Guns lead to rising suicide rates in US cities

Guns lead to rising suicide rates in US cities

September is Suicide Prevention Awareness Month, and it brings bad news about the relationship between guns and suicide. The first-ever city-level analysis of Centers for Disease Control and Prevention (CDC) data on firearm deaths found that the rate of firearm suicides increased by 11% between 2014 and 2020.

Firearm homicide rates also increased over the period, by 18%. Mass shootings in 2022 have understandably sparked outrage, but more than half of all gun deaths in the United States are the result of suicide.

Suicide itself is a more important factor in premature death that can be commonly understood. According to the CDC, in 2020 it was the second leading cause of death (after unintentional injuries) for Americans ages 10-14 and 25-34. Among 15-24 year olds it was third (just behind homicides) and for 35-44 year olds it was fourth.

Firearms add a deadly dimension to this public health problem; a study published in Annals of Internal Medicine which reviewed millions of hospital and emergency department records found that while less than 9% of all suicide attempts were fatal, nearly 90% of those involving firearms resulted in death.

The city-level findings are outlined in the report Gun Suicide in Cities, a collaboration between the nonprofit organization Everytown for Gun Safety and New York University Langone Health. Data on gun deaths has been incorporated into a City Health Dashboard from Langone Health that includes more than 40 measures of health and health equity.

“When we think of guns in cities and the damage they cause, our minds tend to go straight to the shooting of others,” says Marc Gourevitch, chair of the Department of Population Health at NYU Grossman School. of Medicine and Lead Dashboard Architect. . “A lesson from this analysis is that it is important to focus on reducing the availability of firearms to people who may be contemplating suicide.”

Suicide rates have increased by 12% between 2010 and 2020, with high demographic rates that might surprise those who do not study this health problem. (KFF)

Fewer policies, more deaths

Nationally, the suicide death rate increased by 12% between 2010 and 2020, according to an analysis by the Kaiser Family Foundation (KFF), which represents more deaths than road accidents.

White Americans were more than twice as likely to commit suicide as blacks, although the rate among African Americans rose from 5.4 to 7.7 per 100,000 over the decade. The largest increase over the period, 62%, was seen among 12-17 year olds.

Heather Saunders, postdoctoral health services researcher for KFF, published her findings regarding the prevalence of gun suicides in these trends in July this year, the month a three-digit national code for suicide and crisis , 988, has been uploaded.

Saunders looked at state-level suicide rates and found substantial variation between states. “When we broke it down by type of suicide and included firearm suicide, I noticed that the variation seemed to be driven by firearm suicide rates.”

Next, she searched the state’s gun law database and categorized the states into groups based on the number of gun law provisions, assigning them to the “weak” categories. ”, “medium” and “high”. (The categories were based only on number of laws, not type.)

States with the least gun laws had the highest rate of gun suicides, twice as high as those in the “high” category. Saunders estimated that if all states had the gun suicide death rate that she found in states with the most gun laws, 15% of everything suicide-related deaths could be prevented.

“My study is not designed to be causal,” Saunders says. “It’s just about looking at two things happening at the same time.”

Laws may not be the only factor affecting how easy or difficult it is for people contemplating suicide to access a firearm. But city-level analysis by NYU and Everytown found a similar relationship between politics and death rates.

At the state level, a high population does not necessarily equate to a high number of gun suicides – in fact, some of the least populated states have the highest rates.

Understanding the determinants

“We cannot fully address gun violence in cities until we recognize the growing and often unspoken role that gun suicides play in our nation’s gun violence epidemic,” says Megan J O’Toole, deputy director of research at Everytown for Gun Safety.

Analysis of CDC data for more than 750 cities with a population of 50,000 or more found that 4 in 10 suicide deaths were caused by firearms, or 7,000 deaths per year.

Cities in states with the strongest gun violence prevention laws had half as many gun suicides as those in states with the weakest laws, consistent with the KFF findings. “Strength” was determined according to a state gun law grading system developed by Everytown.

The prevalence of gun shops had an even stronger association with gun suicide deaths, with rates four times higher in the highest range (more than 10 shops per 100,000 population) than in the lowest. low (less than 3 per 100,000).

In cities with a shortage of walkable neighborhoods or parks, gun suicide rates were higher — twice as high as in those with the most green space.

Park access and walkability are among the metrics included in the city’s health scorecard. Including gun data in the dashboard allows city planners and health officials to examine the relationships between their gun violence numbers and other social, health and environmental metrics. These can be viewed at the city or census tract level.

A starting point could be life expectancy, Gourevitch says. “There are a lot of things that go into life expectancy, and sometimes the variation can be quite significant from neighborhood to neighborhood. It can start a conversation about what could be causing this, and then we can move on to other measures.


Metrics included in the Healthy City Dashboard include social, economic, behavioral, and environmental factors that can affect health. Shown: Washington, DC air quality details (NYU Langone Health)


Strategies to keep guns away from those contemplating self-harm are well understood and not all require legislative action. Safe storage practices are essential. In 2021, only 14 states had requirements for the safe storage or locking of firearms. Whether or not such laws are in place, gun owners bear the primary responsibility for safe storage.

Everytown’s Be Smart campaign offers a variety of safe storage training resources that jurisdictions and local organizations can use, and its volunteers regularly provide training in communities. Gun stores can help with educational efforts, O’Toole says, and provide third-party storage.

Extreme Risk Protection Orders, also known as “red flag” laws, create a legal mechanism that includes due process by which firearms can be removed from people who have threatened violence against themselves (or against others). Nineteen states have enacted such laws.

Gourevitch notes that a majority of people who attempt suicide have seen a medical professional in the month before their attempt. Opportunities to screen for symptoms are missed and services must be available for those in distress.

Barbers, beauticians, friends and family are also part of the prevention infrastructure, O’Toole says. “We all have a role to play in reducing gun suicides.”

If you know someone who is thinking about suicide, help is available at 988, Suicide and Crisis Lifeline.

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