title: State-specific, racial and ethnic heterogeneity in trends of firearm-related fatality rates in the USA from 2000 to 2010.
abstract: OBJECTIVE
  To document overall, racial, ethnic and intent-specific spatiotemporal trends of firearm-related fatality rates (FRF rates) in the USA.
  
  
  METHODS
  Cross-sectional study per year from 2000 to 2010.
  
  
  METHODS
  Aggregate count of all people in the USA from 2000 to 2010.
  
  
  METHODS
  Data from the Web-based Injury Statistics Query and Reporting System from 2000 to 2010 was used to determine annual FRF rates per 100,000 and by states, race, ethnicity and intent.
  
  
  RESULTS
  The average national 11-year FRF rate was 10.21/100,000, from 3.02 in Hawaii to 18.62 in Louisiana: 60% of states had higher than national rates and 41 states showed no temporal change. The average national FRF rates among African-Americans and Caucasians were 18.51 and 9.05/100,000 and among Hispanics and non-Hispanics were 7.13 and 10.13/100,000; Hispanics had a decreasing change of -0.18, p trend<0.0001. In states with increasing trends (Florida and Massachusetts), Caucasians and non-Hispanics drove the rise; while in states with decreasing trends (California, North Carolina, Arizona, Nevada, New York, Illinois, Maryland), Hispanics and African-Americans drove the fall. The average national FRF rates due to homicides (4.1/100,000) and suicides (5.8/100,000) remained constant, but varied between states.
  
  
  CONCLUSIONS
  Endemic national FRF rates mask a wide variation in time trends between states. FRF rates were twice as high in African-Americans than Caucasians but decreased among Hispanics. Efforts to identify state-specific best practices can contribute to changes in national FRF rates that remain high.
authors.affiliation: Department of Surgery, Columbia University, New York, New York, USA Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Bindu
authors.identifier: http://orcid.org/0000-0002-6543-2774
authors.initials: B
authors.lastname: Kalesan
authors.affiliation: Department of Surgery, Columbia University, New York, New York, USA.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Vasan
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Mobily
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Marcos D
authors.initials: MD
authors.lastname: Villarreal
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hlavacek
authors.affiliation: Trauma and Critical Care Services, Jacobi Medical Center, Bronx, New York, USA.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Teperman
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York, USA Department of Law, Columbia University, New York, New York, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Fagan
authors.affiliation: Department of Epidemiology, Columbia University, New York, New York, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D001741:Black or African American; D003430:Cross-Sectional Studies; D005389:Firearms; D006630:Hispanic or Latino; D006801:Humans; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D014948:Wounds, Gunshot / Q000401:mortality*
keywords: EPIDEMIOLOGY; PREVENTIVE MEDICINE; PUBLIC HEALTH; STATISTICS & RESEARCH METHODS