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Global Mortality From Firearms, 1990-2016 Publisher Pubmed



Nand D115, 116 ; Naghavi M1 ; Marczak LB1 ; Kutz M1 ; Shackelford KA1 ; Arora M1 ; Millerpetrie M1 ; Aichour MTE2 ; Akseer N3 ; Alraddadi RM4 ; Alam K5 ; Alghnam SA6 ; Antonio CAT7 ; Aremu O8 Show All Authors
Authors
  1. Nand D115, 116
  2. Naghavi M1
  3. Marczak LB1
  4. Kutz M1
  5. Shackelford KA1
  6. Arora M1
  7. Millerpetrie M1
  8. Aichour MTE2
  9. Akseer N3
  10. Alraddadi RM4
  11. Alam K5
  12. Alghnam SA6
  13. Antonio CAT7
  14. Aremu O8
  15. Arora A9, 10
  16. Asadilari M11, 12
  17. Assadi R13
  18. Atey TM14
  19. Avilaburgos L15
  20. Awasthi A16, 17
  21. Quintanilla BPA18, 19
  22. Barkercollo SL20
  23. Barnighausen TW21, 22
  24. Bazarganhejazi S23, 24
  25. Behzadifar M25
  26. Behzadifar M25
  27. Bennett JR1
  28. Bhalla A27
  29. Bhutta ZA3, 28
  30. Bilal AI29
  31. Borges G30
  32. Borschmann R31, 32
  33. Brazinova A33
  34. Rincon JCC34, 35
  35. Carvalho F36
  36. Castanedaorjuela CA37, 38
  37. Dandona L1, 17
  38. Dandona R1, 17
  39. Dargan PI39, 40
  40. De Leo D41
  41. Dharmaratne SD1, 42
  42. Ding EL43
  43. Do HP44
  44. Doku DT45, 46
  45. Doyle KE47
  46. Driscoll TR48
  47. Edessa D49
  48. Elkhatib Z50
  49. Endries AY51
  50. Esteghamati A52
  51. Faro A53
  52. Farzadfar F54
  53. Feigin VL1, 55
  54. Fischer F56
  55. Foreman KJ1
  56. Franklin RC57
  57. Fullman N1
  58. Futran ND58
  59. Gebrehiwot TT59
  60. Gutierrez RA60
  61. Hafezinejad N61, 62
  62. Bidgoli HH63
  63. Hailu GB64
  64. Haro JM65, 66
  65. Hassen HY67, 68
  66. Hawley C1
  67. Hendrie D69
  68. Hijar M70, 71
  69. Hu G72
  70. Ilesanmi OS73
  71. Jakovljevic M74
  72. James SL1
  73. Jayaraman S75
  74. Jonas JB76, 77
  75. Kahsay A78
  76. Kasaeian A79, 80
  77. Keiyoro PN81
  78. Khader Y82
  79. Khalil IA1
  80. Khang YH83, 84
  81. Khubchandani J85
  82. Kiadaliri AA86
  83. Kieling C87, 88
  84. Kim YJ89
  85. Kosen S90
  86. Krohn KJ1
  87. Kumar GA17
  88. Lami FH91
  89. Lansingh VC92, 93
  90. Larson HJ1, 94
  91. Linn S95
  92. Lunevicius R96, 97
  93. Abd El Razek HM98
  94. Abd El Razek MM99
  95. Malekzadeh R100, 101
  96. Malta DC102
  97. Masonjones AJ103
  98. Matzopoulos R104, 105
  99. Memiah PTN106
  100. Mendoza W107
  101. Meretoja TJ108, 109
  102. Mezgebe HB110
  103. Miller TR69, 111
  104. Mohammed S21, 112
  105. Moradilakeh M113
  106. Mori R114
  107. Nguyen CT44
  108. Le Nguyen Q44
  109. Ningrum DNA117, 118
  110. Ogbo FA119
  111. Olagunju AT120, 121
  112. Patton GC122, 123
  113. Phillips MR124
  114. Polinder S125
  115. Pourmalek F126
  116. Qorbani M127
  117. Rahimimovaghar A128
  118. Rahimimovaghar V129
  119. Rahman M130
  120. Rai RK131, 132
  121. Ranabhat CL133
  122. Rawaf DL134, 135
  123. Rawaf S136, 137
  124. Rowhanirahbar A138
  125. Safdarian M139
  126. Safiri S140
  127. Sagar R141
  128. Salama JS1
  129. Sanabria J142, 143
  130. Milicevic MMS144
  131. Sarmientosuarez R145
  132. Sartorius B146
  133. Satpathy M147
  134. Schwebel DC148
  135. Seedat S149
  136. Sepanlou SG100, 101
  137. Shaikh MA150
  138. Sharew NT151
  139. Shiue I152
  140. Singh JA153, 154
  141. Sisay M49
  142. Skirbekk V155
  143. Filho AMS156
  144. Stein DJ157, 158
  145. Stokes MA159
  146. Sufiyan MB160
  147. Swaroop M161
  148. Sykes BL162
  149. Tabaresseisdedos R163
  150. Tadese F164
  151. Tran BX165
  152. Tran TT44
  153. Ukwaja KN166
  154. Vasankari TJ167
  155. Vlassov V168
  156. Werdecker A169
  157. Ye P170
  158. Yip P171
  159. Yonemoto N172
  160. Younis MZ173, 174
  161. Zaidi Z175, 176
  162. El Sayed Zaki M177
  163. Hay SI1
  164. Lim SS1
  165. Lopez AD1, 178
  166. Mokdad AH1
  167. Vos T1
  168. Murray CJL1
Show Affiliations
Authors Affiliations
  1. 1. Global Health Department, Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave., Seattle, 98121, WA, United States
  2. 2. Higher National School of Veterinary Medicine, Algiers, Algeria
  3. 3. Centre for Global Child Health, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
  4. 4. Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
  5. 5. School of Population and Global Health, University of Western Australia, Perth, WA, Australia
  6. 6. Department of Population Health, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
  7. 7. Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
  8. 8. Department of Public and Community Health, Birmingham City University, Birmingham, United Kingdom
  9. 9. School of Science and Health, Western Sydney University, Penrith, NSW, Australia
  10. 10. Oral Health Services, Sydney Local Health District, Sydney, Australia
  11. 11. Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
  12. 12. International Relations Department, Iranian Ministry of Health and Medical Education, Tehran, Iran
  13. 13. Education Development Center, Mashhad University of Medical Sciences, Mashhad, Iran
  14. 14. Department of Pharmacy, Mekelle University, Mekelle, Ethiopia
  15. 15. Center of Health System Research, National Institute of Public Health, Cuernavaca, Mexico
  16. 16. Indian Institute of Public Health, Gandhinagar, India
  17. 17. Public Health Foundation of India, Gurugram, India
  18. 18. Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
  19. 19. General Office for Research and Technological Transfer, Peruvian National Institute of Health, Lima, Peru
  20. 20. School of Psychology, University of Auckland, Auckland, New Zealand
  21. 21. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  22. 22. Department of Global Health and Population, Harvard University, Boston, MA, United States
  23. 23. Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
  24. 24. Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, United States
  25. 25. Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorranmabad, Iran
  26. 26. Faculty of Health and Nutrition, Lorestan University of Medical Sciences, Khorranmabad, Iran
  27. 27. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  28. 28. Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  29. 29. School of Pharmacy, Addis Ababa University, Addis Ababa, Ethiopia
  30. 30. Department of Epidemiology, National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico
  31. 31. Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
  32. 32. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
  33. 33. Institute of Epidemiology, Comenius University, Bratislava, Slovakia
  34. 34. National Institute of Health, Cuernavaca, Mexico
  35. 35. Escuela de Medicina, Universidad Valle de Cuernavaca, Cuernavaca, Mexico
  36. 36. Ucibio, Requimte, Faculty of Pharmacy, University of Porto, Porto, Portugal
  37. 37. Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia
  38. 38. Epidemiology and Public Health Evaluation Group, Universidad Nacional de Colombia, Bogota, Colombia
  39. 39. Department of Clinical Toxicology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
  40. 40. Department of Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
  41. 41. Australian Institute for Suicide Research and Prevention, Griffith University, Mt Gravatt, QLD, Australia
  42. 42. Department of Community Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  43. 43. Harvard School of Public Health, Department of Nutrition, Harvard University, Boston, MA, United States
  44. 44. Institute for Global Health Innovations, Duy Tan University, Hanoi, Viet Nam
  45. 45. Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
  46. 46. Faculty of Social Sciences, University of Tampere, Tampere, Finland
  47. 47. School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University (RMIT), Bundoora, VIC, Australia
  48. 48. Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
  49. 49. School of Pharmacy, Haramaya University, Harar, Ethiopia
  50. 50. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  51. 51. Department of Public Health, Saint Paul's Hospital Millennium, Medical College, Addis Ababa, Ethiopia
  52. 52. Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
  53. 53. Department of Psychology, Federal University of Sergipe, Sao Cristovao, Brazil
  54. 54. Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
  55. 55. National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
  56. 56. Department of Public Health Medicine, Bielefeld University, Bielefeld, Germany
  57. 57. College of Public Health Medical and Veterinary Science, James Cook University, Douglas, QLD, Australia
  58. 58. School of Medicine, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, United States
  59. 59. Department of Epidemiology and Biostatistics, Jimma University, Jimma, Ethiopia
  60. 60. Epidemiological and Psychosocial Investigations, National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico
  61. 61. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  62. 62. Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
  63. 63. Institute for Global Health, University College London, London, United Kingdom
  64. 64. Biomedical Science Division, School of Medicine, Mekelle University, Mekelle, Ethiopia
  65. 65. Research Unit, Parc Sanitari Sant Joan de Deu (CIBERSAM), Sant Boi de Llobregat, Spain
  66. 66. Department of Medicine, Universitat de Barcelona, Barcelona, Spain
  67. 67. Department of Public Health, Mizan-Tepi University, Mizan Teferi, Ethiopia
  68. 68. Unit of Epidemiology and Social Medicine, University Hospital Antwerp, Wilrijk, Belgium
  69. 69. School of Public Health, Curtin University, Bentley, Perth, WA, Australia
  70. 70. Research Coordination, Fundacion Entornos AC, Cuernavaca, Mexico
  71. 71. CISS, National Institute of Public Health, Cuernavaca, Mexico
  72. 72. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
  73. 73. Department of Public Health and Community Medicine, University of Liberia, Monrovia, Liberia
  74. 74. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  75. 75. Department of Surgery, Virginia Commonwealth University, Richmond, United States
  76. 76. Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
  77. 77. Capital Medical University, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing, China
  78. 78. Department of Nutrition and Dietetics, Mekelle University, Mekelle, Ethiopia
  79. 79. Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
  80. 80. Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
  81. 81. School of Continuing and Distance Education, University of Nairobi, Nairobi, Kenya
  82. 82. Public Health and Community Medicine, Jordan University of Science and Technology, Alramtha, Jordan
  83. 83. Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, South Korea
  84. 84. Institute of Health Policy and Management, SNU Medical Research Center, Seoul National University, Seoul, South Korea
  85. 85. Department of Nutrition and Health Science, Ball State University, Muncie, IN, United States
  86. 86. Clinical Epidemiology Unit, Lund University, Lund, Sweden
  87. 87. Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
  88. 88. Child and Adolescent Psychiatry Division, Hospital of Clinics of Porto Alegre, Porto Alegre, Brazil
  89. 89. School of Medicine, Xiamen University Malaysia, Sepang, Malaysia
  90. 90. Independent Consultant, Jakarta, Indonesia
  91. 91. Department of Community and Family Medicine, Academy of Medical Science, Baghdad, Iraq
  92. 92. Helpmesee, New York, NY, United States
  93. 93. Department of International Relations, Mexican Institute of Ophthalmology, Queretaro, Mexico
  94. 94. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  95. 95. School of Public Health, University of Haifa, Haifa, Israel
  96. 96. General Surgery Department, Aintree University Hospital, National Health Service Foundation Trust (NHS), Liverpool, United Kingdom
  97. 97. School of Medicine, University of Liverpool, Liverpool, United Kingdom
  98. 98. Department of Cardiology, Damietta University, Damietta, Egypt
  99. 99. Ophthalmology Department, Aswan Faculty of Medicine, Aswan, Egypt
  100. 100. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  101. 101. Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  102. 102. Departamento Materno Infantil e Saude Publica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  103. 103. Department of Health Sciences, University of York, York, United Kingdom
  104. 104. Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
  105. 105. School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  106. 106. Department of Public Health, University of West Florida, Pensacola, United States
  107. 107. Peru Country Office, United Nations Population Fund (UNFPA), Lima, Peru
  108. 108. Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital, Helsinki, Finland
  109. 109. Department of Surgery, University of Helsinki, Helsinki, Finland
  110. 110. School of Pharmacy, Academy of Medical Science, Baghdad, Iraq
  111. 111. Pacific Institute for Research and Evaluation, Calverton, MD, United States
  112. 112. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  113. 113. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
  114. 114. Department of Health Policy, National Center for Child Health and Development, Setagaya, Japan
  115. 115. Health Information Unit, Ministry of Health, Suva, Fiji
  116. 116. Accamargo Cancer Center, Sao Paulo, Brazil
  117. 117. Public Health Department, Semarang State University, Kota Semarang, Indonesia
  118. 118. Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan
  119. 119. Western Sydney University, Penrith, NSW, Australia
  120. 120. School of Medicine, University of Adelaide, Adelaide, SA, Australia
  121. 121. Department of Psychiatry, University of Lagos, Lagos, Nigeria
  122. 122. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
  123. 123. Department of Paediatrics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
  124. 124. Shanghai Mental Health Center, Shanghai Jiao Tong University, Shanghai, China
  125. 125. Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
  126. 126. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
  127. 127. Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  128. 128. Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
  129. 129. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  130. 130. Research and Evaluation Division, BRAC (Bangladesh Rehabilitation Assistance Committee), Dhaka, Bangladesh
  131. 131. Society for Health and Demographic Surveillance, Suri, India
  132. 132. Department of Economics, University of Gottingen, Gottingen, Germany
  133. 133. Institute for Poverty Alleviation and International Development, Yonsei University, South Korea
  134. 134. WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, United Kingdom
  135. 135. University College London Hospitals, London, United Kingdom
  136. 136. Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
  137. 137. Public Health England, London, United Kingdom
  138. 138. Department of Epidemiology, University of Washington, Seattle, United States
  139. 139. Sina Trauma and Surgery Center, Iran University of Medical Sciences, Tehran, Iran
  140. 140. Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
  141. 141. Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
  142. 142. Department of Surgery, Marshall University, Huntington, WV, United States
  143. 143. Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, OH, United States
  144. 144. Faculty of Medicine, Institute of Social Medicine, Centre School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
  145. 145. Department of Health and Society, Faculty of Medicine, Universidad Ciencias Aplicadas y Ambientales, Bogota, Colombia
  146. 146. Department of Public Health Medicine, University of Kwazulu-Natal, Durban, South Africa
  147. 147. UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
  148. 148. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
  149. 149. Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
  150. 150. Karachi, Pakistan
  151. 151. College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
  152. 152. Instituts Fur Medizinische Epidemiologie, Biometrie und Informatik, Martin Luther University Halle-Wittenberg, Haale, Germany
  153. 153. School of Medicine, University of Alabama at Birmingham, United States
  154. 154. Department of Epidemiology, University of Alabama at Birmingham, United States
  155. 155. Norwegian Institute of Public Health, Oslo, Norway
  156. 156. Department of Diseases and Noncommunicable Diseases and Health Promotion, Federal Ministry of Health, Brasilia, Brazil
  157. 157. South African Medical Research Council, Cape Town, South Africa
  158. 158. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
  159. 159. School of Psychology, Deakin University, Burwood, VIC, Australia
  160. 160. Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
  161. 161. Department of Surgery, Northwestern University, Chicago, IL, United States
  162. 162. Department of Criminology, Law, and Society, University of California Irvine, United States
  163. 163. Department of Medicine, University of Valencia, Valencia, Spain
  164. 164. Department of Public Health, Wollo University, Dessie, Ethiopia
  165. 165. Department of Health Economics, Hanoi Medical University, Hanoi, Viet Nam
  166. 166. Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Nigeria
  167. 167. UKK Institute for Health Promotion Research, Tampere, Finland
  168. 168. Department of Health Care Management and Economics, National Research University, Higher School of Economics, Moscow, Russian Federation
  169. 169. Demographic Change and Ageing, Federal Institute for Population Research, Wiesbaden, Germany
  170. 170. Division of Injury Prevention and Mental Health Improvement, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Xicheng District, China
  171. 171. Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong SAR, Hong Kong
  172. 172. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  173. 173. Healthcare Management-Health Economics and Finance/Global Health, Jackson State University, Jackson, MO, United States
  174. 174. Research Center for Public Health, Tsinghua University, Beijing, China
  175. 175. Department of Epidemiology, University Hospital of Setif, Setif, Algeria
  176. 176. Faculty of Medical Sciences, A.C.S. Medical College and Hospital, Algiers, Algeria
  177. 177. Faculty of Medicine, Mansoura University, Mansoura, Egypt
  178. 178. School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia

Source: JAMA - Journal of the American Medical Association Published:2018


Abstract

IMPORTANCE Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. EXPOSURES Firearm ownership and access. MAIN OUTCOMES AND MEASURES Cause-specific deaths by age, sex, location, and year. RESULTS Worldwide, it was estimated that 251 000 (95%uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5%(95%UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95%UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95%UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95%UI, 107 000-182 000]); additionally, 27%were firearm suicide deaths (67 500 [95%UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95%UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2%[95%UI, -0.8%to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6%(95%UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95%UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95%UI, 24 900-39 700] and for women, an estimated 3580 deaths [95%UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P <.001; R2 = 0.21) and homicide (P <.001; R2 = 0.35). CONCLUSIONS AND RELEVANCE This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups. © 2018 American Medical Association. All rights reserved.
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