Corinne A. Riddell, PhD; Sam Harper, PhD; Magdalena Cerdá, PhD; Jay S. Kaufman, PhD
Financial Support: Dr. Riddell is a postdoctoral researcher at McGill University and received salary support from the Department of Epidemiology, Biostatistics, and Occupational Health. Dr. Harper is supported by a Chercheur Boursier Junior 2 from the Fonds de la Recherche en Santé du Québec. Dr. Cerdá is a CAMPOS Faculty Scholar, ADVANCE Program at the University of California, Davis, and supported by the National Institutes of Health (grant 1R21 DA041154-01).
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2976.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol: Not available. Statistical code: Available at GitHub (https://github.com/corinne-riddell/InjuryDisparity/tree/master/Code. Data set: Available at GitHub (https://github.com/corinne-riddell/InjuryDisparity/tree/master/Data).
Requests for Single Reprints: Corinne A. Riddell, PhD, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Room 27, Montreal, Quebec H3A 1A2, Canada; e-mail, email@example.com.
Current Author Addresses: Drs. Riddell, Harper, and Kaufman: Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Room 27, Montreal, Quebec H3A 1A2, Canada.
Dr. Cerdá: Violence Prevention Research Program, Department of Emergency Medicine, University of California, Davis, 2315 Stockton Boulevard, Sacramento, CA 95817.
Author Contributions: Conception and design: C.A. Riddell, S. Harper, M. Cerdá, J.S. Kaufman.
Analysis and interpretation of the data: C.A. Riddell, S. Harper, M. Cerdá, J.S. Kaufman.
Drafting of the article: C.A. Riddell.
Critical revision for important intellectual content: C.A. Riddell, S. Harper, M. Cerdá, J.S. Kaufman.
Final approval of the article: C.A. Riddell, S. Harper, M. Cerdá, J.S. Kaufman.
Statistical expertise: C.A. Riddell, S. Harper, J.S. Kaufman.
Obtaining of funding: J.S. Kaufman.
Administrative, technical, or logistic support: J.S. Kaufman.
Collection and assembly of data: C.A. Riddell.
The extent to which differences in homicide and suicide rates in black versus white men vary by U.S. state is unknown.
To compare the rates of firearm and nonfirearm homicide and suicide in black and white non-Hispanic men by U.S. state and to examine whether these deaths are associated with state prevalence of gun ownership.
50 states and the District of Columbia, 2008 to 2016. Cause-of-death data were abstracted by using the Centers for Disease Control and Prevention's WONDER (Wide-ranging Online Data for Epidemiologic Research) database.
Non-Hispanic black and non-Hispanic white males, all ages.
Absolute rates of and rate differences in firearm and nonfirearm homicide and suicide in black and white men.
During the 9-year study period, 84 113 homicides and 251 772 suicides occurred. Black–white differences in rates of firearm homicide and suicide varied widely across states. Relative to white men, black men had between 9 and 57 additional firearm homicides per 100 000 per year, with black men in Missouri, Michigan, Illinois, Indiana, and Pennsylvania having more than 40 additional firearm homicides per 100 000 per year. White men had between 2 fewer and 16 more firearm suicides per 100 000 per year, with the largest inequalities observed in southern and western states and the smallest in the District of Columbia and densely populated northeastern states.
Some homicides and suicides may have been misclassified as deaths due to unintentional injury. Survey data on state household gun ownership were collected in 2004 and may have shifted during the past decade.
The large state-to-state variation in firearm homicide and suicide rates, as well as the racial inequalities in these numbers, highlights states where policies may be most beneficial in reducing homicide and suicide deaths and the racial disparities in their rates.
McGill University and the National Institutes of Health.
Riddell CA, Harper S, Cerdá M, Kaufman JS. Comparison of Rates of Firearm and Nonfirearm Homicide and Suicide in Black and White Non-Hispanic Men, by U.S. State. Ann Intern Med. 2018;168:712–720. doi: 10.7326/M17-2976
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Published: Ann Intern Med. 2018;168(10):712-720.
Published at www.annals.org on 24 April 2018
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