The Rising Epidemic of Mass Shootings in the US and Its Association with Gun Legislation, Laws, and Sales

Introduction: Mass shootings pose a considerable threat to public safety. This study aims to (1) assess US mass shootings, firearm-related sales, laws, and regional differences from 2015-2021 and (2) investigate changes in mass shootings and firearm sales before and during the Coronavirus Disease 2019 (COVID-19) pandemic. Method(s): A retrospective review of mass shootings, gun sales, and laws regarding the minimum age required to purchase a firearm within the US from 2015-2021. The 10 states/regions with the greatest mean mass shootings/capita from 2015-2021 were selected for further analysis. Result(s): Mass shootings correlated significantly with firearm sales from 2015-2021 nationwide (p< 0.02 for all). The growth in mass shootings, the number killed/injured, and gun sales were greater in 2020 and 2021 compared withthe years prior. The 10 states with the highest mean mass shooting/capita over the study period were Alabama, Arkansas, the District of Columbia, Illinois, Louisiana, Maryland, Mississippi, Missouri, South Carolina, and Tennessee. No significant correlation was found between the number of mass shootings/capita and the minimum age to purchase a firearm. Conclusion(s): Firearm sales correlated significantly with mass shootings from 2015-2021. Mass shootings and gun sales increased at greater rates during the COVID-19 pandemic compared withthe years before the pandemic. Mass shootings exhibited inconsistent trends with state gun laws regarding the minimum age to purchase a firearm. Future studies may consider investigating the methods by which firearms used in mass shootings are obtained to further identify targets for prevention.

An investigation of the impact of the pandemic era on shooting victimizations in Detroit, Michigan

Despite the devastating effects of firearm violence on individuals, families, and communities, research on the impact of the COVID-19 pandemic on firearm violence remains at a minimum. Our study contributes to this body of research by estimating the impact of two critical pandemic era timeframes on fatal and nonfatal shooting victimizations in Detroit, Michigan, using an innovative Bayesian Structural Time Series methodology. For each timeframe, we consider the impact of the pandemic era on total shooting victimizations, shooting victimizations that occurred at a residence (or at home), and shooting victimizations that occurred elsewhere. Our findings suggest that the pandemic era contributed to all three types of shooting victimizations in Detroit. We discuss the limitations of our study, along with directions for future research. Overall, we believe that our study underscores the importance of adopting a comprehensive and evidence-based strategy to prevent firearm-related fatalities and injuries. [ FROM AUTHOR] Copyright of Journal of Crime & Justice is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Increases in adolescent firearm injuries were associated with school closures during COVID-19.

BACKGROUND: Mitigation measures, including school closures, were enacted to protect the public during the COVID-19 pandemic. However, the negative effects of mitigation measures are not fully known. Adolescents are uniquely vulnerable to policy changes since many depend on schools for physical, mental, and/or nutritional support.  This study explores the statistical relationships between school closures and adolescent firearm injuries (AFI) during the pandemic. METHODS: Data were drawn from a collaborative registry of 4 trauma centers in Atlanta, GA (2 adult and 2 pediatric). Firearm injuries affecting adolescents aged 11-21 years from 1/1/2016 to 6/30/2021 were evaluated. Local economic and COVID data were obtained from the Bureau of Labor Statistics and the Georgia Department of Health. Linear models of AFI were created based on COVID cases, school closure, unemployment, and wage changes. RESULTS: There were 1,330 AFI at Atlanta trauma centers during the study period, 1,130 of whom resided in the 10 metro counties. A significant spike in injuries was observed during Spring 2020. A season-adjusted time series of AFI was found to be non- stationary (p = 0.60). After adjustment for unemployment, seasonal variation, wage changes, county baseline injury rate, and county-level COVID incidence, each additional day of unplanned school closure in Atlanta was associated with 0.69 (95% CI 0.34- 1.04, p < 0.001) additional AFIs across the city. CONCLUSION: AFI increased during the COVID pandemic. This rise in violence is statistically attributable in part to school closures after adjustment for COVID cases, unemployment, and seasonal variation. These findings reinforce the need to consider the direct implications on public health and adolescent safety when implementing public policy.

Challenges, Successes, and the Future of Firearm Injury Prevention.

Policy Points Firearm injury is a leading cause of death in the United States, with fatality rates increasing 34.9% over the past decade (2010-2020). Firearm injury is preventable through multifaceted evidence-based approaches. Reviewing past challenges and successes in the field of firearm injury prevention can highlight the future directions needed in the field. Adequate funding, rigorous and comprehensive data availability and access, larger pools of diverse and scientifically trained researchers and practitioners, robust evidence-based programming and policy implementation, and a reduction in stigma, polarization, and politicization of the science are all needed to move the field forward.

Increase in traumatic injury burden amidst COVID-19 was disproportionately shouldered by racial and ethnic minority patients: An urban case study

Background: When the COVID-19 pandemic intersected with the longstanding global pandemic of traumatic injury, it exacerbated racial and ethnic disparities in injury burden. As Milwaukee, Wisconsin is a racially diverse yet segregated urban city due to historic and ongoing systemic efforts, this populace provided an opportunity to further characterize injury disparities. Method(s): We analyzed trauma registry data from the only adult Level 1 trauma center in Milwaukee, WI before and during the COVID-19 pandemic (N = 19,908 patients from 2015-2021). We retrospectively fit seasonal ARIMA models to monthly injury counts to determine baseline injury burden pre-COVID-19 (Jan 2015-Mar 2020). This baseline data was used to forecast injury by race and ethnicity from April 2020 to December 2021 and was compared to actual injury counts. Result(s): For all mechanisms of injury (MOI), counts during the pandemic were significantly higher than forecasted for Black or African American (mean absolute percentage error, MAPE = 23.17) and Hispanic or Latino (MAPE = 26.67) but not White patients (MAPE = 12.72). Increased injury for Black or African American patients was driven by increases in motor vehicle crashes (MVCs) and firearm-related injury;increased injury for Hispanic or Latino patients was driven by falls and MVCs. Conclusion(s): The exacerbation of injury burden disparities during COVID-19, particularly in specific MOI, underscores the need for primary injury prevention within specific overburdened communities. Injury prevention requires intervention through social determinants of health, including addressing the impact of structural racism, as primary drivers of injury burden disparities.Copyright © The Author(s) 2023.

Trends in paediatric firearm-related encounters during the COVID-19 pandemic by age group, race/ethnicity and schooling mode in Tennessee.

BACKGROUND: Increases in paediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This study examines changes in the frequency of paediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma centre through 2021. METHODS: We use data from a large paediatric and adult trauma centre in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly paediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age. RESULTS: Compared with pre pandemic, we find a 42% increase in paediatric encounters per month during March 2020 to August 2020, when schools were closed, no significant increase during virtual/hybrid instruction, and a 23% increase in encounters after schools returned to in-person instruction. The effects of schooling mode are heterogeneous by patient race/ethnicity and age. Encounters increased among non-Hispanic black children across all periods relative to pre pandemic. Among non-Hispanic white children, encounters increased during the closure period and decreased on return to in-person instruction. Compared with pre pandemic, paediatric firearm-related encounters increased 205% for children aged 5-11 and 69% for adolescents aged 12-15 during the school closure period. CONCLUSION: COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of paediatric firearm-related encounters at a major trauma centre in Tennessee.

Traumatic pediatric firearm injuries during the COVID-19 pandemic

Statement of Purpose: The purpose of this study is to epidemiologically describe firearms injuries treated at a Level 1 pediatric trauma center occurring during the COVID-19 pandemic and compare them to injuries seen in the year prior.Methods: This is a retrospective chart review of patients seen by pediatric trauma surgery for a firearm injury between February 1, 2019 and March 30, 2021;the pre-pandemic time period included February 1, 2019 – March 9, 2020 and the pandemic period included March 10, 2020 – March 31, 2021. We excluded patients with firearms injuries that were not assessed by trauma surgery and patients with injuries from non-powder guns.Results: Twenty-eight patients were seen for firearm injuries in the pre-pandemic period;22 (78.5%) were male, and the mean age was 13.3 years, with 17.8% of patients < 10 years old. Sixteen (57.1%) were black, 8 (28.6%) white, and 4 (14.3%) multiracial. The pandemic period included 80 patients with firearm injuries, with 59 (74%) male, and a mean age of 12.5 years. Seventeen (21.5%) were < 10 years old. Fifty-six (70%) of patients during the pandemic period were black, 15 (20%) white, 6 (7.5%) multiracial, and 2 (2.5%) Hispanic. There was no statistically significant difference between the two groups demographically. No patients were identified as having an intentional self-inflicted firearm injury.Conclusion: While there was a nearly threefold increase in pediatric firearm injuries seen during the pandemic, the demographics of the victims have not changed compared to pre-pandemic patterns. This reflects a need for ongoing and targeted preventive measures to reduce these extremely high-risk injuries.Key Take Away Points [list] [list] [list_item] Since the World Health Organization (WHO) declared a pandemic from the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 or COVID-19), there has been a dramatic increase in the number of pediatric firearm injuries identified when compared to the preceding year. [/list_item] [list_item] A continued pattern of racial distribution before and during the pandemic with black children being overrepresented in the population with firearm injury as compared to all injuries seen was identified, with an overwhelming majority of firearm injuries occurring in urban areas. [/list_item] [list_item] The profound escalation of firearm injury in the pediatric population during the pandemic demonstrates the critical need for intensive community intervention and prevention efforts. [/list_item] [/list]

Defensive Behaviors During COVID-19 and the 2020–2021 Firearm Purchasing Surge: A Latent Class Analysis

Objective: This study examined the extent to which political beliefs and public health behaviors cluster together and define distinct groups of individuals and whether those groups differ on firearm purchasing behaviors. Methods: 6,404 US residents (Minnesota, n = 1,789;Mississippi, n = 1,418;New Jersey, n = 3,197) were recruited via Qualtrics panels. Participants were matched to 2010 census data. Results: Fit statistics determined a four-class solution fit the data best. The Liberal-Many Health Behaviors class had high probabilities of voting for President Biden, reporting more liberal political beliefs than other classes, and engaging in multiple health behaviors (e.g., mask wearing, vaccination). The Moderate-Few Health Behaviors class had high probabilities of voting for President Biden, reporting moderate political beliefs, and engaging in few health behaviors. The Conservative-Few Health Behaviors class had high probabilities of voting for former President Trump, reporting conservative political beliefs, and engaging in few health behaviors. The Conservative-Many Health Behaviors class had high probabilities of voting for former President Trump, having conservative political beliefs, and engaging in many health behaviors. Of the participants in the study who reported owning firearms, those in the Few Health Behavior classes were more likely to have purchased firearms during the purchasing surge, whereas those in the Many Health Behavior classes were likely to have become first-time firearm owners in 2020-2021. Lastly, the Few Health Behavior classes exhibited significantly less trust in the intentions of scientists. Conclusion: Different subgroups of firearm owners may evaluate and respond to risk differently, resulting in a pattern of adopting or avoiding a range of public health recommendations. Those who avoided mask wearing and COVID-19 vaccinations and who purchased firearms during the firearm purchasing surge appear to have less trust in science, highlighting the need for trusted messengers to increase the reach of behavioral interventions. [ FROM AUTHOR] Copyright of Journal of Social & Clinical Psychology is the property of Guilford Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

"Not as Bad as the ‘90s”? Firearm Violence in Small, Mid-Size, and Large US Cities, 2015–2021

I examine firearm homicide and injury data from more cities (N = 1,328) during a longer timespan (2015–2021) than previous research on firearm violence encapsulating the Covid-19 pandemic. I contextualize the historic 2020 spike in gun violence within a broader trend of worsening gun violence impacting hundreds of US cities since 2015. More cities (364) are surpassing adverse homicide rate benchmarks observed during the 1980s–1990s, and US states situated in all regions contain numerous peak gun violence cities. Examining gun violence trends outside of the largest US cities is imperative, since 42% of all firearm homicides occur in places with populations <250,000, and over two-thirds of peak violence cities (243) have fewer than 100,000 residents. A shared sense of the scope and severity of the problem of gun violence is also urgently needed. For too many American communities, it's not as bad as the 1990s, it's worse. [ FROM AUTHOR] Copyright of Homicide Studies is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Insights from law enforcement personnel during the COVID-19 pandemic: a focus on violence reduction and prevention initiatives and firearm violence

In the United States (U.S.), elevated levels of firearm violence following the onset of the COVID-19 pandemic in late March 2020 drew attention to efforts taken by law enforcement to reduce and prevent firearm violence through policing innovations. However, it is not well-understood how operational changes in policing during this time impacted these efforts. Our study is the first to consider the perceptions and experiences of law enforcement personnel during the pandemic as it relates to violence reduction and prevention initiatives (VRPIs) and firearm violence, more broadly. By leveraging partnerships between an academic research team and law enforcement practitioners, our action research approach is well-positioned to offer recommendations to support policies and practices that are responsive to emerging crises. While our study is based within the U.S., our focus on the impact of a global phenomenon on firearm violence is of international interest. To this end, an anonymous and voluntary online survey was distributed to both sworn and civilian personnel of the Detroit Police Department (Detroit, Michigan) in August 2020 to understand how the department's VRPIs and related routine police operations were impacted during the pandemic, and identify potential community and criminal justice system drivers of firearm violence during this time. Our focus on the city of Detroit represents a unique opportunity to explore these connections given the city's volume of firearm violence, as well as the severity and scope of challenges faced in cities of color. We discuss how our findings can be applied to guide the construction of systems that are more robust against and responsive to external and internal pressures. We also provide several recommendations to guide future research in this area. [ FROM AUTHOR] Copyright of Police Practice & Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Etymology of Despair in the Americas

Halfway into White Noise, Don DeLillo's novel from 1985, Jack Gladney packs his family in the car and leaves town running from a black chemical cloud. The "airborne toxic event” had triggered an emergency evacuation plan: floodlights from helicopters, sirens, unmarked cars from obscure agencies, clogged roads, makeshift shelters at a Boy Scout camp where the Red Cross would dispense juice and coffee. People are confused, they seek information wherever they can, "[s]mall crowds collected around certain men.” Among generalized bewilderment, Gladney observes a few individuals moving faster and more assertively than the rest, then getting into a Land Rover. In the chaotic scene of crisis, their confidence gets his attention. "Their bumper stickers read GUN CONTROL IS MIND CONTROL” Gladney reads. And his mind wanders: "In situations like this, you want to stick close to people in right-wing fringe groups. They've practiced staying alive.”

Youth Firearm Injury: A Review for Pediatric Critical Care Clinicians.

Firearms are now the leading cause of death among youth in the United States, with rates of homicide and suicide rising even more steeply during the SARS-CoV-2 pandemic. These injuries and deaths have wide-ranging consequences for the physical and emotional health of youth and families. While pediatric critical care clinicians must treat the injured survivors, they can also play a role in prevention by understanding the risks and consequences of firearm injuries; taking a trauma-informed approach to the care of injured youth; counseling patients and families on firearm access; and advocating for youth safety policy and programming.

The effect of the COVID-19 pandemic on community violence in Connecticut.

INTRODUCTION: Natural disasters may lead to increases in community violence due to broad social disruption, economic hardship, and large-scale morbidity and mortality. The effect of the COVID-19 pandemic on community violence is unknown. METHODS: Using trauma registry data on all violence-related patient presentations in Connecticut from 2018 to 2021, we compared the pattern of violence-related trauma from pre-COVID and COVID pandemic using an interrupted time series linear regression model. RESULTS: There was a 55% increase in violence-related trauma in the COVID period compared with the pre-COVID period (IRR: 1.55; 95%CI: 1.34-1.80; p-value<0.001) driven largely by penetrating injuries. This increase disproportionately impacted Black/Latinx communities (IRR: 1.61; 95%CI: 1.36-1.90; p-value<0.001). CONCLUSION: Violence-related trauma increased during the COVID-19 pandemic. Increased community violence is a significant and underappreciated negative health and social consequence of the COVID-19 pandemic, and one that excessively burdens communities already at increased risk from systemic health and social inequities.

The impact of the COVID-19 pandemic on pediatric firearm injuries in Colorado.

BACKGROUND: In 2019 firearm injuries surpassed automobile-related injuries as the leading cause of pediatric death in Colorado. In the spring of 2020, the COVID-19 pandemic led to community-level social, economic, and health impacts as well as changes to injury epidemiology. Thus, we sought to determine the impact of the COVID-19 pandemic on pediatric firearm injuries in Colorado. METHODS: We conducted a retrospective review of pediatric firearm injured patients (≤ 18-years-old) evaluated at three trauma centers in Colorado from 2018-2021. Patients were stratified into two groups based on the time of their firearm injury: pre- COVID injuries and post- COVID injuries. Group differences were examined using t-tests for continuous variables and Chi Squared or Fisher's exact tests for categorical variables. RESULTS: Overall, 343 firearm injuries occurred during the study period. There was a significant increase in firearm injuries as a proportion of overall pediatric ED trauma evaluations following the onset of the COVID-19 pandemic (pre COVID: 5.18/100 trauma evaluations; post COVID: 8.61/100 trauma evaluations, p<0.0001). Assaults were the most common injury intent seen both pre and post COVID (70.3% vs. 56.7%, respectively); however, unintentional injuries increased significantly from 10.3% to 22.5% (p = 0.004) following the onset of the pandemic. Additionally, the COVID-19 pandemic was associated with a 177% increase in unintentional injuries in adolescents. CONCLUSION: Pediatric firearm injuries, particularly unintentional injuries, increased significantly in Colorado following the onset of the COVID-19 pandemic. The substantial increase in unintentional injuries among adolescents highlights the necessity of multi-disciplinary approaches to limit or regulate their access to firearms. LEVEL OF EVIDENCE: Level III. STUDY TYPE: Retrospective.

An Examination of US School Mass Shootings, 2017-2022: Findings and Implications.

Objectives: Gun violence in the USA is a pressing social and public health issue. As rates of gun violence continue to rise, deaths resulting from such violence rise as well. School shootings, in particular, are at their highest recorded levels. In this study, we examined rates of intentional firearm deaths, mass shootings, and school mass shootings in the USA using data from the past 5 years, 2017-2022, to assess trends and reappraise prior examination of this issue. Methods: Extant data regarding shooting deaths from 2017 through 2020 were obtained from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, the web-based injury statistics query and reporting system (WISQARS), and, for school shootings in particular (2017-2022), from Everytown Research & Policy. Results: The number of intentional firearm deaths and the crude death rates increased from 2017 to 2020 in all age categories; crude death rates rose from 4.47 in 2017 to 5.88 in 2020. School shootings made a sharp decline in 2020-understandably so, given the onset of the COVID-19 pandemic and subsequent government or locally mandated school shutdowns-but rose again sharply in 2021. Conclusions: Recent data suggest continued upward trends in school shootings, school mass shootings, and related deaths over the past 5 years. Notably, gun violence disproportionately affects boys, especially Black boys, with much higher gun deaths per capita for this group than for any other group of youth. Implications for policy and practice are provided.

A scoping review of nursing education for firearm safety.

BACKGROUND: Firearm violence, whether intentional or accidental, affects families worldwide. Nurses often encounter firearm-related injury and death with little knowledge or preparation for dealing with firearm safety issues. OBJECTIVES: The aim was to locate published research on nurse education in firearm safety and examine the preparation of nurses to deal with issues of firearm safety as a deterrent toward decreasing violence. The review included nurse perceptions of barriers and facilitators related to firearm safety in clinical situations. DESIGN: A literature scoping review for article identification, examination, and reporting was structured on the extended form of Arksey and O'Malley's 5-step design framework. DATA SOURCES: Databases CINAHL, MEDLINE, Sociological Abstracts, PsychInfo, and ERIC were searched for articles in English language published between 2010 and 2021 that included nurses in the studies' samples. REVIEW METHODS: Searches were managed via Covidence®, a literature screening and data extraction tool. Two independent reviewers screened the articles retrieved from the databases by title, abstract, and full-text review. Data from selected articles were extracted onto a spreadsheet and critically appraised for eligibility. RESULTS: A search of healthcare databases resulted in identification of 645 articles, of which 15 met inclusion criteria. Seven of the 15 articles addressed nurse firearm safety preparation, and seven related to counseling firearm safety for suicide prevention. Main barriers included lack of standardized guidelines, inadequate knowledge, and discomfort discussing firearm safety with patients and families. CONCLUSIONS: The scoping review findings show a noticeable gap: nurse education addressing firearm safety is, for all purposes, non-existent. A need exists for evidence-based training within academic curricula and across acute and behavioral healthcare settings.

Interpersonal Firearm Injury and Death in Portland, Oregon: 2018 Through 2021.

The annual number of firearm injuries in Portland, Oregon has been higher in the years since 2020 than in any prior year in the city's history. This descriptive study analyzed data from Gun Violence Archives (GVA) from January 1, 2018, to December 31, 2021. All incidents in GVA of interpersonal firearm injury that occurred in Portland during this period were analyzed for location, number of people injured or killed, and demographic information for those injured or killed. Comparisons in firearm injury rates were made with Seattle and San Francisco. Interpersonal firearm injuries began to rise after the first COVID-19 case in Oregon; July 2020 had the most injuries in the four-year period. Black men suffered the highest rate of interpersonal fatalities, with more than 11-fold higher rate per 100,000 than White men in every year studied. Portland had a higher rate of total interpersonal firearm injuries and a higher rate of firearm fatalities from 2018 through 2021 compared to Seattle and San Francisco. Neighborhoods near Downtown and those on the Eastside of the city had the highest rates of interpersonal injuries and deaths from firearms, whereas those in the Southwest had the lowest. Defining the burden of disease from interpersonal firearm injuries is a fundamental step in designing future public health research and implementing interventions to curb the trauma brought by interpersonal firearm injury.

Clinical Rounds

Dogs can detect human stress... Children with COVID-19 at higher risk of T1D... ED-ICU not associated with substantially increased costs... Strategies to reduce pediatric deaths by guns... Electronic gaming and pediatric dysrhythmias

Adolescents' Suicide Rates by Ethnicity - Data from the National Vital Statistics System 2015-2020

Background/Aim: Since the COVID-19 pandemic, emergency departments across the United States have seen an increase in patients seeking care for psychiatric complaints to include suicidal ideation and attempts. A recent national study reported that the suicide rate has decreased since 2018 but this decrease may not be equal across all age groups and ethnicities especially the younger aged. Using mortality data from the National Vital Statistics System (NVSS), we investigated the trends in the suicide death rate among those aged 10-19 by gender, ethnicity and mode of suicide between 2015-2020. Method(s): We identified individuals with intentional self-harm reported on death certificates as a leading cause of death or contributory cause of death from 2015-2020 using ICD-10 codes *U03,X60-X84,Y87.0. Annual percent change was calculated;ANOVA was used to determine differences. Result(s): From 2015 to 2020, overall, there were 16,600 (12,310 males;4,290 females) deaths from suicide among those aged 10-19;average age was 16.6+/- 2.1 males;16.02+/- 2.22 females, 84% of males had some college;77% females had some college;99% were single in both groups. Non-Hispanic whites accounted for over 50% of all suicides followed by Hispanics at >20%. The number of deaths by suicide increased over time for males but decreased for females- both groups' age at death decreased over time. By ethnicity, both non-Hispanic black males and females saw a significant increase in their suicide rates from 10.3% (2015) to 12.3% (2020, P=0.03) males and 11.1% to 13.9% (P=0.05) females. Similar findings were noted for Hispanic males (13.3% to 18.3%, P=0.0001) and females (18.7% to 23.4%, P=0.006) while suicide rates decreased for non-Hispanic whites and Asians. The top three most frequent modes of suicide for females were hanging, strangulation and suffocation (>50%);discharge of firearms (>20%) and intentional self-poisoning by and exposure to drugs and other biological substances (>15%). The largest increase of over 250% was intentional self-poisoning (suicide) by and exposure to other and unspecified solid or liquid substances and their vapors. For males the top three most frequent methods used for suicide were discharge of firearms (>50%);hanging, strangulation and suffocation (>35%) and intentional self-poisoning by and exposure to drugs and other biological substances (>15%) while the largest increase (100%) was the same as for females- intentional self-poisoning (suicide) by and exposure to other and unspecified solid or liquid substances and their vapors. Conclusion(s): Although suicide deaths have been reported to be decreasing, we found among those aged 10-19, suicide rates were increasing for both non-Hispanic blacks and Hispanic males and females but not for whites or Asians. The most vulnerable time may be when this age group starts college suggesting more support is needed for those transitioning from home for the first time. The large increase of 250% for females and 100% for males related to intentional self-poisoning and correlation with exposure and access to drugs and other biological substances requires further investigation as well. This includes evaluating the role of social media platforms particularly during the COVID-19 pandemic in promoting and facilitating access to drugs and biological substances. No, authors do not have interests to disclose Copyright © 2022