Trends in Mortality From Poisonings, Firearms, and All Other Injuries by Intent in the US, 1999-2020

Area of Science:

• Public Health
• Epidemiology
• Injury Prevention

Background:

• Deaths from external causes are a major mortality concern in the US.
• Understanding temporal trends in mortality by intent and demographics is crucial.

Purpose of the Study:

• To analyze national trends in mortality rates from external causes (1999-2020) by intent and demographics.
• To compare US death rates in 2019 and 2020, considering the COVID-19 pandemic's impact.

Main Methods:

• Serial cross-sectional study utilizing national death certificate data (1999-2020).
• Included over 3.8 million deaths from external causes in individuals aged 20+.
• Analyzed trends by intent (suicide, homicide, unintentional, undetermined) and demographics (age, sex, race/ethnicity).

Main Results:

• Poisoning death rates increased annually (7.0%), most rapidly among men and American Indian/Alaska Native individuals.
• Unintentional poisoning rates saw the fastest increase (8.1% annually).
• Firearm death rates increased (1.1% annually), with a notable rise in firearm homicides (6.9% annually from 2014-2020).
• External cause mortality accelerated in 2019-2020 due to unintentional poisonings and firearm homicides.

Conclusions:

• US death rates from poisonings, firearms, and other injuries substantially increased between 1999 and 2020.
• The rise in unintentional poisonings and firearm homicides constitutes a national emergency.
• Urgent, multi-level public health interventions are necessary to address these escalating trends.