Executive Summary

Firearm violence in North Carolina: a public health epidemic

Gun violence is a public health epidemic that ravages communities and families across North Carolina and the country. The United States has, by far, the highest firearm death rate of all high-income countries worldwide.[1],[2] The 2015 U.S. firearm mortality rate was over 11 times higher than in other high-income countries, and of all firearm deaths among high-income countries that year, 83.7% were in the U.S.[3]

Simply put, no other high-income country in the world allows its citizens to die by guns the way that we do in the United States.

In 2018, firearm deaths in the United States reached their second highest level in at least 40 years as 39,740 people were killed by gun violence. That’s 108 individuals per day. Between 2008 and 2018,
the rate of firearm mortality in the United States increased nearly 16%.[4] North Carolina is no exception, with a firearm death rate above the average national rate every year from 2008-2018.

This report examines the impact of different types of gun violence at state and county levels, including firearm-related suicide, homicide, legal intervention, and unintentional injuries. We also include county-level injury and mortality data, to determine which parts of the state have been most impacted by each type of gun violence.

Unlike many diseases and other public health problems,
every firearm injury and death is preventable. Ongoing research and evaluation across the country is uncovering program and policy solutions to each type of gun violence, some of which are discussed in the final sections of this report. We now understand that solutions must address both the immediate cause or event precipitating the firearm injury or death, as well as the underlying causes that make populations vulnerable to all types of gun violence in the first place. The approach must be comprehensive. Each type of firearm violence has multiple causes, and therefore, requires a combination of evidence-based programs and policies, and a broad coalition of stakeholders willing to work towards real and lasting solutions.

North Carolina’s firearm violence epidemic

In 2018, 1,416 North Carolinians were killed by gun violence – 3.9 lives lost per day.[5] That year, N.C. ranked 7th nationally by number of firearm-related deaths, and 24th by firearm mortality rate (13.26 deaths per 100,000 people).

In 2018, nearly two in every three firearms deaths in North Carolina were suicides.[6] The number of N.C. children and youth who take their own life with a gun doubled from 2008 to 2018, and firearm suicide rates in this group increased 91%.[7]

One in three N.C. firearm deaths is a homicide. North Carolina ranked 11th in the U.S. by number of firearm homicides (489 homicides), and 22nd by firearm homicide rate (4.88 homicides per 100,000).[8] Firearm homicide in N.C. disproportionately impacts Black and Native communities. Black, Non-Hispanic North Carolinians suffer the highest number of homicide deaths: 67% of 2018 N.C. homicides were among this group; and they experienced the highest age-adjusted homicide rate[9] four of the 11 years in this report. N.C. Native Americans experienced the highest homicide rate the other seven years (though the second lowest number of deaths every year except 2018, when they had the 3rd lowest number). Asian-American/Pacific Islanders in N.C. had the fewest homicides.[10] Among N.C. children and youth, the 2018 firearm homicide rate was highest among Black children ages 0-19 years, and was nearly ten times the rate among White children.[11]

Legal intervention deaths represent a small but important portion of the overall deaths in the state. By number, White, Non-Hispanic North Carolinians experience the most deaths. While Black North Carolinians experienced approximately half the number of legal intervention deaths as White North Carolinians from 2014 through 2018, the rate of legal intervention death among Black North Carolinians is 1.5 times higher than among White North Carolinians.

These statistics illuminate a haunting and self-evident truth: Gun violence is a public health crisis in North Carolina.

Recognizing and defining gun violence as a national public health issue can help drive implementation of common sense, evidence-based gun reform by increasing bipartisan support.

This report illustrates the state of gun violence in North Carolina in recent years, and how North Carolina’s current gun safety laws and violence prevention programs need real reform and investment in order to address and reduce gun violence.

[1] Grinshteyn E, Hemenway D. Violent death rates in the US compared to those of the other high-income countries, 2015.

[2] Wintemute GJ. The epidemiology of firearm violence in the twenty-first century United States. Annu Rev Public Health. 2015 Mar 18;36:5-19.

[3] Grinshteyn E, Hemenway D. Violent death rates in the US compared to those of the other high-income countries, 2015.

[4] Centers for Disease Control and Prevention. 2020. WISQARS fatal injury reports, national, regional and state, 1981 – 2018.

[5] Ibid (e.g., same as above).

[6] Centers for Disease Control and Prevention. 2020. WISQARS Fatal Injury Reports, National, Regional and State, 1981 – 2018.

[7] Ibid.

[8] Ibid.

[9] Rates in this report are age-adjusted per 100,000 population in that group, unless otherwise stated. Age-adjustment is a standard statistical technique, enabling communities with different age distributions to be compared. Explanation at: https://wonder.cdc.gov/wonder/help/faq.html.

[10] Centers for Disease Control and Prevention. 2020. WISQARS fatal injury reports, national, regional and state, 1981 – 2018.

[11] Ibid