Citation

Smart R, Schell TL, Morral AR, Nicosia N. New Engl. J. Med. 2022; 387(2): 189-191.

Copyright

(Copyright © 2022, Massachusetts Medical Society)

DOI

10.1056/NEJMc2203322

PMID

35830647

Abstract

After two decades of decreasing rates, the rate of homicides in the United States began increasing in 2014.1 The increase has been driven entirely by a rise in firearm-related homicides, which diverged from the trend in non-firearm-related homicide in the late 2000s, starkly separated from it in 2014, and reached a rate of 4.4 deaths per 100,000 population in 2019 (Fig. S1A in the Supplementary Appendix, available with the full text of this letter at NEJM.org).2,3 In 2019, firearm use accounted for three of every four homicides, the highest ratio since systematic data on homicide mechanisms became available (Fig. S1B).2 Although increasing rates of firearm-related homicides have garnered attention from researchers and the media, limited research has evaluated the extent to which this increase is a national phenomenon or is concentrated among geographic areas or demographic groups.

We used mortality microdata from 2006 through 20194 and mixed-effects negative binomial regression models that predicted annual firearm-related homicides within demographic groups to estimate changes in the rates of firearm-related homicides (see the Supplementary Appendix). On average, the rate of firearm-related homicides decreased by 1% annually from 2006 to 2014 (incidence rate ratio, 0.99; 95% confidence interval [CI], 0.99 to 0.99) and then increased by 6% annually from 2014 to 2019 (incidence rate ratio, 1.06; 95% CI, 1.04 to 1.07); during the latter period, trends across the 50 U.S. states and the District of Columbia varied substantially...

Language: en