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Homicides involving firearms during the first year of the COVID-19 pandemic reached the highest rates the country has seen in more than a quarter century, according to new CDC data.

From 2019 to 2020, gun-related homicides increased from 14,392 to 19,350, representing a 35% increase (4.6 to 6.1 per 100,000 persons), reported Thomas Simon, PhD, of CDC's National Center for Injury Prevention and Control (NCIPC), and colleagues in .

"That is nearly 5,000 more lives lost to firearm homicide in 1 year," said Simon during a press call on Tuesday.

Firearm-related suicides -- which make up the bulk of gun deaths each year -- remained essentially flat during this time, increasing from 23,888 to 24,245 (7.9 to 8.1 per 100,000 persons).

The increased rate of gun homicides was "pervasive," affecting both rural and metropolitan areas alike, males and females, and all age groups, Simon said, with the greatest increases seen among those ages 10 to 44, males, and in Middle Atlantic states and large metropolitan areas.

While the study was not designed to address whether the pandemic was responsible for the increase in homicides, "disruptions to services and education, social isolation, economic stressors such as job loss, housing instability, and difficulty covering daily expenses," may have played a role, said Simon.

The data also revealed a "widening of some longstanding disparities," Simon said.

For example, even before the study, Black males ages 10 to 44 already had the highest firearm homicide rate, and those rates increased. In 2020, Black men and boys ages 10 to 24 had 21 times the rate of firearm homicide as white men and boys of the same age, Simon said.

By analyzing age, sex, and race/ethnicity at once, researchers found the largest increases among Black males ages 10 to 24 (54.9 to 77.3 per 100,000) and 25 to 44 (66.5 to 90.6) as well as among American Indian and Alaskan Native men ages 25 to 44 (18.9 to 28.7). Similarly, among females, the largest increases and highest rates of firearm homicides occurred among Black individuals ages 10 to 24 (6.4 to 9.1) and 25 to 44 years-old (6.9 to 10.2).

However, the link between poverty and suicide and homicide extends beyond race, Simon noted.

"Firearm homicide rates were higher and showed larger increases among people living in communities at higher poverty levels and were lowest and increased the least among persons living in communities at the lowest poverty level," he explained.

Firearm suicide rates were higher in non-metropolitan and more rural areas of the country, and American Indian and Alaskan Native males experienced the greatest increase in such deaths, particularly those ages 10 to 24 (14.0 to 23.4 per 100,000) and 24 to 44 (16.0 to 23.8). As with homicides, yearly suicide rates by firearm were highest among those living in communities categorized as in the highest poverty level, said Simon.

County poverty levels may be a marker for systemic inequities, structural racism, and limited economic and academic opportunities, all of which factor into "unfair and avoidable health disparities" across certain racial and ethnic groups, Simon said.

Prevention

Debra Houry, MD, MPH, acting principal deputy director for the CDC and Director of NCIPC, who was not involved in the study, stressed the need for targeted prevention.

"Programs, policies, and practices can reduce risk for violence and inequities by focusing on the places and the people experiencing the greatest burden of violence, as well as the underlying conditions contributing to risk," she said on the call.

As an example, Houry noted that "street outreach workers" or "violence interrupters" -- individuals who identify and mediate potentially lethal conflicts and prevent them from escalating -- have shown "promising results."

The study authors also highlighted examples of prevention strategies, including the , which has demonstrated a reduction in suicides and suicide attempts; hospital-based intervention programs that support victims of violence and those at risk of suicide; and violence prevention programs that teach coping and problem-solving skills and promote help-seeking or offer mentoring.

Finally, the study noted that when coupled with access to a safety device has been linked to safer firearm storage practices in homes.

If you or anyone you know is struggling with a mental health concern or having thoughts of suicide, please call the at 1-800-273-TALK (8255).

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