Unintentional Shootings, Not Accidents
The public health approach is centered on the idea of prevention. As the Society for Public Health Education puts it, “Injuries are not accidents — they are not random incidents. Injuries have identified risk and protective factors making them preventable.”8
Unintentional deaths and injuries are often called accidents, which can imply that nothing could be done to stop them from happening. For this reason, we do not use “accident” terminology because gun violence is preventable.
This framework applies to other injuries like car crashes, falls, and drownings. Words matter!
In 2018, 458 Americans died from unintentional firearm injuries — about 1.2% of total gun deaths.9
Unintentional is the description used in public health for an injury or death that was not caused purposely (in contrast with suicide and homicide, in which there is an intent to cause harm). Unintentional shootings can be self-inflicted or inflicted by someone else. About half of all unintentional gun deaths are caused by another person pulling the trigger.10 Each year, nearly 500 people die from unintentional firearm injuries — more than one person every single day.9
Much like other forms of gun violence, unintentional gun deaths are more likely to occur in the United States than in other high-income countries. Americans are four times more likely to die from an unintentional gun injury than those in comparable countries.11
The CDC Plays a Vital Role in Providing Public Health Data to Researchers
Researchers need robust and reliable data on unintentional gun injuries and fatalities to study and develop solutions to address the epidemic of gun violence in the United States. The Centers for Disease Control and Prevention (CDC) is the federal agency responsible for protecting the health of Americans by ensuring that data is properly collected to develop solutions to our nation’s public health crises, including gun violence. The CDC’s National Violent Death Reporting System (NVDRS) plays an instrumental role to gun violence prevention advocates and researchers. The NVDRS uses death certificates, police reports, and hospital records to report information about the victim, the cause of death, and the circumstances surrounding their death.12 The CDC makes this data publicly available and easily accessible through their Web-based Injury Statistics Query and Reporting System (WISQARS).
Misclassification of Unintentional Gun Injuries and Deaths
Although the CDC releases data on firearm injuries and deaths in the U.S., the data, especially related to firearm injuries, is not reliable. As a result of a lack of a robust and reliable data source, there are often misclassifications for firearm injuries and deaths. Due to these misclassifications and underreporting of gun injuries and deaths, we do not know the true burden of unintentional firearm injuries and deaths in the U.S.
According to a 2017 study, over half (50.2%) of all nonfatal gun injuries are assaults and over one-third (36.7%) are unintentional injuries. However, the unintentional category may be overreported because those with gun injuries may not admit that they were assaulted to either avoid law enforcement scrutiny or out of fear of retaliation.13
Data problems exist for fatal injuries, too. A 2011 study found that “As much as 38% of true cases of unintentional firearm deaths were missed, as were 42% of cases reported as false-positives.”14 The study authors write, “In answer to the question, ‘Are there too many or too few unintentional firearm deaths in official mortality data?’ the best answer is, ‘Both.’ Many true accidents are missed, while many suicides and homicides are mistakenly reported as accidents.”
There is a critical need for accurate data on the burden of gun violence in the United States.
Circumstances in which unintentional shootings can happen
One study found that, across all ages, the most common circumstances in which an unintentional gun death occurs are:15
- Playing with a gun (28.3%),
- Believing that the gun was not loaded (17.2%), and
- Hunting (13.8%).
This study also found that nearly a quarter of those who died from an unintentional firearm injury — and nearly half of all 20-29-year-olds who died from unintentional shootings — had consumed alcohol.16
Gun Ownership and Unintentional Firearm Deaths
Studies show that higher rates of household gun ownership and availability of guns are associated with higher rates of unintentional firearm deaths.17,18,19 There is an association between unsafely stored firearms and unintentional gun deaths — one study found that states with higher rates of unsafely stored guns have higher rates of unintentional gun deaths.20
Children ages 5-14 were more likely to die from unintentional gun injuries if they lived in states where guns are more prevalent.21,22 This trend holds for adults, too. A 2013 survey found that in New York, 10.3% of the adult population owns guns while 48.9% of Alabama’s adult population owns guns.23 Alabama’s unintentional firearm death rate is 48 times that of New York.24
Preventing Unintentional Shootings
Safer Storage of Firearms
Evidence shows that parents of adolescents — the most at-risk group in terms of unintentional firearm deaths — were more likely than parents of younger children to keep guns in the home stored unsafely (unlocked, loaded, or both).25
If a person chooses to store their firearm in the home, it is important to always practice safe firearm storage. For at-home firearm storage, it is widely recommended to store firearms locked and unloaded, store and lock ammunition separately from firearms, and ensure the key or lock combination is inaccessible to children or others who may be at risk for injury.
Safely storing and reducing access to firearms for the gun owner and other individuals, especially children, in the home is an unintentional injury prevention strategy supported by researchers, healthcare professionals, and gun owners alike. While there is no safer storage law at the federal level, various safer storage laws exist at the state level.26
Healthcare providers can also play a role in preventing unintentional firearm injuries by improving their patients’ safer storage practices through lethal means safety counseling. Studies show that healthcare providers influencing patients’ gun storage practices can substantially lower the risk of firearm-related injury.27 For example, researchers found that for every five gun-owning parents whose child’s pediatrician gave them lethal means safety counseling and free cable locks, two parents reported using the cable locks six months later.28 In addition to parents, lethal means safety counseling should be given to individuals who have risk factors for unintentional firearm injury, including people with risky alcohol or substance use and individuals with dementia or conditions impairing cognition and judgment.
To learn more, visit our page on lethal means safety counseling.
Alcohol and Unintentional Shootings
Guns should never be handled after consuming alcohol and other substances. Alcohol use is a risk factor for all forms of gun violence, including unintentional injuries and deaths.29 Alcohol can impair judgment and lead to violent behavior. Adding firearms to this already dangerous situation can be deadly.
Indeed, evidence shows that alcohol use is common in unintentional firearm deaths. A 2019 study found that nearly a quarter of those who died from an unintentional firearm injury — and nearly half of all 20-29-year-olds who died from unintentional shootings — had consumed alcohol.30 For the oldest age group in the study (adults aged 60 or older), alcohol was involved in 11.3% of unintentional gun deaths.
Dementia and Unintentional Shootings
Older adults living with dementia or conditions impairing cognition and judgment may be at an increased risk of firearm injury and death.31 One-third of adults 65 and older own guns, and another 12% live in a household with a gun.32 It is estimated that 60% of people living with dementia live in a household with a gun.33
People living with dementia who have a firearm in the home may pose a risk to themselves and others. Dementia may make a person unable to safely handle a firearm, and also may result in misperceptions of actual threats.34 Further, dementia, and other diseases, could impair logical thinking and emotional control.35
Just as family members may consult with older relatives’ physicians about concerns about their ability to drive or live alone, family members may also express concerns about their relatives’ ability to use a firearm.36 The Alzheimer’s Association recommends removing firearms from the home of someone living with dementia to prevent unintentional shootings, recognizing that storing or locking up a firearm may not be enough.37 Extreme risk laws may be an appropriate mechanism for removing firearms from an individual living with dementia. This tool has the potential to prevent all forms of gun violence, including unintentional shootings.
To learn more, visit our page on extreme risk laws.
Unintentional Gun Injuries in the United States
Annually, more than 27,000 individuals are admitted to the emergency department for unintentional firearm injuries. The vast majority of these individuals, more than 26,000, do not succumb to their injuries and die. In fact, unintentional firearm injuries account for 37% of all nonfatal firearm injuries but less than 2% of all gun deaths.38 The lethality of unintentional firearm injuries is far less than any other type of gun violence. According to Nationwide Emergency Department Sample (NEDS) and CDC data, two out of every 100 unintentional firearm injuries are fatal.39 However, as previously mentioned, some nonfatal injuries classified as unintentional may actually be the result of an assault. Regardless, the vast majority of unintentional firearms injuries are not fatal.
Unintentional Firearm Deaths in the United States
Although there are still far too many unintentional firearm deaths, the number of unintentional firearm deaths has decreased in the past decade. In the first half of the decade (2009-2013), there were nearly 561 annual unintentional firearm deaths (all ages); in contrast, in the second half of the decade (2014-2018), there were nearly 478 annual unintentional firearm deaths (all ages), a 15% decrease. Similarly, the number of unintentional firearm deaths among children and teens (ages 0-19) dropped by 11%, from an average of 124 annually from 2009-2013 to 110 annually from 2014-2018.40 The expansion of interventions to improve safer firearm storage and handling practices may contribute to further decreases in unintentional firearm deaths in the years to come.
Unintentional Firearm Deaths in the United States,2009-2018
Number of deaths
Source: CDC WONDER.
Unintentional Firearm Death Rate in the United States,2009-2018
Age-adjusted rate per 100,000
Source: CDC WONDER.
All rates listed are age-adjusted in order to allow for accurate comparisons between populations with differing age distributions.
Disparities Across Demographics
Across all ages, races, and ethnicities, males die from unintentional shootings more often than females. Among males, American Indian/Alaska Native men ages 20-34 are at the highest risk of dying from an unintentional shooting. Among females, Black females ages 0-19 are at the highest risk of dying from an unintentional shooting.40
The vast majority of victims of unintentional shootings are male. In 2018, 90% of unintentional gun death victims were male.40 For both self-inflicted and other-inflicted unintentional gun deaths, the lowest percentage of male victims occurs in the youngest age group: those 0 to 9 years old.41
Unintentional Firearm Deaths by Sex, 2018
Source: CDC WONDER.
By Race, Ethnicity, and Age
About half (53.7%) of unintentional firearm deaths occur under the age of 34. Nearly one-quarter of all unintentional firearm decedents are 0-19 years old and nearly one-third of all unintentional firearm decedents are 20-34 years old.42
One study found that victims were more likely to be unintentionally shot by someone else the younger they were. Over three quarters (78%) of unintentional firearm deaths for children 0-14 were caused by someone else while the majority of unintentional shootings among older Americans were self-inflicted.43
It is important to note that when looking at unintentional gun deaths for both males and females by age, race, and ethnicity, the subgroups have few deaths and as a result, much of the data is unreliable or suppressed. For males, Black and American Indian /Alaska Natives ages 20-34 are at highest risk. For females, Black youth ages 0-19 are at highest risk, though the rates for all races and ethnicities for women are small. Rates of unintentional gun deaths for White women are similar across most of the lifespan.40
Female Unintentional Firearm Death Rates byRace, Ethnicity, and Age,2014-2018
Rate per 100,000
Source: CDC WONDER.
Note: The CDC considers unintentional firearm death rates based on fewer than 20 deaths “statistically unreliable” and suppresses unintentional firearm death rates based on fewer than 10 deaths. Fewer than 20 unintentional firearm death rates were reported during this time period for the following races and Hispanic Origin category and therefore are omitted from the above chart: American Indian/ Alaska Native females all ages; Asian/ Pacific Islander females all ages; Black females ages 20-34, 35-54, 55-74, 75+; White (non-Latino) female ages 75+; and Hispanic/Latino females all ages.
Male Unintentional Firearm Death Rates byRace, Ethnicity, and Age,2014-2018
Rate per 100,000
Source: CDC WONDER.
Note: The CDC considers unintentional firearm death rates based on fewer than 20 deaths “statistically unreliable” and suppresses unintentional firearm death rates based on fewer than 10 deaths. Fewer than 20 unintentional firearm death rates were reported during this time period for the following races and Hispanic Origin category and therefore are omitted from the above chart: American Indian/ Alaska Native males ages 0-19, 35-54, 55-74, 75+; Asian/ Pacific Islander males all ages; Black males ages 75+; and Hispanic/Latino males 55-74, 75+.
There is wide regional variation in where unintentional shootings occur. More than half of all individuals who die by unintentional gun injuries live in the South.44 Individuals who live in the South are three times more likely to die by an unintentional shooting compared to those living in the Northeast.45 Out of the five states that have the highest rates of unintentional shooting deaths, four are in the South. Mississippi has the highest unintentional death rate, followed by South Dakota, Alabama, Arkansas, and Kentucky. This regional variation may be linked to the strength of state gun violence prevention laws. For example, states in the Northeast region tend to have stronger gun laws than states in the South.46 States with strong gun laws have been found to be associated with lower unintentional firearm injuries.47
Enact and implement programs and practices that promote safer firearm storage and handling.
Easy access to firearms, particularly unsecured firearms and the presence of firearms in risky situations, increases risk of unintentional injury and death by firearm. Mitigating access with safer storage practices and through evidence-based policy prevents unintentional gun violence. Shifting behaviors related to firearm storage and handling practices may contribute to further decreases in unintentional firearm injuries and deaths in the years to come. We recommend:
- Safer storage: Safely storing and thereby reducing access to firearms is an unintentional injury prevention strategy supported by researchers, healthcare professionals, and gun owners alike. For at-home firearm storage, firearms should be stored locked and unloaded, ammunition should be stored and locked separately from firearms, and the key or lock combination should be inaccessible to children and adolescents or others at elevated risk of harm to self or others. Storing firearms outside of the home is the safest option.
- Safety technologies: Technological solutions have the potential to reduce firearm injury. We encourage the development and evaluation of technological solutions to improving the safety of firearms and storage devices.
- Lethal means safety counseling: Lethal means safety counseling is an evidence-based healthcare intervention that is effective in preventing unintentional firearm injuries and deaths. Lethal means safety counseling helps providers work collaboratively with gun-owning patients and their families to reduce risk of injury by improving their patients’ safer storage practices. Healthcare professionals should be trained on lethal means safety counseling as an unintentional injury prevention intervention. All patients and parents/guardians of pediatric patients should be asked about firearms access and provided safer storage information. Patients at elevated risk of unintentional injury, such as individuals with dementia or conditions impairing cognition and judgment, should receive more in-depth lethal means safety counseling. See Lethal Means Safety Counseling for more information.
- Extreme risk laws: Extreme risk laws empower law enforcement and the people closest to an individual at elevated risk of harm to self or others to intervene to help prevent gun tragedies before they occur. These state laws allow law enforcement, and in some states family and household members, among others, to petition a judge to temporarily limit an individual’s access to firearms if they are at elevated risk of violence. Extreme risk laws may be an appropriate mechanism for removing firearms from an individual who is at high risk for unintentional injury, including individuals living with dementia or other conditions impairing cognition and judgment. Every state should have its own extreme risk law and continuously monitor and evaluate the law to ensure equitable implementation and ongoing effectiveness. See Extreme Risk Laws for more information.
- Avoid alcohol and other substances when accessing guns: Just like driving a car, alcohol and other substances increase risk of violence and injury. Firearm access should be limited after consuming alcohol and other substances.
- Fowler KA, Dahlberg LL, Haileyesus T, & Annest JL. (2015). Firearm injuries in the United States. Preventive Medicine.
- Gani F, Sakran JV, & Canner JK. (2017). Emergency department visits for firearm-related injuries in the United States, 2006–14. Health Affairs. Appendix 13.
- Guetschow B, Lilienthal M, & Willey M. (2018). Unintentional firearm injuries remain prevalent over a 12 year experience at a rural midwestern level 1 trauma center. Iowa Orthopaedic Journal.
- Hemenway D, Barber C, & Miller M. (2010). Unintentional firearm deaths: a comparison of other-inflicted and self-inflicted shootings. Accident Analysis and Prevention.
- Hemenway D & Solnick SJ. (2015). Children and unintentional firearm death. Injury Epidemiology.
- Miller M, Azrael D, & Hemenway D. (2001). Firearm availability and unintentional firearm deaths. Accident Analysis and Prevention.
- Miller M, Azrael D, & Hemenway D. (2002). Firearm availability and unintentional firearm deaths, suicide, and homicide among 5-14 year olds. Journal of Trauma.
- Miller M, Azrael D, Hemenway D, & Vriniotis M. (2005). Firearm storage practices and rates of unintentional firearm deaths in the United States. Accident Analysis and Prevention.
- Solnick SJ & Hemenway D. (2019). Unintentional firearm deaths in the United States 2005–2015. Injury Epidemiology.
- Wiebe DJ. (2003). Firearms in US homes as a risk factor for unintentional gunshot fatality. Accident Analysis and Prevention.
- American Academy of Pediatrics’s Gun Safety and Children
- Firearm Safety Among Children and Teens (FACTS) Consortium’s “Safe Storage” video
- How Gun Policies Affect Unintentional Injuries and Deaths from the RAND Corporation
- Harvard Injury Control Research Center’s information on “Accidents”
- The National Crime Prevention Council and the Advertising Council’s Lock It Up campaign
- Safe States’s Injury Prevention Inventory: Unintentional Firearm Injury
Last updated July 2020