Emergency Room Visits for Gunshot Injuries, 2018–2023: Down From the 2020 Peak

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Summary

• Deaths and injuries from firearms rose in 2020, alongside the COVID-19 pandemic and other social factors, and stayed high in 2021–2022.
• CDC's National Syndromic Surveillance Program shows emergency department (ED) visits for firearm injuries rose in 2018–2020, then fell each year in 2021–2023 — but remain above 2019.
• Preventing firearm injuries calls for a comprehensive public health approach.

Background

From 2019 to 2020, firearm homicides rose about 35% and ED visits for nonfatal firearm injuries about 37%. The rise coincided with the pandemic and with strained police–community relations, more gun purchases, increases in some crimes, and wider discussion of systemic inequities in economic, educational and job opportunities. Comparing each year with the one before shows which way the trends are heading.

What the data show

The data covered about 425 million ED visits in 2018–2023, from EDs that reported consistently, including 338,390 for firearm injuries — 81.2 per 100,000 ED visits on average. Injuries of every intent were counted: unintentional, self-inflicted, assault, undetermined, legal intervention and terrorism.

• Monthly visits averaged from 3,754.4 in 2018 to 5,559.0 in 2020. The monthly rate peaked at 114.7 per 100,000 ED visits in 2020 and has not returned to 2019's 64.3.
• Men and women followed the same pattern. The steepest drops in 2021–2022 were among men 65 and older (34.3%) and 25–34 (14.6%), and women 65 and older (24.0%) and girls 0–14 (14.1%).
• In 2023, firearm injury visits were still 13.5% higher than in 2019, and significantly higher for both sexes at every age except 65 and older.

Prevention

About 50,000 Americans die from firearms each year, and about twice as many are injured. Continued monitoring — through the surveillance program and CDC's FASTER program for near-real-time data on violence-related ED visits — can guide and evaluate prevention.

CDC's Prevention Resources for Action set out the best evidence for preventing suicide and community, intimate partner and other violence, including firearm injuries:

• teaching coping, problem-solving and healthy relationship skills;
• street outreach and hospital-based violence prevention programs;
• place-based prevention, such as cleaning up vacant lots, and secure firearm storage;
• strengthening household financial security through economic supports.

Sources

Based on Kristin M. Holland, Yushiuan Chen, Marissa L. Zwald and others, "Notes from the Field: Trends in Emergency Department Visits for Firearm Injuries — United States, January 2018–December 2023," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.