Firearm Violence as a Public Health Problem

The What You Can Do initiative approaches firearm violence as a public health problem and believes in the unique position of physicians to help reduce it.

Several major medical and public health associations have made similar statements on firearm violence, citing it as a leading cause of death in the U.S. and a substantial burden on the U.S. economy. The American Medical Association, the American Academy of Pediatrics, and most recently the California Medical Association have issued statements on firearm violence as a public health problem and set priorities for reducing it.

Here we review the statistics of firearm violence. For more information, see the WYCD Resources section.

On average in 2016, 105 Americans died by firearm each day. There were 38,658 deaths by firearm in the U.S. Nearly 60% (22,938) of these deaths were suicides and 37% (14,415) were homicides. An additional 495 firearm deaths in 2016 were unintentional.1

In the last three decades, firearm suicide deaths have exceeded firearm homicide deaths, even when firearm homicide deaths peaked in the mid-1990s.2

Mass shooting events, though becoming more common in the U.S., only account for between one and two percent of deaths from firearms per year.3,4 To reduce firearm injury and death, providers should focus on prevention and work to ensure that when firearms are present, patients and their loved ones understand the risk of firearms and take all actions for increasing safety.

The Data on Firearm Injury and Death

  • About 3/5 of deaths from firearms in the U.S. are suicides. In 2016, nearly 23,000 people in the U.S. died by firearm suicide.1
  • Approximately 17,311 people in the U.S. sustained non-fatal unintentional firearm injuries in 2015.1
  • The estimated annual cost of gun injury in 2012 exceeded $229 billion—about 1.4% of GDP.5
  • 31% of all households in the U.S. have firearms, and 22% of American adults personally own one or more firearms.6
  • The U.S. has relatively low rates of assaultive violence but high firearm mortality rates in comparison with other industrialized nations.7
  • Overall since 2006, firearm homicides in the U.S. have decreased, but the number of firearm suicides has increased by a similar amount.7 The rates of both firearm suicide and homicide in the U.S. increased from 2015 to 2016.1
  • Research has found that individuals who have other risk factors for firearm violence are less likely to safely store their firearms when compared to firearm owners without other risk factors.8,9
  • Mass shootings only account for between 1% and 2% of firearms deaths in the U.S. each year.10
  • There are no state or federal statutes that prohibit health care providers from asking about patients’ access to firearms when the information is relevant to the health of the patient or the health of someone else.11,12
  • Research has shown patients to be receptive to provider question on firearms access and safety.13,14

  1. Web-based Injury Statistics Query and Reporting System (WISQARS). Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2016.
  2. Wintemute GJ. Firearms as a cause of death in the United States, 1920-1982. J Trauma 1987;27:532-6.
  3. US mass shootings, 1982-2017: data from Mother Jones’ investigation. 2017. (Accessed 10 December, 2017, at http://www.motherjones.com/politics/2012/12/mass-shootings-mother-jones-full-data/#)
  4. Webster DW. The true effect of mass shootings on Americans. Ann Intern Med 2017;166:749-50.
  5. Follman M, Lurie J, Lee J, West J. The true cost of gun violence in America. 2015. (Accessed 10 December, 2017, at https://www.motherjones.com/politics/2015/04/true-cost-of-gun-violence-in-america/)
  6. Smith TW, Son J. General Social Survey final report: trends in gun ownership in the United States, 1972-2014. 2015.
  7. Wintemute GJ. The epidemiology of firearm violence in the twenty-first century United States. Annu Rev Public Health 2015;36:5-19.
  8. Nelson DE, Grant-Worley JA, Powell K, Mercy J, Holtzman D. Population estimates of household firearm storage practices and firearm carrying in Oregon. JAMA 1996;275:1744-8.
  9. Nordstrom DL, Zwerling C, Stromquist AM, Burmeister LF, Merchant JA. Rural population survey of behavioral and demographic risk factors for loaded firearms. Inj Prev 2001;7:112-6.
  10. Wintemute GJ. What you can do to stop firearm violence. Ann Intern Med 2017;167:886-87.
  11. Wintemute GJ, Betz ME, Ranney ML. Yes, you can: physicians, patients, and firearms. Ann Intern Med 2016;165:205-13.
  12. Kapp MB. Geriatric patients, firearms, and physicians. Ann Intern Med 2013;159:421-2.
  13. Betz ME, Flaten HK, Miller M. Older adult openness to physician questioning about firearms. J Am Geriatr Soc 2015;63:2214-5.
  14. Walters H, Kulkarni M, Forman J, Roeder K, Travis J, Valenstein M. Feasibility and acceptability of interventions to delay gun access in VA mental health settings. Gen Hosp Psychiatry 2012;34:692-8.