A groundbreaking study analyzing emergency department (ED) visits across multiple U.S. jurisdictions has revealed a sobering reality: every thirty minutes, an individual is treated for a firearm injury. Conducted by researchers at the Centers for Disease Control and Prevention (CDC), this cross-sectional analysis draws on data spanning from 2018 through 2023, representing one of the most comprehensive examinations of firearm injury temporal patterns to date. The results illuminate critical time-based trends that could fundamentally influence healthcare system preparedness and public safety strategies nationwide.
The CDC team utilized data from the Firearm Injury Surveillance Through Emergency Rooms program (FASTER), encompassing nine states—Florida, Georgia, New Mexico, North Carolina, Oregon, Utah, Virginia, Washington, and West Virginia—as well as the District of Columbia. This geographically diverse sample includes data from large urban centers and rural regions, thus offering a layered understanding of firearm injury occurrences. Their rigorous approach involved calculating firearm injury ED visit rates per 100,000 total visits, breaking down occurrences by hour of the day, day of the week, month, and significant U.S. holidays and culturally important days, such as Independence Day and Super Bowl Sunday.
The resultant dataset identified a total of 93,022 firearm injury-related ED visits over the study period, which translates to an alarming average of one such visit every 30 minutes. The overall rate was established at 73.9 firearm injury visits per 100,000 total ED visits, underscoring the significant burden firearm-related trauma places on emergency healthcare infrastructures. Significantly, the rate was not static over time but displayed distinct temporal fluctuations that reflect broader social and behavioral patterns.
The analysis uncovered a notable escalation in firearm injury presentations as the day progresses, with a peak incidence occurring between 2:30 and 3:00 a.m. This nocturnal surge suggests an interplay between nighttime social behaviors, possibly linked to alcohol consumption and reduced visibility, and increased risk of firearm-related harm. The findings also hint at the challenges emergency departments face in staffing and resource allocation during these critical hours, often outside typical business hours when hospital staffing levels may be leaner.
Beyond daily patterns, the study documented heightened rates on weekends, specifically Friday through Sunday. This clustering implicates weekend social dynamics and increased outdoor activities as potential risk modifiers. These temporal spikes could inform hospital staffing models, emergency preparedness protocols, and community-based intervention strategies aimed at addressing firearm violence in real-time, especially during these peak periods.
Seasonal trends were equally striking. July registered the highest monthly rate of firearm injury ED visits. The American summer often brings together larger crowds for outdoor festivities and holidays, which might explain this uptick. Additionally, key holidays such as New Year’s Eve, Independence Day, Memorial Day weekend, and Halloween were identified as periods with significantly increased firearm injury rates compared to non-holidays. The symbolic and cultural significance of these days may correspond with spikes in gatherings and firearm-related incidents, underscoring the need for targeted public health messaging and preventive measures ahead of and during these high-risk times.
While the research acknowledges its limitations—particularly that the data do not represent the national experience comprehensively—the insights generated remain critically important. Understanding temporal patterns allows policymakers, hospital administrators, and public health stakeholders to better anticipate when firearm injuries are most likely to occur and allocate resources accordingly. This enhanced anticipation capability not only improves emergency response but may ultimately reduce preventable deaths and improve patient outcomes by curbing treatment delays.
The study’s temporal granularity also opens avenues for innovative prevention programs. For example, community outreach and violence interruption programs could strategically intensify their efforts on specific holidays and weekends, directly addressing times of heightened firearm injury risk. Moreover, emergency departments can use these data to adjust staffing schedules to ensure adequate coverage during peak injury times, thus enhancing the quality of care and reducing the burden on healthcare professionals during demand surges.
This research further dovetails with complementary efforts in firearm injury prevention by demonstrating that temporal trends are foundational to comprehending the epidemiology of firearm trauma. Incorporating this temporal dimension adds sophistication to existing surveillance models and fosters cross-sector collaboration, linking healthcare providers, public safety officials, and community organizations in multifaceted intervention frameworks.
At the technical level, the use of the FASTER surveillance system exemplifies advances in public health monitoring through real-time data aggregation and epidemiologic analysis. This system enables rapid identification of injury trends, facilitating timely public health responses. The study’s methodological rigor—straddling descriptive epidemiology and applied health informatics—sets a new benchmark for injury surveillance and could be adapted for monitoring other injury types or emergent health threats.
In conclusion, this extensive analysis presents a compelling picture of how firearm injuries temporally distribute across time, day, month, and special occasions within the United States. Every half hour, an affected individual enters an emergency department seeking care for firearm-related trauma—a stark reminder of the ongoing public health crisis posed by firearm violence. By elucidating these temporal patterns, the study advocates for a strategic, data-driven response that extends beyond reactive treatment, toward anticipatory prevention and preparedness practices aimed at mitigating the damage caused by firearms in communities nationwide.
Subject of Research: People
Article Title: Patterns of U.S. Firearm Injury Emergency Department Visits by Month, Day, and Time During 2018 to 2023
News Publication Date: 15-Apr-2025
Web References: DOI Link
Media Contact: Angela Collom, American College of Physicians, ACollom@acponline.org, Office: 215-351-2653
Keywords: Firearms, Public health, Emergency medicine
