Using the Centers for Disease Control and Prevention's National Syndromic Surveillance Program Data to Monitor Trends in US Emergency Department Visits for Firearm Injuries, 2018 to 2019

Abstract

Study objective: We describe trends in emergency department (ED) visits for initial firearm injury encounters in the United States.

Methods: Using data from the Centers for Disease Control and Prevention's National Syndromic Surveillance Program, we analyzed monthly and yearly trends in ED visit rates involving a firearm injury (calculated as the number of firearm injury-related ED visits divided by the total number of ED visits for each month and multiplied by 100,000) by sex-specific age group and US region from 2018 to 2019 and conducted Joinpoint regression to detect trend significance.

Results: Among approximately 215 million ED visits captured in the National Syndromic Surveillance Program from January 2018 to December 2019, 132,767 involved a firearm injury (61.6 per 100,000 ED visits). Among males, rates of firearm injury-related ED visits significantly increased for all age groups between 15 and 64 years during the study period. Among females, rates of firearm injury-related ED visits significantly increased for all age groups between 15 and 54 years during the study period. By region, rates significantly changed in the northeast, southeast, and southwest for males and females during the study period.

Conclusion: These analyses highlight a novel data source for monitoring trends in ED visits for firearm injuries. With increased and effective use of state and local syndromic surveillance data, in addition to improvements to firearm injury syndrome definitions by intent, public health professionals could better detect unusual patterns of firearm injuries across the United States for improved prevention and tailored response efforts.

Figure 1.

Monthly rate of ED visits per 100,000 ED visits related to a firearm injury by sex and age group—NSSP, United States, between January 1, 2018, and December 31, 2019. The monthly rate is calculated as ED visits involving a firearm injury divided by the total ED visits, multiplied by 100,000. Joinpoint reports average annual percent change, but the unit of time for this analysis is 1 month; thus, this has been modified to average monthly percent change or AMPC. Data are current as of October 23, 2020, representing data from participating EDs in the NSSP, where the coverage was 53.9% and 62.4% of ED visits in 2018 in 2019, respectively, in the United States.

Figure 2.

Monthly rate of ED visits per 100,000 ED visits related to a firearm injury by sex and US region—NSSP, United States, between January 1, 2018, and December 31, 2019. The monthly rate is calculated as ED visits involving a firearm injury divided by the total ED visits, multiplied by 100,000. Joinpoint reports average annual percent change, but the unit of time for this analysis is 1 month; thus, this has been modified to average monthly percent change or AMPC. Data current as of October 23, 2020, representing data from participating EDs in the NSSP, where the coverage was 53.9% and 62.4% of ED visits in 2018 in 2019, respectively, in the United States.