Geographic Disparities in Rising Rates of Firearm-Related Homicide

Abstract

After two decades of decreasing rates, the rate of homicides in the United States began increasing in 2014.1 The increase has been driven entirely by a rise in firearm-related homi-cides, which diverged from the trend in non–fire-arm-related homicide in the late 2000s, starkly separated from it in 2014, and reached a rate of 4.4 deaths per 100,000 population in 2019 (Fig. S1A in the Supplementary Appendix, available with the full text of this letter at NEJM.org).2,3 In 2019, firearm use accounted for three of every four homicides, the highest ratio since system-atic data on homicide mechanisms became avail-able (Fig. S1B).2 Although increasing rates of firearm-related homicides have garnered atten-tion from researchers and the media, limited research has evaluated the extent to which this increase is a national phenomenon or is concen-trated among geographic areas or demographic groups