Gun Violence in the United States 2023: Examining the Gun Suicide Epidemic
In 2023, total gun suicide deaths reached a new all-time high. Overall, firearms remained the leading cause of death for young people 1 to 17 for the past four years, accounting for more deaths than car crashes, overdoses, or cancers. While the burden of gun violence remains high, there are evidence-based solutions to prevent gun violence. These solutions are supported by most people, including gun owners.1
27,300 people died by firearm suicide, the highest number ever recorded.
6/10
Nearly 6 out of every 10 gun deaths were suicides in the United States.
245%
Overall gun suicide rates among Black and Hispanic/Latino young people (ages 10-19) surged from 2014 to 2023—tripling among young Black people (245% increase) and nearly doubling among young Hispanic/Latino people (98% increase).
10x
Wyoming’s overall gun suicide rate was 10x higher than Massachusetts’ overall gun suicide rate.
An Overview of U.S. Gun Deaths in 2023
In 2023, someone was killed by a gun every 11 minutes.The Centers for Disease Control and Prevention (CDC) data shows, 46,728 individuals died from gun violence in the United States, the third-highest annual total ever recorded. Firearms were the most common method in fatal suicides among most age groups. 27,300 people died by firearm suicide—the highest number ever recorded in American history. The overall gun death rate declined 3.4% from 2022 to 2023, resulting in 1,476 fewer deaths. This reflects a decrease in homicides, even as gun suicides reached record levels.
Overall, firearms remained the leading cause of death for young people 1 to 17 for the past four years, accounting for more deaths than car crashes, overdoses, or cancers. In 2023, there were 2,566 gun deaths among young people including 118 from ages 1–4, 116 from ages 5–9, 530 from ages 10–14, and 1,802 from ages 15–17. While firearms are the leading cause of death overall for young people ages 1 to 17, they are among the leading causes, but not always the top cause, for some individual youth age groups.
In 2023, gun injury deaths accounted for 1,108,690 years of potential life lost before the age of 65—more than diabetes, stroke, and liver disease combined.2
Since 2021, the overall gun suicide rate has reached near record highs, while the overall gun death rate including the overall gun homicide rate, has decreased.
Lethality and Availability of Guns
Due to their high lethality and availability, guns fuel our country’s high suicide and homicide rates. Nearly four out of every five homicides and more than half of all suicides are by gun. In 2023, firearms were used in 79% of all homicides and 55% of all suicides.
Gun Violence Across States
Gun violence manifests itself differently across states; but the end result—a preventable death—is the same.
In general, the states with the highest gun death rates tend to be states in the South or Mountain West, with weaker gun laws and higher levels of gun ownership, while gun death rates are lower in the Northeast, where gun violence prevention laws are stronger.
The gun death rate in Mississippi, the state with the highest gun death rate, was eight times higher than the gun death rate in Massachusetts, the state with the lowest rate in 2023. In other words, someone living in Mississippi was eight times as likely to die by gun violence than someone living in Massachusetts.
While two states might have similar overall gun death rates, the type of gun violence driving that rate can differ entirely. Maryland and South Dakota, for instance, have similar gun death rates. Yet, 63% of gun deaths in Maryland were homicides while in South Dakota, only 10% were.
“Other gun death rate” includes legal intervention, unintentional, and undetermined.
The Rise of Gun Suicides
The majority of suicide deaths in the U.S. involve a gun. In 2023, someone died of gun suicide every 19 minutes. Guns are dangerous when someone is at risk of self-harm as they are the most lethal suicide attempt method.3 Although the majority of suicide attempts do not result in death, the use of a gun in an attempt is lethal in 90% of cases.4 In 2023, 27,300 people died by gun suicide—the highest number ever recorded.
"It's a myth that if someone survives a suicide attempt, they'll inevitably try again or simply find another method. That's not what the data shows. The majority of people—about 94% of people who survive a suicide attempt—will continue to survive."
— Paul Nestadt, MD, Psychiatrist, Core Faculty at the Johns Hopkins Center for Gun Violence Solutions, Medical Director of the Johns Hopkins Center for Suicide Prevention
Gun suicide has a greater impact on older adults, but younger people also bear a significant burden. Rising firearm death rates from both suicides and homicides among young people have contributed to the decline in overall U.S. life expectancy.5 When people in crisis, especially younger people, lose their lives to guns, they lose decades of potential: the potential to grow up, have a family, contribute to society, and pursue their passions in life. These losses are felt across families, neighborhoods, and communities for generations. Compared to other causes of death, gun violence and suicide often pose a larger burden on society in terms of years of potential life lost. Years of potential life lost calculations estimate the average time a person would have otherwise been expected to live if they had not died prematurely.
In 2023, gun injury deaths accounted for 1,108,690 years of potential life lost before the age of 65—more than diabetes, stroke, and liver disease combined.6
Elder white males (ages 70+) face the highest rates of gun suicide compared to any other demographic. In 2023, elder white males were nearly five times as likely to die by gun suicide than their Black counterparts of the age group.
In 2014, gun suicides accounted for 32% of all suicides among young Black people (ages 10-19). By 2023, this proportion has increased to more than half (56%).
* The “All other methods combined” category includes: Other specified, classifiable Injury (697 deaths), Drowning (453), Fire/Flame (183), Other land transport (174), Other specified, not elsewhere classified Injury (125), and Unspecified Injury (71).
Companion Piece
Recommendations for Firearm Suicide Prevention
A core framework in public health is the social ecological model. Firearm suicide prevention involves intervention across multiple levels (individual, relationship, community, and society), to address the urgent issue of firearm suicide. Read the companion piece to our report, From Crisis to Action: Public Health Recommendations for Firearm Suicide Prevention, for multi-level recommendations for firearm suicide prevention.
The Burden of Gun Suicide Across Demographic Groups
While gun violence and suicide can affect anyone, certain demographic groups face a disproportionately higher risk of gun suicide. In 2023, males had a significantly higher rate of gun suicide than females. Among racial and ethnic groups, white males had the highest rate of gun suicide accounting for nearly nine out of every 10 deaths. While not as high as for white males, gun suicide rates for other racial and ethnic groups have been on the rise in the last five years.
The gun suicide rate of Black females increased by nearly two-thirds (65%) from 2019 to 2023, the highest relative increase of all female races and ethnicities.
Male Native Hawaiian or Pacific Islanders were nearly 10 times as likely to die by gun suicide than their female counterparts in 2023.
The gun suicide rate among Hispanic/Latino females increased by 25% from 2019 to 2023.
Guns accounted for nearly half (49%) of suicide deaths among American Indian or Alaska Native males ages 25–34 in 2023. The overall gun suicide rate in American Indian or Alaska Native males of the same age group doubled (109%) from 2019 to 2023.
The number of gun suicide deaths for female Native Hawaiian/Other Pacific Islander was “suppressed” as the death count was less than 10.
Gun Suicides By Age
Guns were the most common method used in suicides across most 10-year age groups in 2023, underscoring the impact of guns on most ages when considering suicide.
Guns accounted for the majority of all suicides across the following 10-year age groups: ages 20–29 (56%), ages 50–59 (53%), ages 60–69 (59%), ages 70–79 (73%), ages 80–89 (77%), and ages 90+ (75%).
Elderly people ages 70 and older were at higher risk to die by gun suicide. Seven out of 10 elderly suicides were by gun in 2023.
Gun as Leading Method of Suicide by 10-Year Age Groups, 2023
Age Group
Total Suicide Deaths
Number Of Gun Suicide Deaths
% of Overall Suicide Deaths By Gun
Ages 10-19
2,637
1,252
47%
Ages 20-29
7,833
4,370
56%
Ages 30-39
8,729
4,082
47%
Ages 40-49
7,943
3,831
48%
Ages 50-59
7,919
4,205
53%
Ages 60-69
6,839
4,063
59%
Ages 70-79
4,513
3,278
73%
Ages 80-89
2,402
1,847
77%
Ages 90+
494
371
75%
Ages 1–9 were excluded because the data was “suppressed,” or the death count was less than 10.
Gun Suicides Among Young People
Overall, guns have been the leading cause of death for young people 1–17 for four consecutive years. The overall gun death rate for this age group nearly doubled (+95%) between 2014 to 2023. While the rise was mainly from an increase in gun homicides, gun suicides have also surged among young Black and Hispanic/Latino people (ages 10–19) over the past decade. Because CDC data on firearm suicide among 1–9-year-olds is suppressed, including 18–19-year-olds provides a more complete picture of firearm suicide trends among youth and emerging adults.
Although the number of gun suicide deaths was higher for young white people than young Black people (ages 10–19) in 2023 (740 deaths compared to 207 deaths), the overall gun suicide rate among young Black people tripled (+245%) from 2014 to 2023.
The overall rate of gun suicides for young Hispanic/Latino people (ages 10–19) nearly doubled (+98%) from 2014 to 2023.
Historically, young white people have had higher gun suicide rates than young people of other races and ethnicities. However, this dynamic has started to shift as the overall gun suicide rate among young Black people (ages 10–19) surpassed the rate of their white counterparts for the second consecutive year.
The Geography of Gun Suicides
Gun Suicides by State
Gun suicides vary widely across states as a result of socioeconomic factors, demographics, and gun policies. Guns drove overall suicide rates in the country as they were used in the majority of suicide deaths in states with the highest rates of gun suicide, whereas non-guns were used in most suicide deaths in states with the lowest rates of gun suicide.
In 2023, Wyoming had the highest gun suicide rate, 10 times higher than Massachusetts, which had the lowest gun suicide rate.
Wyoming, Montana, Alaska, and Idaho not only had the highest gun suicide rates but also had the highest overall suicide rates in the country in 2023. Guns drove the overall suicides among these states as six out of every 10 people who died from suicide used a gun.
New Mexico had the highest rate of gun suicide among young people (ages 10–19) in the country in 2023. The state also had a gun suicide rate three times the national average.
Gun Suicides by Urbanization
Gun suicide rates are closely related to urbanization. Generally, the more rural a county is by population density, the higher the gun suicide rate. Research shows rural counties experience higher rates of gun suicide because of limited access to mental health services, high rates of alcohol use, and the highest rates of gun ownership, thus allowing for easier accessibility and exposure to guns.7
Rural counties had a higher percentage of gun suicides out of total suicides compared to metropolitan counties. Nearly two-thirds (63%) of all suicide deaths in rural counties were by gun, while more than one-third (37%) of suicide deaths were by non-gun.
Large metropolitan counties had a lower percentage of gun suicides compared to rural counties as half of all suicide deaths were by gun, and the other half were by non-gun.
The 2013 urban classifications were combined for simplification. Large Central Metro and Large Fringe Metro classifications were combined as “Large Metro.”
The 2013 urban classifications were combined for simplification. Micropolitan and Noncore classifications were combined as “Rural.”
Gun Suicide Among Veterans
Research shows that access to guns increases the risk of death by suicide.8 Veterans disproportionately carry the burden of gun suicide, in part due to their high rates of gun ownership as nearly half of all veterans own at least one gun.9 Additionally, one in three veterans store their guns loaded and unlocked, further elevating the risk of suicide.10
According to the CDC’s National Violence Death Reporting System, 24,995 current and former military personnel died by suicide between 2018 and 2022. More than two-thirds (73%) of the suicides were by gun.11
Policy Recommendations
Guns are the most common suicide method in the U.S. due to their high lethality and easy accessibility. Gun suicides can be prevented through effective, evidence-based gun policy solutions. Below are select policy recommendations that limit access to lethal means from individuals with an elevated risk of self-harm. For more information on a broader range of firearm suicide prevention methods, read the companion piece to our report, From Crisis to Action: Public Health Recommendations for Firearm Suicide Prevention.
Adopt Laws to Promote Safe and Secure Gun Storage Practices
More than half of all U.S. gun owners do not practice safe gun storage.12 In fact, 4.6 million young people in the U.S. live in homes with at least one gun that is loaded and unlocked, exposing young people to guns and increasing the risk of gun violence, including gun suicide, among young people.13 Seventy-nine percent of gun suicides in young people under 18 years old used a gun belonging to a family member.14
Many of these deaths can be prevented through strong safe and secure storage laws, such as Child Access Prevention (CAP) laws, which require that guns stored in households with a young person be kept secured when unattended. Safe storage laws are an effective tool to promote responsible gun storage practices as well as to restrict access to unauthorized or at-risk individuals, thereby preventing suicide.15 These laws are linked with sizable reductions in gun suicide rates.16,17,18 Safe storage laws should apply to both handguns and long guns to ensure these laws are as effective as possible.19,20 Additionally, even in states where safe storage laws might not be in place, gun owners have a responsibility to store their guns safely in their homes and cars to ensure those who should not have access to firearms do not get them.
Prevent Prohibited People from Purchasing a Firearm Through Firearm Purchasing Laws
Most states do not require background checks on private purchases, meaning that people convicted of a felony, with severe mental illness, or who are otherwise prohibited from possessing a gun can purchase one from a private seller. To address this dangerous gap, states should implement firearm purchaser licensing laws (sometimes referred to as permit-to-purchase) that require all prospective gun purchasers to obtain a license prior to buying a gun from a dealer or a private seller.
Firearm Purchaser Licensing (FPL) laws enhance universal background checks by establishing a licensing application process. The additional components of permit-to-purchase laws—fingerprinting, a more thorough vetting process, and a built-in waiting period—all play a vital role in preventing people with a history of violence, including those at risk for suicide, from purchasing a firearm. Studies show that states with FPL laws were associated with reductions in gun suicides.21 Handguns often have more stringent regulations than long guns (i.e., rifles and shotguns). This creates a loophole where long guns may be easier to acquire for those who might be prohibited. Firearm purchaser licensing laws should apply to both handguns and long guns to close this gap.
Remove Guns From Individuals Determined to Be at Elevated Risk for Violence and Suicide
In some cases, people who are not otherwise prohibited from owning a gun may be at clear risk of violence or self-harm, often during a time of crisis. Strong Extreme Risk Protection Order (ERPO) laws include mechanisms to temporarily remove guns from individuals at risk for suicide. Research found that states with ERPO laws were associated with decreases in gun suicides.22 In order to make these laws most effective at reducing harm, states should enact and implement ERPOs that include firearm relinquishment requirements for those who are subject to an ERPO.
Guns don’t make people suicidal; however, because they are so lethal, guns increase the likelihood that someone who is experiencing suicidal ideation will die in the attempt if used. America’s suicide epidemic—fueled by guns—is preventable. We must address this crisis through a comprehensive public health approach pushing for equitable, evidence-based gun violence and suicide solutions.
Age-adjusted rate: The rates of almost all causes of death vary by age. Age adjustment is a technique for“removing”theeffectsofagefromcruderatestoallowmeaningfulcomparisonsacrosspopulationswithdifferentunderlyingagestructures.Age-adjusteddeathratesareweightedaveragesoftheage-specificdeathrates,wheretheweightsrepresentafixedpopulationbyage.An age-adjusted rate represents the rate that would have existed had the age-specific rates oftheparticularyearprevailedinapopulationwhoseagedistributionwasthesameasthatofthefixedpopulation.Age-adjustedratesshouldbeviewedasrelativeindexesratherthanasdirectoractualmeasuresofmortalityrisk.
Burden of injury: Describes the impact of a health problem (injury), including death and loss of health due to injuries, related financial costs, andother indicators.
Cause of death: Based on medical information—including injury diagnoses and external causes of injury—entered on death certificates filed in the U.S.This information is classified and coded per the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD–10).
International Classification of Diseases (ICD):CausesofdeathareclassifiedpertheInternationalClassificationofDisease.Deathsfor1999andbeyondareclassifiedusingthe10thRevision(ICD-10).ICDisdesignedtopromoteinternationalcomparabilityinthecollection,processing,classification,andpresentationofmortalitystatistics.Thisincludesprovidingaformatforreportingcausesofdeathonthedeathcertificate.ThereportedconditionsarethentranslatedintomedicalcodesthroughtheuseoftheclassificationstructureandtheselectionandmodificationrulescontainedintheapplicablerevisionoftheICD,publishedbytheWorldHealthOrganization(WHO).
Underlying Cause of Death database: The database contains mortality data based on information from all death certificates filed in the 50 states and the District of Columbia. Deaths of nonresidents (e.g. nonresident aliens, nationals living abroad, residents of Puerto Rico, Guam, the Virgin Islands, and other territories of the U.S.) and fetal deaths are excluded. Each death certificate identifies a single underlying cause of death and demographic data.
County classification: The CDC categorizes all counties into six levels of urbanization that incorporatepopulation number and density. From largest and most urban to smallest and most rural, they are:
Large central metro counties:Countiespartofametropolitanstatisticalareawith ≥1millionpopulationandcoversaprincipalcity;mosturban,largecities.
Large fringe metro counties: Counties part of a metropolitan statistical area with ≥1 million population but does not cover a principal city; akin to suburbs.
Medium metro counties: Counties part of a metropolitan statistical area of 250,000–999,999 population.
Small metro counties: Counties part of a metropolitan statistical area of less than 250,000 population.
Micropolitan (non-metro) counties: Counties part of a micropolitan statistical area (has an urban cluster of ≥10,000 but <50,000 population).
Non-core (non-metro) counties: Counties not part of a metropolitan or micropolitan statistical area; the most rural counties.
Legal intervention: Injuries inflicted by the police or other law-enforcing agents, including military on duty,in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order,and other legal actions. Excludes injuries caused by civil insurrections. The ICD-10 cause of death code forlegal intervention by firearm is Y35.0 Legal intervention involving firearm discharge.
Suicide: An intentionally self-inflicted injury that results in death. The ICD-10 cause of death codes for firearmsuicide are X72 Intentional self-harm by handgun discharge; X73 Intentional self-harm by rifle, shotgun, andlarger firearm discharge; and X74 Intentional self-harm by other and unspecified firearm and gun discharge.
Unintentional: Unintentional injury that results in death. The ICD-10 cause of death codes for unintentional firearm deaths are W32 Accidental handgun discharge and malfunction; W33 Accidental rifle, shotgun, and larger firearm discharge; and W34 Accidental discharge and malfunction from other and unspecified firearms and guns.
Injury mechanism or method:Thecause,ormechanism,ofinjuryisthewayinwhichthepersonsustainedtheinjury;howthepersonwasinjured;ortheprocessbywhichtheinjuryoccurred.
Suppressed: Rates are marked as suppressed when there are zero to nine deaths.
Unreliable: Rates are marked as “unreliable” when the death count is less than 20.
Years of potential life lost (YPLL):CDCcalculatesprematuremortalityorearlydeathbysubtractingtheageatdeathfromthestandardyearandthensummingtheindividualYPLLacrosseachcauseofdeath.
WISQARS Years of Potential Life Lost (YPLL) Report, 2018 - 2023. (2023). Centers for Disease Control and Prevention. Available: https://wisqars.cdc.gov/lcd/
Conner A, Azrael D, & Miller M. (2019). Suicide Case-fatality Rates in the United States, 2007 to 2014. A Nationwide Population-based Study. Annals of Internal Medicine. https://doi.org/10.7326/M19-1324
Kalesan B, Vyliparambil MA, Zuo Y, Siracuse JJ, Fagan JA, & Branas CC. (2019). Cross-sectional Study of Loss of Life Expectancy at Different Ages Related to Firearm Deaths Among Black and White Americans. The British Medical Journal. https://doi.org/10.1136/bmjebm-2018-111103
WISQARS Years of Potential Life Lost (YPLL) Report, 2018 - 2023. (2023). Centers for Disease Control and Prevention. Available: https://wisqars.cdc.gov/lcd/
Anglemyer A, Horvath T, & Rutherford G. (2014). The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among House-hold Members: A Systematic Review and Meta-analysis. Annals of Internal Medicine. https://doi.org/10.7326/M13-1301
Cleveland EC, Azrael D, Simonetti JA, & Miller M. (2017). Firearm Ownership Among American Veterans: Findings from the 2015 National Firearm Survey. Injury Epidemiology. https://doi.org/10.1186/s40621-017-0130-y
Simonetti JA, Azrael D, Rowhani-Rahbar A, & Miller M. (2018). Firearm Storage Practices Among American Veterans. American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2018.04.014
Barber C, Azrael D, Miller M, & Hemenway D. (2022). Who Owned the Gun in Firearm Suicides of Men, Women, and Youth in Five US States? Preventive Medicine. https://doi.org/10.1016/j.ypmed.2022.107066
Azad HA, Monuteaux MC, Rees CA, Siegel M, Mannix R, Lee LK, Sheehan KM, & Fleegler EW. (2020). Child Access Prevention firearm laws and firearm fatalities among children aged 0 to 14 Years, 1991–2016. JAMA Pediatrics. https://jamanetwork.com/journals/jamapediatrics/fullarti-cle/2761305
Monuteaux MC, Azrael D, Miller, M. (2019). Association of Increased Safe Household Firearm Storage with Firearm Suicide and Unintentional Death Among US Youths. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2019.1078
Athey A, Nestadt PS, Rogers ML, Dunton Z, McCourt A, & Wilcox HC. (2024). A National Evaluation of the Impact of Child Access Prevention Laws on Rates of Youth Suicide and Other Youth Firearm Deaths. Journal of the American Academy of Child & Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2024.11.009
Nestadt PS, MacKrell K, McCourt AD, Fowler DR, & Crifasi CK. (2020). Prevalence of Long Gun Use in Maryland Firearm Suicides. Injury Epide-miology. https://doi.org/10.1186/s40621-019-0230-y
Pan I, Zinko J, Weedn V, & Nestadt PS. (2023). Long Gun Suicides in the State of Maryland Following the Firearm Safety Act of 2013. Suicide and Life-Threatening Behavior. https://doi.org/10.1111/sltb.12919
McCourt AD, Crifasi CK, Stuart EA, Vernick JS, Kagawa RMC, Wintemute GJ, & Webster DW. (2020). Purchaser Licensing Laws, Point-of-sale Background Check Laws, and Firearm Homicide and Suicide in 4 US States, 1985–2017. American Journal of Public Health. https://doi.org/10.2105/AJPH.2020.305822
Kivisto AJ & Phalen PL. (2018). Effects of Risk-based Firearm Seizure Laws in Connecticut and Indiana on Suicide Rates, 1981–2015. Psychiatric Services. https://doi.org/10.1176/appi.ps.201700250
