The Scope of the Problem: Gun Violence in the USA


Purpose of Review

To update current understanding of the extent and impact of firearm violence in the USA.

Recent Findings

In the past decade, rates of firearm injury have increased in the USA, both absolutely and in comparison to other high-income countries. Firearm homicides, firearm suicides, and public mass shootings have all been increasing. Firearm homicide rates remain highest for young non-White males in urban areas, and firearm suicide rates remain highest for older White males in rural areas. The burden of all these shootings falls not only directly on the victims themselves but also can impact their families, friends, and communities. These more indirect costs include medical care, grief, fear, hopelessness, and PTSD. The negative effects of exposure to firearm violence have been highlighted in the literature. Individual and community efforts to prepare for and prevent the shootings entail additional costs and burdens.


The scope of the US gun problem in 2019 is far greater than is indicated merely by medical costs and body counts.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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  3. 3.

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    •• Doucette ML, Bulzacchelli MT, Frattaroli S, Crifasi CK. Workplace homicides committed by firearm: recent trends and narrative text analysis. Inj Epidemiol. 2019;6:5. paper presents the first national-level epidemiologic investigation of firearm workplace homicides. Its focus on specifically how shooters obtained their guns in the course of shootings allows the inference that limiting access to guns in the workplace can help to prevent such homicides.

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    •• Francis M. A narrative inquiry into the experience of being a victim of gun violence. J Trauma Nurs. 2018;25(6):381–8. a “narrative inquiry” technique of gathering personal stories of victims of gun assault, this study offers insight from victims’ perspectives into the relentless cyclical nature of gun violence in an urban setting. It provides a deeper understanding of the persistent fearfulness and hopelessness that gun violence can bring to both individuals and communities.

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    •• Klarevas L. Rampage nation: securing America from mass shootings. Amherst: Prometheus; 2016. The author analyzes the nature and characteristics of public mass shootings, including human targets, sites, shooters, and weapons used. Policy proposals include bans of high-capacity magazines and buy-back programs.

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Correspondence to David Hemenway.

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Dr. Hemenway and Dr. Nelson have nothing to disclose.

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Hemenway, D., Nelson, E. The Scope of the Problem: Gun Violence in the USA. Curr Trauma Rep (2020).

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  • Firearm suicide
  • Firearm homicide
  • Firearm costs
  • Exposure to firearm violence
  • Medical costs
  • Weapons effect