PHILADELPHIA— Black Americans experienced nonfatal firearm injuries 10 times more frequently than White Americans in 2019 and 2020, according to research from the Perelman School of Medicine at the University of Pennsylvania, published today in Annals of Internal Medicine. Researchers found that Black boys and men aged 15 to 34 experienced the highest rate of firearm injuries caused by assault and unintentional injuries.

Racial disparities from fatal firearm injuries are well established, but data is limited in explaining the racial breakdown of nonfatal injuries. In 2019, the Nationwide Emergency Department Sample began tracking patient race and ethnicity for the first time, allowing researchers to evaluate the demographics of firearm injuries that were either unintentional (from an accidental gun discharge or malfunction), from self-harm (attempted suicide), assault (intentional attack by someone else), or legal intervention (from a law enforcement officer or similar). 

“There are twice as many nonfatal injuries from firearms as fatal ones, so focusing only on deaths misses a huge part of the impact that firearm injury has on health,” said lead author, Elinore Kaufman, MD, MSHP, an assistant professor of Medicine in the Division of Trauma Surgery, and director of the Trauma Violence Recovery Program. “We want to reduce the number of total injuries from firearms – both fatal and nonfatal – and in order to design interventions and measure their efficacy, we need the full picture.” 

Analysis revealed that for 2019 and 2020, there were a total of 252,376 firearm injuries, with 84,908 deaths and 167,468 nonfatal injuries. Of the total injuries, 37 percent were assaults, nearly 38 percent were unintentional, 21 percent were from self-harm, and 1 percent were law enforcement-associated.

While Black individuals make up only 12.6 percent of the U.S. population, they experienced 44.5 percent of total firearm injuries, including deaths, at a rate of 136 injuries for every 100,000 people per year. The group also experienced the highest rate of nonfatal firearm injuries, with 106.7 injuries per 100,000 people per year, 10 times that of white individuals. 

The rate was highest among Black boys and men aged 15 to 34 years, at a rate of 245.1 per 100,000 people per year, which is over 10 times the rate for all White individuals, who experienced firearm injuries at a rate of 23.5 injuries per 100,000 people per year. For this group the cause of injury with the highest rate of nonfatal injury per 100,000 people per year was from accidents (100 injuries) and assault (80.8 injuries). 

The researchers found that Native Americans also experienced firearm injuries at a disproportionate rate. While they account for only 0.7 percent of total firearm injuries, they experienced the highest rate of injury caused by law enforcement, and the second-highest rate of injury from assault. 

Finally, the rate of nonfatal firearm injuries resulting from self-harm was highest among White males (1.5 injuries per 100,000 people per year), which corresponds with the high rates of completed suicide by firearm among white males. 

“Our hope is that this research will encourage federal agencies to collaborate and track more detailed data around firearm injuries,” said study co-author, M. Kit Delgado, MD, MS, an associate professor of Emergency Medicine. “Then they can better learn what programs and policies are most effective in reducing firearm injuries, especially in populations that are disproportionately impacted.”

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, excellence in patient care, and community service. The organization consists of the University of Pennsylvania Health System and Penn’s Raymond and Ruth Perelman School of Medicine, founded in 1765 as the nation’s first medical school.

The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines.

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