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(54413849800)DingDo, Huyen Phuc (57200737094)Huyen Phuc (57200737094)DoDoku, David Teye (36015210300)David Teye (36015210300)DokuDoyle, Kerrie E. (55693710800)Kerrie E. (55693710800)DoyleDriscoll, Tim Robert (7005928308)Tim Robert (7005928308)DriscollEdessa, Dumessa (56922334200)Dumessa (56922334200)EdessaEl-Khatib, Ziad (54908919000)Ziad (54908919000)El-KhatibEndries, Aman Yesuf (57216324852)Aman Yesuf (57216324852)EndriesEsteghamati, Alireza (11240321100)Alireza (11240321100)EsteghamatiFaro, Andre (36770969600)Andre (36770969600)FaroFarzadfar, Farshad (57195049611)Farshad (57195049611)FarzadfarFeigin, Valery L. (57203677957)Valery L. (57203677957)FeiginFischer, Florian (55508208800)Florian (55508208800)FischerForeman, Kyle J. (57209064414)Kyle J. (57209064414)ForemanFranklin, Richard Charles (7201428429)Richard Charles (7201428429)FranklinFullman, Nancy (57211064970)Nancy (57211064970)FullmanFutran, Neal D. (35554564000)Neal D. (35554564000)FutranGebrehiwot, Tsegaye Tewelde (57216482917)Tsegaye Tewelde (57216482917)GebrehiwotGutiérrez, Reyna Alma (57200298415)Reyna Alma (57200298415)GutiérrezHafezi-Nejad, Nima (57216814261)Nima (57216814261)Hafezi-NejadBidgoli, Hassan Haghparast (57201491554)Hassan Haghparast (57201491554)BidgoliHailu, Gessessew Bugssa (57219637263)Gessessew Bugssa (57219637263)HailuHaro, Josep Maria (57215877903)Josep Maria (57215877903)HaroHassen, Hamid Yimam (57188660707)Hamid Yimam (57188660707)HassenHawley, Caitlin (57196078801)Caitlin (57196078801)HawleyHendrie, Delia (6602071966)Delia (6602071966)HendrieHíjar, Martha (57216555124)Martha (57216555124)HíjarHu, Guoqing (57218106596)Guoqing (57218106596)HuIlesanmi, Olayinka Stephen (54782692800)Olayinka Stephen (54782692800)IlesanmiJakovljevic, Mihajlo (14318929700)Mihajlo (14318929700)JakovljevicJames, Spencer L. (57202557998)Spencer L. (57202557998)JamesJayaraman, Sudha (57204716526)Sudha (57204716526)JayaramanJonas, Jost B. (7202492953)Jost B. (7202492953)JonasKahsay, Amaha (57216608121)Amaha (57216608121)KahsayKasaeian, Amir (57195540738)Amir (57195540738)KasaeianKeiyoro, Peter Njenga (57203177260)Peter Njenga (57203177260)KeiyoroKhader, Yousef (55654192600)Yousef (55654192600)KhaderKhalil, Ibrahim A. (58255049500)Ibrahim A. (58255049500)KhalilKhang, Young-Ho (57198904674)Young-Ho (57198904674)KhangKhubchandani, Jagdish (57211720011)Jagdish (57211720011)KhubchandaniKiadaliri, Aliasghar Ahmad (57199100665)Aliasghar Ahmad (57199100665)KiadaliriKieling, Christian (57218820714)Christian (57218820714)KielingKim, Yun Jin (57211086375)Yun Jin (57211086375)KimKosen, Soewarta (57211346192)Soewarta (57211346192)KosenKrohn, Kristopher J. (57194138806)Kristopher J. (57194138806)KrohnKumar, G. Anil (57139550500)G. Anil (57139550500)KumarLami, Faris Hasan (57200737005)Faris Hasan (57200737005)LamiLansingh, Van C. (57194598546)Van C. (57194598546)LansinghLarson, Heidi Jane (57202559142)Heidi Jane (57202559142)LarsonLinn, Shai (7102590173)Shai (7102590173)LinnLunevicius, Raimundas (57216165063)Raimundas (57216165063)LuneviciusAbd El Razek, Hassan Magdy (57195948985)Hassan Magdy (57195948985)Abd El RazekAbd El Razek, Muhammed Magdy (57192379650)Muhammed Magdy (57192379650)Abd El RazekMalekzadeh, Reza (7005197760)Reza (7005197760)MalekzadehMalta, Deborah Carvalho (15835283500)Deborah Carvalho (15835283500)MaltaMason-Jones, Amanda J. (7201563263)Amanda J. (7201563263)Mason-JonesMatzopoulos, Richard (57203438721)Richard (57203438721)MatzopoulosMemiah, Peter T. N. (57217207827)Peter T. N. (57217207827)MemiahMendoza, Walter (57216905642)Walter (57216905642)MendozaMeretoja, Tuomo J. (57202554188)Tuomo J. (57202554188)MeretojaMezgebe, Haftay Berhane (57222113213)Haftay Berhane (57222113213)MezgebeMiller, Ted R. (7403948600)Ted R. (7403948600)MillerMohammed, Shafiu (57838689000)Shafiu (57838689000)MohammedMoradi-Lakeh, Maziar (35617421300)Maziar (35617421300)Moradi-LakehMori, Rintaro (57072757600)Rintaro (57072757600)MoriNguyen, Cuong Tat (56531347200)Cuong Tat (56531347200)NguyenLe Nguyen, Quyen (57204521771)Quyen (57204521771)Le NguyenNingrum, Dina Nur Anggraini (57195329470)Dina Nur Anggraini (57195329470)NingrumOgbo, Felix Akpojene (57200737136)Felix Akpojene (57200737136)OgboOlagunju, Andrew T. (26029995700)Andrew T. (26029995700)OlagunjuPatton, George C. (7102184358)George C. (7102184358)PattonPhillips, Michael R. (57202563610)Michael R. (57202563610)PhillipsPolinder, Suzanne (12766122200)Suzanne (12766122200)PolinderPourmalek, Farshad (8309390500)Farshad (8309390500)PourmalekQorbani, Mostafa (24831040300)Mostafa (24831040300)QorbaniRahimi-Movaghar, Afarin (8696686900)Afarin (8696686900)Rahimi-MovagharRahimi-Movaghar, Vafa (6507646446)Vafa (6507646446)Rahimi-MovagharRahman, Mahfuzar (35571661300)Mahfuzar (35571661300)RahmanRai, Rajesh Kumar (51864423900)Rajesh Kumar (51864423900)RaiRanabhat, Chhabi Lal (56719695500)Chhabi Lal (56719695500)RanabhatRawaf, David Laith (57209228052)David Laith (57209228052)RawafRawaf, Salman (6602475959)Salman (6602475959)RawafRowhani-Rahbar, Ali (8840642000)Ali (8840642000)Rowhani-RahbarSafdarian, Mahdi (57203849024)Mahdi (57203849024)SafdarianSafiri, Saeid (56009654100)Saeid (56009654100)SafiriSagar, Rajesh (26643103100)Rajesh (26643103100)SagarSalama, Joseph S. (57202975625)Joseph S. (57202975625)SalamaSanabria, Juan (7006262917)Juan (7006262917)SanabriaMilicevic, Milena M. Santric (57211144346)Milena M. Santric (57211144346)MilicevicSarmiento-Suárez, Rodrigo (57204744430)Rodrigo (57204744430)Sarmiento-SuárezSartorius, Benn (12788526800)Benn (12788526800)SartoriusSatpathy, Maheswar (57202563691)Maheswar (57202563691)SatpathySchwebel, David C. (6603681532)David C. (6603681532)SchwebelSeedat, Soraya (7003445887)Soraya (7003445887)SeedatSepanlou, Sadaf G. (36248136000)Sadaf G. (36248136000)SepanlouShaikh, Masood Ali (57203122601)Masood Ali (57203122601)ShaikhSharew, Nigussie Tadesse (56539990300)Nigussie Tadesse (56539990300)SharewShiue, Ivy (35811219800)Ivy (35811219800)ShiueSingh, Jasvinder A. (7404421736)Jasvinder A. (7404421736)SinghSisay, Mekonnen (57193254700)Mekonnen (57193254700)SisaySkirbekk, Vegard (57202564482)Vegard (57202564482)SkirbekkFilho, Adauto Martins Soares (49961178500)Adauto Martins Soares (49961178500)FilhoStein, Dan J. (55769747595)Dan J. (55769747595)SteinStokes, Mark Andrew (7102859000)Mark Andrew (7102859000)StokesSufiyan, Mu'Awiyyah Babale (58294633600)Mu'Awiyyah Babale (58294633600)SufiyanSwaroop, Mamta (8635158800)Mamta (8635158800)SwaroopSykes, Bryan L. (57211183396)Bryan L. (57211183396)SykesTabarés-Seisdedos, Rafael (6602981102)Rafael (6602981102)Tabarés-SeisdedosTadese, Fentaw (57190805861)Fentaw (57190805861)TadeseTran, Bach Xuan (57209107515)Bach Xuan (57209107515)TranTran, Tung Thanh (57199423355)Tung Thanh (57199423355)TranUkwaja, Kingsley Nnanna (57202824584)Kingsley Nnanna (57202824584)UkwajaVasankari, Tommi Juhani (57200592416)Tommi Juhani (57200592416)VasankariVlassov, Vasily (57211633239)Vasily (57211633239)VlassovWerdecker, Andrea (57208964895)Andrea (57208964895)WerdeckerYe, Pengpeng (57202839295)Pengpeng (57202839295)YeYip, Paul (7102503720)Paul (7102503720)YipYonemoto, Naohiro (57204947657)Naohiro (57204947657)YonemotoYounis, Mustafa Z. (8549393000)Mustafa Z. (8549393000)YounisZaidi, Zoubida (57197376721)Zoubida (57197376721)ZaidiEl Sayed Zaki, Maysaa (57203666922)Maysaa (57203666922)El Sayed ZakiHay, Simon I. (7101875313)Simon I. (7101875313)HayLim, Stephen S. (57201800433)Stephen S. (57201800433)LimLopez, Alan D. (7401455668)Alan D. (7401455668)LopezMokdad, Ali H. (7004813962)Ali H. (7004813962)MokdadVos, Theo (57223885848)Theo (57223885848)VosMurray, Christopher J. L. (55481130700)Christopher J. L. (55481130700)Murray2025-06-122025-06-122018https://doi.org/10.1001/jama.2018.10060https://www.scopus.com/inward/record.uri?eid=2-s2.0-85052567667&doi=10.1001%2fjama.2018.10060&partnerID=40&md5=b4795bff10119f3370076615633afa43https://remedy.med.bg.ac.rs/handle/123456789/6235IMPORTANCE Understanding global variation in firearm mortality rates could guide prevention policies and interventions. OBJECTIVE To estimate mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories. DESIGN, SETTING, AND PARTICIPANTS This study used deidentified aggregated data including 13 812 location-years of vital registration data to generate estimates of levels and rates of death by age-sex-year-location. The proportion of suicides in which a firearm was the lethal means was combined with an estimate of per capita gun ownership in a revised proxy measure used to evaluate the relationship between availability or access to firearms and firearm injury deaths. EXPOSURES Firearm ownership and access. MAIN OUTCOMES AND MEASURES Cause-specific deaths by age, sex, location, and year. RESULTS Worldwide, it was estimated that 251 000 (95%uncertainty interval [UI], 195 000-276 000) people died from firearm injuries in 2016, with 6 countries (Brazil, United States, Mexico, Colombia, Venezuela, and Guatemala) accounting for 50.5%(95%UI, 42.2%-54.8%) of those deaths. In 1990, there were an estimated 209 000 (95%UI, 172 000 to 235 000) deaths from firearm injuries. Globally, the majority of firearm injury deaths in 2016 were homicides (64.0% [95%UI, 54.2%-68.0%]; absolute value, 161 000 deaths [95%UI, 107 000-182 000]); additionally, 27%were firearm suicide deaths (67 500 [95%UI, 55 400-84 100]) and 9% were unintentional firearm deaths (23 000 [95%UI, 18 200-24 800]). From 1990 to 2016, there was no significant decrease in the estimated global age-standardized firearm homicide rate (-0.2%[95%UI, -0.8%to 0.2%]). Firearm suicide rates decreased globally at an annualized rate of 1.6%(95%UI, 1.1-2.0), but in 124 of 195 countries and territories included in this study, these levels were either constant or significant increases were estimated. There was an annualized decrease of 0.9% (95%UI, 0.5%-1.3%) in the global rate of age-standardized firearm deaths from 1990 to 2016. Aggregate firearm injury deaths in 2016 were highest among persons aged 20 to 24 years (for men, an estimated 34 700 deaths [95%UI, 24 900-39 700] and for women, an estimated 3580 deaths [95%UI, 2810-4210]). Estimates of the number of firearms by country were associated with higher rates of firearm suicide (P <.001; R2 = 0.21) and homicide (P <.001; R2 = 0.35). CONCLUSIONS AND RELEVANCE This study estimated between 195 000 and 276 000 firearm injury deaths globally in 2016, the majority of which were firearm homicides. Despite an overall decrease in rates of firearm injury death since 1990, there was variation among countries and across demographic subgroups. © 2018 American Medical Association. All rights reserved.