Firearm-related hospitalizations surged by 34% during the COVID-19 pandemic, reversing a five-year downward trend.
Demographic groups such as individuals under 18, Medicaid recipients, and Black individuals saw even higher hospitalization increases.
The study found a strong correlation between firearm sales and hospitalizations from 2015 to 2021.
Limitations include exclusion of pre-hospitalization deaths, emergency department releases, and lack of state-level law analysis.
Findings aim to inform policy and spur further research on reducing firearm injuries and deaths.

Did an increase in gun purchases lead to the increase in firearm-related injuries?

Pandemic firearm-related hospitalizations rose during the pandemic: © Mariusz Blach - stock.adobe.com

Firearm injuries requiring hospitalization surged during the COVID-19 pandemic, reversing a five-year downward trend, according to a study from the University of Michigan published in JAMA Network Open. The research shows a 34% increase in firearm-related hospitalizations in 2020 and 2021 compared to predictions based on pre-pandemic trends.

Certain demographic groups experienced even larger increases in hospitalization rates. Among individuals under 18, those on Medicaid, and Black individuals, hospitalization rates rose 44%, 46%, and 41% higher, respectively, than anticipated. The study’s lead author, Raymond Jean, M.D., M.H.S., a trauma surgeon at Michigan Medicine, highlighted the disparities.

“Taken together, our findings raise new concerns about the sustained increase in firearm-related injury, and in particular the disproportionate increase in younger, low-income and Black individuals,” said Jean.

The researchers used national hospitalization data from the Healthcare Cost and Utilization Project to create a model based on trends from 2015 to 2019. Comparing those projections to actual hospitalizations in 2020 and 2021 revealed the stark rise. Although the study did not directly link increased firearm sales during the pandemic to the spike in hospitalizations, the data showed a strong correlation between firearm sales and hospitalizations from 2015 through 2021.

While the overall increase in hospitalizations was 34%, older adults and Medicare beneficiaries experienced smaller but still notable rises. The study’s findings add to growing concerns about the broader impact of firearm injuries in the U.S., according to the researchers.

“I have seen firsthand what bullets can do to the human body, and worked to save the lives of those who have survived long enough to reach the operating room,” said Jean, an assistant professor in U-M’s Department of Surgery. “That drives my interest in understanding the scope of this issue, and trends over time, through advanced data tools.”

The study’s authors acknowledged several limitations, including the exclusion of data on individuals who died before hospitalization, those treated and released from emergency departments, and those who did not seek care. Additionally, the data did not allow analysis of state-level firearm laws, COVID-related policies, or social unrest.

Despite these limitations, the researchers said they hope the findings will spur further studies and inform policy aimed at reducing firearm injuries and deaths, whether from suicides, interpersonal violence, or accidents.

The study was funded by the Association for Academic Surgery Foundation.