This study assessed temporal patterns and inflections in the rates of firearm deaths and percentage of years of potential life lost (YPLL) due to firearms for the overall U.S. population and by sex, age, race/ethnicity, intent, and states in the United States between 1999 and 2016.
This study obtained age-adjusted firearm mortality and YPLL rates per 100,000, and percentage of YPLL from 1999 to 2016 from the WONDER (Wide-ranging Online Data for Epidemiologic Research) database maintained by the Centers for Disease Control and Prevention (CDC). Joinpoint Regression was used to assess temporal trends, the inflection points, and annual percentage change (APC) from 1999 to 2016. National firearm mortality rates were 10.3 and 11.8 per 100,000 in 1999 and 2016, with two distinct segments, i.e., a plateau until 2014, followed by an increase of APC = 7.2 percent (95 percent CI 3.1, 11.4). YPLL rates were from 304.7 and 338.2 in 1999 and 2016 with a steady APC increase in percentage of YPLL of 0.65 percent (95 percent CI 0.43, 0.87) from 1999 to an inflection point in 2014, followed by a larger APC in percentage of YPLL of 5.1 percent (95 percent CI 0.1, 10.4). The upward trend in firearm mortality and YPLL rates starting in 2014 was observed in subgroups of male, non-Hispanic Blacks, Hispanic Whites, and for firearm assaults. The inflection points for firearm mortality and YPLL rates also varied across states. Within the United States, firearm mortality rates and YPLL remained constant between 1999 and 2014 and has been increasing since 2014. There was, however, an increase in firearm mortality rates in several subgroups and individual states earlier than 2014. (publisher abstract modified)