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(CNN) --
Gun deaths hit a peak -- a peak -- in the United States during the Covid-19 pandemic, with a record number of fatalities in 2021. But as America's gun epidemic worsens, its effects are not the same for everyone.
A new study published Tuesday in JAMA Network Open looked at firearm deaths over the past three decades: More than a million lives have been lost in total since 1990. The researchers found that firearm death rates increased for most demographic groups in recent years—especially during the pandemic—and that large disparities persist.
Although recent data shows some familiar patterns, the sheer magnitude of the problem brings the United States to a "new moment in the history of firearms deaths," said Dr. Eric Fleegler, a pediatric emergency physician and investigator for the Children's Hospital Boston and Harvard Medical School, and co-author of the study.
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"Right now, we've seen an increase that's really unparalleled," he said.
"During the time of the covid pandemic, which was from 2019 to 2021, we saw an increase of more than 25% in deaths, in just two years. That had never happened before."
In general, men are at significantly higher risk.
According to the study, which used data from the US Centers for Disease Control and Prevention, nearly 86% of all firearm deaths since 1990 have occurred among men.
The researchers found that firearm homicides were higher among black men, and firearm suicide rates were higher among older white men.
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Firearm homicide rates for both men and women nearly doubled between 2014 and 2021, yet men were still more than five times more likely to die than women.
Firearm suicide rates were also seven times higher among men than among women in 2021, even though suicide rates among women were increasing over time.
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Racial disparities are even starker.
The homicide rate among black youth—142 homicide deaths per 100,000 black men ages 20 to 24—was almost 10 times the overall rate of gun deaths in the United States in 2021.
Homicide rates among black and Hispanic men were highest in the 20-24 age group.
But for white men, the rate was highest in the 30-34 age group.
Comparing these groups, the homicide rate was nearly four times higher among young Hispanic men compared to white men, and the homicide rate among young black men was a staggering 22 times higher than among white men.
"When we think of disparities, we often think of a 20% or 50% increase. In the case of infant mortality in the United States, if you compare black babies to white babies, the death rate doubles. It's a huge number," Fleegler said.
"And here we are talking about more than 20 times difference. These are differences of magnitude that are worsening. And they demand attention."
A county-level analysis showed that firearm mortality shifted from the west to the south over time, as firearm homicide rates remained concentrated and rising in the South and rates of suicide by firearms were more evenly spread across the country.
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In addition, urban areas had a higher firearm mortality burden than rural areas.
There are two key factors driving gun violence in the community, says Jonathan Jay, an adjunct professor at the Boston University School of Public Health: disadvantage at the neighborhood level and exposure to gun violence. on an individual level.
"Gun violence is more likely in spaces that show signs of physical disinvestment. Sometimes that looks like vacant, neglected lots or abandoned houses that are boarded up, perhaps a high density of liquor stores and a low density of food options. healthy," he said.
For Jay, who received a grant from the National Institutes of Health to study racial disparities in gun injuries among US youth, it's not surprising that patterns in gun death rates from fire have only made it worse, because the pandemic has only exacerbated existing disparities.
"It makes sense that the worst early impacts would be in neighborhoods that were facing the greatest disadvantage and impacts of segregation before the pandemic," he said.
"Some people have talked about it as a mystery as to why gun violence would remain high even when things changed during the pandemic. I think one possible explanation is that things — social conditions — haven't changed. so much".
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In addition, "the pandemic exposed people to a lot of things that made them feel unsafe and may have made individuals more likely to feel they need to carry a gun to protect themselves," he said.
Mental health problems have increased during the pandemic and violence has increased, but a separate analysis by Johns Hopkins University researchers found that guns made those problems significantly more deadly.
Between 2019 and 2021, all of the increase in suicides and most of the increase in homicides was due to firearms.
The gun suicide rate increased 10%, while the unarmed suicide rate decreased 8%, and the gun homicide rate increased 45%, while the unarmed homicide rate only increased 6%.
"What we've seen is that economic and social stressors during covid have exacerbated health disparities across the spectrum," said Ari Davis, policy adviser at the School of Health's Center for Gun Violence Solutions. Public Bloomberg, from Johns Hopkins.
"The same stressors — social isolation, cutting back on social services and support — are risk factors for violence. I think all of those things have contributed to a widespread increase, but it has been disproportionately unloaded on the most vulnerable."
The research published Tuesday "confirmed much of what we already knew," the University of Michigan researchers wrote in a related editorial: There is a wide gender gap, a gap between urban and rural areas, and racial disparities in rates. firearm mortality in the United States.
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"This burden is not evenly distributed, and recent increases in firearms death rates are most pronounced among demographics and regions already among the hardest hit," they wrote.
However, the analysis also serves to identify high-risk groups that could benefit most from specific interventions.
Dr. Christopher Rees, an emergency department physician at Children's Healthcare Atlanta, an investigator at Emory University School of Medicine, and a co-author of the study, moved from Boston to Atlanta a little over a year ago.
He says he has cared for "many more" children injured by firearms in Atlanta than in Boston, experiencing the same trends he found in his research.
"Every time it happens I think, 'One, this is horrible. Two, this is someone's child.' And immediately I think of my two children at home. a child,'" he said.
"It's very personal every time."
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