Inside Medicine
Subscribe
Cover photo

Firearm deaths spiked in the summer of 2020 and after. What’s really behind it?

It’s not the pandemic, and it’s preventable.

Jeremy Faust

May 10
2
12

Deaths caused by firearms reached 25-year highs in 2020, according to a new report from the Centers for Disease Control and Prevention (CDC).

Lest you worry that pandemic-related shutdowns were responsible for this, let me assure you this is not the case. As my research collaborative showed last year in the Journal of the American Medical Association (JAMA), homicides were initially unchanged at the outset of the shelter-in-place period in the United States, though rates crept up in the spring of 2020 before increasing dramatically in the summer. Peaking in July and August, homicides reached 127%–129% of their normal levels, amounting to over 1,000 more homicides those two months alone than statistical norms would have projected.

The CDC’s new report does not include data for 2021. But I pulled CDC provisional data to see how things developed, and 2021 looks to have been even worse than 2020.

CDC data show a sudden increase in firearm deaths in the months after the Covid-19 shelter-in-place ended.

What’s behind all of this? A number of factors. But one thing we can say is that the increase in homicides does not appear to have been driven by pandemic overreaction, as many will likely try to claim. We know this because most of the homicide increases occurred in the South and the Midwest, regions that did less to stop Covid-19, in comparison to the West and the Northeast, regions where pandemic mitigation measures were observed longer, and also ones that entered 2020 with lower baseline homicide rates. Large increases occurred in cities, which might reflect changes in law enforcement (and that might be pandemic related), but also in rural and non-metropolitan areas.

State politics play a huge role, it appears. States with higher rates of gun ownership have higher rates of firearm deaths. States with universal background checks have lower rates of firearm deaths.

State laws and voting patterns correlate to firearm deaths. (Image by Jeremy Faust and Benjy Renton for Inside Medicine. Data: CDC, Pew, MIT election lab).

And national politics seem to matter too. If nothing else, voting results are an interesting proxy for a group of behaviors and cultural forces that feed into a culture of gun violence. As the graphics we made for Inside Medicine show, states that voted more heavily for the Trump/Pence presidential ticket in 2020 had markedly higher rates of firearm deaths in 2020 than those going for Biden/Harris. (The red state–blue state divide on firearm-related deaths is not a new thing.)

The previous graph with voting patterns and gun ownership swapped. (Image by Jeremy Faust and Benjy Renton for Inside Medicine. Data: CDC, Pew, MIT election lab).

The CDC, of course, isn’t going to “go there” and there’s much to say, outside of politics. “The substantial increase in firearm homicides and suicides are important public health concerns,” said CDC Acting Principal Deputy Director Dr. Debra Houry, via email to Inside Medicine. “It is also critical to understand the widening inequities by race and ethnicity as well as by poverty level. By understanding and addressing the drivers of these complex issues, we can provide needed tools to create healthier and safer communities.”

Writing in JAMA today, Houry also noted that “counties with higher poverty levels already had the highest firearm homicide rates, and these counties also experienced the greatest increases.” Meanwhile, Black and American Indian/Alaskan Native populations had disproportionately higher rates for homicide and suicide, respectively. Houry and her coauthors also pointed out that medical schools don’t teach about screening patients for firearm risks, which is a mistake; conceptualizing firearm safety just as we would any other kind of risk factor for poor health outcomes is useful, they argue. Just as physicians can effectively counsel patients to quit smoking to avoid heart disease, healthcare professionals have been shown to be able to decrease downstream violent injuries and incarceration by engaging youth in counseling that amounts to a kind of preventative care.

•••

According to Dr. Megan Ranney, an expert on gun safety, laws can and do make a difference. During a brief conversation last night, she pointed out to me that in states which have loosened gun laws, many adolescents and young adults have paid with their lives in the aftermath. But she has also written that increases in firearm deaths in states which pulled back from gun safety laws might reflect the cultural shifts that in fact led to the legal changes, as opposed to the laws themselves being the drivers of increases in firearm-related deaths.

To untangle all of this, firearm violence research must be funded, just like any other public health menace might be. And the CDC’s new report is an example of that. Until a few years ago, the CDC was routinely allocated exactly $0 per year to study firearm violence. Finally, Congress infused the CDC’s Injury Center with $12.5 million earmarked for this type of work. Today’s report is actually the first time that the CDC has published a report like this, and it comes as a direct result of that funding. So in the midst of a lot of bad news, the fact that there is public funding for firearm violence epidemiology is a small step in the right direction. (It’s said that funding earmarked for these purposes may actually increase in the coming fiscal cycle, but that obviously remains to be seen.) Meanwhile, the CDC is not permitted to advocate for gun control in any way, shape, or form, including even commonsense policies like background checks, which have been shown to reduce firearm deaths. That’s due to a rider which was added to a budget bill in the 1990s, the so-called Dickey Amendment. So, while the CDC is not permitted to advocate for even the slightest modicum of gun control, it can at least advocate for firearm injury and homicide prevention via other methods, such as medical education, funding for youth and young adult counseling, and the publishing of important, if unsettling, public health data.

•••

•••

❓💡🗣️ What are your questions? Comments? Join the conversation below!

Follow me on Twitter, Instagram, and on Facebook and help me share accurate frontline medical information!

📬 Subscribe to Inside Medicine here and get updates from the frontline at least twice per week.

Acknowledgements: Dr. Megan Ranney for expertise and insights; Benjy Renton for data acquisition and images.

Subscribe to Inside Medicine
By subscribing, you agree to share your email address with Jeremy Faust to receive their original content, including promotions. Unsubscribe at any time. Meta will also use your information subject to the Bulletin Terms and Policies
2
12

More from Inside Medicine
See all

Six crucial lessons from Omicron.

What we learned in the last wave can help us survive the next one.
Feb 28
3
5

Is this monkeypox strain more contagious? What have we learned and how worried should we be?

It’s too soon to tell, but the rising number of suspected cases is alarming.
May 19
2
1

Preview: Live Q&A with an allergist.

Wednesday May 18, 4:15pm ET and streaming on Inside Medicine.
May 18
1
Comments
Log in with Facebook to comment

12 Comments

  • Joel Thompson
    While Dr. Faust mentions loosening gun laws can predate increases in firearm deaths, I don't believe that there was any major change in policy that would have driven such a dramatic increase precisely in June of 2020. I think it would also be instructi…
    See more
    • 1w
  • August Hillman
    WTF is this gaslighting BS? We all know why
    • 3d
  • Alan Jackson
    My personal theory is that we are all going through the grieving process for how life was pre-pandemic, and many people are stuck in the anger phase.
    • 1w
  • John Noonan
    Propaganda BS. I don’t believe this article with any credit of facts. Be Ready highwayholster.com.
    Home | Highway Holster
    HIGHWAYHOLSTER.COM
    Home | Highway Holster
    Home | Highway Holster
    • 3d
  • Wil Harison
    it is obvious that the writer and researcher is biased, and left leaning,
    i.e. when talking about trump voters it was put as gun violence and gun deaths, but when factoring in black and indian it was added as gun deaths and suicide, so to infere that …
    See more
    • 1w
    Brian Dawson replied
      ·
    2 Replies
  • Kevin Kletke
    Ummm. Letting criminals run wild without charging them. Bail reform allowing criminals to continue breaking the law. The Left demonizing all police and not allowing them to do their jobs. The mental illness problem in this country that no one seems to …
    See more
    • 1w
  • Andrew Adams
    BLM and their “mostly peaceful” Riots
    • 6d
  • Brian Dawson
    Your article is fake news. Where are the Pinocchio’s? You comment that states with high gun ownership have higher gun violence. NOT TRUE! CBS last month: https://www.cbsnews.com/.../gun-ownership-rates-by-state/ if your comment was true expl…
    See more
    Gun map: Ownership by state
    CBSNEWS.COM
    Gun map: Ownership by state
    Gun map: Ownership by state
    • 4d
  • Lilita
    male violence
    • 4d
  • Chris Short
    Why don't you try Blue Cities vs Red States and see where the numbers wind up? Cities that are predominantly black make up a widely disproportionate share of firearm deaths...regardless of how the state as a whole voted.
    Cities with a high percentage …
    See more
    • 4d
Share quoteSelect how you’d like to share below
Share on Facebook
Share to Twitter
Send in Whatsapp
Share on Linkedin
Privacy  ·  Terms  ·  Cookies  ·  © Meta 2022
Discover fresh voices. Tune into new conversations. Browse all publications