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A Tale of Three (Major) Cities: Trends in Covid-19 Firearm Deaths Pre- vs. Post-Pandemic

Cardone, C.; Kilpatrick, A.; Bunker, S.; Ledet, R.; Duran, M.; Coello-Sanchez, C.; D'Amico, M.; Richman, M.

2025-05-01 emergency medicine
10.1101/2025.04.28.25326367 medRxiv
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IntroductionPrevious studies have identified an increase in the percent of the population dying from firearms during vs. before the COVID-19 pandemic. Such increases have been attributed to a rise in mental health disorders due to medical and financial fear, social isolation, and social unrest. This paper describes in more-depth such changes in the three most-populous counties in the United States: Cook (Chicago), Los Angeles, and New York. MethodsData was collected from the publicly-available, anonymized/de-identified, and aggregated CDC WONDER database. A chi square test compared rates of firearm deaths by county in 2019 and 2021, with comparisons being made between counties within one year (eg, Cook vs. Los Angeles in 2019) and within a county between years (eg, Cook in 2019 vs. Cook in 2021). We also performed a chi square test to compare changes in the rates of percent of firearms deaths from 2019 to 2021 between the counties. ResultsIn 2019 and 2021, there were statistically-significant differences in the percent of the population dying from firearms between Cook, Los Angeles, and New York counties (both years: p <0.0001) (Tables 1 and 2). In each county, there was also a statistically-significant increase between 2019 and 2021 in the percentage of population dying from firearms (p <0.0001). (Table 3) However, the rate of increase was not different between the three counties (p = 0.16). That is, the increase in percent of population dying from firearms between 2019 and 2021 in Cook County was not different from that increase in Los Angeles or New York counties. O_TBL View this table: org.highwire.dtl.DTLVardef@1607b27org.highwire.dtl.DTLVardef@1355ef9org.highwire.dtl.DTLVardef@ee4084org.highwire.dtl.DTLVardef@1cdc4a5org.highwire.dtl.DTLVardef@2938d8_HPS_FORMAT_FIGEXP M_TBL O_FLOATNOTable 1.C_FLOATNO O_TABLECAPTIONFirearm deaths in Cook County, Los Angeles County, and the aggregated New York counties in 2019 C_TABLECAPTION C_TBL O_TBL View this table: org.highwire.dtl.DTLVardef@5310e4org.highwire.dtl.DTLVardef@17a07acorg.highwire.dtl.DTLVardef@8de768org.highwire.dtl.DTLVardef@535e27org.highwire.dtl.DTLVardef@14a6c40_HPS_FORMAT_FIGEXP M_TBL O_FLOATNOTable 2.C_FLOATNO O_TABLECAPTIONFirearm deaths in Cook County, Los Angeles County, and the aggregated New York counties in 2021 C_TABLECAPTION C_TBL DiscussionRates of death from firearms increased between 2019 and 2021 in the three largest counties in the United States: Cook, Los Angeles, and New York. The current study validates the findings of prior studies. However, we found the rate of increase was not statistically-significant between the three counties. Numerous causes may underlie the increase, including changes in mental health related to pandemic stressors (physical isolation, unemployment, and actual or fear of poverty1) or difficulty accessing mental health services.

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