Mortality Trends in Gunshot and Firearm-related Assault Victims: A CDC Wonder Database Analysis from 1999 to 2020

Introduction: Firearm violence in the U.S.A. is an epidemic that is rapidly spreading, with a 25-fold higher rate of firearm homicides among comparable developed countries. Methods: Death certificates from the CDC WONDER for Epidemiologic Research database were examined from 1999 to 2020 for firearm-related mortality. The AAMR per 100,000 persons and the APC were calculated and stratified by year, sex, race/ethnicity, and geographic region. Results: The AAMR for men decreased from 7.1 in 1999 to 6.4 in 2014 (APC: -0.75; 95% CI: -2.5-0.2), after which it increased to 10.9 in 2020 (APC: 6.6; 95% CI: 3.3-15.3). Men had consistently higher AAMRs than women did: from 1999 (AAMR men: 7.1 vs. women: 1.5) to 2020 (AAMR men: 10.9 vs. women: 1.9). African American individuals had the highest overall AAMR (16.4), followed by American Indian/Alaskan Native (3.5), White (2.4), and Asian/Pacific Islander individuals, who had the lowest AAMR of 1.3. Discussion: Men are biologically predisposed to displaying hostile conduct and are more likely to express overt physical aggression. Black communities disproportionately impacted by poverty and unemployment often serve as perfect breeding grounds for crime, where interpersonal conflicts are more likely to escalate into violent encounters, contributing to increased gun-related crime. The consumption of violent media such as arcade games involving firearms has been at an all-time high level in the last decade and can be linked to more gun-related deaths. The hysteria surrounding the COVID-19 pandemic, socioeconomic chaos, and mental health conditions led to an exponential rise.