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Alarming Rising Trends in Suicide by Firearms in Young Americans

Between 2008 and 2018, rates of suicide by firearms quadrupled in young Americans ages 5 to 14 years and increased by 50 percent among those ages 15 to 24 years.

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Deaths from suicide are rising in the United States. These rising trends are especially alarming because global trends in suicide are on a downward trajectory. Moreover, in the U.S., the major mode of suicide among young Americans is by firearms.    

Researchers from 91���� ’s and collaborators explored trends in suicide by firearms in young white and black Americans (ages 5 to 24 years) from 1999 to 2018. Results, published in the journal Annals of Public Health and Research, showed that between 2008 and 2018, rates of suicide by firearms quadrupled in young Americans ages 5 to 14 years and increased by 50 percent among those ages 15 to 24 years. Deaths from suicide by firearms were more prevalent in white than black Americans. These trends are in marked contrast with homicide by firearms, which are far more prevalent in black than white Americans.  

From 1999 to 2018, white Americans ages five to 24 years comprised 87.5 percent of deaths from suicide from firearms and 79.9 percent of the comparable U.S. population. Specifically, there were 34,629 deaths from suicide by firearms among whites and 5,588 among black Americans ages 5 to 24 years. The age-adjusted rates increased from 3.47 per 100,000 to 4.60 among whites and from 2.88 to 3.03 in black Americans.   

Overall, from 1999 to 2018, the 47,015 deaths from suicide by firearms among young Americans included 2,115 (4.5 percent) between ages 5 and 14 years and 44,900 (95.5 percent) between ages 15 to 24 years. Death rates from suicide due to firearms from 2007 to 2018 were 0.43 for whites and 0.16 for black Americans ages 5 to 14 years and 6.79 for whites and 4.05 for black Americans ages 15 to 24.

“ While further analytic studies are needed, there are certainly important public health implications in this data,” said , M.D., senior author, interim dean and senior associate dean for education, Schmidt College of Medicine.   

From 1996 to 2020, U.S. federal laws effectively prohibited research related to investigations of death from firearms. However, in 2020, $25 million was appropriated to the U.S. Centers for Disease Control and Prevention (CDC) and the U.S. National Institutes of Health to conduct analytic studies.

“Descriptive data such as those we used in our analyses are useful to formulate but not test hypotheses,” said , D.O., M.P.H., M.B.A., corresponding author, associate professor and associate chair, Department of Integrated Medical Science, Schmidt College of Medicine.

For the analyses, researchers utilized descriptive data from the Multiple Cause of Death file and the CDC’s “Wide-ranging Online Data for Epidemiologic Research” (WONDER). They used CDC criteria to compare the rates of suicide by firearm for white and black Americans ages 5 to 14 and 15 to 24 years.

“In the meanwhile, we believe that combating the epidemic of mortality due to firearms without addressing firearms is analogous to combating the epidemic of lung cancer due to cigarettes without addressing cigarettes," said , M.D., Dr.PH, co-author and the first Sir Richard Doll Professor and senior academic advisor, Schmidt College of Medicine.

Co-authors include Vishnu Muppala, M.D., the first author who received his M.D. from the Schmidt College of Medicine; Alexandra Rubenstein, a fourth-year pre-medical student at Bowdoin College; and , M.D., professor of family and community medicine, and an affiliate professor in the Schmidt College of Medicine.

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