AMERIKA
Firearm-related hospitalizations had dropped before the pandemic, then shot up, study finds
Rise was fastest for Black patients, children, and people covered by Medicaid
Michigan Medicine - University of Michigan
Firearm injuries that sent victims to the hospital had gone down steadily over the five years before the COVID-19 pandemic began, but reversed course sharply over the next two years, a new University of Michigan study finds.
In all, 34% more people were hospitalized for a firearm-related injury in 2020 and 2021 than would have been predicted based on pre-pandemic trends.
The gap between expected and actual hospitalizations was even bigger for patients under the age of 18, those covered by Medicaid insurance for people with low incomes or disabilities, and those who are Black. The study is published in JAMA Network Open.
These groups had firearm hospitalization rates 44%, 46% and 41% higher, respectively, than they would have if pre-pandemic trends had continued.
And while the researchers cannot directly link the rise in firearm hospitalizations to the increase in firearm sales during the first two years of the pandemic, they show a significant association between trends in such sales and trends in firearm-related hospital stays – all the way from the end of 2015 to the end of 2021.
“Taken together, our findings raise new concerns about the sustained increase in firearm-related injury, and in particular the disproportionate increase in younger, low-income and Black individuals,” said Raymond Jean, M.D., M.H.S., the lead author of the new study and a trauma surgeon at Michigan Medicine, U-M’s academic medical center.
Jean and colleagues used the most recent national hospitalization data available from the federal Healthcare Cost and Utilization Project to create a computer model of the 2015-2019 trends that allowed them to predict expected firearm hospitalizations for 2020 and 2021.
They then compared those forecasts to what actually happened, revealing the 34% overall increase and the larger increases in some groups. Two major groups had increases smaller than the average: those over age 55 and those insured by Medicare. But even these groups had increases in firearm hospitalization.
While there are peaks and valleys in firearm hospitalizations and firearm sales every year, both the peaks and valleys for both measures dropped steadily from 2015 to 2019. But by the summer of 2020, firearm hospitalizations had shot up to higher than the highest peak of the previous five years. This lagged the rapid rise in firearm sales during the first months of 2020.
Jean notes that the data source the researchers used does not include data on people who died from a firearm injury before reaching a hospital, or were treated at an emergency department without being admitted to the hospital for at least one night. It also doesn’t include those who didn’t seek care.
The researchers also can’t tell the exact location where each person was hospitalized, or who fired the firearm that caused the injury. So, they can’t look at the impacts of state-level firearm law changes, COVID-related policies or violence related to social unrest.
Even so, Jean hopes the findings could help spur further research using other data sources, and inform policy efforts to reduce firearm-related injuries and deaths, including suicides, interpersonal violence and accidents.
“I have seen firsthand what bullets can do to the human body, and worked to save the lives of those who have survived long enough to reach the operating room,” said Jean, who is an assistant professor in the U-M Medical School’s Department of Surgery, in the division of Acute Care Surgery. “That drives my interest in understanding the scope of this issue, and trends over time, through advanced data tools.”
In addition to Jean, the study’s authors are fellow U-M Surgery faculty members Andrew Ibrahim, M.D., M.Sc., Mark Hemmila, M.D., and Staci Aubry, M.D.; statistician Aayushi Sinha, M.S., U-M medical student Sarah Diaz, B.S.N., and Katerina Jou, M.D., a surgical resident at North Shore University Hospital.
Ibrahim is an editor at JAMA Network Open but was not involved in decisions about the paper’s review or acceptance.
The study was funded by the Association for Academic Surgery Foundation.
Reference: Firearm-Related Injury Hospital Admissions During the COVID-19 Pandemic, JAMA Network Open, doi:10.1001/jamanetworkopen.2024.56234
Journal
JAMA Network Open
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Firearm-Related Injury Hospital Admissions During the COVID-19 Pandemic
Article Publication Date
27-Jan-2025
COI Statement
Senior author Andrew Ibrahim, M.D., M.Sc. is an editor at JAMA Network Open but was not involved in decisions about the paper’s review or acceptance.
Firearm-related injury hospital admissions during the COVID-19 pandemic
JAMA Network Open
About The Study:
This cohort study evaluating hospitalizations for firearm-related injuries during the COVID-19 pandemic has 2 principal findings. From 2020 to 2021, there was a 34% increase in firearm-related hospitalizations, consistent with an additional 13,268 admissions. Second, the increase in firearm-related hospitalization disproportionately affected children, patients enrolled in Medicaid, and Black individuals. Taken together, these findings raise new concerns about the sustained increase in firearm-related injury that disproportionately affected younger and minoritized Americans.
Corresponding Author: To contact the corresponding author, Raymond A. Jean, MD, MHS, email rayjean@med.umich.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2024.56234)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
Journal
JAMA Network Open
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