An overview of gun violence in the U.S. (quick facts from a CMA member)


Gun violence is one of the most pressing health issues in the United States today. As Americans continue to die at an alarming rate from firearm violence, many health experts are concerned that the issue is not being addressed properly by state governments.

In 2016, according to the CDC (Center for Disease Control), there were 37,863 total violence related firearm deaths in the United States. Of these, 14,925 were homicide related and 22,938 were suicide related. The United States ranks first in the world for gun-ownership, with the number of privately owned firearms around 300 million. According to the Global Mortality from Firearms study in JAMA 2018, the United States ranked 2nd in the world for total firearm deaths with most other countries having less financial resources and governmental stability than the U.S.

We have the most guns and a very high firearm fatality rate compared to countries with similar resources as us. Obviously more guns is not the solution.

Furthermore, 1 out of 5 guns are sold without a background check, due to loop holes in the Brady Bill for online sales and gun shows.  And 90% of crime guns are traced back to 5% of gun dealers.  The Firearm legislation, gun violence, and mortality in children and young adults study by Tseng J et al in 2018 showed that suicides and accidental gun injuries were more common in states with lenient gun laws.  Whites had higher rates of suicides and accidental injuries, while blacks and Hispanics had higher rates of assault-type injuries. The Mass Casualty Shooting study by Brown JD et al in American Journal Public Health 2018 showed the median perpetrator age in school shootings was 21 and victims of perpetrators aged 18 to 20 years made up 31.1% of victims of school shootings.

I think most people would agree that Universal background checks are a good idea.

Lastly, the Lethality of Civilian Active Shooter study in JAMA 2018 showed more people were wounded and killed in incidents where semiautomatic rifles were used compared to other firearms.  Semiautomatic rifles are designed for easy use, can accept large magazines, and fire high velocity bullets, enabling active shooters to wound and kill more people per incident. 


In the U.S., research in firearm violence has been impeded by the Dickey Amendment. This amendment has largely prevented the CDC from funding gun research since 1996, robbing two decades worth of researchers the ability to study gun violence.  In general, guns kill American’s via a few mechanisms: 

  1. Criminals get guns through straw purchases (someone who can pass a background check buys a gun for someone who can’t pass background check)

  2. Private sales where there is no background check

  3. Stolen guns 

These account for about 1/3 of total annual firearm deaths and affect urban minorities and are usually violent crimes.  About 2/3 of total annual firearm deaths affect whites in rural or non-urban areas and are usually suicides or unintentional deaths via the 300 million guns already available in society.

In order to make our country safer, we need to address the different demographics via different mechanisms. The answer to gun violence should be incremental evidence-based improvements that focus on changing social norms and collecting data. But ignoring the issue while 37,000 of our fellow Americans die every year is simply not good enough.


Mehran Mostafavifar MD, MBA


Naghavi, Mohsen, MD, PHD.  The Global Burden of Disease 2016.  JAMA.  2018;320(8): 792-814.

Tseng J, Nuno M, Lewis AV.  Firearm legislation, gun violence, and mortality in children and young adults: A retrospective cohort study of 27,566 children in the USA.  Int J Surg.  2018 Sep; 57:30-34.

Brown, JD, Goodin, AJ.  Mass Casualty Shooting Venues, Types of Firearms, and Age of Perpetrators in the United States, 1982-2018.  Am J Public Health.  2018 Oct, 108(10): 1385-1387.

De Jaqer E, Goralnick E.  Lethality of Civilian Active Shooter Incidents with and without Semiautomatic Rifles in the United States.  JAMA.  2018 Sep 11; 320(10): 1034-1035.