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“Women can get lost in the discussion because so many of the fatalities are men,� said one the authors, Dr. Eric Fleegler of Harvard Medical School.

Among Black women, the rate of firearm-related homicides more than tripled since 2010, and the rate of gun-related suicides more than doubled since 2015, Fleegler and his co-authors wrote in published by JAMA Network Open.

The research is one of the most comprehensive analyses of U.S. gun deaths in years, said David Hemenway, director of the Harvard University’s Injury Control Research Center.

In October, the Centers for Disease Control and Prevention released data on U.S. firearm deaths last year, counting more than 47,000 — the most in at least 40 years.

The U.S. population is growing, but researchers say the rate of gun deaths has been getting worse, too. America’s gun-related homicide and suicide rates both rose 8% last year, each hitting levels not seen since the early 1990s.

In the new study, the researchers examined trends in firearm deaths since 1990. They found gun deaths began to steadily increase in 2005, but the rise accelerated recently, with a 20% jump from 2019 to 2021.

Why did gun deaths rise so dramatically during the COVID-19 pandemic? That's "a straightforward question with probably a complicated answer that no one really knows the answer to," said Fleegler, an emergency medicine physician at Boston Children’s Hospital.

Factors could include disruption of people's work and personal lives, higher gun sales, stress, and mental health issues, experts said.

The researchers counted more than 1.1 million gun deaths over those 32 years — about the same as the number of American deaths attributed to COVID-19 in the last three years.

About 14% of those killed by guns were women, but the rate increase among them is more pronounced. There were about 7 gun deaths per 100,000 women last year, up from about 4 per 100,000 in 2010 — an increase of 71%. The comparable increase for men was 45%, the rate rising to about 26 per 100,000 from about 18 per 100,000 in 2010.

For Black women, the firearm suicide rate rose from about 1.5 per 100,000 in 2015 to about 3 per 100,000 last year. Their homicide death rate last year was more than 18 per 100,000, compared with about 4 per 100,000 for Hispanic women and 2 per 100,000 for white women.

The highest homicide gun death rates continue to be in young Black men, at 142 per 100,000 for those in their early 20s. The highest gun suicide death rates are in white men in their early 80s, at 45 per 100,000, the researchers said.

In a commentary accompanying the study, three University of Michigan researchers said the paper confirmed racial and sexual differences in U.S. gun deaths and that homicide deaths are concentrated in cities and suicides are more common in rural areas.

“Firearm violence is a worsening problem in the United States,� and will require a range of efforts to control, they wrote.

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