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Prev Med. 2019 Jun;123:20-26. doi: 10.1016/j.ypmed.2019.02.026. Epub 2019 Feb 25.

Violent death rates in the US compared to those of the other high-income countries, 2015.

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Health Professions Department, School of Nursing and Health Professions, 2130 Fulton Street, San Francisco, CA 94177, United States of America. Electronic address:
Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States of America. Electronic address:


Violence is a serious public health issue in the U.S. This research compares the US and other high-income countries in terms of violent death. We used data from the World Health Organization for populous, high-income countries. Data from CDC's WISQARS and WONDER systems were used to assess mortality data among US white and non-white populations and in low-, medium-, and high-gun states in 2015. Death rates per 100,000 populations were calculated overall, by age, and by sex. Poisson and negative binomial regression were used to test for significance. The homicide rate in the US was 7.5 times higher than the homicide rate in the other high-income countries combined, which was largely attributable to a firearm homicide rate that was 24.9 times higher. The overall firearm death rate was 11.4 times higher in the US than in other high-income countries. In this dataset, 83.7% of all firearm deaths, 91.6% of women killed by guns, and 96.7% of all children aged 0-4 years killed by guns were from the US. Firearm homicide rates were 36 times higher in high-gun US states and 13.5 times higher in low-gun US states than the firearm homicide rate in other high-income countries combined. The firearm homicide rate among the US white population was 12 times higher than the firearm homicide rate in other high-income countries. The US firearm death rate increased between 2003 and 2015 and decreased in other high-income countries. The US continues to be an outlier among high-income countries with respect to firearm deaths.


Accidents; Cross-national; Firearms; Guns; Homicide; Suicide; Unintentional death; Violence

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