Explore California data on firearm injuries that resulted in death, hospitalization, or an emergency department (ED) visit.

Injury Severity

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Pie chart showing firearm injuries by injury severity.

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Bar chart showing firearm injuries by injury severity.

This dashboard contains data on firearm injuries among Californians that resulted in death or treatment at a California state-licensed hospital or emergency department (ED). Non-fatal firearm injuries that result in hospital admission are typically more severe than those where the victim is treated and discharged from the ED. The U.S. Government Accountability Office estimates that the average initial cost for firearm injury treatment is roughly $30,000 for hospitalizations and $1,500 for ED visits. Many victims who survive firearm injuries will require follow-up treatment after discharge from acute care, including additional surgery, physical therapy, and mental health services.

Injury Intent

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Bar chart showing firearm injuries by injury intent.

Intent is meant to capture the reason for the injury. Intents include unintentional (accidental), suicide/self-harm, homicide/assault, undetermined, and legal intervention/war operations. Intent is recorded by coroners or medical examiners for fatal injuries and clinicians and hospital staff for non-fatal injuries. It is based on information available, and may not always be known. For non-fatal injuries, coding guidelines from the Centers for Medicare and Medicaid Services state that when the injury intent is unknown, the coders should default to unintentional intent. Because of this, non-fatal unintentional firearm injuries are likely over-reported and non-fatal assault firearm injuries are likely under-reported. Non-fatal self-harm firearm injuries are rare because suicide attempts with a firearm are almost always fatal.

Injury Year

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Line graph showing firearm injuries by year.

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Injury year corresponds to the time period when the victim died, was discharged from the hospital, or received care in the ED. The firearm injury data on this dashboard go back to 2016 because prior years of hospitalization and ED injury data are not directly comparable due to changes to the non-fatal injury coding system that occurred in 2015. Similar to national trends , California’s firearm homicide rate declined sharply through the 1990’s, then remained relatively stable through 2015. California’s firearm suicide rate declined gradually from the early 1990s to mid-2000s, then remained relatively stable through 2015. California firearm injury data for years prior to 2016 can be queried on CDPH’s legacy EpiCenter website .

Victim Age

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Bar chart showing firearm injuries by victim age.

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Victim age is recorded at the time of death, admittance to the hospital, or ED service date. Similar to national trends , California rates of homicide/assault firearm injuries peak in the late teens and early 20s, while rates of suicide/self-harm firearm injuries also peak in the late teens and early 20s but then continue to rise through older adulthood.

Victim Sex

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Bar chart showing firearm injuries by victim sex.

Sex refers to the victim’s biologic sex. “Other/Unknown” is used when sex is not recorded, non-binary, undetermined, or in the case of congenital abnormalities that obscure sex identification. In California and nationally, males are much more likely than females to be victims of firearm injuries. The vital statistics and healthcare data used on this dashboard do not contain information on the shooter when a victim is shot by another person. However, data from the FBI's Supplementary Homicide Reports indicate that males accounted for almost 93% of firearm homicide offenders in California from 2016 to 2020.

Victim Race and Ethnicity

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Pie chart showing firearm injuries by victim race and ethnicity.

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Bar chart showing firearm injuries by victim race and ethnicity.

Victim Race and Ethnicity is reported by an informant in the case of deaths and recorded by a provider in the case of non-fatal hospitalizations and ED visits. The Hispanic category includes Hispanic ethnicity of any race; all other categories are non-Hispanic. Consistent with national patterns , non-Hispanic White Californians have the highest rates of suicide/self-harm firearm injuries and non-Hispanic Black Californians have the highest rates of homicide/assault firearm injuries. Research suggests that differences in firearm injuries by race and ethnicity are largely attributable to the constellation of external social contexts that are differentially allocated by racial and ethnic status in American society. These include family structure, residential stability, generation since immigration, economic opportunities, neighborhood environment, religious involvement and firearm access.

Victim County of Residence

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Choropleth map and bar chart showing firearm injuries by victim county of residence.

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County of residence is based on the victim’s residential address. Victims with no address or an unreported address are categorized as “N/A (Unknown or Unhoused).” In general, urban areas tend to have higher rates of firearm homicide and rural areas tend to have higher rates of firearm suicide (Branas et al., 2004). Geographic patterns of firearm injuries can be attributed in part to structural inequalities. Firearm homicide rates are higher in areas with greater poverty, income inequality, and unemployment and less social mobility and social capital (Kim, 2019). Firearm suicides, along with drug overdoses and alcoholic liver disease mortality, are considered “deaths of despair.” They disproportionately affect middle-aged, less-educated, White populations living in rural communities that have experienced a loss of economic and social status since the turn of the century (Case & Deaton, 2015).

* indicates data are suppressed to protect privacy.

Documentation

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Source Data

Firearm injury deaths are identified from the California Department of Public Health (CDPH) California Comprehensive Master Death File (CCMDF). The CCMDF includes in-state deaths and deaths of California residents that occurred in other states or jurisdictions. It is derived from the death registration process and includes information from the death certificate, which is provided by informants and clinicians. More information can be found on the CDPH Vital Records Data and Statistics web page. Firearm injury hospitalizations and emergency department (ED) visits are identified from the California Department of Health Care Access and Information (HCAI) Patient Discharge Data (PDD) and ED Data, respectively. The PDD include records of inpatient discharge from California-licensed hospitals, including general acute care, acute psychiatric, chemical dependency recovery, and psychiatric health facilities. The ED data include records of patient face-to-face encounters with providers at hospitals licensed to provide emergency medical services. If an ED encounter resulted in a same-hospital admission, the ED encounter would be combined with the PDD record and only appear as a hospitalization. More information can be found on the HCAI Data Documentation web page.

On this dashboard, deaths, hospitalizations, and ED visits are limited to California residents with a recorded age between 0 and 119 years. Additionally, hospitalizations and ED visits are limited to non-fatal dispositions, as fatalities are captured in the death data.

Firearm Injury Case Definition

Firearm injury deaths are identified from International Classification of Diseases, 10th Revision (ICD-10) codes appearing in the underlying cause of death field. Firearm injury hospitalizations and ED visits are identified from ICD-10, Clinical Modification (ICD-10-CM) codes appearing in any of 25 diagnosis fields and 12 external cause of morbidity fields. The ICD-10 and ICD-10-CM codes used to identify firearm injuries are listed in table 1. These codes include firearm injuries resulting from the discharge or malfunction of a firearm. They exclude injuries due to the discharge of air guns and paintball guns as well as strikes by firearms used as blunt objects.

Table 1: firearm injury ICD-10 and ICD-10-CM codes by intent
Intent ICD-10 Codes ICD-10-CM Codes*
Unintentional W32-W34 W32, W33, W34.00, W34.09, W34.10, W34.19
Suicide/Self-harm X72-X74 X72, X73, X74.8, X74.9
Homicide/Assault U01.4, X93-X95 X93, X94, X95.8, X95.9, Y38.4
Undetermined Y22-Y24 Y22, Y23, Y24.8, Y24.9
Legal/War Y35.0 Y35.00-Y35.03, Y35.09, Y36.42, Y36.43, Y36.92, Y37.42, Y37.43, Y37.92
* Only includes codes with a 7th character of A, B, C or missing (reflects initial encounter, active treatment)

Variable Definitions

Severity is defined by the data source: death, hospital discharge or ED visit. Deaths are most severe; ED visits tend to be least severe.

Intent is derived from the ICD-10 or ICD-10-CM code. Table 1 lists the codes that correspond to each intent classification.

Year corresponds to the time period when the victim died, was discharged from the hospital, or received care in the ED.

Age is measured in years and recorded at the time of death, admittance to the hospital, or ED service date. Victims aged 100 and greater are collapsed into a single “100+” age group.

Sex refers to the victim’s biologic sex. “Other/Unknown” is used when sex is not recorded, non-binary, undetermined, or in the case of congenital abnormalities that obscure sex identification.

Race and ethnicity are normalized groups based on a combination of reported race and ethnicity. Groups are defined as follows:

  • Hispanic: Hispanic ethnicity of any race
  • White: Non-Hispanic White
  • Asian: Non-Hispanic Asian
  • Black: Non-Hispanic Black
  • American Indian/Alaska Native: Non-Hispanic American Indian/Alaska Native
  • Pacific Islander: Non-Hispanic Native Hawaiian or other Pacific Islander
  • Multiracial: Non-Hispanic and more than one of the five race groups listed above (White, Asian, Black, AI/AN, Pacific Islander)
  • Other/Unknown: All other Non-Hispanic races and incomplete reporting

County of residence for deaths is based on the decedent’s address or as entered on the death certificate. “N/A (Unknown or Unhoused)” category is used when state residence is reported as California, but county of residence is missing or unknown. Decedents with missing or unknown state and county of residence are excluded along with those residing outside California. For Hospitalizations and ED Visits, county of residence is based on patient-reported ZIP Code. Unhoused patients identified in the data are included under a “N/A (Unknown or Unhoused)” category. Patients with unknown or missing ZIP codes are excluded along with those residing outside California.

Rates

Rates are calculated using population projections from the California Department of Finance’s Report P-3: Complete State and County Projections Dataset:

  • Data years 2016 – 2019 use the Vintage 2020 release (2021.7.14).
  • Data years 2020 – 2022 use the Vintage 2023 release (2023.7.19).

Rates are not available for other/unknown categories of populations. Due to differences in how race and ethnicity is reported in the population and injury data, caution should be used when interpreting rates involving race and ethnicity. Because injuries are events that occur over time, incidence rates are used and expressed as injuries per 100,000 person-years. Person-years are the population multiplied by the number of years of observation. Incidence rates can be conceptualized as the number of events per 100,000 persons, per year. A thorough explanation of incidence rates can be found in Tenny & Boktor’s, “Incidence” StatPearls Article.

Data Suppression

In compliance with the California Health and Human Services data de-identification guidelines, injury counts and rates will not be shown when the number of injuries and variable specificity may risk an individual being re-identified from the data. When this is the case, as determined by the Publication Scoring Criteria presented on page 16 of the guidelines, actual results are suppressed and replaced with an asterisk (*).

Suggested Citation

California Department of Public Health, Injury and Violence Prevention Branch. (2024, February 2). California Firearm Injury Dashboard. Retrieved Month DD, YYYY, from https://skylab4.cdph.ca.gov/firearm-injuries/.

Help

For additional firearm injury data help, please email .


This dashboard was developed by the California Department of Public Health (CDPH) Injury and Violence Prevention Branch (IVPB). To learn more about what IVPB is doing to prevent firearm injuries, visit the IVPB home page.