 1,000 and 1,200 and the most accurate numbers still seem to come from public efforts like the Washington Post and individuals making a job of it.

          Just look at all the various official statistics that are now funky like those on inflation and unemployment. Deaths from suicides and from homicides are supposed to have risen or fallen in tandem, which makes sense, but the availability of guns anywhere has not really gone down, the conditions that cause suicides have gotten worse as have the police, and I believe also the areas with gangs. And no, gangbangers are not just psychopathic monsters looking to kill, but often just scared people looking to defend themselves or get some justice for a dead friend or for family.

          A decently cared for gun can be around for an entire lifetime. But who knows? Maybe the availability of guns truly has dropped or it could be something else like better mental health programs, or they finally got around to refunding those gang violence intervention programs. Those programs are basically getting the gangs’ leadership together and talking about the problems, offering some help like after school activities, and pounding the first gang that breaks a brokered truce. It is treating people as people and not monsters. Although some twits will say that is being soft on the “criminals.” That is something I intend to study again even though statistics are not easy for me.

          1. jsn

            This is a key aspect of institutional collapse.

            By the time of the Soviet disintegration the Party in Moscow couldn’t tell what was happening anymore because the inbound information flows were so distorted by generations of accreted distortions to serve the interests of whatever party at whatever time downstream could bend an information flow to their own benefit.

            Our post Citizens United, really post Buckley vs Valeo, Government for purchase has so facilitated information flows to guarantee profits to the profitable and cost to the citizenry that any citizens interest shows up as a cost somewhere that has to be stamped out. Treating people like people would shatter rice bowls in MilitaryIC, MedicIC, PrisonIC, Finance and Education. What would be left of the US economy?

  2. Roland

    USA’s overall homicide rate has been pretty stable over the past decade:

    USA’s overall homicide rate has fallen considerably over the past generation:

    The USA’s overall homicide rate today is in the range of the early to mid 1960’s, and a lot lower than in the period 1975-94.

    It’s the USA’s suicide rate that’s rising significantly in this century:

  3. Tom Stone

    To add to JBirds comment, we don’t know how many are killed annually by Police in the USA.
    The best figures show somewhere between 4-5,000.
    And that does not include the wounded, just the dead.
    If the figures match the Killed/Wounded ratio of the military we are talking about 15-20K a year wounded by cops.
    Not an unreasonable figure considering the high quality of trauma care in major US Cities…this assumes that the cops actually call in emergency services personnel rather than simply let their victims bleed out.

    1. JBird4049

      Four to five thousand homicides seems rather high unless one is adding the jails and perhaps the prison deaths? Finding those statistics seems impossible, but if someone has found a creditable effort please let me know. I really want something solid. Something other than a gut feeling.

      Of course, the lowest figure for the street is about 1,000 homicides per year and several times that in injuries with the unofficial numbers always, always higher than the official numbers. Then again, this is the nonsense that makes discussions from gun violence to the economy difficult. The numbers are distorted. It is only when you see something like the homeless, read the official story and numbers, and compare it to your personal memory that you realize something is truly off.

  4. polar donkey

    Memphis has been flooded with guns over the past 5 to 10 years. Gun fights at malls, gun fights at football games, gun fights at music festivals, gun fights in restaurant parking lots, gun fights on the interstate. Shootings are so common on interstate, the police have a squad car sitting at every 4th exit. Doesn’t matter. We have a shooting every week or two. 80% of the people I work with are african americans. Every single one of them has had a relative or friend shot to death. Imagine if every white person had that same experience. I doubt many rabid gun bunnies share that gun carnage experience.

    1. Seamus Padraig

      Think about what you’re saying here. You’re actually recapitulating one of the favorite arguments of those “rabid gun bunnies.” They have long maintained that we don’t have a gun problem in America; we have a crime problem instead. The Second Amendment crowd has always maintained that ‘if guns are outlawed, only outlaws will have guns.’ In virtually every state of the union, crime is always most concentrated in the urban Black ghettos. If criminals are not going to obey laws against murder, the NRA has always argued, what makes you think they will obey laws against owning guns?

      1. JBird4049

        It is not a crime problem. It is a fear problem. Both the anti and pro gunners are overemphasizing, even exaggerating, the use of guns in violence without getting into why, today, people are so compelled to use them.

        I can make a good case for banning, maintaining, or even increasing the availability of guns, but unless I address the issues of poverty, stress, despair, and corruption that are destroying us, it would be an inadequate argument at best, if not just disingenuous.

      2. Bern

        “In virtually every state of the union, crime is always most concentrated in the urban Black ghettos.”

        Depends on what crimes you focus on. The vast majority of crime (lives lost due to pollution and faulty consumer products, or dollars lost due to fraud) takes place in corporate board rooms, investment bank trading sites, defense contractor budgeting sessions, etc…

  5. DJG

    There is something wrong with the analysis:

    In order of magnitude, the rates of homicides, suicides, and unintentional deaths incurred in the United States are 25.2, 8.0, and 6.2 times higher than rates occurring in other developed countries.

    A quick check of Wikipedia gives the U.S. homicide rate at 5.30 per 100,000. Iran is at 2.47. Ireland is 0.90. Scotland 1.10. Finland 1,20. Portugal 0.70. The U.S. isn’t at 25x the rate of these other comparable countries.

    I am wondering what is going on in this analysis. Yes, there are problems in the U S of A, but this article doesn’t seem to shed light on them.

    1. Greg Taylor

      The relative death rates in the quote are likely “firearm-related.” This Wikipedia entry seems consistent with the analysis in the article.

  6. chuck roast

    I like that the line chart is labeled as a part of “Epidemiological Research”. For years my wife has been saying that gun possession and violence are serious public health issues. Things will not change here until we begin discussing and attacking this the same way we did the Polio Epidemic in the ’50’s.

  7. anonymous

    Exhibit #1 has been drawn to emphasize the data for the last three years. Data look very different when plotted on a graph with the y-axis starting at zero. Is the exhibit an objective presentation of data or a message intended to elicit or support a particular response?

    1. GF

      The NRA did/has/will continue to lobby against reporting on gun violence and analysis of gun deaths by CDC etc. for many years now. That is why the data doesn’t start until 1999 when data collection began. The author does state that there has been a 13.8 percent increase from 2015 through 2017 compared to the previous 1999 to 2014 period. I would call that significant. What did happen in 2015 when the increase started?

      1. JBird4049

        Like the anti gun groups, the NRA does not want accurate data on gun violence, which makes research, never mind discussing the issue difficult. That is what too many want. Disingenuous “arguments” on gunz, which too often are just part of the grift. Look out, those bad, bad people want to hurt you, so give me money to fight them! Ka-ching!

  8. Alan Coovert

    I know 5 people killed in traffic violence. 2 were pedestrians,2 on motorcycles and one on a bicycle. They were all killed by motorists. None of the motorists suffered any consequences for killing my friends. Plus a new study came out that says more than half of all motorist carry guns in their cars. I don’t own a car so i walk, ride my bicycle and take the bus. I’m more afraid of motorists than anything else in my life.

    1. Tony Wright

      If you are on two wheels you have bitumen airbags.
      Nobody should be allowed to get a car or truck drivers license until they have learnt to ride a bicycle and/or motorcycle ( or a trike for the balance impaired) in non-freeway traffic. That way potential motorists get a healthy awareness of vulnerability on the roads and an improved level of attention concerning other road users.
      As for US firearm fatalities, the causes are relatively obvious to anyone living outside the US:
      Too many nut jobs allowed to buy guns due to pissweak gun control laws, especially concerning assault rifles and concealable hand guns, and
      NRA advocacy and coercion of elected representatives, funded by firearm manufacturers, and cowardly hiding behind the anachronistic second amendment (which was written when firearms were single shot muzzle loaders, there was no police force, and there was a perceived need for citizen militias in case of invasion by the dreaded redcoats).

      1. Tony Wright

        Also, the unwinnable war on illegal drugs, which has led to the proliferation of murderous gang turf wars. This factor has also been very successfully exported to Mexico and other Central and South American countries – nice little export earner for US (and other) gun manufacturers.

        1. Tony Wright

          Oh, and another knock on effect of the widespread, indiscriminate allowance of private gun ownership in the US? Paranoid, trigger happy police shooting innocent citizens.

          1. JBrird4049

            Not quite. Gun ownership has always been high in the United States, but the American police were not as fearful even when gun control was far more lax in decades past when violent crime and police deaths were much higher. Today, police use the excuse that someone might be armed for their extremely short or quick triggers (no pun intended) even when police deaths and violent crime are extremely low especially when compared to the past.

  9. nlowhim

    murders rose in 2015 to 2017, but showed a drop after that. Not sure if this will follow the same pattern. New news that life expectancy has gone up (or, really, remained flat, as it seems to me).

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