Black men disproportionally affected by firearm violence

Key takeaways:

• Firearm assault injury rates disproportionally affected men and Black individuals.
• Native American individuals had the second highest assault injury rate despite making up just 0.7% of total firearm injuries.

Black individuals experienced nonfatal firearm assaults at a rate 20 times higher than their white counterparts in 2019 and 2020, according to new study results published in the Annals of Internal Medicine.

The findings come as the United States Surgeon General recently declared firearm violence a public health crisis in the country, with over 48,110 people having died from firearm-related injuries in 2022.

Data on firearm fatalities are “well established," according to Elinore J. Kaufman, MD, MSHP, an assistant professor in the department of surgery at University of Pennsylvania Perelman School of Medicine, and colleagues. “But much less is known about the magnitude of nonfatal and total firearm injuries, and little research addresses whether the disparities seen in deaths are paralleled in nonfatal injuries,” they wrote.

In the retrospective cross-sectional analysis, researchers examined 2019 and 2020 fatal firearm injury data and nonfatal firearm injury data taken from the CDC and Nationwide Emergency Department Sample dataset, respectively.

They reported 252,376 total firearm injuries during the examined years, of which 84,908 resulted in death.

Among the total injuries:

• 37.3% were from assaults;
• 37.8% were unintentional;
• 21% were from self-harm; and
• 1.3% were law enforcement related.

Self-harm had the highest case-fatality ratio (CFR) at 90.9%, which remained similar across diverse populations and genders. The highest rate of self-harm occurred among white men aged 55 years or older at 26 deaths per 100,000 people.

Assault rates disproportionally affected men and Black individuals, with the latter experiencing 61.5% of all firearm assaults and homicide deaths despite making up 12.6% of the total U.S. population in 2020, Kaufman and colleagues noted.

The total assault injury rates were highest among Black adolescents and men in every age group. The highest assault rate of any subgroup was among Black people aged 15 to 34 years, at a rate of 291 injuries per 100,000 people, “making firearm assault injuries more common in this group than ED visits for sports injuries in any age group,” the researchers wrote.

Native American individuals experienced the second highest assault injury rates among all diverse populations — despite accounting for just 0.7% of total firearm injuries — followed by Hispanic people, white people and Asian people.

Black adolescents and men aged 15 to 34 years also had the highest unintentional injury rate of any subgroup, at a rate of 235 injuries per 100,000 people.

Native Americans had the highest rate of CFR for assault (3.5%) and law enforcement-related injuries (53.8%).

“Evidence suggests that Native Americans have the lowest access to trauma centers of any U.S. racial group, and this disparity may be an important contributor to high fatality rates,” Kaufman and colleagues noted.

The researchers acknowledged they likely undercounted nonfatal assaults and overcounted unintentional injuries, although they had no information on the contexts of injuries.

They highlighted several possible interventions to address the ongoing gun violence epidemic, such as trauma care resources, suicide prevention initiatives and violence intervention and mental health services for survivors and families.

Still, “better data to more accurately capture underlying causes of firearm injury and case fatality are needed to focus resources and interventions,” they concluded.