Southeastern states have highest unintentional gun death rates, study finds

There's more than a 10-fold difference in the rates of unintentional gun deaths across US states, with such incidents claiming more than 12,000 lives between 2001 and 2021, finds research published online in the journal Injury Prevention.

Poverty, rural residency, non-white ethnicity and firearms ownership are all associated with higher rates, the findings show.

Firearms kill over 130 Americans every day. Most of these deaths are intentional, but of the 48,830 firearm related deaths in 2021, 549 were unintentional, note the researchers. But it's not clear whether rates differ within and between states.

To explore this further, the researchers looked at data on unintentional firearms deaths recorded in the Centers for Disease Control WISQARS database for the period between 2001 and 2021—a time period chosen to gather meaningful estimates from less populated states.

And they drew on national data sources for rurality, non-white ethnicity, poverty, gun ownership, and population by state to assess which of these factors might be associated with a heightened risk of an unintentional gun death.

Analysis of all the data showed that there's more than a 10-fold difference in the rates of unintentional gun deaths across US states, with such incidents claiming more than 12,000 lives between 2001 and 2021.

The highest rates clustered in the southeastern states, followed by states in the Northern Plains and Mountain West. The highest unadjusted rates were in Mississippi (0.68/100,000 of the population), Louisiana (0.64), and Alabama (0.60).

The lowest rates were in the Northeast, followed by scattered states in the West and Midwest, such as Washington, Utah, and Michigan. The lowest unadjusted rates were in Massachusetts (0.03/100,000 of the population), New York (0.06), Maryland (0.06) and Connecticut (0.06).

Rhode Island (0.05) also had a low rate, although the estimate was unstable due to the low number of deaths in the state.

Factors significantly associated with a heightened risk of an unintentional firearms death were the percentage of families living below the poverty line in each state, the percentage of the population living in rural areas, and the percentage of gun owners.

Further in-depth analysis revealed strong predictors of an unintentional firearm death: the percentage of people identifying as non-white; the percentage of families living below the poverty line; and the estimated firearms ownership in each state.

The researchers note various limitations to their findings, including that no precise measurement of firearm ownership exists, and that other factors omitted from their analysis might be strongly associated with a heightened risk of unintentional firearms deaths.

"Attempts to alleviate the complex nature of poverty in America are challenging, complex and unlikely to happen quickly. Attempts to reduce firearms ownership are equally unlikely, and arguably inappropriate as firearms represent an integral part of culture and life for many Americans, including especially Americans living in rural areas," write the researchers.

"Prevention of unintentional firearms mortality is essential nationwide, but should be targeted especially to vulnerable populations, including those living in states identified by this research to have crude rates that far exceed national averages and are 10 times higher than crude rates in the least vulnerable states," they state.

"Prevention must be multifaceted," they add, "and should include efforts along at least three pathways: education and training; policy; and engineering of safer firearms and firearms storage."